Original Content at http://www.opednews.com/articles/life_a_vi..._u_s__veter.htm June 27, 2007

1,800,000 U.S. VETERANS HAVE NO HEALTH CARE

By Victor Martinez

As the nation struggles to improve medical and mental health care for
military personnel returning from Afghanistan and Iraq, about 1.8
million U.S. veterans under age 65 lack even basic health insurance or access to care at Veterans Affairs hospitals, a new study has found.

The ranks of uninsured veterans have increased by 290,000 since 2000, said Stephanie J. Woolhandler, the Harvard Medical School professor who presented her findings yesterday before the House Committee on Veterans Affairs.

About 12.7 percent of non-elderly veterans -- or one in eight -- lacked
health coverage in 2004, the most recent year for which figures are
available, she said, up from 9.9 percent in 2000. Veterans 65 and older are eligible for Medicare. About 45 million Americans, or 15 percent of the population, were uninsured in 2005, the Census Bureau reports.

"The data is showing that many veterans have no coverage and they're sick and need care and can't get it," Woolhandler said.

Woolhandler's findings are based on data from two national surveys --
the Current Population Survey administered by the Census Bureau and the National Health Interview Survey administered by the Department of Health and Human Services. Veterans who said they had neither health insurance nor veterans or military health care were counted as uninsured.

Woolhandler is a well-known advocate of guaranteeing access to health care for all Americans through a government-run national health insurance program. Republican lawmakers seized on that association to question whether she was trying to advance that goal with her study.

"The difficulty would be that because of your desire for universal
health care, that could influence how you felt about veterans," Rep.
Cliff Stearns (R-Fla.) said.

Woolhandler said the data are sound. She has firsthand experience with the issue as well, she said, because as a physician she has seen
uninsured veterans with untreated high blood pressure, diabetes and
other conditions.

"It breaks my heart," she said. "The VA should be an important safety
net for my patients, and it's not."

Nearly 8 million veterans were enrolled in the VA health system in 2006. The focus of the hearing was whether to open VA hospitals' doors to so-called Priority 8 veterans, who have no service-connected
disabilities and whose earnings generally are above 80 percent of the
median income where they live.

Doing so would add significantly to VA's caseload and costs -- estimates range from $366 million to $3.3 billion annually -- and some veterans groups and lawmakers are concerned that it would make it harder for veterans with serious service-related health problems to get timely care.

Only about half of the 1.8 million uninsured veterans are classified
Priority 8, Woolhandler said. The rest may technically be eligible for
some VA care but live too far from its facilities for it to be a real
option, she said.

Rep. Steve Buyer (Ind.), the committee's ranking Republican, said
Veterans Affairs should focus on its "core constituency" -- veterans
with service-related health problems, the indigent and those with
"catastrophic" disabilities.

"Some say the government is obliged to provide essentially free health care for life to anyone who served even a year or two," he said. "I intend to protect the core constituency first."

But Rep. Bob Filner (D-Calif.), the committee's chairman, said taking
care of veterans is a continuing cost of war. "All veterans should have
access to 'their' health-care system," he said. "This is rationing
health care to veterans, those who have served our nation. And I think it's unacceptable for a nation of our wealth and our ability."





Back

Methinks the whole premise of the above article is at best misleadin', but maybe is actually dishonest, eh? Any veteran of U. S. military service (as defined in Title X of the United States Code) and honorably discharged is eligible to apply for VA medical bemefits!

Are these 1,800,000 U.S. veterans that the article claims have no health care all reciprients of dishonorable discharges? Maybe they've just not bothered to apply? Tough to figure, and methinks the article, unless I missed it, gives no clue.

Politicians and ideologues've frequently used hyperbole and dishonest rhetoric on veterans' issues as a wedge issue for a long time, eh? IMHO this article is an indication it continues. For a real good example of how it's been used in the past methinks a visit here'd be an eye opener.

Here are a couple of sites about veterans' benefits, but I'm not certain what it all means and how the info might explain why so many veterans have no health care insurance.
http://www.va.gov/healtheligibility/Librar...s/CombatFAQ.asp
http://www.military.com/benefits/veterans-...are-eligibility

I don't know the answers to these questions: Fly, maybe you or other vets here know the answers.
Maybe there are no VA hospitals within reach?
Do vets have to be treated at VA facilities in order to have VA health coverage or can they go anywhere and the government will compensate the hopitals/doctors?
Are vets who are above the income eligibility requirements within the VA, not covered by other health insurance because they can't afford it?

This story is hoakum.

Every region in a place with the vast distances such as Texas has a VA clinic available if it's too far from a VA Hospital.

Some vets simply do not know they qualify for health care. Thats why the DAV holds informational outreaches. How you are classified in the VA system also has some bearing on your axcess to health care. The whole issue is not as simple as some would indicate.

So, what do vets do if the VA clinic and/or the VA hospital are too far?

The VA, like most of the rest of the American (and other modern countries) health care systems has started shiftin' the onus from large expensive and underutilized inpatient facilities to community based outpatient clinics, eh? As old antiquated and unsupportable hospitals've been closed they've been replaced by outpatient clinics, methinks at a ratio of somethin' like eight clinics opened for each hospital closed. That puts VA health care facilities within easy reach of almost all vets, the only exception bein' them who choose to live in more isolated areas.VA beneficiaries in certain categories and meetin' special requirements're eligible for a program called CHAMPVA, which pays for care in other'n VA facilities. Other'n that, like most health plans, they've got to go through participatin' health care facilities (in this case normally VA owned and operated), eh?If you look at the criteria methinks you'll find the income eligibility requirements are set at less that 80% over the local area median income. More'n that methinks you'll agree should be able to afford health on their own, but even these're offered VA care after payin' a relatively small ($500 I think) enrollment fee and then reasonable co-payments similiar to the TRICARE Prime program military retirees're under.IMHO this's a bunch of hooey! At least since the early 70s every member undergoin' separation outprocessin' been informed of and they've had to acknowledge their eligibility for VA benefits, includin' medical, and advised to make an appointment with a VA counselor to get set up - if they so desire. That some choose not to do so to me indicates a failure on their part, not the system's, eh? Let's not call lazy folks victims here, they was all grown up girls or boys when they got out of the service.Please define "too far", eh? Methinks if you use this site you'll find facilities within easy and/or reasonable reach of almost every eligible vet.

Nonsense. My brother in law was a Marine vet. I had to tell him he qualified for perscription drugs from the VA. The rules are complex for most people. Thats why the DAV provides guidance and other help to assist vets with the VA system. If any vet needs help with the VA I suggest they see the DAV to help them through the system.

Guess he didn't pay attention to the VA brief durin' separation processin' and probably never went to see the VA counselor after separation like was recommended, eh? Had he done so I'd be bettin' there'd have been no need for this.Methinks DAV and groups like them provide a valuable service for folks havin' problems figurin' out what exactly they're eligible for. Just the same, IMHO if them bein' separated would pay attention to what's bein' explained to them, and get in to see a VA counselor soon after separation there'd be less requirement to go into crisis mode to get their benefits when the need arises, eh? Folks can whine all they like, but methinks a little personal responsibility goes a long way.

Amy, I generally consider myself as pretty much living out in the boonies.

Even with living out here in the middle a nowhere I guess I'm lucky, I got the choice of a major VA hospital or three outpatient clinics within 35 miles a where I live.

I'm sorry but Victor Martinez just didn't find out the facts before he wrote this story.

Reviewing the Main Page of the news outfit who published this story it appears most of the writers they got are a bit deficient doing their homework before they put pen to the paper.

It may be relative to when they were separated. Two cousins, my brother and myself were all separated within several months of each other and we all had the same experience. Nothing, nada, not one word of advice or information was provided about future benefits or the Veterans Administration at the time of separation, in my case it was October 1970. I know this holds true for a multitude of vets my age.
Also to be considered is the fact that many of the bennies have changed. My uncle is receiving services now that hadn’t been considered in 1945.

New Mexico, the 5th largest state in land area has but one VAMC. Some vets travel as far as 300+ miles to receive their med services.

My brother in law was discharged in 1962. When he got old and needed drugs he did not even think of the VA. Things are not as simple as some would like them to be.

