February 03, 2006
the VA going private?
Since the war in Iraq began nearly three years ago, the official number of wounded from the Department of Defense totals more than 16,000. The website www.antiwar.com puts the number closer to 48,000, possibly taking into account the number of soldiers who are and will be affected by Post Traumatic Stress Disorder (PTSD).
For many veterans who fight and come home either physically or mentally wounded by war, the Veteran’s Administration medical system is their only source of medical care. Some veterans advocates, such as Larry Scott, founder and administrator for a website www.vawatchdog.org, believe that the current administration is not only woefully under funding the VA medical system, but is trying to dismantle it.
“Veterans are seeing something happening here and it is the government moving toward a more privatized medical practice,” said Scott, who lives in Oregon and is a veteran and self-employed businessman.
Scott spent four years in the Army from 1976-81. “I’ve been involved with the VA system since I was in the Army,” he said. “I have an injury from duty and I’m on disability.”
Scott said he had what he described as “unfortunate experiences” with the VA when he moved from his home on the East Coast to Oregon several years ago. “It took me 18 months to get a primary care provider and that delayed some much needed medical services.”
Scott did some research and realized there was no one single entity advocating for rights of veterans and being a watch dog over the VA system. He began writing commentary for some veterans and military websites, and then founded his website at first to help direct veterans to needed services and help them enroll for benefits.
As word about his website spread and Scott fielded sometimes dozens of calls per day from veterans, he began further researching the system and has become convinced that the government will eventually privatize the whole system.
To understand what Scott believes the government has in mind, he said one must understand the history of medical care for military personnel and their families.
“For many years, the military hospitals operated and took care of retired veterans who had twenty-plus years in the military,” said Scott. “Suddenly, military hospitals closed and the government began contracting out healthcare. What was a benefit became a cost to retirees.”
Scott said that military healthcare was dismantled, leaving the military and retirees with the TRICARE Medical system, which is private healthcare qualified military and retirees must pay for, much like plans offered by private employers.
Scott said the biggest evidence of the same thing happening with the remaining Veteran’s Administration medical system lies in a pilot program in South Carolina in which the VA there has contracted with the University of South Carolina Hospital to provide services to veterans. “They are exploring options for a joint hospital,” said Scott. “They already have entered into a $7 million medical equipment sharing program.”
Scott said as more VA hospitals age, he is afraid the government will enter into more such agreements to avoid building new hospitals or refurbishing the old ones. He also points to VA medical funding, something that is a congressional trigger point on the budget each year.
“The 2006 medical portion of the VA budget is $22.5 billion, which, on the surface, looks like a seven percent increase in funding,” said Scott.
In reality, he explains, the $22.5 billion includes a $1.5 billion carry over from last year and $1.2 billion in emergency funding, which can only be released by the president of the United States. “No one has ever released that,” said Scott.
Deducting those amounts leaves the actual budget at $19.8 billion or just a 2.6 percent increase over last year. “When you figure that the inflation rate in healthcare is currently at 5.6 percent per year, that isn’t adequate funding,” said Scott.
Scott points to the problems at his own VA medical system in Oregon. Scott claims there is such an under funding problem at the medical center in Portland that administrators there had to enact a hiring freeze, leaving 61 previously filled positions empty.
“They are short 13 janitors and the list goes on and on,” said Scott. More shockingly than the facility not being able to hire enough people to keep it clean, the hospital doesn’t have enough qualified surgeons to perform needed operations in a timely manner.
“These are necessary surgeries, orthopedics, hernia repair, joint replacements,” said Scott. “There is a 36-month waiting list for most surgeries and that’s for the veterans who are qualified.”
Ranking the vets
To help reduce the number of veterans applying for medical services, the VA in 2003 developed a ranking system categorizing veterans.
“The average American thinks that if you served, you are qualified for medical,” said Scott. “The VA has cut hundreds of thousands from the system.”
Scott said that if a veteran is lucky enough to be in categories 1-7, they have varying degrees of enrollment fees and large co-payments on prescription drugs.
“People are just now starting to realize what happened to the retirees when the medical system was dismantled,” said Scott. “They haven’t made a move yet to totally dismantle the system, but they’ve started with cutting the funding, which cuts services, which cuts benefits.”
Officials with the VA medical system referred all questions to the public relations office in Washington D.C., which did not return calls from this reporter.
Scott said the most troubling aspect is that at least 119,247 returning veterans from Iraq and Afghanistan have sought treatment at VA Medical Centers since 2001.
