The focus on improving veterans’ lives and their access to health care during Wednesday night’s live commander-in-chief forum underscored the importance of reforming and effectively managing the Veterans Affairs Department – and the difficulty presidential candidates have articulating their plans to accomplish that.
Service members and vets questioned the Democratic and Republican presidential nominees on their strategies to deal with issues like sexual assault in the military, suicide among vets, and proposals to privatize VA health care, but the candidates – who appeared separately on stage with moderator Matt Lauer – didn’t offer much beyond generalities during the one-hour event hosted by the Iraq and Afghanistan Veterans of America and NBC.
“Look, I was outraged by the stories that came out about the VA,” Democrat Hillary Clinton said when Lauer asked her to explain her comment during an interview with MSNBC’s Rachel Maddow last fall, when Clinton said the wait-times scandal engulfing the department was not “as widespread” as it’s been made out to be. “And I have been very clear about the necessity for doing whatever is required to move the VA into the 21st century, to provide the kind of treatment options that our veterans today desperately need and deserve. And that’s what I will do as president.” She also reiterated her pledge not to privatize the Veterans Health Administration.
» Get the best federal news and ideas delivered right to your inbox. Sign up here.
Then there was Republican Donald Trump.
He said he would never “take the Veterans Administration private” because he has “too much respect for our people.” But then he also said vets were “dying on line” waiting “five” and “six” days for appointments. The wait-times scandal, which erupted at the Phoenix VA medical center in 2014, involved employees at hospitals falsifying medical appointment data for vets to comply with the department’s 14-day target for scheduling appointments. Many vets waited months and years to get an appointment, and some vets died while on a waiting list.
“Under a part of my plan, if they have that long wait, they walk outside, they go to the local doctor, they choose the doctor, they choose the hospital, whether it’s public or private, they get themselves better,” Trump said. “In many cases, it’s a minor procedure or a pill or just a prescription. And they end up dying because they can’t get to see the doctor. We will pay the bill. They go outside, they get a doctor, they get a prescription, they do what they have to do, and we pay the bill.”
The average wait time now varies across the VA health system, but as of August 15, 93 percent of appointments nationwide were scheduled within 30 days, and under the 2014 Choice Act, vets who wait longer than a month to see a doctor can get care in the private sector on the VA’s dime.
The Republican nominee fielded a question from a female vet wondering what he would do to stop “20 veterans a day from killing themselves.” Trump said he’d “speed up the process” when it comes to mental health care access and “create a great mental health division.” That was after he erroneously “corrected” her by citing an outdated statistic that 22 veterans a day take their own lives. The VA released a study in July that examined more than 55 million veteran records from 1979 to 2014 from all 50 states, and showed on average 20 veterans a day kill themselves.
He followed up that answer with this: “The VA is really almost, you could say, a corrupt enterprise. If you look at what’s going on, as an example, Matt, in Arizona, where they caught people stealing, and they can’t even do anything about it, they can’t even fire the people. So we are going to make it efficient and good. And if it’s not good, you’re going out to private hospitals, public hospitals, and doctors.”
Of course, both Trump and Clinton have outlined their plans for improving vets’ access to health care and reforming the VA in greater detail on their websites and during other public appearances. And Clinton has a track record on veterans’ issues based on her years in the Senate. But the fact that a forum devoted to issues facing vets and service members happened at all during a presidential campaign was unprecedented and a “great moment” for the veterans’ community, said Paul Rieckhoff, founder and CEO of IAVA.
Rieckhoff, who spoke with MSNBC’s Rachel Maddow after the forum, said he’d like to see the candidates elaborate more on specific vets’ issues and how they would fix the VA. For example, do they plan to keep current Secretary Bob McDonald, who has been leading a major transition at the department, in his job after January? Or how would they deal with the major technology challenges the VA faces, challenges that have affected everything from veterans’ electronic health records to the appointment scheduling system? And what about adapting health care services and benefits to the unique needs of female vets?
“Problems in the VA are extremely complicated,” Rieckhoff said. “It’s almost as complicated as ISIS.”
Clinton on Wednesday mentioned the problems VA and the Defense Department have had creating joint electronic health records for vets and making the transition out of the military services easier for them.
“I’m going to have a meeting every week in the Oval Office. We’re going to bring the VA people, we’re going to bring the DoD people, because we’ve got to have a better fit between getting mustered out and getting into the VA system,” she said. “We’re living in a technological world. You cannot tell me we can’t do a better job getting that information. And so I’m going to focus on this. I’m going to work with everybody. I’m going to make them work together.”
Well, easier said than done.
“Every president says, ‘I’m gonna clean up the VA,’ " said Rieckhoff. “Every one has failed.”