In New Mexico, many of these vets were drafted away from their farms and ranches. They had no choice in the matter of being remote. Do they not deserve some consideration? Or is this just an inconvenient truth?
We are fighting to up the mileage pay for these vets, to at least offset some of the expense in traveling to the VAMC.

andNew Mexico Veterans Health Administration facilities:

VA Health Care System
Albuquerque: New Mexico VA Health Care System

Community Based Outpatient Clinic
Alamogordo: Alamogordo Clinic
Artesia: Artesia Clinic
Clovis: Clovis CBOC
Espanola: Espanola CBOC
Farmington: Farmington CBOC
Gallup: Gallup CBOC
Hobbs: Hobbs CBOC
Las Cruces: Las Cruces CBOC
Las Vegas: Las Vegas CBOC
Raton: Raton CBOC
Santa Fe: Santa Fe CBOC
Silver City: Silver City Clinic
Truth or Consequences: Truth or Consequences CBOC

Vet Center
Albuquerque: Albuquerque Vet Center
Farmington: Farmington Vet Center Satellite
Santa Fe: Sante Fe Vet Center

Although methinks it could always be better, 'twould seem there be VA clinics pretty well spread throughout the state. For them that don't need inpatient treatment (which'd be almost all the way medical practice has evolved) 'twould seem travel shouldn't be as problematic as you describe, eh?

Funny how this works eh, when you’re very ill you have to do some serious driving or riding. When you’re not quite so ill there may be a clinic within a hundred miles or more, depending on where in the 5th largest state you live.
Things like MRI, CAT scans, isotopic bone scans and many other med needs are only available at the regional med center. Every day veterans are traversing New Mexico for their health care, we know more inpatient facilities are not practical. What we are after is an increase in the paid mileage for those traveling the greater distances.

Here is an example of the services available at an outlying clinic;
• Blood Draws (by appt only)
• EKGs (Electrocardiograms)
• Evaluations by Doctors
• Routine Lab Tests
• Social Work Services
Hours of Operation: Monday through Friday 8:00 a.m. - 4:30 p.m. (closed Saturday, Sunday and Federal holidays).
And keep in mind;
No walk-in appointments are available at facility. For appointments, call the clinic or go to Albuquerque.

I am at a loss to understand why some of you criticize those veterans who are having difficulty getting medical care. IMHO, our veterans deserve the best medical care out there. Period.

Yes, you're fortunate to have VA facilities so close. But what of those who don't? For instance, what about a vet who's having a heart attack or stroke. Obviously he/she needs immediate attention at the closest hospital. What then? Do VA benefits cover the acute care at a non VA hospital?

It looks to me like they need at least 2 more (Socorro and either Lordsburg or Deming) clinics, possibly 3 (Tucumcari) to be sure almost all vets are within 100 miles of a clinic.

How much would not needing appointments and allowing walk ins at the clinics help?

May be a wedge issue for you, for many it’s way more than that. Do you support a means test?
I’m 100%, priority group one, none of this directly applies to me. My brother who separated as a 1st Lieutenant Jan, 1970 with 1 Silver Star, 2 Bronze Stars with V, and two Purple Hearts, he is an Agent Orange Diabetic, yet he has to annually meet the means test. His income has been middle class but he exceeds the means and he is not entitled to the same health care at the same cost I am, (I pay nothing). Is this what you support, or should all like my brother be entitled?
There are no one fix fits all solutions, except IMHO every combat vet should be entitled regardless……..

Exactly

Tremendously.
Even more important would be for the government to pay the expenses for vets who need to use an emergency room closer to home. The way it is now there are only a very few exceptions to what the VA will pay outside their system.

In the 37 years I’ve been in the system it has seen vast improvements, none of which came to us without a fight. The VA has given us nothing; we have fought for our improvements which includes our clinics. New Mexicans have been fortunate because we actually have access to our elected officials, most of whom have supported New Mexico’s veterans. We know there is lots of room for improvement, we hope the current trend continues and we know it takes pressure on our politicians to make this happen.

It seems to me it shouldn't be terribly difficult to craft decent guidelines for using community hospitals and in some places I can see where it would make a world of difference.

If NM's only a little more'n 400 miles long and 400 miles wide with Albuquerque not quite in the center then how could this be the case in all but the rarest of situations? Could you please show where anyone here's done what you indicate? Methinks a couple of us've questioned the veracity of the article you posted in the first note of this thread and provided specific reasons for doin' so. We've also tried to fill in some blanks and provide sources for info, but IMHO that don't equate to folks here that "criticize those veterans who are having difficulty getting medical care", eh? It's a discussion where differin' viewpoints're presented, ain't that what CGCS is supposed to be here for? I'd be happy to apologize if you can show me where I'm wrong, and would expect the same courtesy if it's you that ain't got it right, eh?

In addition I've indicated that there're probably folks out there separated from military service after the early 70s who might not've listened too good when informed of potential VA benefits and/or who never bothered to see a VA counselor to get enrolled and so ain't takin' advantage of what they're entitled to. Amy and I've provided links to get more info on what's available and where, Vaughn and tomhye indicated where, even though many more clinics have opened, there's probably room for more improvement (methinks the 40 new VA clinics openin' this year, and them scheduled to be openin' in subsequent years'll help address these problems of locale), and Amy's asked 'bout emergency care at non-VA facilities under current law.If I ain't mistaken there've been more'n a few news articles, includin' some posted here on CGCS 'bout the high quality of care in the VA system puttin' it ahead of the civilian health care delivery system in this country. 'Twould seem the VA's tryin' to make it even better for everyone too. It'll never be perfect, nor will it ever satisfy everybody, but methinks it also ain't near as bad as some'd have us believe. Unfortunately eligible beneficiaries do hafta make the effort to enroll in the VA system though, eh?andMethinks this. might be of interest (available here in html format). It indicates how 'bout seven years ago Congress provided VA with new authority to pay for emergency care in non-VA facilities for veterans enrolled in the VA health care system, eh?

In when what's covered it specifically states "The care must have been rendered in a medical emergency of such nature that a prudent layperson would have reasonably expected that delay in seeking immediate medical attention would have been hazardous to life or health" and says you must present for care in a designated emergency room. Also "If you are an eligible veteran, a VA facility is not feasibly available, and you believe your health or life is in immediate danger, report directly to the closest emergency room. You, your representative, or the treating facility should then contact the nearest VA as soon as possible (within 48 hours) to arrange a transfer to VA care, if hospitalization is required.", eh? That methinks is pretty straightforward. There's even more information available here for anyone interested.Methinks you'll find those type of diagnostic tools're rarely available in anything but the biggest fully equipped facilities in any health care delivery system. Methinks that's probably the same for most local private health care providers, even hospitals, unless you present to the emergency room. I don't understand how this's a problem, and if it's thought to be an emergency there's provision for immediate treatment, as described above.

I'm a bit curious 'bout the specifics of New Mexico others here've brought up. Do folks there have to drive as far for state services and facilities (e.g. gettin' a driver's license) as they do to get to a VA medical facility? Are some NM vets closer to VA facilities in AZ, UT, CO or TX and do they use them? Is there any other health care delivery system (government or private) with facilities more widespread and/or better situated to cover everyone anywhere in the state?

I am of the belief that any veteran, who has been in a combat or war zone, should have medical coverage (through the VA) that would allow them to seek medical care at any facility in the U.S. If they are covered under medicare or medicaid they should have additional coverage that would allow them to seek out the best care for their medical problems. Anyone agree with me on this?

I would go so far as to say that any veteran (there is always the risk of being called up to combat or war zone, after all) should have medical coverage, upon honorable discharge, granted by the VA that would allow them medical care at any facility in the U.S. that accepts Medicare or Medicaid, without regard for whether said vet is otherwise eligible for Medicare or Medicaid.

It's the least we can do for their service to our country.

I agree about all veterans having the best medical coverage by the VA. I'm wondering if that proposal wouldn't gain much momentum because of the cost...but I agree that's the way it shoud be.

If anyone can say "the government owes this to me" it's veterans.

I AGREE. To be clear, I believe the taxpayers should pay the full freight of the costs. Life time benefits. No means testing. No nada.

Survey Looks at Veterans' Care Problems
By HOPE YEN 06.29.07, 5:09 PM ET


A presidential panel said Friday it was compiling a first-of-its-kind national survey to determine scientifically the extent of health care problems for veterans returning from Iraq and Afghanistan.

Speaking in its last public hearing before considering final recommendations, the nine-member commission said its final report could shed light on a long point of dispute in the veterans' care debate: whether highly publicized horror stories of lost paperwork, delays in disability benefits and other problems are more isolated or significantly widespread.

