(2009-0628-F) Reinventing Government Initiative and the Delivery of Health Services to Veterans

The materials in FOIA 2009-0628-F are a selective body of documents responsive to the topic of the FOIA. Researchers should consult the archivist about related materials. FOIA 2009-0628-F contains records regarding President Clinton’s reinventing government initiative and its impact on the delivery of health services to veterans. Attention is focused on the year 1993 since at that point both the Health Care Task Force (HCTF) came into existence and the effort to streamline the federal government started to assume an integral part of the reform package put forth by the Clinton administration. It should be noted at the outset that not many documents could be found tying together health care for veterans and the reinvention of government on the national level. What does exist in relative abundance for the year 1993 is material on the health system for veterans and memos, newspaper articles, speeches, and so forth describing the main precepts of governmental downsizing and contraction. The records in this collection can best be characterized as a mixture of papers dealing with health care for veterans, President Clinton’s reinvention of the federal government, and related material about veterans’ organizations, veterans parades and events, and appointments to positions in the Department of Veterans Affairs (DVA). The material found in the Subject Files (VA and VA003) is largely in the form of correspondence and focuses on cases where veterans benefits have been either hard to obtain or outright denied. As for the reinvention of government, consideration was given to consolidating Veterans Employment and Training Service (VETS) under Employment and Training Administration (ETA). This possibility met with disapproval from veterans of all eras and a number of letters in the collection attest to the utter disbelief that such a move could even be pondered by those in charge of such matters. The papers of Christine Varney of Cabinet Affairs contain memos, correspondence, fact sheets and news releases concerning a few topics related to veterans issues. A significant matter covered in these records revolves around the Veterans Health Care Act of 1992. The legislation provided for the President to appoint an individual from an appropriate agency to “coordinate all research activities undertaken or funded by the Executive Branch of the Federal Government on the health consequences of military service in the Persian Gulf Theater of operations during the Persian Gulf War.” The Department of Veterans Affairs and the Department of Health and Human Services (DHHS) lobbied to be selected by President Clinton as the lead agency to study the Persian Gulf War Syndrome and similar illnesses. Fact sheets list the VA’s vital statistics in such areas as medical training, medical research, clientele, and clinical care. News releases address such topics as the awarding of disability payments to veterans of the Vietnam conflict suffering from maladies presumed to be caused by exposure to Agent Orange and the awarding of a contract to the National Academy of Sciences (NAS) to investigate health problems connected with service in the Persian Gulf. Containing lists and comments, the records of Simone Rueschemeyer of the Health Care Task Force provide useful information pertaining to veterans and the Clinton health care plan. There is a listing of features of Clinton’s plan vis-à-vis Veterans Affairs and a document entitled “National Health Care Reform Plan: Questions on Veterans Participation.” A lengthy report includes extensive comments by staff from the DVA centered on the suitability of Clinton’s plan to the needs of veterans. Comprising several folders of material, the records of Ben Johnson of Public Liaison have a smattering of documents devoted to health care services for veterans. There are statements before congressional subcommittees on VA outpatient care, publications by various veterans’ organizations focusing on the DVA and mistreatment issues, and flyers proclaiming that veterans are relying on Congress to make things right with respect to the VA and national health care reform. That is, they urge Congress to take action to ensure that the VA’s outmoded eligibility system for benefits gets drastically overhauled and modernized. In pretty much every instance the records in this FOIA dealing with the reinvention of the federal government provide very little in the way of insight, addressing the delivery of health care services to veterans either not at all or in very general terms. Several offices contain the same packet of material on the National Performance Review, the name given the interagency task force assembled during the Clinton administration charged with cutting waste in the federal government. The content of these packets varies precious little—talking points for the National Performance Review, questions and answers for the same, and newspaper articles about the same.