Informal Caregiver Support Policies Change Use of Vocational Assistance Services for Individuals With Disabilities

Support policies for caregivers improves care-recipient access to care and effects may generalize to nonhealth services. Using administrative data from the U.S. Department of Veterans Affairs (VA) for veterans <55 years, we assessed the association between enrollment in a VA caregiver support program and veteran use of vocational assistance services: the post-9/11 GI Bill, VA vocational rehabilitation and employment (VR&E), and supported employment. We applied instrumental variables to Cox proportional hazards models. Caregiver enrollment in the program increased veteran supported employment use (hazard ratio = 1.35, 95% confidence interval [1.14, 1.53]), decreased VR&E use (hazard ratio = 0.84, 95% confidence interval [0.76, 0.92]), and had no effect on the post-9/11 GI Bill. Caregiver support policies could increase access to some vocational assistance for individuals with disabilities, particularly supported employment, which is integrated into health care. Limited coordination between health and employment sectors and misaligned incentives may have inhibited effects for the post-9/11 GI Bill and VR&E.

The Origins of National Technological Advantage

This chapter addresses how big government is also responsible for countries achieving strategic technological advantages. Strategic technological advantage is the key to gaining from unequal terms of trade. If your country has invented something and controls proprietary technology, your nation has a monopoly and can charge monopoly prices. Other countries have to compete with other vendors to sell their goods and sell at low competitive prices. But how do countries get technological monopolies? America's scientific and engineering dominance comes from the superiority of its higher education. The United States was the only country to create large public universities with cheap tuition in every state or province in the nation. The chapter then looks at the Morrill Acts of 1862 and 1890; the Hatch Act of 1914; and the GI Bill. It also considers the founding of the National Science Foundation. The plan was that not only would the United States have stronger armed forces due to military technology, but it would also have a better economy due to civilian technology and would be better able to solve social problems with the use of social technology.

School and a Changing Profession

After returning from the war, Smith had purpose. He enrolled in law school at the University of Florida. His earnings and the GI Bill supported him, his wife, and his new family. Smith was a leader at the law school in a class of outstanding students, serving as an assistant to a professor and cofounding the University of Florida Law Review, a scholarly journal.

Prison or the Canadian Wilderness

In this chapter Patrick struggles with his rage and PTSD. While a patient at Walter Reed he breaks his doctor’s jaw after punching him twice. He would have been in military prison if not for the intervention of his father and his psychiatrist. The doctor finds a research grant that would allow Patrick to count bald eagles in the wild for three years. Patrick receives a discharge from the Army, though he will never be able to receive VA benefits except for college under the GI Bill.

Military Service, Combat Experience, and Civic Participation

Military service is a highly social—and potentially socializing—experience. However, the long-term social effect of military service is a little-studied topic, and some have dismissed any direct impact of service on civic participation. Using data from a large, national survey, our estimates show, in contrast, that the likelihood and intensity of group participation is higher among veterans than other men and that combat veterans have the highest level of participation. Mettler argued that education funded through the GI Bill gave veterans both resources (“civic capacity”) and a desire to reciprocate to society (“civic predisposition”) for the generous benefits they received, but she did not allow for the possibility that service itself could also increase both civic capacity and predisposition. Furthermore, our estimates confirm that education is strongly associated with higher civic participation and that the association between military service and participation is largely independent of education.