“Add that to the millions of veterans still alive from other wars,” said Scott. “With an under-funded VA, if they can’t get health care or have to wait, they will have to find healthcare in their civilian communities or try to get Medicaid. That shifts the burden back to the states. Or, they can just sit and wait and hope they make it.”
One of those soldiers who tried to sit and wait was Specialist Douglas Barber, a veteran who had spent the past two years since his return home trying to qualify for disability for PTSD.
“I myself have trouble coping with an everyday routine that deals with other people that often causes me to have a short fuse,” wrote Barber for Coalition for Free Thought in the Media in 2005.
“Soldiers live in deplorable conditions where burning your own feces is the order of the day,” Barber continued. “Where going days on end with no shower and the uniform you wear gets so crusty it sometimes sticks to your body becomes a common occurrence. We also deal with rationing water or even food for that matter. So when a soldier comes home to what they left they are unsure of what to do being in a civilized world again.
“This is what PTSD comes in the shape of — soldiers cannot often handle coming back to the same world they left behind. It is something that drives soldiers over the edge and causes them to withdraw from society. As Americans we turn our nose down at them wondering why they act the way they do. Who cares about them, why should we help them?”
According to a blog connected with Vietnam Veterans Against the War (www.vvaw.org/blog), Barber had only recently qualified for 50 percent disability, with 100 percent disability to start 90 days from his eligibility date, when he committed suicide on Jan. 18, 2006.
“After two years of hell and agony, he was finally able to access proper counseling for his PTSD. Sadly, it was too little, too late,” the blogger wrote.
Why not privatize?
Scott said when he is asked this question, he replies, “Why should it?”
Scott defends the VA medical system as a system that can work as long as adequate funding and facilities are available. The government “unleashed a ton of money to fix it,” Scott said of the Clinton administration when the VA system was “in a mess” in the early 1990s.
“The VA system is a large scale, publicly funded system that works. It’s been used as a model for a privatized national healthcare system, but its been going down again because people in this (Bush) administration don’t want a national healthcare system to become a reality.”
Scott points to the cost of TRICARE for retirees who are using it now, along with a shortage of private healthcare providers who want to deal with TRICARE.
“There’s definitely a lack of services in that system, which works much like an HMO,” said Scott. “Many doctors and hospitals don’t want to deal with TRICARE, so they will not take it.”
Scott said that privatizing the VA medical system would put more veterans at a disadvantage, especially when being treated for combat related injuries and trauma. “It’s a specialized system for a specialized segment of the population,” said Scott. “Most of the time, it is veterans who understand what they are going through treating veterans.”
A medical doctor who currently works in the psychiatric department for the VA Medical Center in Kansas City, but did not wish his name used for this article, said that he has not seen evidence that the government is trying to privatize the VA medical system.
“We are bracing for the troops returning from Afghanistan and Iraq, and I have not seen that in the mental health side,” the physician said. “We have interns from the University of Kansas Medical Center, but I haven’t seen anything in the way of partnerships.”
The physician said there does seem to be a high level of distrust among veterans, especially older veterans still suffering from PTSD, about the current administration.
“People who have PTSD can be triggered and for some reason, the Bush administration has triggered a lot of distrust among veterans,” said the physician. “It’s bringing about a lot of anxiety and sparking a lot of rumors.”
As for funding, the doctor said, “There is never enough funding and we’re always asking if the funding is there, will it go where it needs to go?”
Scott said the signs may not be evident yet in all hospitals, but points to the CARES Commission, which was appointed by Congress. “The CARES Commission went out and polled private healthcare providers in the Northwest and these providers told them they couldn’t take on veterans,” said Scott. “Why would they even ask the question if they didn’t have a motive to privatize?”
Scott also said the VA’s constant desire to outsource jobs to the private sector is also pointing toward privatization. He adds that the agency has used healthcare dollars to fund outsourcing studies.
“Outsourcing equals privatizing,” said Scott
The only way to stop the government from dismantling the system is for citizens to learn what is at stake and be vigilant, said Scott. Most of the VA funding is mandated and is used for disability payments, but the medical portion is discretionary and is haggled over every year, he said.
“I agree with full and mandatory funding (for the VA medical system) every year,” said Scott. “We need to bring it from discretionary funding to mandatory funding, but the Republicans, so far, have refused to bring it to a vote.”
Kerri Fivecoat Campbell can be contacted at firstname.lastname@example.org.
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