Any qualitative or quantitative study may require the collection of data that will need statistical processing afterward. Generally speaking, the establishment of hypotheses is an essential feature of experimentation because it determines its foundation and sets the vector for development. Within the framework of the discussed topic of the project, hypotheses will be established in the next question, but now it is clear that it will be necessary to test them statistically with the help of existing tools of analysis. Thus, in general, the entire procedure of hypothesis examination comes down to testing their statistical significance.
In more detail, once the null and alternative hypotheses have been established, it is necessary to select the criterion used for the analysis. The criterion should be understood as a mathematical characteristic of the sample, based on which the decision to reject or accept the working hypothesis will be made later (Introduction to hypothesis testing, n.d.). It can be the Shapiro-Wilk criterion, Student’s t-criterion (or Fisher’s F-criterion), and, for example, Wilcoxon’s criterion. The choice of the criterion is replaced by the choice of the statistical significance level alpha, which is 0.05 by default: this is the so-called probability of error of the first kind (UU, 2021). The fourth step is essential to find the boundaries of the hypothesis acceptance area; for this purpose, the statistical calculations of the selected criterion for the data set are performed. If the initial level of significance fits the processing result, then a conclusion is made that there is no sufficient reason to disprove the null hypothesis.
The purpose of the paper is to determine the level of effective integration of Iraq War veterans into academic communities based on opioid use. The null hypothesis is that most veterans use opioid medication to integrate into academia. The alternative hypothesis is that most veterans do not use opioid medication to integrate into learning.
This should be a virtual survey of respondents administered via the Internet. The choice of a nonphysical survey is driven by the epidemiological difficulty of being present in person (Tuma et al., 2021). The survey should be structured so that participants choose pre-generated responses on satisfaction, efficiency, and mental health scales.
The population is all Iraq War veterans, and the sample will be randomly selected by assigning a number to each veteran from the (pre-generated) list. The number will be chosen using a random number generator (randomly), which will reduce sampling error or bias.
Levels of satisfaction with training, levels of calmness and mental health, levels of PTSD-related stress absence, and levels of personal well-being after military service are measured.
The independent variable is the amount (or frequency) of opioid medication taken, which will determine how well student veterans integrate into learning (dependent variable). The dependent variable is a composite of the individual metrics discussed in (4). The independent variable is subject to a simple calculation of the amount or frequency of pain medication and nootropic medication. The reliability of the quantitative hypothesis measure will lie within the participants’ responses or the provision of medication prescriptions. The reliability of the independent variable measurement should be determined by scientifically valid scales of satisfaction, stress, and others (Beidas et al., 2015).
The statistical analysis used is the ANOVA analysis of variance, which will assess the significance of the results for multiple groups. Analysis of the quantitative data collected will be done using MS Excel.
Since a set of dependent variables is being measured, the ANOVA test is preferable to the paired t-test. In addition, ANOVA can control for the incidence of false positives. Finally, because the general population is expected to have a normal distribution (mean number of opioid drugs), ANOVA as a type of parametric test would be most appropriate.
Four basic assumptions do need to be made to do a regression analysis. These mainly concern the nature of the mutual relationship between the independent variable and the dependent variable and the reliability of the measurements. First and foremost, it is crucial to assume that there is a linear relationship between the number of opioids taken and the effectiveness of integration in learning (Vidhya, 2016). This can be assessed by performing a linear regression separate analysis of the independent variable and the assessed satisfaction, stress, and so on. The second assumption concerns homoscedasticity, where in all individual groups, the variance remains constant. This can be checked visually: one has to plot the dependence of the values of random residuals on the aligned value of the resulting variable.
The third assumption will be the independence of observations from each other. This means that there is no overlap between the levels of stress, satisfaction, and mental health. Finally, the fourth assumption will be the assumption of a normal distribution of the dependent variable. By plotting the regression relationship, it will be possible to infer the extent to which inclusion effectiveness usually is distributed relative to the amount of medication used.
Many statistical tools can be used to evaluate a data set. One such tool that is highly popular among researchers is the ordinary least squares (OLS) regression method. Such a model aims to find a curve that fits the variance of the data with the minimum sum of the squares of error. In other words, the variance for a given data set should be minimal because the closer the curve describes the trend to each point on the existence interval of the entire scatter, the more accurate the OLS satisfies that set.
When using OLS, the regression coefficient is usually a statistical relationship between the two variables under study. In other words, it is the degree of dependence of one line on the other. Consequently, if the regression coefficient is negative, it is reliable evidence of the so-called negative relationship between the variables. Visually, as the independent variable, for example, increases, the values of the dependent variable decrease.
During the use of regression analysis, the specialist must take into account the interaction terms. These conditions arise if the relationship between the independent variable and the dependent variable — in other words, the effect of the independent on the dependent — can change when influenced by external, other independent variables. Using this concept allows us to consider more hypotheses and, in general, to expand our understanding of the mechanisms of the relationship in the measured variables by finding new patterns. However, the use of interaction terms can be problematic, so the researcher must be confident in the statistical apparatus. Finally, for binary studies that measure the binary (dichotomous) dependent variable, logistic regression should be used instead of OLS. In addition, logistic regression produces discrete results, whereas OLS produces continuous.
References
Beidas, R. S., Stewart, R. E., Walsh, L., Lucas, S., Downey, M. M., Jackson, K.,… & Mandell, D. S. (2015). Free, brief, and validated: Standardized instruments for low-resource mental health settings. Cognitive and Behavioral Practice, 22(1), 5-19
Introduction to hypothesis testing [PDF document]. (n.d.). Web.
Tuma, F., Nituica, C., Mansuri, O., Kamel, M. K., McKenna, J., & Blebea, J. (2021). The academic experience in distance (virtual) rounding and education of emergency surgery during COVID-19 pandemic. Surgery Open Science. Web.
Vidhya, A. (2016). Going deeper into regression analysis with assumptions, plots & solutions. AV. Web.
Veterans often become students, attempting to begin or continue their education after service. However, prior traumatic experiences, generally manifested in Post-Traumatic Stress Disorder (PTSD), frequently become a considerable issue during learning, causing mental and physical complications (Rudd et al., 2011). In addition, the onset of the opioid epidemic and the use of this substance for pain relief significantly decreases the Veterans’ well-being, impeding their educational success. Scholarly research regarding opioid use and the alleviation of PTSD symptoms highlights the implementation of Posttraumatic Growth (PTG) as a prominent approach that could aid these individuals in battling the mental consequences of trauma and drug use (Smith, 2021). Moreover, Veteran students have been reported to be more severely affected by the opioid epidemic, which reduces the possibility of coping with potential stress and fitting into social groups properly (Blevins, 2019; Boccieri et al., 2019). Therefore, assisting Veteran students in overcoming the consequences of PTSD worsened by opioid misuse is a significant issue for scholarly research.
The onset of the opioid epidemic and the popularity of opioids as pain relief medicine has considerably affected the welfare of veterans struggling with PTSD. Several studies suggest that opioid misuse and drug addiction can be common consequences of trauma in numerous ethnic minorities, including Veteran students (Kip et al., 2014). Although the primary purpose of opioid medicine is to relieve physical pain, scientists have noted that there is a potential correlation between physical pain manifestations and psychological trauma, which might result in the prescription of opioids and substance abuse (Carrola & Corbin-Burdick, 2015). Considering that opioids can be related to the development of such mental issues as drug misuse, anxiety, psychosomatic pain, and depression, posttraumatic growth methods can be efficiently used to address the occurrence of these problems is essential.
Of special concern are the Veteran students belonging to various ethnic minorities, whose well-being can be more severely affected by the opioid epidemic. African-American populations are reported to suffer from higher rates of PTSD, while veterans belonging to ethnic minorities are less likely to manifest positive results of symptomatic treatment in comparison with other patients (Coleman et al., 2018). In this regard, student Veterans afflicted by PTSD and receiving opioid medication become a group of risk in consideration of their welfare. Given that the current findings regarding the implementation of commonly used therapies to battle these issues are an inconsistent, further investigation of effective approaches focused on Veteran students belonging to ethnic minorities is needed (Coleman et al., 2018). Thus, the posttraumatic growth methodology can be a prominent approach to confront the emergence of PTSD and opioid abuse symptoms in the chosen population.
The current study focuses on the effect of the posttraumatic growth concept as a strategy that could alleviate the consequences of PTSD and the opioid epidemic in Veteran students, implementing the Delphi method to examine the efficiency of the suggested model. Considering that this proposition is rather innovative and concerns a particular group of Veterans, specifying the opinions of professionals who possess the corresponding experience is highly necessary (Birtles, 2017). As such, experts in the fields of student Veteran PTSD counseling, ethnic minorities counseling, and PTG application for Veterans or Veteran students will be needed for this task. By focusing on the insights and ideas from a chosen expert panel, it will be possible to outline the main complications and properly address them in future experimental investigations.
The research question for this study is still in the process of development, as several crucial complications regarding the topic specificity and expert panel are to be resolved. The current research question is formulated as follows: how can the posttraumatic growth method be applied to the psychological rehabilitation of student veterans suffering from PTSD and opioid treatment effects? The variables considered at this stage are the severity of the PTSD condition, the duration of opioid substance abuse, and the scores delivered by an expert panel. As the study grows, additional variables might be introduced to enhance topic coverage.
The research methodology for this research includes both theoretical and experimental stages of conducting a Delphi study. The theoretical step will be conducted using recent publications on the suggested topic, outlining the proposed effectiveness of the chosen framework and creating experimental hypotheses. After that, the panel size and its composition will be established according to the findings. The number of experts is to be increased if little theoretical information is available. After that, the professionals’ opinions will be gathered and evaluated, determining if a consensus was reached. If not, an additional round of questions will be conducted, and this will be repeated until a consensus is reached.
The research design for this investigation generally follows a qualitative method of examination, attempting to provide exploratory findings on the issue, but a quantitative method of examination could be implemented as well. Delphi investigations might be deemed both qualitative and quantitative, which perfectly suits the data to be used in this investigation (Kennedy, 2004). While expert panel’s opinions and insights and the prominent theoretical and practical findings from corresponding research are referred to as qualitative information, the scores distributed by the professional must be accounted for as quantitative data. Thus, a mixed-method approach will be used to analyze the relevant information appropriately.
Boccieri, B. J., Gazdik, K. W., Kerns, L., Williams, P. L., Landgraff, N. C., & Ge, W. (2019). Severe pain in veteran students. Journal of Allied Health, 48(3), 172-180,180A-180B.