"With this survey, we should be able to say some things in a more systematic way," said former Health and Human Services Secretary Donna Shalala in an interview. "One thing that will make our report truly different is that it will be evidence-based, based on the current science and present-day practice."

Former Sen. Bob Dole, R-Kan., who co-chairs the panel with Shalala, said he wasn't ready to put the moral weight of a presidential commission behind findings and recommendations until he saw some actual numbers.

"We don't want a bunch of Band-Aids that further complicate the system and create more problems," Dole said. "Observations sometimes don't translate to reality."

Their comments came as the commission began honing in on a set of findings and recommendations for their final report on improving care to President Bush.

The panel hopes to issue the report by mid-July.

Bush created the commission March 6 to devise recommendations following reports of shoddy outpatient treatment at Walter Reed Army Medical Center.

But Congress is already moving forward with its own efforts to improve care. A bill passed earlier this month by the Senate Armed Services Committee would make sweeping changes to improve the VA and Pentagon, boosting family services as well as how disability pay is decided and doled out.

The full Senate was expected to consider the measure sometime in July.

The commission's survey, conducted by telephone over the last two months, queried 1,730 injured service members on their experience in getting care, family support, going through the disability ratings system, and what they were doing now.

From their three months of investigation and site visits to medical facilities, it has extensive anecdotes of short-staffing and overwhelmed facilities. Commission staff are now crunching numbers regarding the final statistical outcome, Shalala said.

Earlier in the hearing, congressional leaders urged commission members to embrace bold solutions and utilize their sway with Bush to finally push through changes after years of delay. Lawmakers were open to adding amendments to their bill that would incorporate the commission's recommendations, they said.

"You can give a major push legislatively, but still encounter resistance within the agencies," said Sen. Carl Levin, D-Mich., chair of the Armed Services Committee. "It has to be hammered home."

Rep. Steve Buyer of Indiana, the top Republican on the House Veterans Affairs Committee, was more blunt as to who was to blame.

"We do not need legislation to do the right thing for our service members - we need leaders in the executive branch to take charge of their bureaucrats," he said. "I was heartened when the president formed this commission. ... I remain hopeful, even confident, that your work will take advantage of that support."

Shalala said the final report will take into account Senate legislation but will otherwise seek to be concise and understandable to the everyday reader with about a dozen or so pointed recommendations.

Past reports as long as 10 years ago have long cited problems of poor Pentagon and VA coordination, but may have been ignored or lost in the shuffle partly due to length and their complexity, she said.

In particular, many of the commissioners expressed a desire to strengthen or add provisions that would ensure that families could have free access to private medical care if no adequate government facility is available in their cities.

Currently, injured service members are restricted under Pentagon and VA rules on their choice of facilities, at times forcing them to travel hundreds of miles away for treatment and imposing burdens on family members who must give up their full-time jobs and personal lives to help care for their loved ones.

"Our charge has and will be to focus on solutions that can be activated in a reasonable time," Dole and Shalala said in a joint statement. "We are solution-driven. We will not be issuing a report that points fingers."

Copyright 2007 Associated Press. All rights reserved. This material may not be published broadcast, rewritten, or redistributed

From another source comes a simila
About 1.8M Veterans Are Uninsured, Lack Access To VA Hospitals, Study Finds
Main Category: Health Insurance / Medical Insurance News
Article Date: 25 Jun 2007 - 2:00 PDT
| email to a friend | printer friendly | view or write opinions |

• Public Health

digg_url = 'http://www.medicalnewstoday.com/medicalnews.php?newsid=74981'; digg_title = 'About+1.8M+Veterans+Are+Uninsured%2C+Lack+Access+To+VA+Hospitals%2C+Study+Finds'; digg_bodytext = '%0ALawmakers+on+Wednesday+at+a+hearing+of+the+%3Ca+href%3D%22http%3A%2F%2Fveterans.house.gov%2F%22+target%3D%22_new%22%3EHouse+Committee+on+Veterans%27+Affairs%3C%2Fa%3E+discussed+a+proposal+to+lift+a+ban+on+%3Ca+href%3D%22http%3A%2F%2Fwww.va.gov%2F%22+target%3D%22_new%22%3EDepartment+of+Veterans+Affairs%3C%2Fa%3E+health+benefits+for+higher-income+veterans+w'; digg_topic = 'health';
rate this article



Lawmakers on Wednesday at a hearing of the House Committee on Veterans' Affairs discussed a proposal to lift a ban on Department of Veterans Affairs health benefits for higher-income veterans who have no service-related disabilities in response to a study that found 1.8 million veterans younger than age 65 lack health insurance or access to care at VA facilities, the Washington Post reports.

The ban applies to Priority 8 veterans -- those who have annual incomes that exceed 80% of the median income where they live and have no service-related disabilities (Lee, Washington Post, 6/21). The Bush administration implemented the ban in 2003 because of a need to maintain VA health benefits for an increased population of veterans (CQ HealthBeat, 6/20).

At the hearing, Stephanie Woolhandler of Harvard University presented the study, for which researchers examined data from the Current Population Survey administered by the Census Bureau and the National Health Interview Survey administered by HHS. Researchers considered veterans uninsured when they said they lacked health insurance or access to care at VA facilities. The study found that 12.7% of veterans younger than age 65 were uninsured in 2004, the most recent year for which data were available, compared with 9.9% in 2000 (Washington Post, 6/21). In addition, the study found that 26.5% of uninsured veterans failed to obtain necessary health care because of cost issues and that 31% delayed such care because of cost issues (Reichard, CQ HealthBeat, 6/20).

Woolhandler recommended that Priority 8 veterans receive VA health benefits. According to Woolhandler, about half of the 1.8 million uninsured veterans are considered Priority 8, and the remainder might qualify for VA health benefits but lack access to care because they do not live near department facilities (Washington Post, 6/21). Possible Congressional Action
Committee chair Bob Filner (D-Calif.) said that he plans to introduce legislation to lift the ban on VA health benefits for Priority 8 veterans. Filner said, "I think there is sufficient money for category 8. If the committee and if the Congress approves, I think we could move ahead with the resources that we've put in with the budget."

However, Michael Kussman, undersecretary for health at VA, said, "We believe the current restriction on enrollment of new Priority 8 veterans is necessary to maintain the timelines and quality of health care we provide to currently enrolled veterans." In addition, Rep. Steve Buyer (R-Ind.), ranking member of the committee, said that lawmakers should study the potential effects of removal of the ban on demand for care at VA facilities, adding that the proposal "will open the gates and the surge will come in."

Veteran organizations said that Priority 8 veterans are legally entitled to VA health benefits. John Rowan, president of Vietnam Veterans of America, said, "We strongly urge that you truly honor the commitment that we as a nation have made" (CQ HealthBeat, 6/20).

Washington State
In related news, the AP/Spokane Spokesman-Review on Wednesday examined how Sen. Patty Murray (D-Wash.), a member of the Senate Veterans' Affairs Committee, recently sent a letter to VA Secretary Jim Nicholson that asked for information related to reported problems with two psychiatric wards at department hospitals in Seattle and Tacoma, Wash. Murray also recently flew to Seattle to tour the VA hospitals (Johnson, AP/Spokane Spokesman-Review, 6/20).

Broadcast Coverage
Several broadcast programs recently reported or are scheduled to report on issues related to mental health care for veterans. Summaries appear below.

• C-SPAN's "Washington Journal": The program on Wednesday included a discussion with Vice Adm. Donald Arthur, co-chair of the Department of Defense Mental Health Task Force ("Washington Journal," C-SPAN, 6/20). Video of the segment is available online.
• KCRW's "To the Point": The program on Thursday is scheduled to include a discussion on mental health care for veterans ("To the Point" Web site, 6/22). Additional details about the segment are available online. A broadcast schedule also is available online. Audio of the segment will be available on the program's Web site after the broadcast.
• WBUR's "Here & Now": The program on Tuesday included a discussion with Mark Kaplan, a professor of community health at Portland State University and lead author of a recent study that examined the suicide rate among veterans. The program also included a discussion with Barbara Romberg, a clinical psychologist in Washington, D.C., who provides care to veterans at no cost ("Here & Now," WBUR, 6/19). Audio of the segments is available online.

