Caring for Veterans: The Civil War and the Present

In recent history, the state of veteran healthcare has received negative media coverage. The United States Department of Veterans Affairs suffered immense scrutiny for the deaths of at least forty United States veterans who died awaiting assistance. The deaths of these veterans prompted investigations and the eventual dismissal of Secretary of Veterans Affairs Eric Shinseki in May 2014 because these veterans did not receive the timely access to medical staff they required.[1] In December 2016, shocking reports about maggots being found in the wounds of a veteran surfaced.[2] Just recently, federal authorities announced that they were ramping up investigations regarding the increase in opioid theft and unauthorized drug use by VA employees.[3] The U.S. Accountability Office provided a harsh critique of the VA’s handling of patient claims in 2014, and a year later the Center for Effective Government gave the Department of Veterans Affairs the grade of “D”. [4] The concern for the care of veterans among public officials, soldiers, and citizenry is prevalent. While there are current criticisms regarding the management of Veterans Affairs, and demands to provide better care for veterans is widespread, this is far from the first time that healthcare for veterans has concerned the public and initiated Federal action.

The Civil War produced unparalleled casualties as well as an incomparable number of veterans. Prior to the Civil War, an estimated 80,000 veterans from previous conflicts lived in the United States. Soldiers’ homes were organized in the 1810s and later the 1850s, had a board of commissioners, and existed under federal regulations. Yet, the system was not prepared for the mass of troops that would eventually need medical assistance. The Union had 1.9 million veterans after the war’s conclusion, and Congress began to take steps towards providing care for soldiers who would require care and places of rest.[5]

In October 1862, Congress passed The General Pension Act of 1862 which provided disability payments based on rank and degree of disability. Furthermore, the act provided compensation for diseases incurred during service.[6] This proved significant. Tuberculosis, rheumatism, chronic dysentery, and other ailments plagued Civil War veterans for years after their discharge. The Lincoln administration, however, realized that medical care for veterans—particularly the disabled—was still undermanned and staff were often inept to handle the forthcoming medicinal needs of former soldiers. Civil War casualties superseded well over 600,000 men, and tens of thousands of survivors required long-term care for wounds both mental and physical.

Concern regarding medical care of veterans was paramount enough to work its way into President Lincoln’s second inaugural address with the phrase, “…to care for him who shall have borne the battle, and for his widow and his orphan.”[7] Fulfilling this need, and with rousing public support, President Lincoln signed congressional legislation which created the National Asylum for Disabled Volunteer Soldiers in March 1865. This national institution to care for veterans was the precursor to the modern-day U.S. Department of Veterans Affairs. Hundreds of thousands of Union veterans now had an opportunity to receive treatment for their injuries and assistance with their disabilities. The National Asylum ultimately expanded to eleven homes for veterans. Quickly, the government dropped the term “asylum” because they did not wish to characterize the men receiving care at these institutions as being mentally unstable.[8]

The first branch opened in Togus, Maine, and soon the system grew to accommodate veterans from the Civil War, survivors from earlier wars, and those from subsequent military actions. By 1873, the United States Congress approved significant changes to veteran pension acts, cemetery construction, and care. As a part of these acts, Congress started an aid program in which disabled veterans received funds to hire a nurse to care for their medical issues and a housekeeper to help disabled veterans with chores and duties. The number of veterans also led to Congress authorizing further action in the 1880s to accommodate more veterans needing assistance. Many Civil War veterans lived into the twentieth century, and with the United States’ involvement in World War I, medical care for a new batch of veterans brought forth changes. In the 1920s, medical care at the homes had transformed. With veterans requesting increased benefits, each major soldiers’ home soon operated as a complete medical center with amenities matching that of hospitals at the time.[9]