Traumatic experiences can significantly disrupt the individuals’ flow of life, leading to adverse psychological consequences and mental conditions. Although trauma typically leaves a negative impact, it has been suggested that positive outcomes might emerge as a result of a negative experience (Tedeschi et al., 2018). While some studies present positive results, there are still mixed findings connected to the connection between Posttraumatic Growth (PTG), mental well-being, and particular populations (Schubert et al., 2016). Therefore, the current Specialization Plan aims to analyze the research on the problem of rehabilitation through PTG in veteran learners, identifying major theories and conceptual frameworks used to address this issue. In addition, interventions aimed at improving the student veterans’ mental well-being through PTG will be discussed, outlining directions for future improvement.
Problem Statement
While trauma can occur in the lives of various populations, individuals with military experience have been suggested to be more seriously affected by the traumatic circumstances. Although the literature suggests that this affliction can be mediated through PTG, more evidence is required to understand the factors that promote this process and ensure successful rehabilitation (Schubert et al., 2016). A common complication encountered by veterans is connected to returning to higher education, as completing the educational activities becomes especially strenuous (Reyes et al., 2019). From this perspective, student veterans are in tremendous need of psychological support that could mitigate the negative impact of trauma and assist them in achieving academic excellence.
Importance of the Problem
Given the stressful environment of higher education, the complications connected to maintaining a stable mental condition can become overwhelming for student veterans. Previously, research suggested that student veterans are especially vulnerable to manifesting symptoms of major depressive disorder and PTSD (Shackelford et al., 2019). However, even though research on specific populations prone to PTG, such as military personnel or people with PTSD, has been conducted, only a small number of studies question how PTG occurs in student veterans (Schubert et al., 2016; Mark et al., 2018). As PTG is generally regarded as a process that can result in a better rehabilitation process, knowledge about the factors connected to PTG achievement in veteran learners is essential for developing an efficient rehabilitation program.
However, recent research suggests that PTG achievement in veteran populations could be enhanced through the implementation of relevant strategies and therapeutical approaches (Tsai et al., 2015). Many veterans report experiencing PTG after returning to civilian life, and evidence suggests that PTG occurrence may be improved through therapy (Tsai et al., 2016). Additionally, similar tendencies in PTG facilitation have been established among students affected by trauma. It seems to be possible to improve the students’ PTG prevalence rates through education and therapy, strategies that are also beneficial for the veteran population (Taku et al., 2017).
Interventions Related to PTG Facilitation
Recovering from the military experiences is a crucial issue for numerous personnel after returning to civilian life. With the possibility to enhance the process of rehabilitation through the achievement of Posttraumatic Growth (PTG) emerging through recent research, several programs to facilitate PTG have been proposed. According to Kanako Taku, a scholar researching the manifestations of PTG in various populations, rehabilitation interventions aimed at facilitating PTG are especially effective when they incorporate relevant scientific evidence (Taku et al., 2017). In the recent studies, Taku introduced three programs that could help address PTG in individuals from veteran and student communities, conducting research to confirm the interventions’ validity.
Randomized Controlled Trial of SecondStory
One of the proposed strategies involves performing group-based sessions that promote reflection and meaning-making in affected populations. This approach is named SecondStory, and it allows individuals to battle the negative consequences of trauma through psychological growth. Introduced in the study by Roepke et al. (2018), SecondStory integrates the recent PTG interventions which were proven to have a positive impact on the participants’ well-being and distress symptoms. Contemporary research suggests that a consistent therapeutic strategy is most efficient for ensuring successful recovery from such negative trauma-induced symptoms as anxiety and depression (Roepke et al., 2018). Therefore, positive psychology, future-directed thinking, meaning-making, and narrative therapy served as the basis for the intervention, which was performed on a sample of individuals who had similar experiences of trauma. According to the results, although SecondStory was not significantly more efficient in promoting PTG achievement among trauma survivors, it was still beneficial for facilitating PTG, meaning that it could be useful for future therapeutic endeavors.
Psychoeducational Intervention Program for Students
Another approach suggested by Taku concerns the subject of educational interventions and their effects on promoting the occurrence of PTG in students. Taku et al. (2017) devised a strategy to improve the students’ knowledge of PTG and research whether such initiatives could facilitate positive psychological growth. The intervention discussed stressful events, various types of reactions to them, psychological distress, PTSD, and the PTG’s potential to promote personal changes. Various forms of PTG were also described, allowing the participants to understand the predictors and mechanisms of PTG. The reported findings demonstrate that learning about PTG can significantly improve the PTG prevalence rates in high school students, facilitating positive growth and promoting the achievement of psychological changes. The majority of the respondents reported PTG achievement three weeks after the intervention, meaning that the educational program had positive effects.
Warrior PATHH: Program for Veteran Mental Health
The final method discussed refers to the psychological interventions for veteran populations. The researched strategy was named Progressive and Alternative Training for Healing Heroes (Warrior PATHH), created and studied by Moore et al. (2021) on the basis of the Boulder Crest Foundation. Considering the importance of using relevant research data, the PATHH program was devised with the implementation of the evidence-based approach, integrating the PTG model from the original authors and the Expert Companionship intervention strategy. The resulting intervention was delivered by experts to the participants who experienced trauma during combat exposure, addressing such topics as psychoeducation, emotional regulation, self-disclosure, narrative development, and learning about the value of life. Moore et al. (2021) report that, although the created method is not psychotherapeutic, it helped facilitate PTG in veterans and promoted education on trauma, emotional and behavioral regulation, and well-being after deployment.
References
Mark, K. M., Stevelink, S. A., Choi, J., & Fear, N. T. (2018). Post-traumatic growth in the military: a systematic review. Occupational and Environmental Medicine, 75(12), 904-915.
Trauma is one of the most complex and problematic issues in therapy in the USA. This complexity arises from several important factors. First of all, the state has a diverse population, meaning a wide variety of causes might trigger the development of complex responses within an individual and promote a prolonged reaction. Second, every individual might have his/her own trigger that leads to an outburst of emotions and extreme response. Moreover, every trauma is unique and might differ regarding the peculiarities of the area or individuals’ mentality. For this reason, understanding the given issue requires the in-depth analysis of specific events that led to the alterations in individuals’ behaviors and the employment of this information to create a better vision of trauma’s peculiarities and how they can be addressed to acquire better outcomes.
Triggers
Triggers are one of the fundamental issues regarding trauma and its management. They can be viewed as a specific aspect affecting the emotional state of a person, causing distress or overwhelm. The problem is that in some cases, events normal for one individual might be extremely difficult for another one. It means that every case requires an individualized approach and attempts to determine what and why causes overreacting and distress. That is why therapists should never disregard the hyperarousal triggers in their clients (Anderson, 2016). This knowledge is critical to help individuals separate or get out of extreme responses (Anderson, 2016). It means that attempts to find triggers and why they formed are fundamental aspects of any psychologist’s work. It requires an in-depth analysis of individuals’ states and an understanding of what promotes them. It is a complex task because trauma differs, and every client has his/her own story that promotes the emergence of changes in the brain work and responses to stressors.
Historical Traumas
Moreover, the sophistication of the problem comes from the fact that some traumas might be historical and deeply rooted in families. This issue is especially important for the USA, with the population consisting of numerous trauma survivors, such as black, indigenous, or Jewish people, immigrants, or other individuals with complex family histories (Mandley, 2020). Representatives of this cohort might suffer from triggers that are unclear to them but act on the unconscious levels. For instance, a young woman from a Jewish family who escaped the holocaust might feel bursts of anger or inadequate and violent response accompanied by abdominal pain when seeing cases of discrimination or unfaithful attitude (Mandley, 2020). It is a result of this historical trauma acquired by her family members. However, it proves the complexity of the phenomenon and the diversity of triggers that might lead to distress.
For this reason, understanding American trauma might be a complex issue. The diversity of backgrounds and presence of population groups representing various cultures means that various factors should be considered when working with these clients. The hopeless situation in their states and difficulties with raising children and finding jobs make people leave their land and arrive in the USA (Imberti, 2017). In some cases, it might lead to the emergence of stress, anxiety, and trauma, which can impact individuals later when the outlined problems are resolved. Moreover, shocking conditions in detention centers increase the diversity of traumas and triggers that might lead to extreme reactions (Howes, 2019). In this regard, therapists face the challenge of analyzing diverse backgrounds to provide assistance and ensure the major peculiarities of every case are taken into account and used when providing treatment.
Immigrants and Exclusion
Furthermore, exclusion and otherness when arriving in a new state can serve as the basis for the formation and development of traumatic experiences. In these cases, cultural legacies might impact numerous generations and become worse (Mandley, 2020). Thus, survivors of cultural and historical traumas might suffer from the feeling of otherness, impacting their ability to integrate with society and become part of it (Mandley, 2020). For first-generation migrants, the problem is also critical as their adjustment to new conditions might be traumatizing and require much effort, which is a potential source of psychological problems that should be resolved (Howes, 2019). Asking for help requires realizing the source of these traumas, which might also be difficult and demand a certain effort. That is why numerous immigrants live with undiscovered psychological traumas or memories that are suppressed. However, it impacts their well-being and might transform into a cultural trauma affecting many generations.
The unresolved psychological issues might also be a cause for isolation and exclusion. Subconsciously, individuals with trauma might avoid talking with others or prefer interacting with individuals or psychologists who are also survivors (Mandley, 2020). As a result, they acquire problems in social relations and prefer to avoid them. It results in exclusion and isolation, which are the potential causes for the deterioration of individuals’ mental health and their inability to enjoy numerous benefits available to healthy people. The past experiences of trauma or inherited cultural legacies promote the feeling of shame. It complicates diagnosing and the delivery of care. Under these conditions, traumas acquired by immigrants or other survivors might be extremely complex and diverse. Their analysis is vital for understanding the nature of the phenomenon and assisting patients who have specific issues.
Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) is another important aspect of American trauma that should be considered. Thus, the U.S. military has one of the highest rates of PTSD in history (Junker, 2016). It means that the prevalence of the problem in the country is exceptionally high, and it should be viewed as one of the mental disorders that should be given much attention. Moreover, the country shelters numerous immigrants from regions seized by war, and they have a high risk of being traumatized. From this perspective, PTSD can be considered one of the critical mental health disorders affecting the nation and impacting the emergence of undesired behavioral patterns and deterioration in the quality of people’s lives (Schein et al., 2021). Being in the activated state, the brain tries to protect individuals, preventing them from relaxing and using normal responses to stressors (Van der Kolk, 2014). As a result, they suffer from chronic distress that requires treatment. Nevertheless, it is vital to consider that PTSD might not be as prevalent as it seems at the moment. It is an extremely complex disorder that requires specific treatment. In other cases, a person might suffer from other psychological issues that cannot be viewed as PTSD.