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.r article:

Senators dispute hybrid benefits, Priority 8

By Rick Maze - Staff writer
Posted : Wednesday Jun 27, 2007 18:20:12 EDT An unusually contentious Senate Veterans’ Affairs Committee meeting Wednesday featured a fight over the creation of hybrid benefits — partly guaranteed and partly set by the whims of the federal budget — plus a battle over priorities for treatment of veterans’ hospitals and even a mention of socialite Paris Hilton.

It was Sen. Bernard Sanders, the political independent from Vermont and sponsor of the proposed hybrid benefits, who brought up Hilton during debate on veterans’ funding as he and Sen. Larry Craig, R-Idaho, discussed veterans’ health care legislation.

Craig, the committee’s former chairman and now senior Republican, was trying to block Sanders’ amendments to increase veterans’ burial benefits and grants for autos and homes that are equipped for the handicapped. Craig also opposed a committee plan that would restore the right to enroll in the veterans’ health care system to veterans with modest incomes and no service-related disabilities, who are in the lowest priority group for care.

“I am concerned that if we flood the system and don’t fund it, we are in for consequences,” Craig said, warning that quality of care could dip and combat-injured veterans from Iraq and Afghanistan could be “shouldered out of the way.”

Sanders said the VA budget could be increased, and that would take care of everything.

“I was elected to change priorities here in Washington,” Sanders said. “Before I give tax breaks to Paris Hilton’s parents and other millionaires, I want to make certain we take care of our veterans,” he said.

Even Craig smiled at the reference to Hilton, but he was not smiling through most of the hearing.

On a mostly party-line vote, Sanders’ proposal to increase plot allowances, funeral benefits and auto and home grants through supplemental payments passed the committee over Craig’s objections. Sen. John Ensign, R-Nev., voted with Sanders and the committee Democrats for the hybrid benefits.

Under Sanders’ plan, attached to S 1315, the Veterans’ Benefits Enhancement Act of 2007, eligible veterans or their survivors would continue to receive current payments — up to $300 for buying a burial plot, up to $2,000 for funeral expenses, and grants of up to $11,000 for adapted vehicles and $50,000 for adapted housing — but could get more than twice as much if Congress pays for supplemental benefits.

His plan would create a supplemental $445 burial plot allowance, up to $2,100 more for funeral expenses and an additional $11,000 for an auto grant and $10,500 for a housing grant.

Sanders said he was creating supplemental benefits rather than increasing existing benefits to try to get around internal budget restrictions used in Congress that require increases in mandatory benefits to be offset by cuts in existing benefits, tax increases or a combination of the two.

Craig said the idea is fraught with problems. First, he said that while he supports some of the ideas, particularly an increase in the burial plot allowance, there is no guarantee any increases would be approved. Second, he said the funding scheme was just a ruse to get around rules that exist to prevent runaway budgets, and that Sanders’ success could start a spending wave if other lawmakers use the same tactic. Third, Craig said it is possible that the supplemental benefits could be paid some years and not paid others, depending on the availability of funding, which would create unfairness.

By a 10-6 vote, the veterans’ committee rejected an attempt by Craig to gut a committee proposal in S 1233, a health care bill that orders the Department of Veterans Affairs to reopen enrollments in the VA for so-called Priority 8 veterans, those with no service-connected disabilities and incomes of at least $27,000 a year.

Four years ago, the VA closed enrollment to this group of veterans, the lowest on the priority list, saying there was not enough money to cover their care. At the urging of Sen. Daniel Akaka, D-Hawaii, the committee chairman, and Sen. Patty Murray, D-Wash., the bill would reopen enrollment for Priority 8 veterans.

The potential effect on the VA of the extra patients is not known. About 17 million veterans could technically qualify, but only about 1.6 million are believed to be really interested in enrolling for VA health care.

Craig noted that 80 percent of Priority 8 veterans have health insurance that would allow them to get care elsewhere. He said their treatment should not come at the expense of other veterans, so he proposed am amendment that would allow enrollment only if the VA certifies that higher-priority veterans would not be hurt and that there is space, people and equipment for the new patients.

“I think opening the system to 17 million new veterans at this time is a bad idea,” Craig said.

But Murray said the VA was “wrong” four years ago to deny care to Priority 8 veterans and that Congress needs to fix the problem, regardless of cost.

“To tell a veteran we may not have enough money to take care of you is the wrong approach,” she said.

Akaka said adding the Priority 8 veterans could end up helping the VA because they will be making co-payments and their private insurance can be billed for care.

“We have fought hard to see that these veterans who have served their country honorably get the care they deserve,” Akaka said.

The committee’s legislation would have to be passed by the full Senate, agreed to by the House and signed by President Bush before it could take effect.

[/list]By JACQUELINE PALANK Published: June 30, 2007 WASHINGTON, June 29 — The presidential commission investigating problems in health care for military personnel wounded in Iraq and Afghanistan held its final hearing Friday, and focused on problems with moving patients through various stages of aid, from Defense Department hospitals to those run by the Veterans Administration or private health care, to home care and to jobs.

Today’s veterans are more likely than those of previous conflicts to suffer from “polytrauma,” including burns, brain injury and shrapnel from explosives, members of the commission said, making their treatment more complicated.

the health care system should also take into account the strain that puts on family members, Comissioners said, and should make more use of contractors who can help in out-patient care.

The commission, led by a Democrat and former secretary of health and human services, and Bob Dole, the Republican presidential nominee in 1996, was established in March after articles in The Washington Post described poor conditions at the Walter Reed Army Medical Center here.

“We’re very solution-driven,” Ms. Shalala said of the panel. “We will not be issuing a report that points fingers.”

Because today’s wounds are different and the families of the veterans are different — many are older, with homes and spouses to return to — more veterans should be allowed to return home for treatment, commissioners said.

Returning patients to their homes can relieve the strain on some families, said commissioners, who reported that some relatives must now leave their homes and jobs to assist with their service members’ treatment in distant hospitals run by the Departments of Defense or Veterans Affairs. But caring for injuries at home requires support from the V.A., they said, and support offered now is often insufficient.

Another consideration is that the patients’ physical wounds are also accompanied by post-traumatic stress[/url] disorder, commissioners said.

The hearing on Friday was the commission’s seventh, and several members of Congress who have introduced legislation on veterans care came to testify. Mr. Dole and Ms. Shalala asked if they would include the commission’s recommendations in pending legislation.

“We would welcome suggestions, absolutely,” said Senator Carl Levin, Democrat of Michigan and chairman of the Senate Armed Services committee.

Mr. Levin said the Senate’s veterans bill, which is scheduled for the floor, seeks to improve medical record sharing between the military and the Department of Veterans Affairs as well as address discrepancies in the disability ratings each department uses to determine how much in benefits a service member is paid each month.

Representative Steve Buyer, Republican of Indiana and the ranking member of the House Veterans’ Affairs Committee, said he was concerned that the departments did not adequately use private contractors to provide outpatient treatment, which could allow patients to receive care at home rather than have to travel to a veterans hospital.

“If we’re patient-centric, we should allow the transition of that patient to occur,” Mr. Buyer said.

Ms. Shalala said, “This is a different war in which we have people who have families and they want to go home.”

Insult to Injury:

War Wounded Underpaid Tom Philpott | June 15, 2007 VA Disability Pay Set too Low for Many War Wounded Disability compensation for veterans severely wounded in Iraq and Afghanistan, particularly the youngest, is set too low, creating a lifetime earnings gap with non-disabled peers, according to a draft study on disabled veterans’ incomes prepared for the Veterans Disability Benefits Commission.

The same study found that disability compensation probably is set too high for veterans who first begin drawing the disability payments at age 65 or older, having already retired from post-service careers.

This imbalance in disability compensation paid by the Department of Veterans Affairs (VA) was a point of contention at a June 8 commission hearing. The data help to explain why younger disabled veterans, facing a lifetime of income challenges, are more dissatisfied with disability pay. But commissioners sounded divided on how to address the imbalance in earning capacity if part of the perceived solution is to dampen future payments to elderly veterans who are awarded VA compensation late in life.

Congress created the commission to examine the appropriateness of benefits being paid to veterans and their survivors. The commission hired the think tank CNA to survey more than 20,000 veterans to determine the effectiveness of VA disability payments in replacing earnings capacity lost to service-connected disabilities when compared to non-disabled peers. The law states restoration of veterans’ average earnings capacity as the primary purpose for VA disability payments.

