On the campaign trail, the Republican’s presumptive nominee has talked of a new mission for the Department of Veterans Affairs (VA) and argued that veterans with non-combat medical problems should be given vouchers to receive care at private, for-profit hospitals — in other words, an end to the kind of universal health care the government has guaranteed veterans for generations.
"We need to relieve the burden on the VA from routine health care," McCain told the National Forum on Disability Issues last month. "If you have a routine health care need, take it wherever you want, whatever doctor or health care provider and get the treatment you need, while we at the VA focus our attention, our care, our love, on these grievous wounds of war."
The Republican senator argues that giving veterans a VA card that they can use at private doctors would shorten the long wait times many veterans face in seeing government doctors, who are nearly universally viewed as among the best in the world.
A recent study by the RAND Corporation found that "VA patients were more likely to receive recommended care" and "received consistently better care across the board, including screening, diagnosis, treatment and follow up" than that delivered by other
Virtually all veterans groups oppose McCain’s plan. The Veterans of Foreign Wars’ national legislative director has said the VA card would "undermine the entire system".
According to the Centre for Responsive Politics, Democrat Barack Obama has received nearly six times as much money from troops deployed overseas at the time of their contribution than has Republican John McCain.
This may seem odd to some since McCain is a former naval officer, prisoner of war, and Vietnam War veteran.
However, Paul Sullivan, a Gulf War veteran and executive director of the non-partisan Veterans for Common Sense, says that for McCain, free market ideology is more important than providing care for former soldiers.
"Ideologues like John McCain and George Bush hate the fact that the VA exists," Sullivan told IPS, noting that the Republican candidate also wants to partially privatise social security and offer private school vouchers to students currently enrolled in public schools.
"They hate the fact that there’s a functional example out there of the government providing better care at a lower cost than the private sector," Sullivan said. "The problem that the VA faces now is that the Bush administration failed to hire enough doctors and disability claims adjusters when they chose to go to war with
McCain has also never spelled out what he means by a "combat injury", leading many veterans worried they could be left out in the cold.
"If I’m driving a Humvee in Iraq and a roadside bomb explodes and I veer off the road and crush my arm and end up losing it and needing a prosthetic, is that a combat wound according to Sen. McCain?" asked retired Air Force Colonel Richard Klass, the president of the Council for a Livable World’s VETPAC, which has endorsed Obama.
Official Pentagon policy calls such an incident a non-combat injury. Technically speaking, the only soldiers "wounded" in combat are those hit by direct enemy fire. As of Aug. 5, Department of Defence statistics showed 32,799 U.S. soldiers had been "wounded" in Iraq and Afghanistan. Another 10,685 had sustained "non-hostile" injuries which required a medical evacuation, while 29,881 were classified as "ill" enough to be airlifted out of the war-zone.
Veterans are also sceptical of McCain’s plans because as a senator, he has repeatedly voted against fully funding veterans’ health care. In 2005 and 2006, McCain voted against expanding mental health care and readjustment counseling for service members returning from Iraq and Afghanistan, efforts to expand inpatient and outpatient treatment for injured veterans, and proposals to lower co-payments and enrollment fees veterans must pay to obtain prescription drugs.
McCain’s vote also helped defeat a proposal by Democratic Sen. Debbie Stabenow that would have made veterans’ health care an entitlement programme like social security, so that medical care would not become a political football to be argued over in Congress each budget cycle.
Iraq and Afghanistan Veterans of America (IAVA) gave him a D+ when they scored his voting record (whereas Obama got a B+). He’s voted with the interests of Disabled American Veterans only 20 percent of the time.
"If McCain would work to properly fund VA care, there would be no issue about a VA card," said Larry Scott, who edits the website VAWatchdog.org. "McCain, by wanting to give vets private care, is walking away from the VA and ignoring the problem. He is admitting that he will not properly fund the VA to the level where it can care for all qualified vets. "
Scott is sharply critical of the VA’s often cumbersome and ineffective bureaucracy, but like most veterans’ advocates, believes the VA system needs to be strengthened. He sees McCain’s plan as a way to phase out the government’s commitment to those who’ve served.
"For every vet who would get a VA card, that would be one less vet using the VA," he wrote in an e-mail to IPS. That "would mean, in a short period of time, a smaller budget, fewer locations…and the eventual dismantling of the best health care system in the country."
IPS Correspondent Aaron Glantz is author of the upcoming book "The War Comes Home: Washington’s Battle Against America’s Veterans".