Amid the rhetorical fog of their game-changing presidential debate in June, Donald Trump and his then opponent, Joe Biden, only dealt with the Department of Veterans Affairs (VA) in passing.

Former president Trump claimed that, after he vacated the White House, “crazy Joe Biden” no longer allowed military veterans to choose between VA care and private sector alternatives to it. When he was in the White House, Trump asserted, VA patients could “get themselves fixed up” in private hospitals and medical practices, rather than waiting “three months to see a doctor.” The results of this outsourcing were “incredible” and earned his administration “the highest approval rating in the history of the VA.”

In response, President Joe Biden understandably failed to make two points in response, either due to cognitive decline or cognitive dissonance. One, out-of-control spending on private care has left the VA-run Veterans Health Administration (VHA) with a projected $12 billion budget shortfall for fiscal year 2025 — which is not good news for veterans. And two, a Democrat in the White House didn’t actually mean abandoning privatization, since there has been more of it under Biden than Trump.