Medical Perspective
In this regard, the ability to recognize trauma and manage it is the top priority. From a medical perspective, it is a psychological and physiological response to a specific event (McBain, 2022). Although symptoms are manifested in a person’s bodily responses, medical traumas have somatic origins (McBain, 2022). It means that addressing the problem might require using a new paradigm. It should include an understanding of the origins of trauma, its development, and its current state (McBain, 2022). In other words, a more expansive process for diagnosing and treating trauma is required (McBain, 2022). It will help to consider the differences in backgrounds and triggers mentioned above and ensure patients acquire personified care aligned with their current demands. Otherwise, there is a high risk of a lack of context understanding (McBain, 2022). It might lead to using a standardized approach that is less effective and cannot consider all individuals’ peculiarities.
Trauma and Family
Finally, addressing trauma requires analyzing the current relations and how they impact an individual. The well-being within a family or positive interactions with close people is fundamental to psychological health. However, in many cases working with traumatized people, specialists might disregard a couple’s medical history (Hepworth, 2007). At the same time, severe mental diseases, a burst of anger, or strong emotions because of PTSD might have a traumatic impact on the relationship and a partner (Hepworth, 2007). It means that the psychological problem might worsen and establish the basis for the further aggravation of symptoms and their sophistication. Tensions in relationships are one of the common causes of psychological disorders, meaning it is critical to consider this aspect when working with patients who have various symptoms that should be managed. Moreover, the family can support traumatized individuals and help them to struggle against their problems. For this reason, it is possible to acquire better results when interacting with clients’ close people and ensuring they are ready to help in most complex cases.
Conclusion
Altogether, working with traumatized patients, it is vital to consider the diversity of aspects that might lead to the emergence of psychological problems. For the USA, the unusual structure of the population means there is a presence of potential risk groups, such as immigrants, war veterans, or dramatic events survivors who might have historic trauma linked to their cultural legacies. In these cases, individuals might have various triggers that are unclear to them but are working on the unconscious level. The bursts of uncontrolled emotions, along with the feelings of shame and isolation, can make the cases even more sophisticated. It means that trauma is characterized by the high level of diversity in causes that lead to its emergence. Working with patients, it is essential to realize contexts, past family histories, and the current state of relations to ensure that effective working approaches are employed.
References
Anderson, F. (2016). Responding to extreme trauma symptoms: How neuroscience can help. Psychotherapy Networker, 40(6), 15-16.
Hepworth, J. (2007). When illness moves in: Healing couples process the trauma of sickness. Psychotherapy Networker, 31(3), 52-57.
Howes, R. (2019). Immigration and trauma. How can therapists help? Psychotherapy Networker, 43(5), 63-65.
Imberti, P. (2017). The immigrant’s Odyssey: Trauma, loss, and the promise of healing. Psychotherapy Networker, 41(2), 54-62.
Junger, S. (2016). The bonds of war: PTSD reconsidered. Psychotherapy Networker, 40(5), 42-48.
Mandley, A. (2020). The legacy of cultural and historical trauma. Psychotherapy Networker, 44(5), 34-35.
McBain, S. (2022). Recognizing medical trauma. Psychotherapy Networker, 46(5), 15-17.
Veterans belong to some of the most vulnerable populations due to a variety of reasons. Moreover, many of the representatives of this group tend to become homeless due to the hardships they have experienced, which resulted in substance abuse and serious mental issues. In their article, Evans, Kroeger, Palmer, and Pohl (2019) investigate how the needs of veterans can affect the allocation of money on the federal level.
The main points of the authors
The main point made by the authors is that the Housing and Urban Development? Veterans Affairs Supportive Housing (HUD-VASH) program has the potential to reduce homelessness among veterans. Evans et al. (2019) admit that it would be wrong to ascribe a considerable fall in veterans’ homelessness entirely to HUD-VASH vouchers. However, scholars also report important positive outcomes of the program. Specifically, each additional HUD-VASH voucher has contributed to an over 1% reduction in homelessness, a 0.9% increase in permanent supportive housing beds, and a 0.7% decline in chronic homelessness in the 2007-2017 period (Evans et al., 2019). Therefore, it is viable to assume that HUD-VASH vouchers are likely to help in the alleviation of homelessness among the identified vulnerable population.
My opinion of the article
I find the article rather valuable since it offers at least two significant findings. On the one hand, scholars have performed a thorough investigation of the various levels of veterans’ homelessness over a decade. Such research allows tracing changes in the area of public services dealing with homelessness among veterans with substance abuse and mental illnesses. Thus, it becomes possible to note the most effective approaches to mitigating the issue. On the other hand, the authors discuss both the advantages and disadvantages of HUD-VASH vouchers. As a result, it is easy to identify the weak points in the program and come up with solutions to them. Overall, my opinion of the article is positive since Evans et al. (2019) have analyzed one of the most burning social issues prevailing in the USA and have distinguished the achievements gained with the help of other programs from HUD-VASH.
The relation of the article to my work
The article related to my experience since I deal with veterans due to some aspects of my profession. I have been in the fire service for twenty-nine years, and I have witnessed numerous cases of adverse outcomes of veterans’ homelessness. Thus, I am concerned about the issue investigated by Evans et al. (2019), and I find the authors’ efforts valuable for U.S. society’s positive development.
Applying the authors’ points to the public sector
It is possible to apply the points and arguments of the scholars to the public sector in a practical sense by engaging more veterans in the program. Also, the connection may be established through the analysis of veterans’ housing needs with respect to the wars in which they participated. As Evans et al. (2019) state, the needs of veterans differ depending on their war experiences. Hence, it is crucial to create a differentiation of these requirements.
Conclusion
There are various positive and negative externalities that could influence the efficiency with which the government allocates resources to provide for citizens’ needs. Among positive ones, there is a reduction of crime and death rate among veterans as a result of providing them with housing. A negative externality may be represented by individuals or groups that consider it more valuable to allocate money for pursuing some other goals, such as dealing with childhood illnesses or epidemics. However, the problem of veterans’ homelessness seems too important to neglect, and it deserves the appropriate attention of the government.
Reference
Evans, W. N., Kroeger, S., Palmer, C., & Pohl, E. (2019). Housing and Urban Development? Veterans Affairs Supportive Housing vouchers and veterans’ homelessness, 2007?2017. American Journal of Public Health, 109(10), 1440-1445.
Veteran healthcare is a common and contentious political and social topic in American society. It has shaped different types of political debates, including presidential elections and national labor politics. The main issues characterizing this debate have pivoted on the provision of quality and affordable care for veterans. These issues are fodder for political discussions because successive governments have been accused of neglecting veterans’ health concerns, despite the immense sacrifice they make in serving the nation (Patel and Rushefsky 189). Veteran groups spread across the country have voiced these concerns (U.S. Department of Veterans Affairs).
There have also been cases of some veteran associations claiming the government is not doing enough to address pressing veteran health-related matters (Patel and Rushefsky 189-200). These concerns have prompted different stakeholders in the healthcare and political sectors to negotiate about how to address some of the issues highlighted above. Consequently, there have been ongoing discussions to improve veteran affairs, through an increase in the number of veteran affairs (VA) health facilities and the improvement of healthcare quality for the same demographic. Understanding the ongoing process requires a multifaceted understanding of the different tenets of negotiation that often underscore such deliberations.
The game and bilateral monopolistic theories (BMT) have been partly used to understand the nature of such negotiations (HSRC). This paper explores the relevance of the two theories in understanding current negotiations about the provision of improved veteran healthcare services in the country. The two theories are selected for this review because they are the most commonly used models for evaluating negotiation processes (HSRC). Key tenets of this paper will show how both theoretical frameworks underscore the nature of current veteran negotiations between the government and other stakeholders involved in the provision of veteran health services. They will also explain the limitations of the same models in comprehending the progress made from the same negotiations. The last section of the paper explains which theory is most applicable to veteran negotiations and why it is relevant in understanding future negotiation processes related to the same deliberations. The section below explains key tenets of the game theory and its application to negotiations about veteran affairs.
Game Theory
The game theory is perhaps one of the most widely used models in negotiation. The theory is used by rational and intelligent decision-makers to predict possible outcomes of their choices or decisions based on a predefined set of outcomes (HSRC). The goal of the game theory is to optimize the outcomes of different actors involved in a negotiation process. This theory often operates on the premise that only winners and losers emerge from negotiations (HSRC). This view mirrors some of the outcomes of ongoing discussions about veteran affairs because some people feel like they have been sidelined in the negotiations, while others have made significant gains from the same process. The section below outlines the win-lose dichotomy in veteran negotiations.
The Win-Lose Dichotomy
In an article by AFGE, some people have expressed concern that Congress is not working in the best interest of veterans. Instead, the article suggests that the political organization is working to promote the interest of some shadowy organizations, such as Koch Brothers, at the expense of veterans (AFGE). Consequently, people demand that the government should give veterans the highest quality of care, devoid of the special interests presented by these organizations. The same concerns have also been voiced by Nursing Unions, which have felt sidelined in the ongoing negotiations to improve veteran health affairs (National Nurses United). The same unions have also lauded efforts by the government to formulate legislation that promotes the advocacy of collective bargaining agreements among nurses (National Nurses United). Their main concern has been the attempt by some government agencies and veteran associations to sideline them in the quest to improve the veteran’s healthcare system. Consequently, they suggest that both sets of agencies should closely work with them to make sure that veterans get quality care (National Nurses United). These concerns were registered in a recent incident where nurses staged demonstrations that advocated for their inclusion in ongoing negotiations about veteran healthcare reforms.
Another group of stakeholders that feel sidelined by ongoing negotiations is the veterans themselves. For example, there have been several cases where members of veteran unions have expressed their dissatisfaction with current negotiations between union heads and government officials because they do not feel their interests are being properly represented. These concerns are expressed in an article by Clark, which shows that the active role played by unions in veteran negotiations may be a deterrent to the long-term realization of a solution for long-standing veteran issues. At the same time, the article suggests that funding issues, corruption (especially involving union officials), poor communication, culture, and a significant increase of the veteran population) have significantly impeded proper negotiation among the veterans, the unions that represent them, and the government (Clark).
Another problem highlighted in the same article is the cozy relationship some of the union heads have with government officials (Clark). Clark also demonstrates that there is a lot of money spent on paying full-time employees who work in these unions as opposed to the improvement of veteran affairs. In line with this argument, some union officials have been accused of receiving six-figure salaries to carry out their duties at the expense of the people they represent (Clark). However, the union bosses have refuted such claims and argued that they are working towards the betterment of their members’ welfare. Some union officials have even argued that without their involvement, people would not be aware of veteran affairs in the first place (Clark).
