Reality check for veterans’ care
Post-Dispatch file photo.
The United States will spend $98 billion this year on services for military veterans.
Yet tens of thousands of veterans are on waiting lists for urgently needed counseling and psychiatric care. A backlog of more than 400,000 disability claims awaits processing. Millions of middle-income veterans are excluded from receiving care at Veterans Affairs hospitals because of budget shortfalls.
And dozens of returning veterans reach out to total strangers on websites like USAtogether.org for help with things like food expenses, furniture, auto repairs or a place for their families to stay near medical facilities.
And while it’s heartwarming that individual Americans are willing to extend a hand to veterans, that they must do so is a shameful indictment of the nation’s failure to carry out Abraham Lincoln’s promise “to care for him who shall have borne the battle and for his widow and his orphan.”
Last week, retired Army Gen. Eric Shinseki was sworn in as Secretary of Veterans Affairs. Few are better qualified than he to understand the crucial role played by the VA or the epic scale of its recent failures.
Mr. Shinseki is a twice-wounded veteran of Vietnam who lost so much of his right foot that the Army wanted to muster him out. He persevered, and his 38-year military career culminated in his appointment as Army chief of staff.
Mr. Shinseki was forced to retire in 2003 after telling a congressional committee it would take hundreds of thousands of American troops to maintain peace in Iraq after an invasion. That prediction was at odds with what Bush administration officials were saying in the days leading up to the Iraq invasion. But it proved to be correct.
Mr. Shinseki probably will find few similarities between his old Army job and his new position in the Obama administration.
Running the VA will involve no small amount of consensus-building and political skill in the face of rising demands for service and limited budgets.
Mr. Shinseki took office promising swift action, but the problems he faces are staggeringly large and stubbornly complex.
Those problems continued to mount last week with the release of a Government Accountability Office study that found that the VA repeatedly, and perhaps intentionally, miscalculated its long-term budget needs for rehabilitating veterans.
The VA sends disability checks to about 3.2 million veterans every month. That money automatically is added to the department’s budget. But spending for VA hospitals does not automatically increase. Largely because of the war in Iraq, the gap between demand for care and its availability is widening.
VA health care spending doubled between 2000 and 2008. But as the cost of the Iraq war mounted in 2005, the agency was under enormous political pressure to limit the cost of veterans’ care. That resulted in a $1 billion budget shortfall that year that imperiled care for veterans.
Veterans groups want to prevent a recurrence of that fiasco by moving the VA to a multi-year budget for health care. Health spending would be approved by Congress a year in advance.
Making that change, especially during the worst economic collapse in a generation, will be difficult. But if we really mean what we say about our obligation to returning veterans, it’s unavoidable.
Mr. Shinseki has a difficult job ahead. We’ll know he has succeeded when the backlogs and waiting lists are gone. And when no returning veteran has to reach out to strangers to get the benefits he or she already has earned.
We have promised these people care and we should honor the promise. I would eliminate the VA system of hospitals and use the savings from the loss of the bureacracy to simply pay for vets to be treated at the same hospitals as the rest of us. Where would you rather go, The VA or Barnes? Capacity exists. The system would absorb most of those directly employed providing care and eliminate those shuffling paper. Vets would get better care and we would save money in the process.
jjk, not a bad point however there are some very good military hospitals. Case in point: Tripler Hospital in Honolulu. It used to be called Tripler Army Medical Hospital and served military personel and their families since the 1960s. I had excellent care there in the late 60s as a child and my father had excellent care there in the early 70s.
I think a lot of Americans think of our military hospitals as being as bad as the hospital that was shown in the movie “Born on the Fourth of July”..that couldn’t be farther from the truth. Military hospitals like Tripler have unique capabilities and personel to handle military trauma and military families that civilian hospitals don’t have. I’m unclear in this article whether the problem is strictly budget shortfalls or the inability of our VA hospitals to provide the treatment.
In addition, using private hospitals will cause problems with liberals since many of these hospitals are labeled “Jewish” or “Catholic”. Can you imagine the uproar it would cause if our military wounded were being treated in a “religious” hospital? “Where is the separation of church and state?” they would argue.
And you clowns seriously want the feds to control healthcare for the entire country? This is but a taste of what Americans can expect if that happens.
And I know it’s a popular myth spread by former Pres Bush’s detractors and newspapers that can’t be bothered with searching their own archives, but Gen Shinseki wasn’t “forced to retire” by anyone or for any reason. It was already well known in the Pentagon and several newspapers reported Gen Shinseki’s coming retirement when the search for his replacement as Chief of Staff began in 2002. The claim the Bush Administration made him retire because of a disagreement is utter BS.
Dear Go_Fish, save your breath, every Democrat and Liberal newspaper treat this myth as if it were the General’s middle name. They repeat it every time the General’s name is mentioned. IF A LIE IS REPEATED OFTEN ENOUGH IT WILL SOON BE TREATED AS THE TRUTH!!!
