Category Archives: Veterans Affairs

Failure of the VA

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The way the Department of Veterans Affairs is (mis)treating our veterans suffering from PTSD—post-traumatic stress disorder—is appalling. Drug them up with a multiplicity (as many as five or more simultaneously) of psychiatric drugs and call it a day is the current protocol.

The VA’s own guidelines say no data support drug combinations to treat PTSD. The Food and Drug Administration warns that combining certain medications such as opioids and benzodiazepines can cause serious side effects, including death.
Nonetheless, prescribing cocktails of such drugs is one of the VA’s most common treatments for veterans with PTSD, and the number of veterans on multiple psychiatric drugs is a growing concern at the agency….

Aside from just drugging up these men and women who put their lives on the line for our nation, that “growing concern” is the sham of empty words unbacked by corrective action.

The VA has long been aware of the risks of overprescribing, and has internal research since at least 2016 showing the potential harms, including increased risk of suicide.
…
Studies by VA researchers link the simultaneous use of multiple psychiatric drugs to suicide risk among veterans, including a 2016 paper that found Iraq and Afghanistan war veterans taking five or more central nervous system drugs faced higher risks of overdose and suicidal behaviors.
Yet the agency has been slow to mandate changes. It has failed to implement nationwide electronic systems to alert doctors when they prescribe multiple psychiatric drugs, despite evidence from its own studies that these alerts improve care. The VA doesn’t uniformly require written informed consent for all psychiatric drugs with suicide risk, something that veterans groups and some members of Congress are urging. Some veterans who have resisted taking cocktails of drugs say they were warned by VA and military doctors that refusing them could jeopardize their eligibility for disability benefits, which can reach $4,500 a month.

Not only is the VA passively refusing to do anything about its mistreatment of our veterans, the agency and “doctors” are threatening our veterans if they don’t comply with those dangerously ineffective VA prescriptions.

Some veterans who have resisted taking cocktails of drugs say they were warned by VA and military doctors that refusing them could jeopardize their eligibility for disability benefits, which can reach $4,500 a month.

These men and women would be far better served, as would all of our veterans, if the VA were dissolved and its then-current and all future putative budgets converted to vouchers for each veteran which s/he could use to get treatment from a doctor, clinic, and hospital of his choice and on the schedule that suits him rather than the agency. Other “benefits” of the VA, viz., Home Loan Guarantee, Insurance, Vocational Rehabilitation and Employment, GI Bill, and Compensation & Pension, are far better done from within HUD and DoD.

VA Secretary Doug Collins should have the mission of achieving that dissolution, to be completed by the end of 2028. Continuing to prop up the department is worse than a waste of our taxpayer money: it’s outright destructive of our veterans, who already have sacrificed so much for our benefit.

Veteranos Administratio delende est.

An Outline was Passed

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The House-Senate reconciliation bill has been passed. The bill contains a number of beneficial things and a number of suboptimal things, along with a couple of items that are no good at all (vis., a cut in real dollars on defense spending and an increase in deficit spending and so in national debt of highly dubious estimates, both in size and sign).

So now what?

President Donald Trump (R) offered to use his executive authority to limit spending beyond what’s in the Senate version of the bill, which is what the House passed last Thursday.

In the meetings, Russ Vought, Trump’s White House budget chief, also reassured lawmakers that the administration would use its authority to limit spending, according to people familiar with the conversations. Trump and his advisers have argued that Trump has the authority to refuse to spend money appropriated by Congress, a contention likely to be tested in court.

That’s nice, even if the courts uphold the specific actions (or most of them) Trump might take. At best though, these would be temporary measures, easily undone by a subsequent President.

Now what, then, are the 12 appropriations bills that the current crop of House Republicans have been promising to pass individually and on time for a couple of Congresses. The outline reconciliation bill represents ceilings on spending and tax rates, not floors, even though the Progressive-Democrats will howl that the levels are floors and so spending and tax rates still should go up.