An article authored by Miller also supports the view that union bosses are not working in the best interest of their members because it shows that collusion between government officials and union bosses has created a negative work environment that caters more to the needs of union heads than those of the members they represent. For example, the article highlights the case of one union boss, Peter Cox, who is known for protecting “misbehaving” employees at the expense of the veterans they are supposed to work for (Miller). The article also draws attention to some attempts by union bosses to not only protect errand officers but also actively maintain the status quo of the broken veteran healthcare system (Miller). Generally, this article attributes the problem of veteran affairs to a broken system that protects union bosses more than the veterans who should be represented in the first place.
Limitations of the Game Theory
The sentiments expressed by nurses and members of veteran organizations show the win-lose dichotomy of the game theory in veteran negotiations. Stated differently, the two groups are emerging as losers in the negotiations, while the union bosses and the government are emerging as winners in the same process. Although the game theory highlights this dichotomy of win-lose outcomes, it has been criticized by some people for having limited application because, in reality, other outcomes emerge from negotiations, besides win-lose situations (HSRC). For example, while the game theory could be used to show how members of veteran associations are perceived as “losers” in negotiations that have benefitted their bosses more than them, the same theory neglects some of the gains made by members from the deliberations. Indeed, as highlighted by Patel and Rushefsky (189-200), negotiations between union bosses and the government have yielded in expanded healthcare access for veterans. Also, the repealing of some legislative bottlenecks highlights this fact because they show that veterans are to benefit from improved quality and access to healthcare access, based on current negotiations between union representatives and the government.
Bilateral Monopolistic Theory (BMT)
The BMT is relevant to ongoing negotiations between veteran organizations and the government because it explains how powerful negotiators exert their influence over others. This theoretical framework has been supported by several reports, which show the government’s influence and power in veteran negotiations. The section below explains its dominance in ongoing negotiations.
Powerful Government
An article by Craft has attributed staffing issues at VA facilities to government ineffectiveness in addressing veteran issues. The problem has been partly attributed to the failure of the Secretary of Veteran Affairs, David Shulkin, to allocate enough funds (from Congress) towards hiring more workers in VA hospitals. It is estimated that there are about 35,000 vacancies in Veteran hospitals (Craft). This shortfall in labor requirements is straining the quality of healthcare services that could be offered to veterans (Craft).
An article by Caldwell shows that the government is willing to address some of the pending veteran issues relating to healthcare planning. It explains that President Trump used the first State of the Union address to highlight the need for veterans to have access to alternative healthcare facilities beyond what the conventional veteran healthcare system offers (Caldwell). This proposal has been touted as a solution to some of the veteran healthcare issues highlighted by Craft when he pointed out that most veteran healthcare centers are understaffed and cannot effectively cater to the needs of the people who seek health services. The proposals made by Trump are expected to jumpstart some of the legislative impediments that prevent veterans from getting access to medical services beyond their designated number of healthcare facilities. This proposal is progressive because similar negotiations stalled in late 2017. Despite the onset of these negotiations, there are still many pending issues affecting how healthcare services are delivered to veterans.
Stemming from the White House initiative to jumpstart negotiations about veteran affairs, an article by Wentling shows that senators and other legislators are taking the cue from the White House and are now considering restarting negotiations on other issues relating to veteran affairs, such as choice reforms. Negotiations about the Veterans Choice Program have been ongoing for more than a year and they were supposed to end in 2017, but this did not happen because the legislators did not reach a consensus on various contentious issues (Wentling). The reforms associated with the Choice Program were premised on the recommendations of the 2014 veteran scandal, which highlighted the need to expand the scope of VA health services (Wentling). Although the initiative to provide timely healthcare services to veterans has been a top priority for lawmakers, many of them are still engaged in negotiations regarding several contentious issues, including how to fund the program and how to implement new accountability measures.
Attempts to overhaul the healthcare system to create more options for healthcare access have also been highlighted by the Minister for Veterans’ Affairs in an article that explores possible options for improving veteran healthcare services. The document shows that the US government would be adopting a simplified approach of contracting private health facilities to provide medical services to veterans. So far, the government spends up to $850 million annually on such programs (Minister for Veterans’ Affairs). The quest to contract private health facilities is motivated by three main goals. The first one is to provide the best possible care to veterans, while the second one is to make sure the public gets value for their money. The last goal is reducing the administrative burden on existing health facilities (Minister for Veterans’ Affairs). However, such contracts are governed by strict admission regulations that center on ensuring proper licensing and accreditation procedures are followed. The only common issue earmarked for more negotiation is the fees that will be paid to the contracted facilities.
The negotiations between the government and veteran organizations to improve access to healthcare services for veterans have yielded significant gains. For example, Every CRS Report highlights some of them through an article titled “The Veterans Choice Program (VCP): Program Implementation” which stipulates the rights of veterans under the new Choice Program, which is supported by the provisions of Section 101 of the Veterans Access, Choice, and Accountability Act of 2014 (Every CRS Report). The negotiations that led to these gains meant that several existing statutes, which limited healthcare options for veterans, were suspended. Nonetheless, the additional healthcare options provided under the Veterans Choice Program (VCP) should not be misunderstood to mean they are independent insurance plans; instead, they are additional options for health insurance (Every CRS Report). Additional negotiations are required to make it more accessible to all veterans.
The dominant role played by the government in veteran negotiations has also been highlighted by the actions of the US government through the United States Department of Justice. It has tried to protect the gains made in increasing healthcare access to veterans by regulating market forces that would give dominance to a few healthcare firms, which are at liberty to charge whatever types of fees they want for accessing healthcare services because of the monopolistic power they have in the market. For example, recently, Blue Cross Blue Shield of Michigan and Physicians Health Plan stopped their merger plans after the United States Department of Justice threatened to file an antitrust lawsuit against them. Their planned merger would have given them immense power in the provision of healthcare services in the Michigan area because the two entities would have controlled more than 90% of the market (The United States Department of Justice). The decision to abandon the merger was hailed by some stakeholders because they said it would safeguard the competitive environment of the healthcare sector, which supports the provision of quality healthcare services (The United States Department of Justice).
Nonetheless, there have been negotiations between some government entities and private sector players, which have resulted in beneficial agreements that have been exempted from the kind of opposition highlighted above. For example, an article by Yen shows that veteran organizations have recently been exploring the idea of merging healthcare systems with the Pentagon. Nonetheless, some veteran associations have claimed that such a proposal could undermine the role played by VA hospitals and clinics (Yen). However, opposing views are there because some people have pointed out that such a merger would be a game-changer. After all, it would significantly reduce the cost of accessing veteran healthcare services (Pentagon’s cost-saving measures could help to subsidize some of the healthcare costs associated with VA healthcare) (Yen).
Some of the opposing views are not directly associated with the merits and demerits of the merger; instead, they are associated with the process of consultations that generated the proposal in the first place. For example, some Democrats have voiced their concerns that the negotiations, which led to the proposal, did not involve consultations by Congress (Yen). Similarly, some veterans groups are worried that the negotiations could yield detrimental outcomes to their members because they are not involved. Nonetheless, discussions are still ongoing amid stiff opposition from some members of Congress and veteran associations who are worried that the Trump administration is engaged in these “secretive” talks without their input (Yen).
Multifaceted Nature of Negotiations
Public-private partnerships within the health sector are commonly pursued when there are significant limitations in the ability of the existing healthcare system to provide adequate care (Patel and Rushefsky 189-200). This collaboration has not only been witnessed in the provision of healthcare services but also in the promotion of innovative processes to support the same service. For example, there is evidence in an article by Lovett, which shows that attempts have been made by veteran healthcare organizations to work with private developers to build innovative apps that would specifically cater to the needs of veterans. The goal has been the quest by healthcare service professionals to involve the private sector in improving its healthcare systems using advancements in technology. Most of the technology sought after is based on existing data and is centered on promoting veteran affairs (Lovett). Some prototypes that already exist in the market are also future-proof and standard-based (Lovett).
The collaboration between public and private sectors has also been a driving force in the provision of digital health services, which have been largely exploited by professionals who are willing to work for the government for a short period (Lovett). Most of the innovation sought this way is not expected to fundamentally change how healthcare services are provided to veterans, instead, they are meant to solve common problems affecting the same issue by finding innovative solutions.
For example, an article by Health Affairs shows the billing procedures undertaken by healthcare facilities to treat veterans have been updated using the same process. One of the gains made from this process is the provision that all codes used in healthcare service provision should reflect the level of care provided to the patients (Health Affairs). The second benefit is the presence of valid use of modifiers to make sure the veterans get the best services commensurate with the amount of money they pay for. There is also a provision within the billing guidelines that require VA health facilities to align medical coding with Medicare billing guidelines (Veterans Health Administration). The goal of adhering to these provisions is to promote the correct and accurate filing of medical claims that require simple approval procedures because there is a commitment by the authorities to fast-track them.
Collaborations between veteran healthcare organizations and outside parties have not only been limited to private entities because they also include professional organizations that can improve the modalities used by the same veteran healthcare agencies to undertake their duties. For example, in an article authored by the Institute for Clinical and Economic Review, there is evidence showing that professional healthcare organizations have been working with veteran unions to expand access to high-value drugs. Part of the terms of negotiations that led to the two sets of organizations working together is the stipulation that their staff will collaborate to integrate professional principles in the preparation of veteran healthcare reports (Institute for Clinical and Economic Review). Their negotiations also include a framework for allowing the Institute for Clinical and Economic review to work with veteran staff to promote the use of value-based pricing benchmarks. The goal of this initiative is to help veteran organizations to improve their negotiation skills with pharmaceutical companies. This approach has been associated with the improvement of healthcare access and the proper use of VA resources (Institute for Clinical and Economic Review).
Concerns about how negotiations are done have been highlighted by other observers such as Davis who says that the language used to formulate mergers and agreements needs to be reviewed before such negotiations are finalized. He made this observation about the interoperability concerns that characterized a deal between the Veteran Association Cerner and EHR. The deal was briefly paused because of several interoperability issues. A third party (known as MITRE) was contracted to evaluate the interoperability language used in the deal (Davis). A final report was expected to be presented at the end of January 2018 after a comprehensive review of the issues highlighted.
Relevance of BMT
The insights highlighted in this report show the dominant role played by one party (government) in veteran negotiations. This characteristic of the negotiation process highlights the principles of the BMT, which are partly supported by the structural analysis method, which considers negotiation as a power play between two or more parties (HSRC). However, its main difference with other types of theories used to evaluate negotiation processes is its conception of power. It does not only consider power in its most basic form (such as military or economic power); instead, it perceives it within a broader lens of resources and the processes that lead to their use (HSRC).
