Editor’s Note: DAV – which is a non-partisan organization – believes its members deserve to know where Democratic nominee Hillary Clinton and Republican nominee Donald Trump stand on key veterans issues in time for the general elections on November 8th. DAV asked both candidates to discuss specific policies they would propose regarding particular issues. Their responses are presented below as a way for our members to compare the candidates’ positions on issues affecting America’s veterans and their families. The cooperation of the candidates and their campaign staffs is much appreciated.

Overall Veterans Priorities

DAV: What are your top priorities for addressing the many challenges facing veterans, particularly those who are injured or ill from their service?

Clinton: I firmly believe that caring for our veterans is a sacred responsibility. That belief has helped guide my life in public service, and it will be a core tenet of my presidency. To serve our country, veterans undergo tremendous hardship and sacrifice—our job is to ensure they have access to the tools they need to succeed.

Upon returning home, no veteran should have to fight for a job or struggle to find adequate health care. That is why I have put forward a comprehensive plan to support veterans and their families. The systemic failure of the VA to fully uphold its core mission underscores the urgent need for fundamental reforms and more focused leadership. Long wait times for health care, crippling claims backlogs, and a lack of coordination among agencies represent government at its worst. These problems stem from years of neglect, antiquated systems and lack of strategic oversight. I will create a new framework for VHA health care delivery by refocusing, reorganizing and streamlining the VHA to best serve veterans in the 21st century.

I also will oppose the privatization of the VA health care system, which would throw the brave men and women who served us out into the health care marketplace. Choice should be a part of the solution, but the VA must maintain the ultimate responsibility of ensuring quality health care for every veteran, and delivering the specialized services they need and deserve. Studies have repeatedly shown that VA health care outperforms that of the civilian sector, and veterans are very satisfied with the care they receive once they are in the system.

For injured or ill veterans, my overriding goal will be to eliminate the needless barriers that prevent them from focusing on what matters most: getting better. This includes ensuring the VA has the capacity to effectively treat the visible and invisible wounds of war, including mental health, traumatic brain injury, and post-traumatic stress. We must also deliver the highest quality care in a timely manner, and with as little bureaucratic red tape as possible. I also will tackle the issues about which we must talk more: an unacceptably high veterans suicide rate, and a rising tide of military sexual trauma.

With the needs of the 21st century in mind, I will modernize veterans benefits — streamlining claims processes to deliver earned benefits more efficiently and effectively, ending claims and appeals backlogs, and continuing to improve the VA’s systems for timely payment of benefits to veterans. We will preserve and defend these benefits that veterans have earned, including the post-9/11 GI bill. I will expand education and job-training initiatives preparing our veterans for the next phase of their lives. And, leveraging the private sector, I will incentivize companies to recognize the unique skills of our veterans and offer them the jobs of tomorrow.

Trump: VA reform will be at the top of my priority list when I become President of the United States. Along with growing a strong economy, restoring national sovereignty and recapitalizing our armed forces, making sure our veterans get the care they deserve will be at the forefront of my agenda as we move to restore government to the people.

Keeping faith with the nation’s veterans is a sacred oath. Since President Lincoln first highlighted the virtue in his Second Inaugural Address our nation has made the treatment and care of veterans a priority. The Trump administration will ensure that our service members are taken care of from the time they raise their hands to take their oaths until they give that last full measure for their country. Much of the focus has been on healthcare for our veterans, but my administration will address the totality of veterans’ issues.

As for healthcare reform, access is critical and to that end, we will ensure that every veteran who seeks care will be able to access that care wherever and whenever they want it. Our veterans deserve a VA that works for them. The nearly daily scandals that have plagued the VA are a stain upon our nation. Accountability must be restored its leaders, its employees, and to those they serve. Thus the guiding principle of the Trump Veterans Plan is ensuing veterans have convenient and timely access to top-quality care. The veteran health system will remain a pubic system, because it’s a public trust. But never again will we allow any veteran to suffer or die waiting for care. That means veterans will have the right to go to a VA facility, or the right to see a private doctor or clinic of their choice – whatever is fastest for the veteran.  The veteran will be in control.

In response to the access crisis in 2014, Congress passed and the President signed legislation (P.L.113-146) that created a new, temporary choice program to provide veterans another way to utilize community care when VA was not accessible. An Independent Assessment of the VA health care system also mandated by that law confirmed that the quality of care was as good as or better than private sector care, but that access to care was a problem in many locations around the country. With the current choice program set to expire sometime next year, critical decisions about the future of the VA health care system, as well as the role of community care and choice, will have to be made.

