Controversy Over Bill Aimed at Helping Veterans
Veterans
New Hampshire Union Leader
Greg Hellman
Boston University Washington News Service
4/25/07
WASHINGTON, April 25 —Tales of bureaucratic nightmares at veterans’ hospitals throughout the country in recent months have prompted a flurry of legislation on Capitol Hill aimed at providing relief to veterans.
Amid the maelstrom of activity, a wide-ranging piece of legislation intended to expand access to health care in an unprecedented fashion for veterans is being greeted, however, with mixed responses.
The Veterans Health Care Empowerment Act, which Sen. Larry Craig (R-Idaho) introduced on March 8 and which is scheduled for hearings before the Senate Veterans’ Affairs Committee late next month, would allow veterans with service-connected disabilities to obtain treatment at almost any medical facility in the nation.
The only requirement would be that the facility be authorized to receive payments under Medicare or TRICARE, the military health system.
Under the act, “veterans are empowered to seek care at the place they believe will provide them with the best service, the best quality and the best access,” Sen. Craig said in a statement.
And while the bill is beginning to pick up traction among influential Senate Republicans, it is also being met with resistance from the American Legion, the nation’s largest veterans’ service organization, which fears it would bury the already cash-strapped Department of Veterans Affairs under an even greater financial burden.
In New Hampshire, where the state’s only VA hospital, in Manchester, discontinued primary care seven years ago, however, industry workers and veterans alike are cautiously praising the bill as a promising solution to a growing crisis in health care access.
Since its introduction, the bill has picked up three Republican co-sponsors, including Sens. Thad Cochran of Mississippi, Johnny Isakson of Georgia and Ted Stevens of Alaska. New Hampshire Sens. Judd Gregg and John Sununu also have expressed their support for the legislation.
“There is no question that top-notch treatment is available through the existing VA system, but in New Hampshire, many veterans live a significant distance from the closest VA medical facility,” Sununu said in a statement. “We should take every reasonable step to ensure these veterans have convenient access to care, and the Veterans Health Care Empowerment Act would help cut red tape that prevents them from receiving treatment closer to home.”
Discussion of the bill comes as a nine-member presidential commission headed by former Sen. Robert Dole and former of Health and Human Services Secretary Donna Shalala investigate veterans’ health care problems.
And while all three co-sponsors praised the VA health care system as “among the best in the nation” and said they did not expect a mass exodus from the current system, they insisted that the bill is about giving veterans choices.
“While I have great faith in quality of care available from the VA, I know some veterans are concerned,” Isakson said. “I believe this legislation will ensure that those individuals have additional options.”
But Paul Morin, the American Legion national commander, in a strongly worded March 22 letter written to both Sen. Craig and Sen. Daniel Akaka, chairman of the Senate Committee on Veterans’ Affairs, warned that the proposed legislation would in fact “inevitably lead to the complete dissolution of the VA health care system.”
The letter said the bill would present problems similar to that of Medicare, calling it both a financial burden unless payment caps were added and an invitation for abuse and fraud. The Congressional Budget Office has not yet completed a cost estimate.
“We’re not sure this is going to provide the best health care for rural veterans,” Steve Robertson, director of legislative affairs for the American Legion, said. “In utopia it would work great, but in reality there needs to be limits placed on it.”
For Army National Guard sergeant and Iraq War veteran Trina Wycoff of Allenstown, the half-hour drive to the Manchester VA medical center is not unreasonable. She must take off work to make her appointments but, she concedes, she is within driving distance to receive her medical care.
Many New Hampshire veterans are not as lucky as Wycoff, however. They either live in the North Country hours away from Manchester or are in need of a full-service hospital, and they face tremendous obstacles to accessing health care. For in-patient care and other treatments unavailable at the Manchester VA medical center, the facility must shuttle patients to medical centers in Massachusetts.
Even veterans using services in Manchester, however, face problems of access. Wycoff recalled witnessing an older veteran during one of her visits ask an attendant how he could possibly get to his home in northern New Hampshire after spending his entire day in Manchester. After he received little help from the staff, Wycoff volunteered to give him a ride.
“He had no way of getting home,” she said. “His day had started at 6 in the morning. For many people you can’t come all the way down here, spend a whole day in Manchester and find your way back.”
Mary Morin, director of the New Hampshire State Veterans Council, said that increased access to medical facilities “might streamline veterans from North Country who have difficulty coming down to Manchester. Any time you can get health care to the veterans it’s a good thing.”
While the proposed legislation might help veterans stranded hours away from care receive treatment at their local hospitals, it also would risk taking them away from experts trained to treat injuries unique to returning veterans, such as post-traumatic stress disorder and traumatic brain injury, said Dr. Setin Savage, president of the New Hampshire Medical Society and independent consultant to the Manchester VA.
“There are a limited number of health care facilities for veterans in New England so anything that improves access to quality medical care is something we support,” Savage said. “But you can’t just assume that community providers are as prepared as veteran centers. They don’t have as much experience” in treating combat-related injuries.
Though the fate of the Veterans Health Care Empowerment Act is uncertain, veterans’ advocates are happy finally to see legislators begin to take action.
“Something needs to change within the VA system,” Savage said. “What the bill at least does is create innovative approaches to examine the system.”
###