In most negotiations, there is always a power balance between two types of players: a weak and strong player or two equally powerful players. According to HSRC, the elements from which the two sets of negotiators draw their bargaining power constitute the structure of the BMT. The elements from which it draws power may be understood in the context of soft power (such as precedent or social stature) or hard power (such as weapons). These sources of power are often understood to mean the negotiating tools that those who wield them will use in the negotiation process, but it does not mean that by having them, they would always “win” in negotiations.
Based on the evidence highlighted in the articles sampled in this review, the government appears to be wielding the most power in ongoing negotiations between veterans and healthcare organizations. This unbalanced power structure could be partly attributed to the fact that the government formulates laws and controls financial resources that influence the healthcare services received by the veterans. Although veteran organizations have powerful unions to counter the government’s dominance, they do not match their influence in the negotiation process. This finding espouses the principles of the bilateral monopolistic theory because there are two sources of power in the negotiations: veteran organizations and the government. Based on the nature of current negotiations between both parties, the government has the most power in the negotiation process.
The game theory is unable to espouse the complexity of these issues because it fails to recognize that members of veteran organizations are also benefitting from current negotiations between the veteran groups, the government, and private sector players. Discussions between the two groups show that the members are poised to benefit from improved innovation and service delivery when the private organizations complete their negotiations with the unions. Based on the insights highlighted in this study, game theory oversimplifies the negotiations between veteran groups and the government. More importantly, it simplifies the number of stakeholders involved in the negotiations and the kind of benefits (or outcomes) that could suffice from the same process.
Nonetheless, negotiations regarding the improvement of veteran healthcare systems should be supported more because they would help to provide an effective healthcare framework that could be a model for other national healthcare systems in the country to follow. For example, an article by the Veterans Health Administration reveals that the current negotiations could yield a good model for improving the current Medicaid and Medicare healthcare systems. Furthermore, the same article shows that the process could provide a good model for planning for negotiations in the healthcare sector (Veterans Health Administration). For example, VA health facilities are often permitted to buy drugs at a discount and negotiate for better rates than conventional drug purchasing agreements (Veterans Health Administration). If this model is adopted on a broader scale, it could offer valuable lessons to managers of other national health programs that are also involved in negotiations on drug purchases and similar ventures.
A 2016 state ballot initiative in California also supports this idea because it shows that the adoption of the veteran healthcare plan could lead to significant cost reductions in the state’s $3.8 billion annual budget for drugs (Veterans Health Administration). Therefore, the lessons that could be drawn from the current negotiations are pivotal in understanding how healthcare agencies could reform their systems to provide better healthcare to citizens. The use of the BMT framework also helps in understanding the multifaceted nature of these negotiations by explaining how different stakeholders could agree on pursuing a common goal through making concessions, and compromises that would benefit all parties.
Conclusion
Negotiation is an important process in the social, economic, and political development of any country. In this study, it has been used to refer to the ability of two or more parties to agree on a specific outcome and the ability of every party in the negotiation process to work towards the achievement of the same outcome. The common assumption is that all parties involved in a negotiation process will have varying points of view. Therefore, the potential for disagreements or possible obstacles hindering the negotiation process is inevitable. This is the situation characterizing discussions about veteran negotiations in the US.
The theoretical review undertaken in this analysis demonstrates the difficulty of applying the game theory to veteran negotiations because of the non-zero-sum nature of the deliberations involved. The game theory proposes a rationality type solution to the current negotiations, with calculations for the optimum strategy being at the center of the development of a payoff matrix that would determine the outcomes of the process. However, this theoretical framework is inappropriate for the current review because the ongoing negotiations are aimed at changing the perceptions of the stakeholders about how they see the values comprising the payoff matrix. Therefore, the BMT theory emerges as the best model for understanding veteran negotiations because it is more pragmatic and attuned to the possible outcomes that could emerge from the process. Based on the insights highlighted in this study, it is vital to point out that not all negotiations are free from coercion and influence. At the same time, there is no illusion that all negotiation processes are done in good faith and that there will always be a win-win situation for all parties involved. However, current veteran negotiations represent a situation where parties are working towards the realization of mutual gain.
U.S. Department of Veterans Affairs. “Labour Unions.”Veteran Association, Web.
Veterans Health Administration. “Department of Veterans Affairs Billing Guidelines for Healthcare Provided to Veterans and Beneficiaries.” Veteran Administration, Web.
The United States Department of Veteran’s Affairs (VA) was created in 1930 to ensure the welfare of war veterans by providing coordination and cooperation at the Governmental level with programs such as disability compensation, education, home loans, life insurance, finding a job, medical benefits, pension as also benefits for a decent burial. The aim of the department was to ensure that all veterans and their families would be looked after by the state for the supreme sacrifices that they had made in the line of duty to the nation.
The department’s mission statement borrowed from Abraham Lincoln’s second inaugural address “for he who has borne the battle, and for his widow and his orphan” (Scurfield 88) encapsulates the recognition a state gives and owes to its men in arms. However, there is a mismatch (real or perceived) between the lofty ideals and the actual performance of the VA, a charge which is the main focus of this essay.
To examine the performance of the VA since its inception it is necessary to first examine its structure and administration. The VA is a government run health-care system that has a budget of $ 87.6 Billion and employs about 280, 000 people in scores of VA facilities spread over US territories. The department is headed by a Secretary and is usually a retired service officer chosen by the President. The Department has three main branches; Veterans Health Administration, Veterans Benefits Administration and National Cemetery Administration. Since the entire concept looks at ‘invalidation to grave’ time span, the department has to prioritize its activities to maintain its costs within the allotted annual budget.
Prioritization is carried out by classifying the veterans into eight groups and several additional groups based on a complex matrix of factors such as service related disabilities, the individual’s income and assets. The classification of a disability is carried out by a VA rating board by the numerous VA regional offices. Those who are rated with 50% or more disability get a comprehensive medical care free of cost; others with lesser disabilities have to make pre-determined contributions to receive the medication and care at subsidized rates.
In recent times, veterans have expressed growing dissatisfaction with the performance of the VA department’s ability to look after their genuine needs. One of the main reasons has been that the number of casualties have increased dramatically since the US ‘War on Terror’ unfolded in 2001 and shows no signs of being closed down. The number of veterans with 50% or more disabilities is steadily increasing as militants and terrorists in the two main war fronts; Iraq and Afghanistan use Improvised Explosive Devices (IEDs) and suicide bombers to deadly effects.
Most of these weapons cause US armed personnel to lose limbs or other grievous injuries that qualify for 50% or more disability and this fact is straining the limited VA budget. The sheer number of veterans claiming disability has resulted in a back log which some estimate to be about 340, 000 personnel. In 2006, 7.5 million veterans were listed on the rolls of the VA department (Lee¶ 2). In the US, out of 24.4 million veterans, 16.9 million are not enrolled in the VA health care system (Lee ¶4).
The tragic part of this waiting period is that those personnel who are no longer considered to be on active duty have no medical care cover provided for active duty personnel and till such time they get their VA disability benefits, the veterans have to look after themselves. Such a time lag is ruinous for the veterans, because they then suffer not only physically and mentally but also financially.
The Veteran’s Affairs Department’s own investigation reveals that “a study of group of 52 patients that received VA treatment had gaps in follow-up care and family counseling 16 months after the injury” (Veterans Today ¶3). The Government Accountability Office had found that it takes an average of six months for veterans to get their disability payments (Allen ¶2). One of the main reasons for the delay has been the inadequate numbers of professionals that are employed by the VA department to carry out diagnostics. Post Traumatic Stress Disorder (PTSD) is very hard to diagnose and inadequate health professionals add to the problem.
As far back as 2001, the US Government’s General Accountability Office had noted that “there is a potential shortage of skilled nurses” (GAO 2001 7).It is a fact that some 38 percent of veterans have been identified with some mental health condition (Stiglitz and Bimes 82) and the lack of adequate staff extends the time which veterans suffering PTSD have to wait. Similar is the case with brain injuries. The actual extent of brain injuries again requires specialists, the numbers of which are limited by the budget limitations of the VA department.
The other major weaknesses in the VA department’s structure has been the weakness of its quality and reliability of its workload and cost data. Without reliable data the VA department remains handicapped in its ability to carry out comprehensive long range forecasting. Of the approximately 4,700 buildings and 18,000 acres of land holdings, many regional offices amongst the 57 regional offices are still using legacy IT systems. Some still rely on fax machines and paper records. Since a comprehensive computerized data base of all the veterans is not available at the VA headquarters, identity processing takes a long time which then impinges on the overall planning parameters and leads to further delay.
Delays in getting help from the VA department drastically affects the psychological stability of an already vulnerable veteran who then may soon end up as an alcoholic, taking drugs or resort to violent anti-social behavior.
Crowell reports that one such veteran on not getting a prosthetic leg for months, got drunk and drove his vehicle into a building (Crowell 5). Veterans reveal stories that in an effort to keep the expenses down, the VA regional offices often try and discourage veterans from opting for college education as that would be too expensive for the VA to afford. This sort of negative counseling only increases the frustrations of the veterans who then feel ‘cheated’ and ‘used’ by a country which does not care. Whether such stories are true or figment of imagination of disturbed minds is a contentious issue. The very fact that they surface in the media, points to the fact that all is not well at the VA department.
To cut costs, the VA department has teamed up with the Department of Defense to pool resources. Local VA medical centers and military medical centers have entered into agreement to exchange inpatients, outpatients, and specialty and support services. However, such sharing has been patchy and that overall, 75% of direct medical care episodes provided under the sharing program occurred under just 12 agreements for inpatient care and 19 agreements for outpatients care, which by any standards is just a drop in the ocean.
Another major problem has been the spatial distribution of VA health care facilities. The 2003 GAO report observes that of more than 25 % of the veterans enrolled, about 1.7 million stay more than 60 minutes driving distance from the nearest health care facility (GAO 2003 6).
This means that veterans who require critical health care at critical times may find it difficult to reach the facility in time. The standard is only for those staying in urban areas. For those staying in rural areas, the time lapse is in excess of 90 minutes and those veterans staying in remote parts of America, in excess of 120 minutes. These time delays in reaching critical health care facilities and the uneven spatial distribution of healthcare infrastructure is yet another failing of the VA department which is yet to be rectified.