The 12 appropriations bills are

  • Military Construction, Veterans Affairs, and Related Agencies appropriations bill
  • Defense appropriations bill
  • Homeland Security appropriations bill
  • State Department and Foreign Operations appropriations bill
  • Interior and Environment appropriations bill
  • Legislative Branch appropriations bill
  • Agriculture, Rural Development, Food and Drug Administration, and Related Agencies appropriations bill
  • Commerce, Justice, Science, and Related Agencies appropriations bill
  • Energy and Water Development appropriations bill
  • Labor, Health and Human Services, Education, and Related Agencies appropriations bill
  • Transportation, Housing and Urban Development, and Related Agencies appropriations bill
  • Financial Services and General Government appropriations bill

These are where real spending and tax rate reductions (not formally part of appropriations, but easily enough included by amendment) can—and must this time—occur. Military construction needs to be focused on facilities for housing our soldiers and on bases—new or modified—for housing more of our weapons systems and for our new weapons systems as they come on line. The VA needs no spending increases, it even could stand spending cuts. I’ve argued for its elimination altogether, and this would be a good time to do that.

State, with its more focused foreign aid spending and more tightly controlled embassies and consulates, can absorb reduced spending. After that, all of the appropriations bills, save Defense and Homeland Security, should get 10% cuts in spending across the board. Defense needs, badly, a 10% increase in real terms, and Homeland Security, given the success of the Trump administration—so far—in resecuring our borders, needs a 5% (vice Defense’s 10%) increase.

With all of that, Congress—the House especially—would have some choices to make, any of which would be to the benefit of our nation: statutorily require the vast bulk of the resulting budget surplus go specifically to Treasury to pay down our national debt, further reduce individual and corporate income tax rates and make permanent the existing temporary tax reductions, or some combination of the two.

Congressmen in both houses need now to focus the energy they spent arguing over spending and tax rate maneuvers in the runup to passing the reconciliation bill on achieving real cuts in spending and tax rates via the appropriations bills. And they need to quit dithering about it this time. Pass the bills individually and on time—no more omnibus bills, no more continuing resolutions. Achievement of this would make arguing over the debt ceiling irrelevant by making the debt ceiling itself irrelevant.

Trump could exercise his executive authority in real, proven terms: announce that he’ll veto any omnibus bills and any continuing resolution, even if it means Congress shuts down the Federal government with its failure to perform. And then do so if Congress actually does fail and cause a shutdown.

An Activist Judge’s Pseudo-Concurrence

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The 4th Circuit overruled a District Court judge’s injunction barring the Trump administration from shutting down USAID and allowed the closure to go forward (and the SecState Marco Rubio promptly announced the closure and elimination of USAID effective 1 July).

What interests me, though, is what Circuit Judge Roger Gregory wrote in his “concurrence.” He opened insisting that President Donald Trump (R) had

We may never know how many lives will be lost or cut short by the Defendants’ decision to abruptly cancel billions of dollars in congressionally appropriated foreign aid. We may never know the lasting effect of Defendants’ actions on our national aspirations and goals.
But those are not the questions before the Court today. The question before us is whether Defendants have satisfied their burden for a stay of the district courts injunction pending their appeal to this Court[.]
…
I do, therefore, think that the Executive branch has unconstitutionally invaded the role of the Legislature, upsetting the separation of powers.

Those aren’t the questions before this court, so we have no business addressing them here. But I’m gonna go ahead and do that, anyway, because I gotta have my hype and manufactured hysteria on the record.

Then he closed with this, to give effect to his hype [citations omitted]:

…the Executive has taken many likely unconstitutional actions that, collectively, dismantled an agency, rather than just a single action, does not mean the court cannot render those actions invalid. The sheer number of illegal actions taken necessitates relief that consists of “vast and detailed actions,” to adequately redress the harms caused by the illegal shutdown of a government agency. Rather than “micromanag[ing]” the Executive, the [District] Court was simply attempting to remedy each of the likely illegal actions.
The judiciary is limited to the cases and controversies before it. These Plaintiffs, suing these Defendants, cannot obtain the relief that they seek.

This is the activist judge instructing the plaintiffs in the course of action through which to pursue their own obstruction. This is an activist judge prejudging a future case, and thereby violating his oath of office. This is a judge who insults our judicial system by his presence in it.