Mr. Fish,
Do you think the VA is not controlled by the Feds? Can you please tell me how moving people out of Federally controlled hospitals and into private or non-profit hospitals is moving towards Federal control? It would move away by making the private hospials more productive and viabile. Maybe the Feds should take control of those marijuana clinics you must be patronizing not to see that.
Logic,
While there may be a place for post-battlefield therapy and rehab facilities, I am talking more about the 50 year old veteran who seeks care for general health issues. There is no reason that a man, who may live a hundred miles from a VA hospital shouldn’t be treated locally at a private hospital. Some vets will seek care at the VA because they feel they are entitled to the care…and they are. I had an uncle who wad coverage via the Teamsters, but he isnisted on going to the VA because “he’d earned it”. We all knew he would have been better off at SLU or Barnes, but, it was his decision. While there have been many improvements to VA hospitals since Vietnam, I don’t think anyone can seriously say they are at the same level as private hospitals. Obviously, the VA is a huge bureacracy and they would fight any move to such a plan that would be in the best interests of vets, but would threaten their empire. As far as paying for care in religious affiliated facilities, Federal employees are admitted to them every day and there is no problem.
*Cough* What?
“Mr. Fish, Do you think the VA is not controlled by the Feds?”
Um, no.
“Can you please tell me how moving people out of Federally controlled hospitals and into private or non-profit hospitals is moving towards Federal control?”
I wasn’t arguing with you, jjk. I was pointing out the irony of the editorialist and the Post’s oft-stated position that federal control of health care for all citizens, not just the ones they control the care for now, would be a good thing. As this editorial points out, it quite obviously would not.
“It would move away by making the private hospials more productive and viabile. Maybe the Feds should take control of those marijuana clinics you must be patronizing not to see that.”
Maybe you should cut back on the Bloody Maries.
Sorry.
A few points for a snowy day, folks:
1) The VA medical system is, in fact, controlled by the federal government. It is separate from the military hospital system that includes Walter Reed and the former Tripler Army Hospital (which, BTW, is where I was born).
2) The VA system has a higher patient satisfaction rate, and does considerably better on a number of quality measures like having computerized medical records and prescribing, than the overall U.S. health care system. Unfortunately, as the editorial states, it hasn’t received the resources it needs to keep up with rising demand caused by injuries from the wars in Iraq and Afghanistan, and the aging veteran population swollen by World War II, Korea and Vietnam.
3) The wait for counseling and psychiatric care for returning vets is, unfortunately, a symptom of a larger problem. There’s a general shortage of psychiatrists in both the private and VA systems.
4) The last time someone in a position of authority suggested doing away with the VA system and letting veterans get care at Barnes-Jewish and other private hospitals, it was greeted with a storm of protest. From bureaucrats? No, from veterans. They like the VA system.
One of the biggest issues facing Mr. Shinseki, in fact, is the demand from so-called “priority 8″ veterans — those who don’t have service-connected disabilities and who earn more than about $29,000 a year. They haven’t been able to get care at VA hospitals since 2003. They want to be able to resume getting care there, and veterans groups have been lobbying on their behalf.
5) Sorry, Logicprevails, but the federal government already pays for a substantial amount of the care provided at Barnes-Jewish Hospital, and Christian Hospital, and every other private hospital with a religious name or religious affiliation. It does so through Medicare and Medicaid. I have never heard any controversy about that from anyone.
From your comment, it looks like you were in Hawaii at the same time I was, by the way. My father was stationed at Hickam Air Force Base. He retired in the early 1970s.
Mr. Carlton, you say that satisfaction at VA hospitals is higher than at other hospitals. The New Yorker also put forth that claim in a recent column supporting single payer. Yeah, some people don’t dodge questions.
So here’s what puzzles me: Veterans I know have little good to say about VA medical care except that it’s free. Long delays, incompetent care, and the endless runarounds for which the military is famous, are par for the course. I know, anecdotal … but still …
Of course, there are plenty of non-VA hospitals that stink. One of the biggest problems is, rural hospitals simply can’t provide the level of care that patients require today, because the population can’t support the huge amount of staff and equipment required for a first rate facility like St. John’s Mercy or Barnes. That will always be a problem.
At any rate, I’m all for providing resources to fulfill our promises to our veterans. Thsoe who don’t leave near a VA hospital should be permitted to use private providers. If we can do it for Medicaid folks, we should be able to do it for veterans who have actually earned this benefit.
So what do you say, Mr. Carlton, how about that single payer issue?
John, your information was good to have, thanks for jarring my memory. My dad was stationed at Pearl Harbor in the late 60’s and got a medical discharge in ‘72. During this time, I went to Pearl Harbor Kai and Christian. Good to have a Hawaii military brat (albeit, Air Force one) on these blogs.
jjk, no major arguments with your suggestion that a private facility care for a veteran. Heck, if they can care for illegal aliens, why not a veteran?!
My father has has outstanding care for his dimentia through the Veterans Administration.