Not only are the facilities unevenly distributed, they are being kept alive on shoe string budgets as the disgrace of Walter Reed Hospital shows. The Washington Post story vividly describes the state of the hospital rooms with torn walls and black mold, mouse droppings, dead cockroaches, holes and smell of grease (Priest and Hull ¶1) signifying a larger decay of the system – of accountability at the highest levels.
Yet another problem is the demographic profile of the veterans. More and more veterans are living to a ripe old age. This puts a strain on the health care system for the aged especially when the budget limits the options. The requirement of nursing home facilities is sure to increase as the GAO report states that veterans 85 years or older will increase to one million by 2012 (GAO 2003 11). Thus a long term strategy and requisition for matching budget is required from the VA department leadership.
These problems are only going to be exacerbated. The ongoing ‘War on Terror’ shows no signs of abatement. By reducing force levels in Iraq and increasing those in Afghanistan will not stop the flow of casualties that happen on account of militant attacks. Realizing the gravity of the situation and estimation of possible increase of war veterans, the “Department’s resource request for 2010 is nearly $113 billion–up $15.1 billion, or 15 percent, from the 2009 enacted budget” (VA ¶1).
This estimation is however; far lower than what some scholars and experts have appreciated could be the likely cost to America. Joseph Stiglitz has calculated that the two wars will cost the United States more than Three Trillion dollars in which $717 Billion will be the total long term cost to the US government to provide $285 billion medical costs, $388 billion in disability benefits and $44 billion in social security compensation (Stiglitz and Bimes 87). This humungous medical bill seems too pessimistic for the authorities to even contemplate. However, a study cannot be wished away without basing it on hard facts, which as of now is not forthcoming from Washington.
In conclusion, it can be reiterated that though the Department of Veteran Affairs was set up with all the good intentions, the infrastructure and long term planning has not kept pace with the sheer numbers of veterans entering the system. The fact that the number of facilities are scarce and the policies implemented faulty, only serves to increase the frustrations of the proud men who fought for their country but were let down by a system unable or incapable of looking after them. The problems of the veterans point not just to the VA department but to the problems of the overall direction of American foreign policy and whether America requires sending it’s finest the harms way and at what cost and for what just causes.
Veterans are “individuals who served in the country’s naval, military, or air service, and were released under honorable conditions” (Wormer & Link, 2015, p. 19). The number of elderly veterans in the nation has continued to increase. For instance, in 2015, the largest number of male veterans (28%) were represented by people aged 55-46 (). For women, 45-to-54-year-old veterans were the majority, whereas the 55-to-64-year-old group came an as close second (21.2%) (U.S. Department of Veteran Affairs, 2015b). In 2012, the U.S. Census indicated that the United States had over 12.4 million veterans aged 65 years and above (Torres-Gil, 2014). Most of these veterans were involved in different conflicts around the world such as the Vietnam War, the Korean War, and World War II (Stone, 2012). In 1862, a basic system of pension was established for veterans who were injured during service; however, the proposition was improved when in 1890 the Dependent and Disability Pension Act (DDA) was enacted. DDA consisted of financial programs for war participants and provided pensions to all disabled veterans, including non-wounded or injured veterans. The fact that DDA granted a pension to all disabled veterans regardless of the injured was related to service was a significant breakthrough and an important improvement.
The Veterans Affairs (VA) pension policy is relevant because it ensures that these veterans are eligible for numerous benefits. In 1930, President Hoover signed an executive order for the creation of the Department of Veteran Affairs. The Department of Veterans Affairs (VA) was established to provide adequate services and benefits to meet the changing needs of many elderly veterans. The Veterans Affairs (VA) pension policy is the most important source of income for some veterans and is a comprehensive program that addresses, not only economic needs but numerous social and health benefits. The policy is implemented as a pension program to support more veterans in the country. Some of the benefits covered by the pension policy program include training, home loans, disability compensation, and burial. The support is also extended to members of the family and living spouses. Some of the most important pension benefits for Veterans are:
Final Pay Plan: this plan is for soldiers who entered military service before September 8, 1980. The retirement pay is computed using 50 percent of basic pay after 20 years of services plus an additional 2.5 percent for each year (U.S. Department of Defense, n.d.).
High-36 Plan: Plan 36 is for soldiers who joined the military service between September 1980 and July 31, 1986. Retirement pay is computed using 50 percent of the average of the 36 months of basic pay after 20 years of service, plus an additional 2.5 percent for each year (U.S. Department of Defense, n.d.).
Career Status Bonus (CSB)/REDUX: This retirement plan is for soldiers who joined the military after August 1, 1986, have a choice of two retirements, the High 36 plan or retire under the provision of the Military Retirement Reform Act (U.S. Department of Defense, n.d.).
Despite these initiatives and promises of the pension policy, experts have shown conclusively that many elderly veterans face various predicaments such as lack of proper transportation, unfair judicial processes, inadequate social services, and poor living standards (Wormer & Link, 2015). Some senior veterans are unaware of the requirements needed to qualify for the VA program due to a poor system of management used by the state organizations (Boyer, 2016).
Social Issues Addressed by the Policy
A number of social issues affecting the targeted population such as lack of finances have been the focus of the pension policy. The VA pension program provides various benefits to deal with various problems such as poverty and unstable income, homelessness, and disability among others (Torres-Gil, 2014). The policy has led to the creation of new programs that offer different benefits to elderly veterans. For instance, the aid and attendance program offers monthly pensions to individuals who meet specific conditions or requirements (“The history of aid and attendance assistance,” 2017). Furthermore, the aid and attendance and housebound benefits (i.e., the benefits that are paid in addition to basic pension rate) are provided. This program offers monthly pensions to individuals who meet specific conditions or requirements (“The history of aid and attendance assistance,” 2017), i.e., are unable to care for themselves.
Poverty
Some of the elderly veterans receive insurance cover, home loans, and educational resources. In other words, the program provides the means of addressing poverty among veterans. Financial assistance and saving options are typically viewed as the primary tool for reducing poverty levels among veterans.
Homelessness
Homelessness is another challenge that makes it impossible for several elderly veterans to lead quality lifestyles (Wormer & Link, 2015). Perl et al. (2015) indicate that around 10 percent of homeless citizens in the United States are senior veterans. Most of these veterans are mentally challenged, disabled, or substance abusers (Perl et al., 2015). The current policy lacks adequate channels or measures to address these issues affecting the population. Veterans must be provided with an opportunity to live in a retirement facility. Furthermore, money-saving options should also be offered.
Healthcare
The VA pension policy is implemented to support different elderly veterans with diverse social needs. For instance, the program ensures that long-term care is available to more individuals who are in need of daily support from a caregiver. These benefits are also available to the family members of surviving veterans. The policy has therefore been designed in such a way that it addresses most of the social issues and challenges affecting elderly veterans. Additionally, senior veterans can apply for financial help especially when in need of home care (Cozza, Lerner, & Haskins, 2014). The identified framework is designed for veterans living in different regions (Torres-Gil, 2014). Disabled persons can also benefit from the aid and attendance program.
However, elderly veterans must fulfill specific requirements before benefiting from the program. The use of these requirements has been identified as one of the deterrents that make it impossible for a significant number of elderly veterans to receive high-quality social support (Cozza et al., 2014). Due to the ineffectiveness of the policy, a number of agencies such as the Substance Abuse and Mental Health Services Administration (SAMHSA) have emerged in order to identify and address most of the issues ignored by this policy.
Detailed Analysis of the Policy
Analysis of the Policy
Lengthy or Complicated Application Process
The establishment of the United States Department of Veterans Affairs (VA) was an ingenious move that was aimed at supporting the emerging social and economic needs of many service members (Torres-Gil, 2014). Since the number of aging veterans has continued to increase significantly, more veterans are being required to enroll for the VA benefits and assistance services (Wormer & Link, 2015). The VA pension scheme provides tax-free benefits to wartime veterans earning low incomes (Torres-Gil, 2014). The scheme provides financial support and benefits to veterans who require supplemental income, disability insurance, and healthcare needs. Disabled veterans also qualify for the VA program (Wormer & Link, 2015). The next step consists of initiating the process by filing the right documents. The process has been associated with complex legal processes especially when the applications are rejected by the VA department.
The VA program has gone further to outline a complex process that must be followed by veterans who want to receive such benefits. For an elderly veteran to be eligible for different compensations or benefits, he or she “must have been disabled as a result of illness or disease while in service” (Cozza et al., 2014, p. 5). Furthermore, veterans “must have three months of active service and at least a day during a wartime period” (Torres-Gil, 2014, p. 89). The program also requires targeted veterans to be aged 65 years or more. Eligible veterans should be disabled or receiving social security and disability insurance.
That being the case, the VA pension policy has promised to support the changing needs of many elderly veterans. For instance, the program focuses on various issues such as social problems, transportation, and disability. Unfortunately, the policy has been failing to meet the needs of many veterans in rural regions. Cozza et al. (2014) indicate that majority of rural elderly veterans are forced to deal with chronic diseases, lack of transportation, and depression. This fact explains why rural veterans have been identified as a vulnerable American population whose needs should be taken seriously.
The disparity of Services in Rural Areas
A critical analysis goes further to indicate that more elderly veterans are experiencing a wide range of challenges in their respective communities. For instance, the number of veterans affected by posttraumatic stress disorder (PTSD) has increased significantly (Gale & Heady, 2013). The change has led to an increase in the number of cases of trauma and depression. The number of elderly veterans struggling with personal problems such as substance abuse or mental health is also on the rise (Torres-Gil, 2014). The observed phenomenon means that more are under the threat of committing suicide. Unfortunately, the policy has ignored the issues and facts surrounding the wellbeing of elderly veterans. The identified problem is especially topical for the people living in rural areas due to the infrastructure problems and the ensuing unavailability of the relevant services (Sternberg et al., 2016).
Referral or Education Regarding VA Benefits upon Separation from the Military
The above problem arises from the procedures needed to apply for a number of welfare services and financial assistance. Although the stipulated requirements are necessary, they end up preventing more elderly veterans from benefiting from the policy (“The history of aid and attendance assistance,” 2017). This fact explains why more people have decided to ignore the benefits and handle the hardships of a veteran’s life independently. Additionally, there is a disparity when it comes to the nature and quality of social services available to rural and urban elderly veterans. Other challenges facing this vulnerable population include lack of transformation, and inadequate human services (Torres-Gil, 2014).