 

Strengthen, Reform and Sustain the VA Health Care System

DAV: As President, how would you reform veterans health care in order to ensure that veterans have timely access to high-quality, veteran-focused health care?

Clinton: Veterans must have access to a system that puts their needs first. It is unacceptable that in the 21st century, our veterans still face long wait times and inconsistent care. As president, I will work to build a system that is fully prepared for their unique and growing needs. But I also know that we cannot simply throw money at these problems, as the VA’s implementation of the Veterans’ Choice Act has shown. We also cannot put our veterans at the mercy of the private insurance system without any care coordination, or leave them to fend for themselves with health care providers who have no expertise in the unique challenges facing veterans.

Under my plan, we will reform the Veterans Health Administration (VHA) to create a fully networked organization dedicated to best practices and continuous improvement. That means refocusing, reorganizing, and streamlining the care process. The VHA must be transformed from a provider of services into an integrated health care system that balances its role as health care provider, partner, and payer for veteran-directed care. And it must have the health care providers necessary to ensure it is able to provide quality and timely care.

I would refocus the VHA as a veteran-centric provider of service-connected care. This is especially important in areas where veterans lack access to needed treatment outside of the VHA, such as for prosthetics and traumatic brain injury. I also would synchronize and coordinate VHA care with other government programs, such as DoD and Medicare, to make sure veterans are supported by all systems, and these systems work well together.

So that we never lose sight of the big picture, I would establish a VHA Strategic Oversight and Governance Board composed of health care and management leaders. In line with the best practices of modern hospitals across the country, the board — which will include strong veteran representation — will oversee VHA management processes, monitor accountability, promulgate best practices, and ensure the VHA remains true to its mission of putting veterans first.

And we will hold the VHA accountable by focusing attention on outcomes for veterans, ensuring the VHA delivers timely, quality care in a manner that meets or exceeds the standards of the private sector. I will personally hold the VA Secretary accountable for these outcomes, and ensure the VA Secretary works with his/her counterparts at other agencies such as DoD and HHS to support veterans.

Trump: Every veteran, from the moment of taking their oath of office, should become part of the robust, comprehensive veterans healthcare system. When these individuals leave the service and need access to the VA system, they should be able to get care where and when they need it. This means veterans should be places in a system where with a single ID card, they can go to whatever facility or caregiver they wish. This will force the VA system to compete with the private sector and will relieve pressure on the VA system.

Veterans, particularly those with disability issues, will also be able to access therapy where it is available and from providers who can provide the appropriate care. Administrators who fight these reforms will be reassigned.

What is most critical is not that we get veterans off ghost lists or that we see a veteran in a specified time. We should be concentrating on outcomes for our veterans and not just on outputs of a scheduling system. The totality of care is what is critical for our veterans, and that is what we will focus on in the Trump-Pence administration.

Claims and Appeals Processing Reform

DAV: As President, how would you reform the claims and appeals process to ensure that all veterans get fair, timely and accurate decisions on benefit claims?

Clinton: Our veterans deserve fair, quality treatment, and we need to design a claims and appeals process that provides this treatment in an efficient and deliberate manner. My veterans plan recognizes that it is time for change, and it proposes concrete steps to get us there — ending the benefits and appeals backlog through overtime work, productivity improvements, and brand new initiatives.

The VA and DOD must work together to better anticipate claims and compile resources before backlogs spiral out of control. To streamline and simplify that process, we should integrate their medical evaluations, using “fully developed claims” from private providers, allowing rules-based automatic adjudication for the simplest of applications, and ensuring veterans have an effective appeals process that ensures the VA gets it right. I also will direct DoD and VA administrators to eliminate bureaucratic barriers that inhibit seamless coordination and information sharing, including through new linkages with the private sector.

We also should continue to reform these processes, which is why I will launch an innovation initiative — led by a team of people with diverse backgrounds and expertise — that connects the VA with leaders of the nation’s top businesses, universities, and non-profits. Their mission will be to develop innovative ways to sustainably manage the claims and appeals process, as well as unforeseen challenges.

Trump: The claims process must be reformed if we are to provide timely care to our veterans, regardless of their situation. In order to clear the backlog and to deal with the ever-increasing claims load, a more streamlined system must be put in place that takes advantage of technology and a change in priorities for the VA.

