Trump is Upending the American Approach to Veterans’ Care

On March 5, news broke that the Department of Veterans Affairs is planning to cut 80,000 jobs. The move is unsurprising considering the Trump Administration and its Department of Government Efficiency’s ongoing efforts to shred the federal workforce.

However, Trump Administration officials have sharply departed from past practices and downplayed the impact of these cuts on veterans. In an interview with PBS News Hour, for example, Secretary of Veterans Affairs Doug Collins dismissed former U.S. Marine Jeremy Cope’s claims that staff shortages are leading to cancelled meetings for veterans struggling with substance abuse and mental health issues. It’s “just a piece of journalism that’s not doing its job,” Collins responded.

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The secretary’s response is antithetical to how his predecessors have approached veterans’ care for almost two centuries. In the earliest iterations of federal care for aging and disabled former service members, officials saw achieving a balance between the desire for efficiency and the need to provide American veterans with comfort and good care as not only possible, but essential. When the quest for efficiency upended this balance in the past, previous administrations have listened to veterans who objected. If the Trump Administration begins to focus on maximizing efficiency at any cost, and ignores warnings about how it weakens care, they will be ignoring a formula that has governed since the 19th century.

Read More: Trump’s Massive Cuts to the VA Betrays Veterans Like Me

In 1826, Congress authorized plans to build the U.S. Naval Asylum, the nation’s first federal residence for aging and disabled veterans, in Philadelphia. Even before the asylum opened, federal officials, officers, and private citizens with whom the government contracted attempted to create a facility that materially comforted veteran residents, while also maintaining austerity with public funds.

In December 1829, William Strickland, the architect designing the facility, acknowledged this balancing act in a report to Congress. He labeled the building a “commodious and magnificent edifice,” one that would demonstrate “that the nation is not unmindful of the debt” it owed to its veterans. Despite, the construction already costing nearly $200,000 (more than $6 million today), the architect stressed that he had respected his budget to the best of his ability and made the case that cost of completing the project would be closer to $242,000. In comparing the project to other architectural and engineering endeavors, Strickland explained, “I am not aware that, in this country or in Europe, the same quantity of labor and materials has been procured by government or individuals, by the expenditure of so small an amount of money.”

Once the institution opened in 1833 with space for more than 400 veterans, naval officers endeavored to provide a comfortable life for the residents. That included outfitting them with a full wardrobe. By 1843, veterans regularly received navy blue jackets, pairs of cotton and linen trousers, flannel drawers and shirts, socks, pairs of shoes, white and checked cotton shirts, silk and cotton handkerchiefs, and hats. At less regular intervals, officials provided a quality suit and a thick pea jacket.   

Yet, even as the Naval Asylum’s officers made sure to provide high quality and complete wardrobes to its residents, they and officials in Washington maintained the expectation that federal dollars would be spent efficiently. Naval Asylum Governor William McKean spent considerable time selecting the best fabric available at the fairest price. Secretary of the Navy Abel P. Upshur dictated limits on the cost of clothing. The Navy Department, he said, could spend the equivalent of roughly $1300 in 2025 dollars on the entire wardrobe for each resident.  

As more veterans entered the Naval Asylum in the 1830s and 1840s, officials’ attempted to use space more efficiently. After 1839, the building held three separate institutions: the Naval Asylum for veterans, a hospital for current naval sailors, and a small school for midshipmen—a predecessor to the Naval Academy in Annapolis. Officials believed that by using one structure to fulfill separate functions, they would save the federal government money. 

The move, however, backfired. It precipitated a decline in the quality of life for veterans, who then protested. They petitioned for a reorganization of the facility to better serve their needs. The residents’ objections clued officials in that their quest for balancing efficiency and quality of care had faltered and begun compromising the veterans’ experience at the Naval Asylum.

Officials responded by meeting some of the veterans’ demands and embarking on an expansion project. They rehired Strickland to build two residences on either side of the main structure for the institution’s governor and head surgeon who at the time occupied apartments in the main building. The scope of work also involved constructing walls around the property, erecting two gatehouses, and all the related excavation, drainage work, and paving. 

The official estimate for the digging, walls, and gatehouses was $20,333, or nearly $1 million dollars today. Despite the hefty price tag, Governor Charles W. Morgan explained in reports to the Bureau of Medicine and Surgery that the expenditure would secure both the “efficiency and comfort of the establishment.” To the governor, these two functions were both critical at the asylum.

Around this time, Morgan also suggested removing the midshipmen to a separate institution. Because officers had begun housing the young men in “expensive hotels” in the city and veterans complained of the school impacting their care, the move would not only appease current residents but also save the department money in the long term and create dozens of vacancies for more veterans.

Read More: 80,000 Veterans Affairs Staffers Are on DOGE’s Chopping Block

The officials understood that while establishing a new institution for midshipmen and constructing new buildings would cost more up front, in this instance, it would create a more effective federal government—one that acknowledged when to prioritize quality care over restrictive spending.

Lavish expenditures and good intentions sometimes led to fiscal waste and failed to ensure that all of the veterans who lived at the Naval Asylum had a positive experience. Sometimes residents stole clothing from their comrades, sold it, and pocketed the profits. Officers locked disorderly veterans like these in the cells on the asylum’s top story. Water regularly seeped through the structure’s basement and windows, requiring funds for near constant maintenance.

But even when the quality of care did not match their intentions, officials maintained a commitment to providing it and listening to the veterans in their care, even as they also respected the budgets funded by Congress. For this reason, appropriations for construction, renovations, and provisions at the Naval Asylum property continued for well over a century until 1988, when the federal government finally sold the land and remaining buildings to a private development firm.

The fact that Strickland’s original structure remains standing as the anchor of Philadelphia’s Naval Square community almost 200 years after its construction is a testament to the emphasis on quality care for veterans, even if that meant eschewing maximal efficiency. Federal officials cared about avoiding waste, but they sought a balance, and didn’t see responsible budgeting and quality care as mutually exclusive. In fact, they saw the two as inherently intertwined parts of the job of the federal government. 

This history suggests that steep staffing cuts at the Department of Veterans Affairs would be antithetical to how the U.S. has cared for veterans for nearly two centuries. It also highlights that cuts do not necessarily mean responsible stewardship of public money. Finally, this history demonstrates the benefits of listening to veterans and staff who warn of efficiency’s consequences. When it comes to veterans, the federal government can and has long strived for efficiency and the highest quality care at the same time.

Moyra Williams Eaton is a Ph.D. candidate in the department of history at Pennsylvania State University.

Made by History takes readers beyond the headlines with articles written and edited by professional historians. Learn more about Made by History at TIME here. Opinions expressed do not necessarily reflect the views of TIME editors.

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