January 8, 2006

Did the VA Really Eliminate Those Long Waiting Lists for Veterans' Healthcare? No!

To hide a politically-dangerous situation, VA officials moved healthcare waiting lists from outside the system to inside ? Veterans still wait months or years for necessary healthcare

by Larry Scott -- VA Watchdog dot Org

It?s an old political game.  If you can?t solve a problem, you hide it.  But, this time, the game turned deadly.

For the first three years of the Bush administration pressure had been mounting on the Department of Veterans? Affairs (VA) as veterans tried to enroll for benefits in unprecedented numbers. 

Vietnam-era veterans were experiencing late-onset diabetes and various cancers associated with exposure to Agent Orange.  Older veterans who were on Medicare discovered it was less expensive to get their medications through the VA.  Gulf War veterans complained of a myriad of symptoms that we know as Gulf War Syndrome.  Many veterans were coming to grips with the devastating effects of Post-Traumatic Stress Disorder (PTSD) brought on by their combat experiences.  And, veterans caught in the stagnant economy in the early part of the new millennium found themselves unemployed or underemployed and without healthcare benefits.

The Problem

There were, literally, too many veterans for the VA?s increasingly limited healthcare budget to handle.  Waiting lists were created as veterans lined up at VA facilities seeking healthcare benefits.  The waiting lists grew and by the middle of 2003 there were somewhere between 218,000 and 309,000 veterans waiting to enroll. (The number was in question.  A VA Inspector General report found that the VA was keeping such sloppy records no one knew for sure.)

Major veterans? service organizations claimed that even the VA?s high number was too low.  Some well-educated guesses placed the number of veterans on the VA?s waiting lists at close to 500,000.

By the end of 2003 the political ramifications of all these veterans waiting for VA healthcare hit home.  The election was less than a year away and George W. Bush was determined to get a second term.  He needed the veteran vote.

The Solution, Sort Of

So, the White House made a promise and posted it on their web site:  ?Will have eliminated waiting lists for veterans in need of medical care in 2004.?  And, they did just that.  But, not the way you might think.

The VA, feeling the White House pressure, hired more clerks to staff enrollment offices at hospitals around the country.  And, for the most part, the long waiting lists disappeared as veterans got into the VA system and picked up their red-white-and-blue ID card.  Veterans thought the waiting lists had disappeared.  After all, they were enrolled in the VA system and healthcare was right around the corner.

Going into the 2004 election, President Bush was able to claim that he had eliminated the long lists of veterans waiting for healthcare at VA hospitals.  Pre-election polls showed veterans favoring Bush over Senator John Kerry by 58% to 35% and those numbers held through to Election Day.

Harsh Reality

But, it didn?t take long for veterans to realize that something was wrong.  Even though they were enrolled in the VA system, they weren?t getting the healthcare they had been promised.  They had to wait and wait and wait. 

Many veterans waited 18 months or longer for their first visit with a Primary Care physician.  The wait to see specialists could be even longer.  And, the waiting time for medically necessary surgeries jumped to between 18 and 24 months in many VA facilities.

The Waiting List Shuffle

Veterans soon discovered that the promise of ?no more waiting lists? meant no more waiting OUTSIDE the VA system.  Now the wait was INSIDE the system and the wait was just as long or longer. 

The crass political decision to ?eliminate? waiting lists by moving them inside the VA system brought a new problem to light.  Why was the wait inside the system so long?  For years a common complaint among veterans? groups was that the VA wasn?t properly funded.  Now it became apparent that underfunding at the VA had reached a critical level.

Today the ?inside? waiting lists are longer than ever.  The current VA healthcare budget does not even keep up with the rate of inflation.  And, thousands of troops returning from the battlefields of Iraq and Afghanistan who need immediate medical attention add to the backlog.

How Long?

Every VA facility is experiencing budget problems that force veterans to wait for healthcare inside the system.  One of the most stunning examples of budget problems is the VA hospital in Portland, Oregon.  The Portland hospital continues to enroll veterans in the VA system even though they know they cannot care for them.

One VA employee told me that some enrollment clerks tell newly-enrolled veterans that they may have to ?wait a while? to see a doctor.  And others just ?welcome? veterans to the VA and send them down the hall to get their ID card.  He added, ?Why give them bad news.  They?ll figure it out soon enough.?

At Portland, necessary surgeries have been postponed, some indefinitely.  The hospital has had to raid its equipment and maintenance funds to keep up with minimal healthcare demands.  Last year Portland needed $13 million for equipment and only received $2 million.  Veterans seeking outpatient psychiatric care are on long waiting lists.  Only 120 beds in the 400-bed facility are operational because of staff shortages caused by underfunding.  And, according to a report prepared by the Democratic staff of the House Veterans? Affairs Committee, the hospital is now short at least 150 staff members from housekeepers to nurses, physicians, and social workers.

How long are the waits and how many veterans are on the waiting lists?  That information approaches the ?classified? level at the Portland VA hospital.  The office that handles the waiting lists is in a small, locked (unusual for the VA) office on the ninth floor.  A knock on the door will bring an employee who opens the door only a couple of inches to identify the person seeking entry.  If that person isn?t ?cleared? to be in the room, they are turned away.

Requests for information from VA Public Affairs specialists are routinely ignored, especially if the information might cast the VA in a bad light or be politically harmful to the current administration.  In some cases the VA gives out old statistical data or incomplete information.  The only way to get reliable information is through Freedom of Information Act requests.  These requests can take months to process and by the time the information is received the data requested may be useless.

And, the one piece of information you will NEVER get from the VA is how many veterans have died while waiting for healthcare.

Deadly Wait

For veterans, the wait can be deadly.  One VA employee who used to work in the ?waiting list? office told me the worst part of the job was calling to inform a veteran that they had reached the top of the list only to find out they had died.  What started as a political game to hide the waiting list problem has turned into a life-and-death struggle for many veterans.

There can be an end to all of this.  It?s been floating around Congress for a number of years.  VA healthcare is part of the discretionary budget that must be hammered-out every year.  Both the House and Senate have versions of bills that would make VA healthcare part of the mandatory budget.  But they sit in dusty ?In? and ?Out? boxes and never get anywhere.

Democrats have authored and pushed for passage of legislation that would make VA healthcare part of the mandatory budget.  Republicans have opposed it.  You can take that information anywhere you like.  Me?  I?m taking it with me to the polls this November.

? 2006 Larry Scott / VA Watchdog dot Org -- May not be re-published by any means without permission.
 

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