For many veterans seeking health care, the old adage of “the more things change, the more they stay the same” remains true.
More than a year after an investigation exposed a backlog in the Department of Veteran Affairs (VA)’s patient care system, the number of veterans on waitlists for health care has surged by nearly 50 percent, even with some improvements. Reports show that doctors handled 2.7 million more appointments than in previous years and 900,000 patients have been authorized to seek outside help.
A budget shortfall of $3 billion further complicates matters for the VA. Last year, the department doubled capacity to meet the physicians’ and nurses’ increasing workload. That increase didn’t suffice, however, with patient demand increasing by as much as one-fifth in some hospitals. Access to expensive new Hepatitis C treatment also remains a concern, with debate around whether to ration doses among veterans.
Options on the table to cut costs now include furloughs and hiring freezes. Such circumstances have also prompted VA officials to implore lawmakers to shift available funds into programs running low on money. Doing so, however, would weaken another taxpayer-funded program that allows veterans on waiting lists and in rural areas to choose seek care from private doctors outside of the VA’s healthcare system.
“Something has to give,” the department’s deputy secretary, Sloan D. Gibson, told the New York Times. “We can’t leave this as the status quo. We are not meeting the needs of veterans, and veterans are signaling that to us by coming in for additional care, and we can’t deliver it as timely as we want to.”
No matter how it’s been since their return from combat, health care professionals say that veterans require care that effectively addresses their physical and mental needs. Perhaps more importantly, they need to interact with practitioners who understand the military culture.
When unaddressed, the trauma of war can take a toll on servicemen and women, with unfortunate consequences. A recent study published in the Annals of Epidemiology found that recent veterans have a 50 percent greater likelihood of committing suicide than their civilian counterparts. The issue has become so prevalent that those who haven’t committed suicide most likely know someone who did. A 2014 survey conducted by the Iraq and Afghanistan Veterans of America found that to be the case for 40 percent of members.
Last year’s expose prompted some quick and cooperative legislative action. In February, President Barack Obama signed the Clay Hunt Suicide Prevention for American Veterans Act — a bipartisan bill that requires the VA to undergo annual evaluations. The Army has also tried to act proactively, overhauling its mental health system to better help troops batting post-traumatic stress disorder while on tours of duty.
However, much more needs to be done. VA officials say that even if lawmakers shift funds this year, it would hardly be a panacea for the financial issues that have plagued the department. For years, the shortage of doctors, nurses, and office space for patients care has counted among its most pressing problems. Internal department budget documents show that physician workload increased by more than 20 percent in hospitals and clinics located in Alabama, Georgia, and South Carolina. The Southern California and Southern Nevada regions experienced similar trends.
Additionally, the amount of external patient care — primarily for prosthetic limbs and the new hepatitis C treatment — subsidized the VA increased by 50 percent in Pennsylvania and by 36 percent in the region that includes Michigan and Indiana. For access to the hepatitis C treatment, the sickliest patients receive first priority while those with not long to live are left by the wayside, according to VA emails obtained by The Republic in which nearly 200 specialists make known their disapproval of what they describe as unethical practices.
“To halt hepatitis C treatment at VHA facilities now would be unconscionable,” the letter read. “We can and must end the epidemic. Once we have treated every veteran with hepatitis C, the costs will go away. … Give us the ammunition, and we will win this war.”
The VA budget shortfall and fight to get increased funding has the makings of a budget fight that will pit the agency against Republicans critical of the rising costs of government programs. Gibson, however, says that he remains resilient, saying that it’s only a matter of convincing lawmakers that the VA is a worthy investment. “We have been pushing to accelerate access to care for veterans, but where we now find ourselves is that if we don’t do something different we’re going to be $2.7 billion short,” Gibson said.