CNA also examined how well disability compensation meets the “implied intention” of Congress that disability payments also compensate veterans in some way the decline in quality of life from their disabilities.

CNA officials reported this latest commission meeting that they found no evidence basic VA disability payments are set so as to recognize and compensate veterans’ for diminished quality of life as well as earnings loss. The exception is special monthly compensation (SMC) paid to the most severely injured veterans who have lost organs or major bodily functions.

Briefing commissioners on their findings were CNA analysts Joyce McMahon and Eric Christensen. They said current payment levels are “about right” if the goal literally is to compensate an entire population of disabled veterans for lost earnings capacity compared to non-disabled vets.

The typical veteran is awarded disability pay at about age 55. The prevent value of their diminished lifetime earnings is about $150,000 and over their remaining years they will draw about $145,000 in VA disability compensation, nearly matching average earning loss.

But the fairness of disability payments unravels when actual earning losses are broken out by the veteran’s age when payments start, the severity of disability and whether conditions are physical or mental. Earnings capacity is impacted far more dramatically by mental disorders, CNA found.

Other veterans being under compensated, and by a “substantial margin,” said Christensen, are those left 100-percent disabled or unemployable at 45 or younger. McMahon advised commissioners that they might want to consider adjustments to compensation levels, particularly for these younger veterans, given the rising population of wounded returning home from wars in Iraq and Afghanistan.

The analysts noted that when VA compensation fails to keep pace with lost earnings, declines in qualify of life deepen for veterans and their families.

CNA noted that a 25-year-old veteran who returned from war 100-percent disabled from physical wounds and was rated as unemployable by the VA, began receiving $28,352 a year in disability compensation, using 2005 rates. That amount was more than $11,000 short of the $39,447 needed annually to stay even with non-disabled peers, the study found.

VA paid the same $28,352 to a 65-year-old veteran rated as “IU” or individual unemployable. But if that older veteran became disabled for the first time at 65 based on latent service-connected conditions, after working a full career, VA actually is over compensating him, the study found. That’s because that older veteran, with his working life behind him, would need only $10,223 to close an earnings gap with peers who non-disabled veterans.

“So, while on average [VA compensation is] about right, there are age groups for which it over or under compensates,” said Christensen.

The imbalance occurs in part because the disability compensation system takes no notice of age or work experience when payments begin.

The earnings gap is more pronounced for veterans who suffer mental disorders such as post-traumatic stress, CNA reports. A 25-year-old veteran rated 20 to 40 percent disabled from PTSD received on average VA disability compensation $4629 in 2005. Yet to match the earnings of non-disabled veterans of the same age, that PTSD veteran would need almost $11,500 a year in VA compensation for the rest of his or her life, the study found.

By contrast, the 65-year-old veteran newly diagnosed with PTSD, also rated 20 to 40 percent disabling, faces a smaller earnings gap with peers -- only $4070. It’s a gap fully closed by that VA compensation of $4629.

While some commissioners expressed satisfaction that “average” VA compensation was adequate, and others challenged the notion of elderly veterans being over compensated, Commissioner Dennis V. McGinn, a retired Navy vice admiral, said something must be done to raise compensation younger veterans. Commissioner John Holland Grady, an economist, agreed.

“I think we should be zealous in trying to fix that,” said Grady. “I mean the average is interesting but so what?”

CNA analyst McMahon noted helpfully that “whether you are happy with an average depends on which end of the distribution you are on.”

To comment, e-mail milupdate@aol.com, write to Military Update, P.O. Box 231111, Centreville, VA, 20120-1111 or visit: www.militaryupdate.com

Even though you’re perspective is one looking in from the outside and you have no concept of a veterans life in New Mexico, nor do you understand the vastness of this place, I’ll say this;
The VA is doing little more than an adequate job of keeping healthy vets healthy, they are far behind on what it takes to keep the rest of them healthy. You want healthy vets it’s gonna cost you some more taxes, simple as that. Walk through the front door of any VAMC and ask for a list of jobs they have given up on trying to fill, substantial lists, I’ve seen them,, and the jobs they are trying to fill, sad at best, shortages on almost every level. Reach in you’re pocket or volunteer, nothing else you can say or do would be appreciated more.
Mileage; Albuquerque to Carlsbad 275
Hobbs 315
Animas 305
Clayton 300
NM 121,364 sq miles
pop, 1.73 mil

Just gotta love those who can say it’s good when they’ve never tasted it. They become part and partial to the problem believing solutions are not necessary when they are actually contributing to the suffering of veterans who DO need help.
It’s way to easy to make determinations about things that took place in a prior time when you're too young to know the truth and too lazy to find it, also belittling more veterans who lived through that time and may need help.
If you were not there for the walk, most of us don’t need to hear your talk,
‘IT DON’T MEAN NOTHING’

I would extend this to every Human Being located in the USA or her Territories. A Universal
Health Care Program, as advocated by the movie SICKO and the commonly perceived "sicko
congressman," Kucinich, is the quickest most cost effective way to fix this problem.

Hey, I don't mean to be a conversation stopper but it is Saturday, the Day intended for activities that are both Pleasurable and Meaningfull. Tomorrow is Free Choice day. What does a Diverse Group like Ours perceive and construe to represent the best problem statement/goal solution
statement for all veterans's health care and Wellness Promotion????... A complete Universal
Health Care and Wellness Support for all of their families, friends, community members and fellow citizens and guest is needed to make any system work for the sub-group of Veterans. The general system principle here is that Each and Every Human Being is of
Equal Value...And thus Each and Every Person is of Ultimate Value. Personally, I believe the
Democratic Party (of which I have been a devoted member for 50 years) has about 60 days
to start showing in deeds, not words, that the current Party Leadership is up to the challenge
or a new Party is likely to be born to replace it. In my opinion, Reid must be given a new script that is more congruent with our Democratic Party Principles or a new leader selected. Better coordination and integration of Purpose among the the Speaker of the House, the Leader of the
Senate and Our Grass-roots Representative, Chairman Dean. As the chant of thousnands of Persons with Disabilities during the Independent Living Movement's March on Washington one night in the rain was...WHERE'S GEORGE, WHERE IS GEORGE (this was Bush I), our chant
should be WHERE IS HOWARD?, where is howard? When we need to help Congress End the
War, change our Emperialist Foreign Policy and build a Universal Care System and take
of a few other high priorities the current administration has failed to attend to, where is Howard?
The Grass-roots need someone to speak for us, particularly those of us who want to support
the Party but are not ready to committ to a particular candidate yet.

For the politically devious, the question might be Has Chairman Dean all ready picked a Candidate
and is dealing under the table while representing us at the negotiating table? Personally, I'm looking more systemically at the lack of (up and down levels and across domains Coordination) Leadership in the Democratic Party Effort-as-a-Whole, to offer the Nation-as-a-whole, an
Alternative...Including me for I am both a Veteran and a Citizen...Please excuse the diversion...

Original Content at http://www.opednews.com/articles/opedne_la...ise_to_vete.htm

July 2, 2007

WHAT PROMISE TO VETERANS?

By Larry Scott

I’ve searched high and low for a promise made to veterans. I can’t find it. Surely, it must exist. From George Washington to George Bush, we have reams of flowery rhetoric praising the good deeds of those who have served in the U.S. military. But, where is the promise?

Washington said the nation owes veterans a “debt of honor.” Bush often speaks of “honor,” “support” and “compassion” in speeches about veterans. In between, Abraham Lincoln said our mission is “…to care for him who shall have borne the battle and for his widow and orphan…” All of this sounds good, but it’s not a promise.

The elusive promise to veterans has been used by politicians since the earliest days of our republic to raise armies to fight wars and to pass legislation to care for veterans when they come home from those wars. But, what actually was promised?

It’s a simple fact: that nothing was promised to veterans. There was no promise made, so there’s nothing to keep and nothing to break. It’s the great American myth; an urban legend of epic proportions.

This myth is promulgated by politicians who want us to think they are keeping a promise to veterans or want us to think some other politician isn’t keeping a promise. A quick Google search will show thousands of entries about a promise to veterans. Many are from those claiming to keep the promise. Others are from those who loudly declare the promise is not being kept. But, nowhere will you find exactly what this promise might be.