Recommendations for the Policy Reform and Justifications
The issues and gaps associated with VA pensions explain why new measures should be implemented to support the needs of many veterans. While the number of such veterans is on the rise, most of the programs initiated and supported by the Elderly Veterans Policy have failed to fulfill the promises outlined by the U.S. Department of Veterans Affairs (Cozza et al., 2014). In order to meet the social and economic needs of these elderly veterans, it will be appropriate to begin by revising the eligibility requirements for the targeted clients, i.e., participation in the Mexican Border Period, WWI, WWII, the Korean conflict, Vietnam War, and Gulf War (U.S. Department of Veteran Affairs, 2015a). This kind of reform will make it easier for more elderly veterans and their family members to receive the benefits outlined by the policy since misunderstandings and misconceptions occurring due to the vagueness of the current standards will be avoided (Torres-Gil, 2014). On top of that, the judicial process associated with the application for different benefits should be streamlined. By so doing, more elderly citizens in the United States will address most of the social issues and economic challenges affecting them.
The second recommendation that should be embraced to promote policy reform is to provide assistance and adequate benefits without any form of discrimination. It is agreeable that most of the elderly veterans rendered superior services to the nation. This knowledge should be used by pioneers of the policy to widen the nature and quality of services available to the greatest number of elderly veterans (Perl et al., 2015). By simplifying the application process and reducing most of the requirements, more veterans will find it easier to apply for the benefits and eventually realize their unique needs.
The third recommendation is to address the issues undermining the effectiveness of the VA pension policy. Certain hurdles such as substance abuse, post-traumatic stress disorder, and homelessness make it hard for the affected veterans to lead quality lives. These problems expose them to more challenges that can make it impossible for them to meet their financial needs (“The history of aid and attendance assistance,” 2017). It is also undeniable that these challenges go further to affect the wellbeing of the family members relying on these elderly veterans for upkeep (Perl et al., 2015). Mental health is another problem area that affects the welfare of many elderly veterans in the United States. The majority of the affected veterans eventually become homeless. The policy should, therefore, be changed in order to meet these social needs.
The fourth recommendation is to reduce the existing gaps that make it hard for more beneficiaries to realize their potential. The VA caseworker is usually empowered to make specific decisions whenever targeting specific veterans who can benefit from the aid and assistance program (Perl et al., 2015). These measures have been observed to affect the effectiveness of the program. The policy should be characterized by powerful strategies in order to ensure more veterans lead quality lives.
The fifth recommendation is to restructure the policy in such a way that it addresses the needs of every homeless elderly veteran. This means that veterans should be provided with houses and mental care services (Torres-Gil, 2014). This move will ensure that more elderly veterans should lead better lives. This kind of expansion will ensure the policy meets the unique needs of the targeted beneficiaries. Policymakers should focus on these issues in an attempt to promote the welfare of a population that has been ignored for very many years.
Economic, Political, and Social Implications Associated with the Issues
The VA pension policy has attracted a wide range of political, economic, and social issues. To begin with, the politics of the country have changed in such a way that the needs of women and children are taken seriously than ever before. Additionally, most of the successful laws and regulations have been focusing on the emerging needs of the middle class in the country (Perl et al., 2015). Consequently, the needs of the underprivileged such as the elderly have been ignored. Trump’s presidency appears to present numerous concerns that can disorient the future of the policy. The politics and policies implemented within the next few years will definitely impact the issues surrounding the VA program.
The United States is known to have one of the biggest budgets in the world. This means that the government has been funding a wide range of national functions and welfare programs. In 2015, the proposed budget for the Veteran Affairs (VA) program was around $158 billion (Wormer & Link, 2015). The program was also observed to target more veterans in the country. The country’s resources have therefore been overwhelmed than ever before. Statistics also indicate clearly that over 11 million U.S. veterans are still underserved (Wormer & Link, 2015). The current economic uncertainty in the country might have diverse impacts on the future of the VA policy.
The policy has also been associated with various social implications. For instance, the social developments experienced in the country can have detrimental implications on the future of many veterans. Some economic issues have been observed to impact this policy. This is the case because the policy has also been dictating the way financial resources are allocated in the country. The number of aging baby-boomers in need of pension support is on the rise (Torres-Gil, 2014). Many veterans struggle with their lives and find it hard to realize their economic goals. Family members and spouses of elderly veterans who die find it hard to lead quality lives. These gaps have continued to affect the welfare and wellbeing of many elderly veterans in the United States (Cozza et al., 2014).
Analysis of the Feasibility of the Issues Reaching the National Agenda
Kingdon Theory of Agenda Setting
To begin with, the Kingdon Theory of Agenda setting can be used to explain why the proposed issues in elderly veteran welfare policy have the potential to reach the national agenda. The first phase of the model is the problem stream or recognition. There are various indicators and gaps that show conclusively that the current problem affecting the elderly might get out of hand (Perl et al., 2015). The current indicators include the rate of mortality, worsening living standards, and the inability to access welfare resources. The number of homeless veterans has increased substantially within the past two decades (Baumgartner, 2016). A study focusing on the challenges facing many elderly veterans will definitely deliver useful information to support the identified policy agenda.
The theory goes further to outline a number of factors that can be used to explain why specific problems tend to fade. For instance, negative feedback might be received from the targeted veterans or beneficiaries. The gathered information might fail to support new ideas that have the potential to inform the policy agenda. This kind of scenario will definitely affect the adequacy of the proposed policy agenda (Howlett, McConnell, & Perl, 2014). However, the unique issues facing many veterans explain why the proposed agenda might not be ignored at this stage.
With the existing aspects of the policy, the proposed recommendations can be embraced in order to transform the situation. The involvement of different stakeholders, policymakers, politicians, and activists will ensure the agenda is promoted. Consensus building and agenda-setting should be embraced in order to encourage more politicians and stakeholders to support the proposal (Baumgartner, 2016). Finally, some aspects should be considered in order to ensure the proposed policy change is implemented successfully. For instance, brokerage and advocacy should be used adequately throughout the process. The right people should be identified to support the agenda. A new principal will be identified in order to implement the most viable changes that can transform the experiences of many elderly veterans in the country.
Values and Ideologies Capable of impacting the Issues
The success of the above issues depends on a number of aspects and issues. For instance, the recent past has been characterized by various sets of dual value systems inherent in public and societal institutions policy. The first one is that of equity and adequacy. This value stipulates that a minimum level of benefits will be available to beneficiaries based on need (Perl et al., 2015). The other focus is to have a fair return based on contribution through taxes. This value will definitely disorient the nature of the policy and affect the outcomes of many veterans.
The second value revolves around the public and private sectors (Torres-Gil, 2014). For instance, some trends have the capability to either support or derail every effort aimed at strengthening the VA pension policy. For instance, the economic recession is something that is expected to affect the role of different players in the public sector. In the recent past, social security has been privatized in the country (Perl et al., 2015).
The value of tradition and new innovative solutions is something that might dictate whether or not the issues raised by the pension policy reach the national agenda. This is the case because there is a conflict of interest between the future of social insurance and the reverse annuity mortgage program (RAM). The RAM has been implemented in such a way that “it provides a lump sum amount of money to elderly individuals who have long-term care needs for over a period of six years” (Stone, 2012, p. 58). While the RAM program is capable of supporting the needs of the elderly, the chances are high that the needs of more veterans in the country might be ignored.
With these issues are in place, it will be necessary for policymakers to identify specific recommendations to improve the living conditions of every veteran. With the provision of better living standards, proper medical cover, and support for disabled persons, the targeted individuals will be able to realize their objectives in life (Stone, 2012). Activists can consider the changes experienced in the country’s economy and propose adequate initiatives that can ensure the identified issues reach the national agenda. Consequently, the emerging needs of more veterans in the country will eventually be met.
References
Baumgartner, F. (2016). John Kingdon and the evolutionary approach to public policy agenda-setting. Web.
Cozza, S., Lerner, R., & Haskins, R. (2014). Military and veteran families and children: Policies and programs for health maintenance and positive development. Social Policy Report, 28(3), 1-30.
Gale, J. A., & Heady, H. R. (2013). Rural vets: Their barriers, problems, needs. Health Progress, 94(3), 49-52.
Howlett, M., McConnell, A., & Perl, A. (2014). Streams and stages: Reconciling Kingdom and policy process theory. European Journal of Political Research, 1(1), 1-16.
Perl, L., Bagalman, E., Fernandes-Alcantara, A., Heisler, E., McCallion, G., McCarthy, F.,…Sacco, L. (2015). Homelessness: Targeted federal programs and recent legislation. Congressional Research Service, 1(1), 1-29.
Sternberg, M., Wellnitz, A., Wright, B., Eicher-Miller, H., Topp, D., & Wadsworth, S. M.. (2016). Reaching rural veterans: engaging faith-based food pantries in serving low-income, homeless, and at-risk veterans in rural areas. Washington, DC: VA CFBNP.
Stone, A. (2012). Policy paradox and political reason. New York, NY: W.W. Norton.
The history of aid and attendance assistance. (2017). Web.
Torres-Gil, F. (2014). The new aging: Politics and change in America. Westport, CT: Praeger.
The yearly celebrations of the Memorial Day in the U.S are full of generous praises directed at military personnel who have died in service. The Memorial Day is one of the many events and platforms used by politicians, corporations and members of the public to express their eagerness to support the men and women who have served in the U.S Armed Forces. Lengthy speeches on the plans to assist veterans by giving them access to quality medical care, rehabilitation and compensation for their service to the country are obvious every time American soldiers, dead or alive, arrive home.
An analysis of the history of America’s treatment of war veterans, since the American Revolution, demonstrates a poor job in terms of caring for veterans. Although America spends huge sums of money in erecting monuments for the men and women who have died in service of the country, the country has done little to honor the military personnel who return home. The federal government continues to neglect the veterans in terms of providing comprehensive health insurance, medical treatment, housing aid and other essential supportive services for war veterans.
U.S war veterans constitute a significant percentage of Americans living in extremely deplorable conditions. A significant percentage of the about 23 million veterans who served in the Second World War, Vietnam, Korea, Gulf War, Iraq and Afghanistan lack meaningful employment, suffer maltreatment in various medical facilities and are victims of problems such as PSTD, depression, suicidal tendencies and homelessness.
For example, a 2010 report from the U.S Department of Housing and Urban Development illustrates that war veterans constitute a third of America’s homeless population despite the fact they account for less than 8 percent of America’s total population. In 2009, war veterans represented about 16 percent of American adults who were homeless on a single night. A significant percentage of homeless veterans counted in a single night in 2009 lived in emergency shelters, abandoned buildings, on the streets or other habitats unsuitable for humans (Schnurr 729).
A report from the National Alliance to End Homelessness illustrate that about 90,000 to 468,000 veterans face the risk of homelessness. The report attributes the susceptibility of veterans to homelessness to the fact that most live below the poverty level and spend more than half of their income on rent. The lack of robust and well-funded support systems is the main cause of the rising cases of homelessness amongst veterans in America. Reports from the Bureau of Labor Statistics demonstrates the high unemployment rate, about 8 percent as of 2012, for men and women who have served in the U.S military.