Interestingly, but perhaps understandably, Confederate soldiers did not receive any federal benefits and former foes of the Union relied on other means. Thus, federal efforts to provide care for Civil War veterans did not include hundreds of thousands of individuals who experienced the pitch of battle and endured lasting complications from time spent in the military. Not until 1958, ninety-three years after the last shots of the Civil War, did Congress pardon Confederate soldiers and offer them every benefit Union soldiers had enjoyed since March 1865.[10] In 1958, Congress extended benefits to Walter Washington Green Williams, considered the last surviving soldier from the Confederacy.[11] Williams died the following year. Historians consider the validity of his service controversial; reports argued he never served the Confederacy in any capacity.[12] The last verifiable veteran who fought for the Confederacy, Pleasant Riggs Crump of St. Clair County, Alabama, had died in December 1951. Thus, it is reasonable to assert that no portion of federal aid ever went to the care of a single Confederate veteran.

The climate of the 1860s and the Civil War is different from that of today. Nevertheless, the concern and necessity for quality care for veterans remains a significant issue. The public recognizes the need to take care of those who served in the military. The challenges are different, but the importance remains. Following the Civil War, the federal government had to create a system to accommodate unprecedented numbers of veterans—many requiring care for physical and mental wounds. The task was momentous. In contrast, the contemporary system to care for veterans has its own daunting challenges. The challenges are not in creating a system or setting the course to establish homes and hospitals but rather ensure that those institutions are running properly, effectively, and devoid of corruption. Currently, the new administration is seeking to rectify the paltry condition of the VA and claims that it will do a far superior job than the previous one. Will they? Possibly, but it is an unknown. Nonetheless, every administration bears a responsibility to care for veterans of the United States. It is a task that was of paramount importance immediately after the Civil War and remains the same to this day.

[1] “Veterans Secretary Eric Shinseki resigns after report,” BBC News, accessed February 22, 2017, http://www.bbc.com/news/world-us-canada-27640375.

[2] “Oklahoma veteran dies with maggots crawling in wound; 4 resign from VA center,” Fox 59, accessed February 23, 2017, http://fox59.com/2016/12/05/oklahoma-veteran-dies-with-maggots-crawling-in-wound-4-resign-from-va-center/.

[3] “Opioid Theft, Missing Prescriptions Prompts Investigation of VA Hospitals Staff,” NBC News, accessed February 24, 2017, http://www.nbcnews.com/storyline/va-hospital-scandal/opioid-theft-missing-prescriptions-prompts-investigation-va-hospitals-staff-n723291.

[4] “Making the Grade,” Center for Effective Government, accessed February 23, 2017, http://www.foreffectivegov.org/access-to-information-scorecard-2015/.

[5] “VA History in Brief,” Department of Veterans Affairs, accessed February 24, 2017, https://www.va.gov/opa/publications/archives/docs/history_in_brief.pdf.

[6] “VA History in Brief,” Department of Veterans Affairs, 4.

[7] “Second Inaugural Address of Abraham Lincoln, Saturday, March 4, 1865,” Yale Law School Lillian Goldman Law Library: The Avalon Project, accessed February 23, 2017 http://avalon.law.yale.edu/19th_century/lincoln2.asp.

[8] “The Civil War: The Origins of Veteran’s Health Care,” U.S. Department of Veterans Affairs, accessed February 24, 2017, https://www.va.gov/health/newsfeatures/20110413a.asp.

[9] “The Civil War: The Origins of Veteran’s Health Care,” U.S. Department of Veterans Affairs.

[10] “The Civil War: The Origins of Veterans Health Care,” U.S. Department of Veterans Affairs.

[11] There is no confirmation that Williams accepted any aid.

[12] “Walter Williams: Last Civil War Veteran or Hazy Memory?” Dakota Beach Morning Journal, September 4, 1959, accessed February 24, 2017, https://news.google.com/newspapers?id=Z1crAAAAIBAJ&sjid=8JwFAAAAIBAJ&pg=6005,512182&dq=walter+williams+last+civil+war+veteran+national+archives&hl=en.