What South Korea can learn from, and teach the US, on veterans’ care

From Houston Public Media:

Despite U.S. veterans receiving better medical care after a major law passed two years ago, recipients gripe about the quality and number of services the Department of Veterans Affairs (VA) provides. Still, the agency is a benchmark for veterans’ care that many U.S. allies use for comparison.

South Korea, long one of the United States’ closest allies, has in recent years significantly increased its budget for veterans and their family members. Even though it lags behind the Americans’ level of support, the VA in the U.S. can learn from its East Asian partner.

Veterans’ care in South Korea

The Korean War ceased in 1953 with an armistice agreement, but there’s never been a peace treaty. Officially, North and South Korea remain at war.

In June 2002, the two Koreas were enjoying a thaw in their relationship. South Korean President Kim Dae-jung had begun a program of détente with the North called the “Sunshine Policy,” with cooperative business ventures and brief meetings of family members long separated by the countries’ division. That month, South Koreans were absorbed in co-hosting the 2002 FIFA World Cup.

It came as a shock when two North Korean patrol boats crossed a maritime border dividing the two countries in the Yellow Sea and opened fire on South Korean patrol boats near Yeonpyeong Island.

Lee Hee-wan was then a lieutenant, junior grade, in the Republic of Korea Navy, serving on board the patrol boat PKM 357.

Lee Hee-wan is the South Korean Vice Minister of Patriots and Veterans Affairs.
Courtesy of the ROK Ministry of Patriots and Veterans Affairs

“We fought for 31 minutes after North Korea invaded,” Lee said. “Twenty-seven of the crewmates, among the 27, six were killed in action, and 21 were severely injured, including myself. And I personally went through nine surgeries and had to be hospitalized for a year in the Army Hospital.”

The incident became known as the Second Battle of Yeonpyeong. While it’s little remembered today in the U.S., South Korea still marks its anniversary each year with memorial services for the dead. The battle even inspired a 2015 South Korean film, Northern Limit Line.

For Lee, the memories remain fresh. His right leg was amputated, and he still suffers post-traumatic stress. Nevertheless, Lee was able to return to duty in the ROK Navy, serving 28 years and retiring as a captain. He made it his mission to help his fellow veterans, not only from South Korea, but from all 22 United Nations member countries that defended the country during the Korean War. Now, he’s vice minister of Patriots and Veterans Affairs.

“The ministry, since 60 years ago, has been benchmarking many other countries, especially our allies, including the United States,” Lee said. “In Korea, we call our heroes ‘national merit recipients,’ and we support these people, our heroes, in three big ways.”

The first way the country supports these national merit recipients is through direct financial assistance, including disability pensions.

“Second comes the medical support,” Lee said. “To alleviate and to support such veterans with disabilities, we have established six area hospitals for veterans … and we provide integrated support, including medical treatment, psychological treatment, and the last-stage life treatment for these veterans who are in old age especially.”

South Korea currently has about 36,000 surviving Korean War veterans and nearly 171,000 Vietnam War veterans. With the latter group now in their 70s and 80s, Lee said the country is assigning civilian hospitals to care for veterans as well. That medical care covers more than 60,000 veterans and their children classed as victims of “defoliants” – that is, chemical agents such as Agent Orange, used by the U.S. in Vietnam.

“Lastly,” Lee said, “we also support the descendants and children of those heroes who have passed away in service. And we support them through education support and also occupational support, and the government proactively (supports) these members and descendants of the society, so that they can live a better life as a descendant of our heroes.”

The impact of the attempted martial law declaration

South Korea’s veterans’ affairs program originated in 1962, with the creation of the Military Support Administration. It was upgraded to the Ministry of Patriots and Veterans Affairs in the 1980s. But it only became a cabinet-level ministry in June of last year, as an initiative of President Yoon Suk Yeol.

“Korea has a relatively recent history of being a wealthy country and able to provide for anyone after retirement, veterans or otherwise,” said Henry Haggard, a nonresident fellow with Rice University’s Baker Institute who previously served as the top advisor on Korean politics at the U.S. Embassy in Seoul.