We should focus on further regionalizing the process; taking the claims process to the veteran rather than having a mountainous bureaucracy impede adjudication. Veterans with claims should have an expectation of adjudication within 30 days and an appeal, if required, in a similar time window. If evaluations take longer, the veteran should be fully apprised of the steps along the way and should be involved in the process.

Women Veterans

DAV: What would you do as President to ensure that all women who served are fully recognized for their service and gain and keep equitable access to VA earned benefits and health care that meets their gender-specific needs?

Clinton: Forty years ago, the first women began attending the military’s academies; over the past generation, women have gradually assumed every role and rank within the military, from private to 4-star general. More than 300,000 have deployed to Iraq, Afghanistan, and other theaters of war since 9/11, and women now make up the fastest growing segment of the veteran population.

As president, I will advocate on behalf of these women, including by reforming the VHA to ensure all veterans are fully and equally supported after serving our nation. Right now, female veterans are the fastest growing population served by the VA—further demonstrating the importance of providing health tools catered toward them.

As president, I will also immediately direct the VA to ensure its health facilities and staffs meet the health care needs of women veterans. Where necessary, we will request additional funds from Congress to go beyond simply modifying facilities or increasing the number of OBGYN’s employed by the VHA, to include expanding provider training, ensuring culturally-competent VHA staff and policies, and providing other gender-specific health services—including mental health services.

But we must do more. Women who have volunteered to serve our country should not be denied access to their constitutionally protected reproductive rights. I agree with DOD’s support for lifting bans on women’s reproductive health care and will require the provision of reproductive services across the VHA, providing a full spectrum of medical services. I will also broaden initiatives to provide childcare at medical facilities. As our female veteran population grows — a testament to our nation’s progress— none should have to choose between her child and her health.

Finally, some vital needs are less visible, which is why I will ensure that as a form of post-traumatic stress (PTS), Military Sexual Trauma (MST) has a burden of proof set no higher than that of any other form of trauma, and that men and women who suffer from it are uniformly eligible for disability compensation and treatment. Further, as president, I will work with the Secretary of the VA to expand and enhance treatment services to ensure that all those who suffered MST get high quality health care, including mental health care.

Trump: Women are the fastest growing segment of the veteran population yet there currently is little to no standard of care throughout the VA system. The VA system, like all other programs provided by the federal government, should be gender-blind. There should be no differences in the access to, or the quality of, the care any of our veterans receive. All programs in the VA, from home loans and education benefits to comprehensive healthcare availability, should be offered to all qualified veterans without exception.

Comprehensive Caregiver Benefits

DAV: As President, would you support equal access to the comprehensive caregiver benefits and services to family caregivers of veterans of all eras, and if so, how would you address Congressional budget rules requiring offsets for the increased costs of the program?

Clinton: I have been fighting for military service members and their families for decades. As a senator, I championed efforts to make it easier for military families to provide care for their loved ones. I helped author and introduce legislation that broadened protections afforded by the Family and Medical Leave Act to the family members of wounded service members.

Our nation’s caregivers, military and civilian, serve a vital role in ensuring their loved ones are well supported throughout their recovery and rehabilitation. The comprehensive caregiver program for post-9/11 veterans was implemented at a critical time in our response to the wars in Iraq and Afghanistan, and it was designed specifically to meet the needs of newest era of veterans both demographically and clinically. For many caregivers that serve the permanently disabled or aging veteran population, their situations and needs are different than those of the post-9/11 caregivers.

To ensure that the needs of veterans and their caregivers from all eras are met effectively, we need to carefully review whether the expansion of the comprehensive program would serve them best or whether it would be more effective to optimize the other existing VA benefits and services available for all veterans so that caregivers’ needs are addressed. There are also likely opportunities to more efficiently leverage other existing federal and state caregiver benefits to ensure that they too are meeting the needs of veteran caregivers of all service eras.

As president, I will work with Congress to direct a comprehensive review of these programs, across all departments, to ensure that we are doing all we can to support veteran caregivers.

Trump: If taking care of our veterans is a priority for the administration, Congress and the American people, then we should do whatever is required to ensure those outcomes. Sequestration should be lifted and our budget should reflect the priorities of the American people. Taking care of our veterans is at the top of that list.

All family caregivers should receive consideration for benefits under the Caregiver Support Program, regardless of when the veteran was injured or disabled. It is the right thing to do and I will champion the legislation to make sure this happens.