VA Issues, Part III: What’s The VA’s Mission?

(Part 3 of a series. Part 1 can be found here; part 2, here.)

IMO one of the biggest problems with the VA today is blindingly simple.  Unfortunately, that problem will be very difficult to correct.

The VA doesn’t really know what it’s trying to do as an organization.  The problem begins with the VA’s mission statement itself – and as a result, permeates the agency.

Compounding the problem, the VA is also trying to do too damn much. It’s become unmanageable.

. . .

The VA traces its origin to this lofty phrase from President Abraham Lincoln’s Second Inaugural Address:

“. . . . to care for him who shall have borne the battle, and for his widow, and his orphan . . . .”

Indeed, the VA’s formal mission statement includes exactly this phrase – and not a helluva lot else.  It’s the VA’s formally-stated raison d’être.

But what does that phrase really mean?

I regard Abraham Lincoln as the one of the two truly indispensable figures in all of US history; the other IMO was George Washington. Without either IMO today we would not have a United States.

With all due respect to Lincoln, remember:  he was also a politician.   Politicians deal in flowery phrases that, on analysis, are ambiguous as hell by design. It’s simply what they do, and how they get elected.  Then as now, good “sound bites” worked – even when they actually said nothing.

Lincoln’s statement above was no exception. That fine-sounding phrase? It means pretty much whatever the hell you want it to mean.

And that’s IMO essentially what the VA has done:  whatever.  It’s “chased the latest bright shiny object” for the last 50 years..

Just about every time the “good idea fairy” has flitted by during the last 40 or 50 years, the VA seems to have listened to her – cost be damned. Congress and the US public has gone along with it.  Hell, Congress has even added some extra stuff from time to time.

. . .

Theoretically, the VA is organized into a HQ (plus associated staff elements) and three major functional elements:  the Veterans Health Administration, the Veterans Benefits Administration, and the National Cemetery Administration.  A formal organizational chart may be found here.

However, IMO that chart doesn’t really tell anyone very much about what the VA actually does.  So allow me to try.  I’ve looked over their website and done a cursory analysis of what benefits they provide – and what functions the VA actually performs.

In addition to the normal internal administrative and management functions that any large organization performs to maintain itself (payroll, HR, IT, legal, etc . . . ), VA does a whole lot more.  Here’s what I believe is a partial list of what the VA does today to “care for” veterans. I say “believe is a partial list” because I’m pretty sure I’ve missed something.

• Determines who qualifies for VA benefits, and the benefits for which they qualify – including an extensive appeals system
• Conducts or reviews physical examinations to determine/verify physical disability connected with military service
• Provides counseling on available benefits
• Determines who qualifies, for VA benefits purposes, as a POW (this one really p!sses me off – but it’s actually part of Federal law)
• Provides healthcare and dental services
• Operates and maintains hospitals and other healthcare facilities
• Maintains medical records
• Runs pharmacies (traditional and mail-order)
• Provides mental health care services
• Provides or brokers life insurance coverage
• Provides health insurance coverage (CHAMPVA)
• Provides disability compensation, including additional allowances for dependents
• Provides additional grants and allowances for the severely disabled
• Provides financial assistance to defray costs associated with those veterans needing full-time assistance (Aid and Assistance)
• Runs Community Living Centers (formerly VA Nursing Homes)
• Makes arrangements with other, non-VA nursing homes and/or assisted living facilities to care for eligible veterans
• Provides needs-based financial assistance for destitute or nearly-destitute veterans and their dependents or survivors
• Provides counseling services (of various types other than mental health)
• Provides counseling services (of various types) for dependents of selected deceased veterans
• Provides financial benefits to the dependents of selected deceased veterans
• Provides financial assistance for the education for veterans and selected veterans’ dependents
• Operates and maintains perpetual care cemeteries
• Guarantees home loans for qualifying veterans and their survivors
• Provides limited employment placement services for veterans
• Monitors the financial affairs (at least theoretically, thru proxies) of mentally-incompetent veterans receiving financial benefits
• Provides financial assistance to help defray the cost of veteran’s funerals
• Provides headstones for veteran’s graves
• Provides burial flags for veteran’s funerals

Looking at that list, I’ll just be damned if I can figure out just what kind of “business” the VA is running. They determine eligibility for benefits. They hand out money left and right – for a sh!tload of different reasons. They run hospitals, clinics, and pharmacies. They store records. They provide mental health care. They run nursing homes and contract for nursing home services. They run cemeteries and provide headstones. They guarantee loans. They provide counseling services of various types.  They provide health and life insurance. They even provide funeral flags.

It’s not quite the IPhone with it’s ubiquitous “there’s an app for that” slogan.  But it’s pretty close.  If you can think of it, there’s a damn good chance the VA has a program that somehow can help do it.

If you qualify, of course.

At one point, I thought I’d come up with at least two things the VA would not help do:  send someone to go buy vets’ groceries, and walk vets’ dogs.  Then I realized that arguably they even do that too. The VA has a program that provides what are called “Aid and Assistance” payments to qualifying veterans or veterans’ dependents.  These payments are to help defray additional expenses for qualifying veterans and/or their dependents needing full-time assistance with daily living.  I guess some of those Aid and Assistance funds could be used to send someone to go buy the vets’ groceries or walk their dog.

The common thread? If there is one besides “the individual is a veteran or a veteran’s dependent”, I’ll be damned if I can find one. I just don’t see any business case connection.

. . .

Bluntly put: the VA today appears to be trying to be “all things to all people”. And maybe I’m wrong, but IMO it just isn’t possible to do that and to do it successfully.  There’s no wonder the VA has problems in managing all of those things simultaneously.

Further, doing each function takes money – lots of money.  And, bluntly, a lot of them have essentially nothing to do with military service or any disability an individual may have incurred due to such service.

But each function justifies a part of the VA’s budget. Doing more different functions justifies more dollars. So you tell me: unless forced, is the VA ever going to stop doing anything?

I’ll answer myself: “When pigs fly.” IMO the VA today is pretty close to a real-life example of the term “self-licking ice cream cone.”

Category: Veterans Issues, Veterans' Affairs Department