Under Yoon, the veterans’ budget for roughly 833,000 veterans and family members went up. It now accounts for about $4.5 billion per year, about 1% of South Korea’s total government spending.

Haggard said South Koreans are conflicted about their veterans. On one hand, mandatory military service means most people have either served in the military or have family members who have. On the other hand, they’re wary from decades of military rule, which only ended in the late 1980s.

“There had been a growing nostalgia as the military rule recedes,” Haggard said — not for the brutality of military rule, which resulted in hundreds of deaths, “but nostalgia for the 10% growth that happened for those decades, the economic growth, nostalgia for the clarity of vision that those leaders and the Korean people had to establish companies like world leading companies like Samsung and POSCO and others.”

That was before Yoon declared martial law earlier this month, alleging that his political opponents were collaborating with North Korea to undermine South Korea’s constitutional government. Martial law lasted barely six hours. Yoon withdrew the declaration after the entire National Assembly voted to override it. The National Assembly impeached Yoon on Saturday — suspending him from office and putting his political agenda at risk, including increased spending on veterans.

“Veterans issues, probably in Korea, I think wrongheadedly, are seen as a conservative cause,” Haggard said. “So, I think it’ll be harder for people to find a bipartisan kind of support for greater recognition, whether that’s through pensions or otherwise, of veterans in Korea.”

How South Korean and U.S. veterans’ care compare

Over the past few decades, South Korea has vaulted from developing-nation status to become one of the world’s largest economies. But its gross domestic product is still just a fraction of that of the U.S. So, too, is its population of veterans. The result is that the U.S. – which spends 4% of its budget on the VA, more than $336 billion – covers far more vets.

“I would probably be safe to say that we may be that gold standard that our allies are looking at when it comes to how we as a nation care for our veterans,” said Terrence Hayes, the VA’s deputy assistant secretary for public affairs. “There’s about 19 million veterans in our country, but right now, we only have about 9 million of those veterans in our system. In a perfect world, we would want them all to come to us.”

Compared to the six veterans’ hospitals in all of South Korea, the VA operates 170 medical centers. That doesn’t include the nearly 1,200 outpatient sites the department also manages around the country, making it the largest integrated healthcare system in the U.S.

The VA is not without its problems. In 2014, dozens of veterans died awaiting care at its facilities in Phoenix, a scandal that forced out its then leader, Secretary Eric Shinseki.

Since then, each presidential administration has steadily increased funding toward veterans’ affairs. It’s not always clear that the money is being spent effectively. Take the funding devoted to care for post-traumatic stress disorder, which has soared among veterans in the post-9/11 era.

“We often link PTSD and veteran suicide, and the suicide numbers have not moved much at all,” said Patrick Murray, legislative director for the Veterans of Foreign Wars (VFW). “Even though more money has been allocated to fight this problem, we’re not seeing any demonstrative results up or down. It stayed consistent for the past 5, 10 years, and we want to eventually drive that down to zero.”

Congress passed a series of reforms to veterans’ care over the past decade, culminating in the PACT Act of 2022.

“The PACT Act was huge,” Murray said. “Sometimes I don’t know if there are words to describe how influential for our veterans it can be.”

The new law addresses nearly two dozen medical conditions related to their service that weren’t fully covered before, many of them related to exposure to chemical agents – such as Agent Orange in the Vietnam War.

“That was 50 years ago, and they had to wait decades. They had to fight for years to get the care and the benefits and have it recognized as officially caused by Agent Orange exposure,” Murray said. “Gulf War veterans and some of the low-level sarin that they were exposed to, that (also) took far too long…That’s what the PACT Act did. It cleared a lot of that off the plate.”

Vets in South Korea, and their family members, had been getting this care for years.

Note: Andrew Schneider visited South Korea in September as part of the Korea-United States Journalists Exchange, under the auspices of the East-West Center and the Korea Press Foundation.

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