So, why do we believe there’s a promise to veterans? Because we want to believe it. We want to believe that our country will care and provide for those who have given years of their lives to military service. We desperately want to believe that our country will care for those who return from the fields of battle with physical and emotional wounds. Anything else would not fit the standards we have set for ourselves as Americans.

However, the truth is something different.

Veterans of the Civil War have left us volumes of their post-war battles with the Commissioner of Pensions who parceled out medical care and disability compensation. One document tells of a veteran’s struggle with the Commissioner to get a wooden leg to replace the real leg he’d lost in combat. After years of denials, he carved the leg himself.

Military retirees of the World War II era were under the assumption they would have free, life-time healthcare at military hospitals. Those hospitals were closed. And now, the retirees find themselves in a HMO.

Vietnam veterans fought for years to get benefits for exposure to Agent Orange. Now, many of them who served in the “Blue Water Navy” find their adversary is the Department of Veterans’ Affairs (VA) who is in Federal Court trying to deny them benefits.

Our new veterans coming home from the wars in Iraq and Afghanistan find themselves faced with military and VA healthcare systems that are underfunded, overcrowded and incapable of caring for their needs.

All of these veterans thought there was a promise and found out otherwise.

Veterans have been accepting the constantly-changing hodge-podge of laws and regulations that, sometimes, provide disability compensation and care. And, “sometimes” is the operative word. A check of federal regulations covering veterans’ benefits shows an abundant use of the phrase “the Secretary may.” The “Secretary” is the Secretary of Veterans’ Affairs who “may” or may NOT provide the benefit listed in the specific regulation.

But, could there be a promise to veterans buried somewhere in mountains of laws or hidden deep in the recesses of the Federal Code? The Herculean effort to see if such a promise existed was undertaken by David F. Burelli, a National Defense Specialist for the Congressional Research Service. Burelli’s research paper is titled Military Health Care: The Issue of “Promised” Benefits. The 23-page paper makes this determination: “Many…military retirees…state that they were promised ‘free health care for life at military facilities’ as part of their ‘contractual agreement’ when they entered the armed forces. Efforts to locate authoritative documentation of such promises have not been successful. Congressional report language and recent court decisions have rejected retiree claims [of] a right or entitlement.” While Burelli’s paper deals with military retirees, it can be extrapolated to include non-retiree veterans, as well.

Others, realizing Burelli’s findings to be accurate, have tried to reframe the language of a promise to veterans. Dave Autry of the Disabled American Veterans (DAV) likes to use the concept of a “moral obligation” to veterans. That high-minded verbiage has been used thousands of times by politicians, authors and veterans’ advocates. But, it still doesn’t equate to a promise. And, it assumes that Congress, who supplies funding for veterans’ care and disability compensation, understands what is “moral” and has the fortitude to commit to an “obligation.” Those are two dangerous assumptions.

But, this verbal posturing leaves us where we began. There is no promise to veterans. The government can’t keep a promise that was never made. And, it’s not realistic to assume that they are breaking a promise they never made.

Will there ever be a promise to veterans? A real promise that is codified? A document that positively states what veterans will receive for their service to country? Not unless we, as veterans, force the issue. No politician is brave enough to step forward and say, “We lied to you,” so it’s up to us. We must raise hell about the issue.

I, for one, am tired of the hand-in-glove relationships our veterans’ service organizations (VSOs) have established with Congress and the VA. Every year the VSOs go to Capitol Hill and grovel for next year’s VA budget handout. When the budget is passed and doesn’t meet their expectations, the VSOs politely thank the politicians for doing a good job and then politely urge them to do better.

Whatever happened to in-your-face, do-it-or-else political lobbying? We pay our VSO dues so they can represent us on Capitol Hill. They are failing in their mission. They allow politicians to ramble on about a promise to veterans and never ask the questions: What promise is that, politician? The one you never keep? And, the politicians keep playing us for fools. As long as veterans buy into the myth of a promise, the politicians win.

We, as veterans will continue to scrap and fight for our justly-deserved benefits. But, it’s time we adopt a new attitude. It’s time to stop accepting piecemeal legislation that gives a few budget dollars to slap a Band-Aid on a chronically-underfunded VA healthcare and benefits system. It’s time we stop accepting the nonsense of politicians who openly view VA benefits as charity, to be handed out only to those who fit their warped definition of the deserving. We owe it to all of our Brother and Sister veterans. And, let’s be honest, we owe it to ourselves. This is not the time to be humble.

It’s time for the in-your-face type of confrontation that our VSOs are incapable of providing. We must take our elected representatives to task and demand that they stop talking about a promise and actually give us one. We must tell Congress what we want. We must tell the American people what we want and that we earned our benefits through our service. Most “civilians” live under the assumption that “the VA takes care of it” when it comes to veterans’ benefits. It’s time they were educated. It’s time to stop asking and start telling. No more “Yes sir” and “No ma’am” and “Thank you very much” for what little we get. If we don’t force this issue, we can only blame ourselves.

The next time my Senator or Representative holds a town hall meeting in my area I’ll be there asking about the promise. I want them to tell me what the promise is and where I can find it in writing. They won’t be able to do that. But, maybe, just maybe, they’ll listen as I tell them it’s time to make a real promise and it’s time to really keep it. And, I’ll be wearing the T-shirt with this slogan printed in large letters:

WE ARE U.S. MILITARY VETERANS – YOU OWE US!





Authors Website: http://www.vawatchdog.org

Authors Bio: Larry Scott (larrys@vawatchdog.org)served four years in the U.S. Army with overseas tours as a Broadcast Journalist in Korea and the Azores and a stateside tour as a Broadcast Journalism Instructor at the Defense Information School (DINFOS). He was awarded DOD's First Place Thomas Jefferson Award for Excellence in Journalism. After the Army, Larry was a news anchor on WNBC Radio in New York City. He receives VA compensation for a service-connected disability. Larry is a regular on the Thom Hartmann show on Air America Radio. Today, Larry resides in Southwest Washington and operates the website VA Watchdog dot Org.

Was gonna address more specifics in this previous thread. Unfortunately someone decided to toss this new one out rather than keep the old one goin', eh? Okay, forget existin' discussions and muddle through new ones methinks seems the order of the day, so here goes... Methinks the above article, posted without comment from the initiator of this thread, indicates just how poorly Larry Scott, the author, researched it. Maybe if he'd just done a little lookin' he'da found The Department of Veterans Affairs history page, which lays out much of what was promised quite well, eh?

In addition I was easily able to find the promises made and codified in federal laws goin' back to when Congress established a new system of veterans benefits when the United States entered World War I in 1917. Seems these were greatly expanded and better coordinated when the establishment of the Veterans Administration came in 1930 when Congress authorized the President to "consolidate and coordinate Government activities affecting war veterans".

Since then there've been even more expansions of promises made and codified in public law by the federal government. Here are a few examples:

1. The Mustering-out Payment Act (PL 78-225) is a United States federal law passed in 1944. It provided servicemen, returning from the Second World War, with money to help them start back with their civilian lives.

2. The Servicemen's Readjustment Act of 1944 (PL 78-346, better known as the G.I. Bill) provided for college or vocational education for returning World War II veterans (commonly referred to as GIs or G.I.s) as well as one year of unemployment compensation. It also provided loans for returning veterans to buy homes and start businesses.

3. Veterans' Readjustment Assistance Act (PL 82-550) passed and signed into law in 1952.

4. The Department of Veterans Affairs Act of 1988 (Public Law 100-527) changed the former Veterans Administration, an independent government agency established in 1930, primarily at that time to see to needs of World War I, into a Cabinet-level Department of Veterans Affairs in 1988.

There's plenty more, but methinks you get my drift. Feel free to contact Mr. Scott and tell him IMHO he did an extremely crappy job of journalism if you want, eh?

And please, no more unfounded assertions like "I am at a loss to understand why some of you criticize those veterans who are having difficulty getting medical care" found here, eh? Notice that when challenged on that assertion in this note the silence was deafening!

Editorial, Washington Times




Wounds, real and political
The flurry of media attention directed at the Walter Reed Army Medical Center scandal has subsided, but not for lack of activity. It is time for exhaustive work to improve the nation's complicated military medical system and veterans' health care inside the departments of Defense and Veterans Affairs. Meanwhile, though, a kind of farce of Washington politics is underway in which the scandal is used by some for political effect, who are then opposed by others who fail to understand the magnitude of the problem and thus sound rather callous.