The 4th Circuit’s ruling can be read here.

A Gordian Knot Solution

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I have called, often, for the dissolution of the Department of Veterans Affairs on the basis of that agency’s, and now department’s, poor-to-nonexistent quality-level care for our nation’s veterans.

Now we get this. It’s from the end of the Biden administration, but this sort of thing is not unique to that one.

The inspector general report published Thursday confirms that a $2.9 billion supplemental request went unused because the agency failed to account for “prior-year recoveries” in its budget planning. Had the agency taken into account those recovered funds, the inspector general found, its projections “would have shown a reduced risk of a shortfall by year-end.”

And this, more generally:

The OIG review team found that Veteran’s Benefits Administration wasn’t consistently overspending in FY 2024 for either compensation and pension or readjustment benefits accounts, which were the subject of the budget request. “Realized prior-year recoveries,” which are “unspent deobligated funds,” weren’t included in the agency’s calculations, which contributed to the erroneous predictions.
“Had the realized prior-year recoveries been included in the calculations throughout the year, the monthly funding status reports would have shown a reduced risk of a shortfall by the end of the fiscal year,” the watchdog concluded.

Current VA Secretary Doug Collins has inherited this situation and the permeating VA internal culture; he has this:

It’s just a very, a department that is so bureaucratically bogged down that it has trouble doing its main mission, and that is taking care of veterans, and that’s why we’re actually working very hard to streamline processes, to get better help in place, and to have budgets and numbers that we can be accurate

To an extent, I disagree with Collins. It’s not worth the time, effort, money, or other resources to try to untangle this financial mess. It’s time for the Gordian Knot solution. Just get rid of the VA altogether, and convert the department’s current and putative future budgets to vouchers which our veterans can use to visit the doctors, clinics, and hospitals they choose and from which they’ll be able routinely to get timely care. Transfer the VA’s veteran housing mortgage facilities to HUD for execution.

Veteranos Administratio delende est.

The Veterans Administration Fails Again

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A 22-year USAF veteran has nightmares, the attitude, withdrawal as a result of his experiences while deployed to a plethora of foreign locales. [Emphasis added.]

[H]is wife begged him to get help from the local Veterans Affairs medical facility in West Palm Beach, Florida. [The veteran] said he tried, but after many years and multiple VA therapists who could not see him on a regular basis, he decided to pay out-of-pocket for private care. He would like the VA to pay for his therapy through community care—a program designed for eligible veterans to receive care from a community provider when the VA cannot provide the care needed.

Nor is he alone in this strait. It’s getting worse, too. Now,

the West Palm Beach VA Healthcare System is no longer approving their requests for community care, cutting them off from their longtime mental health providers, with potentially devastating results.

And

Congressman Brian Mast (R, FL), a former Army bomb technician who lost both his legs and a finger in Afghanistan, represents the Palm Beach area in Florida’s 21st Congressional District. He said his office has been contacted by over 70 veterans, relatives, and mental health providers who have complained that the VA will no longer refer patients to community care.

OF course, the VA denies that, claiming to have hired many more doctors and expanded facilities. Never mind the facts provided by our veterans in that district, who know empirically otherwise.

The veterans who spoke to Fox News Digital dispute the VA’s view of its quality of care. [The veteran cited at the top of this post] described how his previous attempts to see a VA psychiatrist were “counterproductive” and “ridiculous.” In a “typical interaction,” the VA would tell him, “we’re going to have somebody call you. This is the date and time,” he said. “Nobody calls.”
When he went back to schedule another appointment, the same thing would happen.
“You’re telling me I missed the appointment, I said. But nobody called me. I have no number to call. This was the norm. It was always a lot of deflection to where I just say, this is beyond ridiculous,” he said.

Even Mast has been denied effective care by the VA at least once.

Mast related that he had to see his primary care doctor, a physical therapist, and a lab technician before VA approved him to receive a new cane—with two-week intervals between each appointment.
“That was the bureaucratic process for getting a guy with no legs a cane,” he said.

Just one more reason why

Veteranos Administratio delende est.