The United States Department of Veteran Affairs is responsible for all areas that concern veterans of the United States. It is the most comprehensive system of assistance for veterans in the world, providing patient care and federal benefits to veterans and their dependents. It covers a myriad of different operations: home loans and insurance, medical treatment and care, burial and memorial benefits, education and vocational training, vocational rehabilitation and employment, life insurance and military pensions and career counseling. It also has a history of problems during its existence.
In the Saturday, May 31, 2014, issue of the L.A. Times there was an article whose title is “Audit finds VA’s goals unattainable.” Basically if we look at a history of the VA we find there is a history of slop that has caused the death of numerous veterans and careless infection for many others. We find instances of incompetence. For example in 1986 the VA’s Inspector General’s office found 93 physicians working for the agency had sanctions against their medical licenses, including suspensions and revocations. In some instances improper sterilization of equipment resulted in infections of hepatitis. There have also been deaths because of delays in diagnosis and treatment, these taking well over a year or longer.
Have similar situations happened in civilian facilities? The answer is probably, yes; but to a lesser degree. The difference is that one can sue there but not in a VA hospital.
Because of greater demand for services than the facility can supply many of the VA hospitals have kept secret lists of clients, not on their computers, so that it looked like there was no waiting period and their executives could receive bonuses for what looked like efficiency, which in some cases ran as high as $33,000 a year.
What is the problem to cause all this? The answers should be obvious. Despite the amounts of funding allocated to the VA it is far from enough and basically the Veteran’s Administration is too big and varied an agency to be run by one man.
While the VA is very expensive to run it has traditionally been underfunded. For example in the 21st Century from 2001 on there have been numerous instances when the GOP in the Senate and after 2011 in the House when the Republicans got a majority there, have either filibustered or voted down any proposed increase in its medical facilities. The comments made in 2014 were that the government could not afford the expenditure with the current deficit. This was a comment made by Senator Rand Paul among others. Of course when it comes to medical plans Congress has given itself one of the best in the world, cost was never a factor here.
From what I understand the VA Hospital’s staffs can be either civilian or military, or a combination of the two. The personnel, both doctors and other medical staff, get the same training as in civilian facilities. The VA is very proud that their rates of pay are market competitive with medical civilian pay. Ostensively there is no difference between the two. If the GOP has supported the expansion of VA medical facilities would it have changed the current situation? The answer is yes, but it would not have solved the problem. Since the beginning of this century the country has been involved in two long wars. One in Afghanistan and one in Iraq. Millions of military personnel have been involved. The VA had long waiting periods before these wars. With no additional facilities the waiting period for any kind of treatment has in some areas been extended to well over a year. It will take a massive number of new facilities to resolve this problem; and it will take a large expenditure of time to build and staff these medical hospitals.
Congress, particularly the Republicans, wants this problem solved immediately with no additional expenditure of funds. Somehow the GOP is arguing out of both side of its mouth at the same time. They want an expensive problem solved but they don’t want it to cost anything. It’s like wanting to buy a new car with no down payment and no monthly installments. Good luck!
How can this problem be immediately resolved? The answer was given by President Obama. Let the veterans apply to public medical facilities if the VA ones are full. Will this solve the problem? That depends upon the facilities available in their area of the country and the amount of money the VA has available.
Probably sooner than later the VA will run out of money to pay the private doctors to attend to veteran’s medical problems. Congress, the Republicans, will have to appropriate more funds to pay for this. Will they do so? That’s an interesting question.
Both Bernie Sanders, the independent senator from Vermont who caucuses with the Democrats, and maverick Republican senator, John McCain have come out with a bipartisan solution to the VA medical crisis. Currently eighteen veterans have died while waiting for medical appointments in Phoenix. A bill cosponsored by these two men is supposed to come to the floor of the Senate the week of June 9, 2014. The bill, if passed, would allow veterans more access to private doctors, give the VA authority to open 28 additional clinics, hire more doctors and nurses, and fire poor performing staff.
Will this solve the problem? Not immediately. The bill has to pass through a Republican dominated House of Representatives and then be signed by the President in order to become law. Will this bill pass the Senate without filibustering? An interesting question! Will John Boehner, the Speaker of the House of Representatives, even bring the bill up for debate and a vote? I can’t even begin to guess what will happen in Congress this coming week and beyond.
And then, if we assume the bill is passed and immediately signed by the President, it will still take a while to come into complete functioning. While funds can immediately be released to take care of veterans needing medical help it will still take a while for the 28 additional clinics to be built and staffed. It will probably be well over a year.
In Aurora, Colorado in August 2009 the government began what was supposed to be the largest VA Clinic in the United States. The structure was supposed to be done in 2013. Today the project is less than half done and is projected to be completed in 2017. It’s cost, that was originally 600 million dollars, is now projected to be one billion dollars.
And then the question arises, are there enough private doctors and medical facilities to immediately treat all the veterans that need medical help?
Of course if the bill fails the argument will remain the same: the government cannot afford it. In essence the Republicans will continue talking out of both sides of their mouths; they will be running investigations as to why the VA is not servicing its members while refusing to pay for this servicing. It will continue to be the epitome of hypocrisy; but they will do it with a straight face, asking soldiers to give their all to their country, but then refusing to help them when they are hurt.
In essence even with this bill we are putting a large bandage over the problem. Solving the problem would require doing a “total needs assessment,” determining the full extent of the medical facilities needed to handle all the VA medical problems and then supplying them. This will take time.
The next problem that then arises is, are there enough doctors and nurses available to fill all these new facilities? The answer to that question is probably not. We need and will continue to need an ever-growing amount of doctors and nurses. Not only for the VA but also for the general public. One estimate I’ve heard is 500,000 doctors for the general public. We could need as many again for the VA. We are talking about the next decade of two.
How can this problem be resolved? A first step would be to allow members of the medical profession in other countries to easily and effortlessly emigrate to the U.S. That would not solve the problem but it would lessen it. The other solution would be for the federal government to set up innumerable scholarship programs that allow a massive increase in medical personnel.
Right now it is inordinately expensive for a student to become a doctor. He/She has to go through numerous levels of education, paying endless amounts of tuition with no immediate return. If the government were to remove this pay factor and allow those capable and willing to go through the process they could easily get the number of doctors and nurses that the society needs. In addition they could require them to serve in a given area for a small number of years in return from what they received. It would be expensive but it would solve the problem for both the VA and the general society.