In April, the Independent Review Group appointed by Secretary of Defense Robert Gates to investigate the Walter Reed scandal and system-wide issues handed down what the New York Times called "a sweeping indictment" of a breakdown in health services. The review, headed by John O. Marsh and Togo West, two former secretaries of the Army, called the Walter Reed scandal a "perfect storm" of harmful factors resulting from the Base Realignment and Closure Commission's recommendations; pressure to outsource work from the administration's "A-76" contracting requirements which caused serious staffing problems; and the sharp rise in the number of casualties, many with very complicated and little-understood traumatic brain injuries or polytrauma and amputations.


Among the review's recommendations: Focus on shoddy outpatient care; create centers of excellence for brain injury and post-traumatic stress disorder; remedy the "systemic breakdown of a seamless and smooth transition from Department of Defense to the Department of Veterans Affairs"; pay particular attention to the appalling failure to achieve, "seamless" transitions; remedy serious problems in the physical disability evaluation system; and lift A-76 requirements.


There is a danger in this climate of a rush to change systems which are not fully understood, owing to the fact that the government-political-media timetable to reach conclusions and make public reports is still wildly ahead of the hard analytical process necessary to reach sound long-term conclusions.


In these debates one sees the reality clash with the theatrics of war and war casualties. Last week, in a hearing at the military personnel subcommittee of the House Armed Services Committee, ample doses of reality included this statement from a senior recently retired service member: "[W]hen you look at the evaluation systems, they are so convoluted, so complicated, that there's only probably a handful of folks in the military that understand it. I just retired from the military after 37 years, and do not ask me a question about them, because I have no idea."


Outside such hearings, one hears two kinds of ill-advised thinking which seem to take such facts less seriously than they should, one frequently heard on the left, the other on the right. On the left is the use of the military-health-care mess as a political cudgel whose real aim seems to be to remind listeners of the decision by President Bush to enter Iraq. The most egregious, later retracted, was Sen. Barack Obama's February "wasted lives" remark which the senator said he came to regret, and for which he apologized repeatedly.


The other, from the right, is a kind of misguided fiscal prudence which opposes typically reasonable legislation designed to improve circumstances for wounded war veterans. Most egregious was Mr. Bush's "pork" remark and his veto threat regarding recent Democratic proposals. But last week in a contentious Senate Veterans Affairs Committee meeting, Sen. Larry Craig, Idaho Republican, warned against the fiscal consequences of a hybrid-benefits proposal by Sen. Bernie Sanders, Vermont Independent, in the wake of an Institute of Medicine determination that the VA's means of judging disability is "hopelessly outdated."

Here's how the Air Force Times was able to characterize his position: Mr. Craig "was trying to block Sanders' amendments to increase veterans' burial benefits and grants for autos and homes that are equipped for the handicapped. Craig also opposed a committee plan that would restore the right to enroll in the veterans' health care system to veterans with modest incomes and no service-related disabilities, who are in the lowest priority group for care." He was quoted: "I am concerned that if we flood the system and don't fund it, we are in for consequences."We wonder how many members of Congress are aware of a January working paper by Linda Bilmes of Harvard University which concluded that "the budgetary costs of providing disability compensation benefits and medical care to the veterans from Iraq and Afghanistan over the course of their lives will be from $350-700 billion," depending on factors like future deployments, recipient lifespans and health-care inflation. A sense of realism on all of this is sorely needed, as is an understanding from our elected leaders that politics should be marginal when it comes to wounded soldiers.

From another Washington Times editorial:

Funds for vets and the wounded
Since the president announced an end to major combat operations on May 1, 2003, deaths of military personnel in Iraq have risen from 138 to nearly 3,600 today. Also, more than 95 percent of the American personnel wounded in Iraq (35,000 to 53,000, depending on how they are counted, according to a recent Associated Press series) have been sustained since the end of major combat operations. Under these circumstances, now would not be an ideal time to reiterate a White House threat to veto the military construction/veterans affairs appropriation if it exceeds the level the president proposed in his 2008 budget. So, the White House has wisely retreated from a veto threat that would have been a political disaster for the president, the vice president and their party. Political ramifications aside, it also would have been a slap in the face to returning wounded warriors.

Acting in a bipartisan manner, Congress is right to increase the president's inadequate funding proposals to serve the needs of injured veterans. On June 6, the House Appropriations Committee voted 56-0 for a bill that would allocate $37.1 billion to the Veterans Health Administration. That was $2.5 billion more than the president requested. As news outlets continue to report on the scandals afflicting the Walter Reed Army medical facilities, Congress is right to attempt to address similar concerns within the Department of Veterans Affairs (VA). To that end, the bill added $500 million to the president's $3.6 billion request for the VA's medical facilities account, which funds maintenance. Another $69 million was added for medical and prosthetic research. On June 15, the House approved the measure by a veto-proof 409-2 margin. Meanwhile, on June 14, the Senate Appropriations Committee voted 28-1 to approve its veterans and military construction spending measure. The Senate bill added $3.6 billion to the president's discretionary spending proposal for the VA.
It is a national disgrace that servicemen and veterans have been facing such huge roadblocks and so many hurtles delaying the recognition and treatment of their disabilities. CQ Weekly recently reported that the VA system has a backlog of more than 400,000 disability claims even as the number of injured soldiers and Marines is poised to increase significantly. The overwhelmed VA system now takes an average of 177 days to process a claim, twice as long as the private health-insurance system.

It is already unconscionable that the military's equipment situation has been permitted to deteriorate to unacceptable levels during wartime. Continuing to deny adequate and timely medical care, both physical and mental, to wounded warriors literally adds insult (and contempt) to injury.

Fighting the system...and winning!

From ABC World News, Friday, June 29, 2007.

Length is 2:59.

Posted on YouTube here...
http://www.youtube.com/watch?v=t_9fDOhyncY

<h2 class="r">Scholarly articles for Military Health Care: The Issue of “Promised” Benefits.
</h2>Telemedicine: a guide to assessing telecommunications in ... - Field - Cited by 167
The Reasoning Voter: communication and persuasion in ... - Popkin - Cited by 706
Boomerang: Clinton's Health Security Effort and the Turn ... - Skocpol - Cited by 73
[PDF] <h2 class="r">Military Health Care: The Issue of "Promised" Benefits</h2>File Format: PDF/Adobe Acrobat - View as HTML
Order Code 98-1006 F. Military Health Care:. The Issue of “Promised” Benefits. Updated August 12, 2003. David F. Burrelli. Specialist in National Defense ...
mrgrg-ms.org/crs1006d-the-issue-of-promised-benefits.pdf - Similar pages [PDF] <h2 class="r">Military Health Care: The Issue of "Promised" Benefits</h2>File Format: PDF/Adobe Acrobat - View as HTML
CRS Report for Congress. Received through the CRS Web. Order Code 98-1006. Military Health Care:. The Issue of “Promised” Benefits. Updated January 19, 2006 ...
digital.library.unt.edu/govdocs/crs/permalink/meta-crs-8298:1 - Similar pages [PDF] <h2 class="r">Military Health Care: The Issue of "Promised" Benefits</h2>File Format: PDF/Adobe Acrobat - View as HTML
CRS Report for Congress. Received through the CRS Web. Order Code 98-1006 F. Military Health Care:. The Issue of “Promised” Benefits. Updated July 10, 2001 ...
digital.library.unt.edu/govdocs/crs/permalink/meta-crs-2040:1 - Similar pages
[ More results from digital.library.unt.edu. ]

Room 333 Cannon HOB For More Information Contact: Washington, DC 20515 Susan Edgerton or
Mary Ellen Mc Carthy @ 202-225-9756


Congressman Lane Evans (D-IL), the Ranking Democratic Member of the House Veterans Affairs Committee, today said the budget adopted by the House Budget Committee would mean drastic reductions in funding for veterans’ benefits and services. Evans called the budget “shameful” and pledged to fight to defeat the Republic budget blueprint. Referring to the more than a trillion dollars worth of tax cuts approved by the Budget Committee, Evans asked, “Who deserves to receive the benefits of the national treasury—America’s disabled veterans or America’s millionaires?”