About 15 percent of the veterans cite service-related disabilities as the main hurdle to employment. The failure by the Congress to establish laws that safeguard the housing rights of the men and women who have made sacrifices for their country is an illustration of the disregard for U.S war veterans. The lack of efficient federal funding to ensure the affordability of housing amongst veterans has exposed war veterans to the high cost of housing in America. For example, veterans can only benefit from guarantees on home mortgage loans by federal government.
Institutions such as the Department of Veteran Affairs (VA), which should be in the frontline in protecting the welfare of war veterans, have come under criticism due to the misdiagnosis and maltreatment of veterans suffering from PSTD. The department has caused a significant number of veterans to lose on disability pay and medical benefits. For example, the dismissal of more than 23,000 veterans on grounds that they suffered personality disorders rather than PSTD aroused suspicion that the military was keen on saving money in disability payouts and lifetime medical care for veterans affected by PSTD (Glantz 105).
The lack of supportive policies to ensure that U.S veterans access health insurance and medical treatment in VA facilities has led to the failure by the U.S government in providing the excellent patient care and veteran benefits American politicians talk about in events such as the Memorial Day. A 2005 study on the state of health insurance coverage in the U.S military demonstrates that most military veterans lack comprehensive health insurance. The study used the 2004 Current Population report and the 2002 National Health Interview survey to examine the number of uninsured veterans. About 1.7 million veterans lacked health insurance.
Similarly, the study established that the number of uninsured nonelderly veterans increase by about 2 percent from 2000 to 2003 (Woolhandler et al. 315). The effects of the lack of comprehensive health insurance for veterans is evident by the fact that about 4 million members of veterans’ households lacked health insurance by 2003 and could not access medical care in VA facilities. The fact that about 682,000 Vietnam War veterans lacked health insurance despite the claim that Medicare covered all veterans from the Korean War and the Second World War illustrates the poor performance by the relevant authorities in terms of caring for war veterans.
A respected broadcasting corporation, CNN, reported that about 40 veterans had died in 2014 waiting to access medical care from Phoenix VA clinics. An investigation revealed secret waiting lists created to hide the long waits at the VA clinics. Veterans seeking treatment at the clinics had to wait for a minimum of 90 days to get a medical appointment rather than the recommended 15 days (Bronstein et al. par. 1). Further investigation into the VA scandal revealed that some psychiatric patients had not received comprehensive evaluation seven to eight years after admission. A significant number of war veterans, especially the uninsured, have expressed their frustrations regarding access to medical care, which predisposes them and their families to substandard lifestyles.
Conclusion
An analysis of the socioeconomic status of the U.S war veterans demonstrates the failure to recognize the invaluable sacrifice by the men and women who have served in the U.S military. It is a shame that the U.S can spend more than 1.2 trillion dollars in the Iraq and Afghanistan wars, but deny its military personnel access to essentials such as comprehensive medical care and proper housing.
The case of the Department of Homeland Security (DHS) hostility towards war veterans and the profiling of military personnel to identify veterans who are extremists or sources of domestic terrorist threats demonstrates America’s disregard for its war veterans. The adoption of programs to portray war veterans as potential threats to Americans rather than addressing the psychiatric problems afflicting the veterans is a clear demonstration of the fact that the U.S has refused to acknowledge the sacrifice by millions of military personnel in protecting the sovereignty of their country and freedoms of fellow citizens.
Works Cited
Bronstein, Scott, Curt Devine, and Jessica Jimenez. A Fatal Wait: Veterans Languish and Die on a VA Hospital’s Secret List. 2014. Web.
Glantz, Aaron. The War Comes Home: Washington’s Battle against America’s Veterans. Berkeley: U of California, 2009. Print.
Schnurr, Paula, Carole Lunney, Michelle Bovin, and Brian Marx. “Posttraumatic Stress Disorder and Quality of Life: Extension of Findings to Veterans of the Wars in Iraq and Afghanistan.” Clinical Psychology Review 29.8 (2009): 727-35. Print.
Woolhandler, Steffie, David Himmelstein, Ronald Distajo, Karen Lasser, Danny Mccormick, David Bor, and Sidney Wolfe. “America’s Neglected Veterans: 1.7 Million Who Served Have No Health Coverage.” International Journal of Health Services 35.2 (2005): 313-23. Print.
Veteran’s benefits administration is mandated to provide financial and other forms of assistance to veterans and their families. Veteran Affairs (VA) manages the benefits and services that ex-soldiers earn after service. Veterans should apply for the benefits that ensure they acquire financial, healthcare, and educational support from their families. After applying for these, a veteran service agent takes the veteran’s responsibility with their family. This assignment explores how the policy works, the qualifications required for a veteran to be considered for the benefits, government expenditure, and the system’s effectiveness in dealing with veteran needs.
Bass claims the GI bill is the most complex former military personnel assistance program with the most extensive scope in American history and proves this through a mixed analytical method of interpreting qualitative and numerical government data. The author utilizes the GI bill to provide supportive information on how the Department of Veteran Affairs has provided such benefits to veterans since the Second World War. The article indicates that the development of the GI bill streamlined the veteran benefits program. Through the policies, the veterans and some dependents can get financial benefits that cover tuition fees at any public institution or get a fixed amount for foreign or private schools with three-year housing allowances. The article is relevant to my study as it provides helpful information about the veterans’ educational benefits and what some of their dependents get from the department of veteran affairs after service.
The central thesis of Belanger et al. is that it is still difficult for veterans to integrate socially and academically into smaller higher educational institutions. They acknowledge veteran challenges like feelings of alienation, access to education, financial needs, enrollment, and learning difficulties. The authors use strength-based programs to show how the government can collaborate with learning institutions to develop courses that make it easy for veterans to reintegrate into higher education. The findings obtained from a five-year study and observation of student veteran reintegration as evidence to support their recommendations. The article is resourceful as it will enable me to develop and recommend strategies that can be used to enhance the effectiveness of educational benefits to veterans.
Bilmes states that federal spending on veteran assistance programs will multiply exponentially by 2050 in both figures and percentages, which is paradoxical as the number of former military staff decreases. It outlines the increasing expenses that the country incurs and is expected to incur until 2050. The author provides an overview of the costs already incurred to care for the needs of the veterans as disability and medical care benefits to show how the government is committed to catering to the support of its ex-soldiers who participated in the Iraq and Afghanistan wars. The author uses data obtained from government expenditures to provide evidence of the costs incurred to support such benefits. She projects the amount expected to be used to finance veterans’ benefits in disability, healthcare costs, and the amounts incurred to create awareness on how the veterans can access their eligibility to the program. Such information is essential to my study as it provides evidence of government expenditures and acts as a reference for projections on plans for veteran benefits.
The main argument of the research report by Bond Hill et al. is that ex-military personnel have significant problems getting into higher education facilities with a high graduation rate, even with benefits. To support this claim, Bond Hill and her colleagues provide government numbers, debunk myths about veterans, and offer real-life-example-based measures to improve their enrollment. The report by Bond Hill et al. is included to present contemporary issues related to veteran benefits.
Burtin argues that the American welfare policy for veterans is globally unique due to its separated nature. Sociologists and historians little understand the reasons it has such a status. The author tries to fix the information gap by applying a broad institutional context, historical method, and comparative analysis. One of the critical inferences of Burtin (2020) is that such a character of veterans’ benefits originates from an ingrained social belief that veterans rightfully earn these. The historical analysis of the ex-military welfare measures in America makes this article relevant to my study topic.
The author’s thesis focuses on understanding the different challenges that experienced veterans who are homeless in American society. The information provided by the study was based on interviews with experienced homeless veterans who lived in permanent houses offered by the providers of homeless housing, which serve as evidence. The authors examined the effectiveness of homeless service providers in solving the challenges that experienced veterans experience when integrating back into society. The findings in the study provide helpful information for my research as they will guide the proposal of policy changes that will enhance the successful integration of veterans into society.
The central thesis of the analytical text of Marshall et al. is that Veterans Health Admiration has failed to provide equal health opportunities among male and female ex-soldiers. The authors undertook semi-structured interviews and observation of leadership in each facility to gather supporting evidence on the effectiveness of the health facilities. Data collected by the article’s creators revealed the barriers to care and was used to hypothesize about measures to remove major institutional obstacles. Through the study, I will gain relevant information on the obstacles that influence the provision of equal healthcare benefits among veterans of both genders and how such barriers have been overcome.
Maynard, C., & Nelson, K. (2019). Compensation for veterans with service connected disabilities: Current findings and future implications. Journal of Disability Policy Studies, 31(1):57-62.
Maynard and Nelson argue that since the compensation program and the health care are vital systemic entities, ex-militaries with service-caused conditions should be more aware of developments related to veterans’ benefits, as about a third of them do not use these. The creators of the article prove their thesis by analyzing policy documents and presenting federal statistics. The inclusion of this scholarly text is because it explains the primary public mechanisms for providing health benefits to veterans.
Shafritz, J., & Hyde, A. (2017). Classics of public administration (8th ed.). Cengage learning.
The book’s central idea is to introduce the learners to the principles of public administration of which veteran assistance initiatives and policies are part. The book utilizes different scholarly articles on the topic as evidence to support how public policy works. Through such writings, the learner can understand the policy development process and implementation, which is critical in studying the effectiveness of different public policies. The book will detail how public policies work and how they can be modified to serve a given group of individuals. I will utilize that information to study the veteran benefit policy and how the shortcoming of the policy can be effectively addressed.
Weeks’ central claim is that local services and opportunities provided by US health institutions to the ex-military must be compared in terms of quality and cost to be easily understood by veterans and accessible to improve public administration workers. The article utilizes national statistics on healthcare expenditure as a basis for comparison. It was identified that the Department of Veteran Affairs purchased higher quality end of life than Medicare. Such evidence shows how the government is keen on ensuring that the quality of healthcare provided to veterans is high compared to the Medicare policy, which provides care for the citizens. This source matters to my project, as I will use the information to show the difference between VA healthcare and Medicare.
Maynard, C., & Nelson, K. (2019). Compensation for veterans with service connected disabilities: Current findings and future implications. Journal of Disability Policy Studies, 31(1):57-62.
Shafritz, J., & Hyde, A. (2017). Classics of public administration (8th ed.). Cengage Learning.
Spiro, A. III, Settersten, R. A., Jr., & Aldwin, C. M. (Eds.). (2018). Long-term outcomes of military service: The health and well-being of aging veterans. American Psychological Association. Web.