Failure to provide timely, effective medical attention for the millions of combat veterans who have served our nation is the scandal that has haunted  the Veterans Administration for the past ten years; veterans dying in corridors and parking lots as they languished on waiting lists; overwhelmed VA hospitals sinking into dereliction as vets begged for help.

How could this happen? Did Congress's fail to provide a robust VA system? Was it the fault of the dedicated medical professionals who work tirelessly in VA hospitals? Were they just "burning out"?

Not The Same Veteran

Not The Same Patient

The most recent research by the VA itself found that the fundamental protocols and procedures designed to care for veterans since WWII were woefully inadequate for our modern fighting force. The makeup and combat experience of our soldiers has changed dramatically since Vietnam. The more than 2 million women and men who served in the global war on terrorism, which has been waged primarily in Afghanistan, Iraq, and Syria, experienced significant and unique challenges.

Here is a summary of the dramatic changes that were underestimated by the VA:

1. These wars were the first major set of conflicts fought exclusively by the all-volunteer force (AVF), established in 1973 when the United States abolished the draft as a result of the protests about the war in Vietnam.
2. The U.S.-involved conflicts between Vietnam and the global war on terrorism were also much smaller, both in duration and in troop deployment. In contrast, the wars in the greater Middle East have been ongoing for nearly two decades.
3. The current wars are also the first since World War II in which U.S. service personnel have undergone multiple deployments. This increases the risk of a veteran suffering post-traumatic stress disorder (PTSD) by 50 percent and has resulted in 45,000 veterans and active-duty personnel committing suicide over the past six years.
4. The reserve component—which consists of the National Guard and Reserves—has been used as an operational rather than a strategic reserve, with reserve units alternating combat deployments with the active force. Reserves are not “combat hardened” soldiers and suffer more frequent psychic injury.
5. Another issue facing today’s veterans results from advances in medical care. On the battlefield and in theater, medical advances have dramatically increased the chances of military personnel surviving their wounds today. Thus, the number of wounded veterans in proportion to overall casualties has increased significantly.
6. The current wars are also the first in which women, who now comprise about 17.5 percent of the total U.S. military force, have been habitually and directly exposed to combat. In addition to the physical and mental toll of combat, about 15 percent of the women serving in Iraq and Afghanistan have experienced sexual trauma during their deployments.
7. At the height of the wars in Iraq and Afghanistan, the U.S. Army had to lower its admission standards to attract and retain sufficient volunteers to wage the increasingly unpopular conflicts. Consequently, some people were sent into war zones with physical and mental health problems that were exacerbated by the pressures, rigors, and dangers of combat.
8. Additionally, the wars in Afghanistan, Iraq, and Syria are the first extended conflicts in which the Army and Marines have deployed whole units rather than individuals, as they did in Vietnam and Korea. This practice has resulted in many individuals having their enlistments involuntarily extended: Once a unit receives notice of a coming deployment, members of the unit cannot leave active duty until after their unit has returned from the deployment, which often lasts a year.
9. In Iraq, Afghanistan, and Syria, the United States is fighting several groups that have different agendas, often fight each other, and sometimes blend in with the civilian population. As a result, today’s veterans experience a higher rate of mental health problems, such as PTSD than veterans from previous conflicts.

The Wrong Tools

It appears that as the Pentagon altered the very nature of its fighting force, no one alerted the VA to the impact of these changes.

Much like car manufacturers gradually shifting the automobile from a mechanical vehicle to a technological gadget without telling the mechanics in the field. They continue to show up with a toolbox full of wrenches and ball-peen hammers, but no matter how hard they work, they will never get the job done.