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VA
Health System Failing, Survey Says
By Susannah
Rosenblatt
Los Angeles Times,
July 15, 2003
WASHINGTON - Veterans are waiting six months or more
for medical care as a severely overburdened Veterans Affairs health system
fails to keep pace with growing demand, a report to be presented to
Congress today concludes.
"Washington, D.C., operates on a mentality of statistics," said
American Legion national commander Ronald Conley, the author of the
report.
"We wanted to make everybody aware that these are not just numbers,
but are actual, real people and they're sick and they need to see a doctor
and they can't wait."
An estimated 110,000 veterans are waiting for initial appointments for
nonservice-related medical problems at hundreds of VA centers around the
country, the VA acknowledges.
Conley is scheduled to testify today before the Senate Veterans' Affairs
Committee.
The VA expects to see 4.7 million veterans in its hospitals and clinics
this year, up more than 54% from 1996. The rising cost of private health
insurance and prescription drugs have led more veterans to rely on VA
medical care. About 7 million of the nation's 25 million veterans, or 28%,
are receiving VA medical benefits.
"A lot of people who may have been able to afford health insurance in
the past are finding it difficult to afford it," said David Autry, a
spokesman for Disabled American Veterans. "They are turning to VA,
where they feel their country should take care of them."
Dr. Robert Roswell, VA undersecretary for health, said he also attributes
the influx of patients to new VA community clinics and improvements in the
quality of care. The waiting list for appointments had been considerably
longer, he added, with 315,000 veterans on it just last summer.
President Bush's 2004 budget allots $27 billion for VA health care, an
increase of 7.7% from last year, Roswell said. "We're quite pleased
with the support the president has shown," he said, but the funds are
still not enough to "keep pace with truly phenomenal growth."
The chairwoman of a presidential task force that examined the VA health
system in 2001 agreed with veterans' groups that the system is unable to
meet patients' needs.
"It was very clear that there were not enough resources currently
available to fund services for veterans in a way that would allow them to
get health care without undue delay," said Gail Wilensky, now a
senior fellow at Project HOPE, a health-care advocacy group.
The American Legion's Conley visited 60 VA medical facilities over 10
months, talking to hospital directors, doctors, nurses and patients to
assess how well the system meets patient demand.
The 162 hospitals, 850 clinics and 137 nursing homes that constitute the
nation's largest managed-care system are chronically underfunded, his
report concluded.
The VA Greater Los Angeles Health Care System, one of the largest in the
country with 12 outpatient clinics and an operating budget of nearly $500
million, was not included in the report and a spokesman there declined to
comment.
Veterans' groups are calling for a change in the way VA health care is
funded, so that it would receive a guaranteed stream of income much like
Medicare already does.
Currently, each year's VA spending must be set by Congress, making it
subject to the constraints of the overall federal budget. Such
unpredictability makes it difficult for hospitals and other facilities to
operate, Conley said.
"No matter what the number is that may actually be needed, there is
no guarantee that that amount of money will be provided in the end,"
Autry said. "The VA doesn't have enough money to begin with, we can't
plan from month to month and we don't know when we're going to get this
money and how much it's going to be."
In 1996, Congress relaxed eligibility requirements for VA health care,
allowing more veterans to enroll. A generous prescription benefit is one
reason that many have for enrolling. The VA offers a 30-day supply of each
medication for a $7 co-payment.
The president's budget includes provisions to increase the co-payment to
$15 for higher-income veterans and eliminate it for those with lower
incomes. The budget also proposes a $250 enrollment fee for higher-income
veterans.
An American Legion survey last year of about 4,000 veterans found the
average wait for an appointment is seven months and that 58% had
appointments rescheduled, many for several months later.
"All I did was put in 20 years of separations, hardships,
sacrifices," wrote one survey responder, Robert Thomas, who served in
Korea and Vietnam in the Navy.
"The thanks I received is to be told that it will be another year
before I see my first VA doctor."
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