The Republican majority of the House Budget Committee approved a federal budget reducing funding for veterans health care and benefit programs by nearly $25 billion. The proposed budget cut $844 million from the President’s request for veterans’ health care next year. Over a ten-year period the GOP is proposing a cut of $9.7 billion in veterans’ health care—an average of more than $900 million less than the President has proposed per year. For other veterans’ benefits, including cash payments to veterans disabled by military service, the Republican budget calls for a $463 million cut during the next year and a $15 billion cut in spending from current levels during the next ten years. The House Budget Committee is chaired by Congressman Jim Nussle (R-IA).

By a nearly party-line vote of 22-19, Republicans defeated an amendment offered by Democratic Representatives Darlene Hooley, Tammy Baldwin, Dennis Moore, Chet Edwards, Bobby Scott, Lois Capps, and Artur Davis that would have restored the proposed $844 million for veterans health care and added a billion dollars to the VA’s budget for discretionary programs. These cuts are made to a budget that already relies upon $1.1 billion in vaguely defined management efficiencies and $1.4 billion in mostly unpalatable legislative and policy proposals already included in the President’s budget. The amendment would also have restored the Budget Committee’s proposed $463 million in cuts to veterans’ benefits. Only Republican Ginny Brown-Waite, a member of the Committee on Veterans Affairs, crossed party lines to vote for increased funding for veterans.

In sharp contrast to Nussle’s proposal, a bipartisan recommendation from Chairman Christopher Smith (R-NJ) and Democratic Ranking Member Lane Evans (D-IL) on behalf of the Committee on Veterans Affairs, would have added $3 billion next year for veteran discretionary programs including medical care and research, construction and programs that fund the administrative costs of other important benefits such as compensation, pension and education programs.

What would $1.844 billion mean to veterans health care?

· Congress would have to seriously consider the new copayments and enrollment fees proposed by the Bush Administration in order to keep the system operating in the next fiscal year. This means:

o New priority 8 veterans would remain ineligible for VA services indefinitely

o Priority 7 and 8 veterans would have an annual enrollment fee in addition to increased copayments for pharmaceutical drugs and primary care

o Only veterans with highly rated service connected disabilities (greater than 70%) would be eligible for placement in VA nursing homes. This would eliminate the need for 5000 nursing home beds from the system.

· In year one VA may have to disenroll at least 168,000 veterans.

· There would be no additional funds available to implement the Homeless Veterans Comprehensive Assistance Act to work toward the goal of eliminating chronic homelessness in a decade.

· The current Capital Assets Realignment for Enhanced Services (CARES) exercise that VA is undertaking to assess the best use of its physical infrastructure will become a “de facto” closure commission with no ability to respond to veterans’ needs for primary care, long-term care, and mental health projected by its own models.

· $1.844 billion =

o about 9,000 doctors or 19,000 nurses

o about 6.6 million outpatient visits

o 870,000 hospital bed days of care

o 2 million psychiatric bed days of care

o 9 million nursing home bed days of care

o all of VA’s top-twenty priorities major construction projects (totaling about $600 million) which include desperately needed seismic and modernization projects and projects to ensure patient and employee safety

What would $463 million cuts in mandatory spending mean to veterans benefits?

· Congress would have to seriously cut the benefits paid to men and women who are disabled as a result of military service. Cash benefits paid to veterans who have disabilities incurred or aggravated during military service comprise the vast majority of VA’s budget for mandatory programs. Ninety percent of the mandatory spending the Budget Committee proposes to cut is from cash payments to service disabled veterans, low-income wartime veterans and their survivors.

· Other programs funded with mandatory spending are the Montgomery G.I. Bill education benefits, vocational rehabilitation and independent living programs for service-disabled veterans, subsidies for VA home loans and insurance for service-disabled veterans and funds to provide headstones, markers and flags for deceased veterans.

· Even if all burial benefits, including flags and markers were eliminated to meet the Budget Committee resolution, funding for benefits for living veterans would need to be dramatically cut.

· Last year the cost-of living increase paid to service-disabled veterans was only 1.4%. In order to meet the Budget Committee criteria the House Committee on Veterans Affairs could propose a cost-of living decrease of 1.4% and no increase for FY 2004.

As our Nation stands on the verge of war, certain to result in disability and death for young Americans, the Budget Committee’s proposal requires the House Committee on Veterans Affairs to make permanent cuts in the benefits paid to those disabled by virtue of their service to our Nation. These cuts must be made, so that our government can afford to provide a tax cut which will benefit only the wealthiest Americans, many of whom have never served in the military.

In contrast, Democrats proposed to restore the “Nussle” cut for benefits and health care and add $1 billion to the VA health care budget to eliminate the need for increased copayments, assist VA in eliminating waiting times, restore VA’s nursing home care mission and provide a small boost to address the queue of VA major construction projects that include seismic projects and other projects that will assure patient and employee safety.

Statement of The Military Coalition (TMC) before the Subcommittee on Military Personnel, House Armed Services Committee
March 1, 2007 (PDF)
Executive Summary

Statement of The Military Coalition before the Veterans Disability Benefits Commission on the Survivor Benefit Plan and Dependency Indemnity Compensation.
February 22, 2007 (PDF)

Statement of The Military Coalition before the Veterans Disability Benefits Committee
January 19, 2007 (PDF)

Being a veteran doesn't guarantee VA health care Eligibility is based on several factors, including income, date of combat and type of injury.


June 3, 2007

APPLYING FOR BENEFITSQUESTIONS AND ANSWERS about applying to receive health benefits from the Department of Veteran Affairs.

Q: How do I apply?

A: You need to fill out the VA Form 10-10EZ. You can obtain the form at any VA health care facility, by logging onto www.va.gov/1010EZ.htm or by calling the VA's Health Benefits Service Center, toll-free at (877) 222-VETS (8387), Monday through Friday between 7 a.m. and 8 p.m.

Q: How do I know if I am eligible?

A: Eligibility depends on a number of factors, including income, level of disability and combat experience. Veterans are placed into eight categories, which vary in the breadth of benefits received. Veterans who were not disabled during their military service and have incomes exceeding the established limits are placed in the lowest priority group, and they are not currently eligible to receive VA health care.

Q: I recently served in combat. Do I qualify for free care?

A: Yes, at least for two years. After you return from combat service, you will receive free health care, including medication. At the end of two years, the VA will reassess your status to determine whether you continue to qualify for care, and if so, whether you will have to make co-payments.



Source: U.S. Department of Veteran Affairs




— By JOSIE HUANG Staff Writer

Being a veteran doesn't guarantee you health care from the Department of Veterans Affairs.

Rather, the VA considers a wide range of factors -- including income, disability and date of combat -- to determine eligibility, and whether services should be free or require co-payments.

Korean War veteran Albert Bishop learned this firsthand. At first, he said, the VA rejected his application because his household income -- about $613 in monthly Social Security benefits and his wife's nearly $30,000-a-year income -- was too high. Also, he had no injury related to his service in the Army.

After his wife was laid off last year, Bishop, a retired carpenter, re-applied. He was accepted about eight months ago, and is now saving hundreds of dollars each month on medications for bronchitis and osteoporosis. He plans to be fitted with new hearing aids next month.

"I think the service is fine once you're in the system," said Bishop, who is 72.

In the mid-1990s, the Department of Veterans Affairs expanded eligibility for health care, according to Jack Sims, the former director of Togus, before his retirement last month.

But in 2003, faced with a backlog of about 200,000 veterans nationally who were waiting an average of six months before receiving their first treatment at a Veterans Affairs health-care facility, the agency decided to cut off enrollment to veterans with higher incomes and no service-related medical conditions.

Veterans Affairs uses national and local wealth and income thresholds to determine eligibility. Take a veteran in the Lewiston-Auburn area, for example. Based on current standards, either a net worth of more than $80,000 or an income exceeding $30,450 a year would disqualify the veteran from receiving VA health care.

Those veterans who are currently eligible are categorized into seven different "priority" groups which differ in the benefits provided. Veterans in the highest priority group have the most serious service-related injuries and illnesses, while those in the lowest priority group do not have service-connected maladies, but their incomes fall below the limits.

The VA says that excluding higher-income individuals has allowed it to schedule appointments more quickly. Bishop, though, said he had to wait nearly three months for his first doctor's visit.

Special enrollment exceptions are being made for recent combat veterans even if they do not have a service-connected condition. For two years, the VA will provide free care to veterans with combat service after Nov. 11, 1998. When the two years are up, the veterans might still be eligible for care, depending on wealth, income and disability.

Togus spokesman Jim Doherty said that the VA is making more of an effort to reach out to eligible veterans than ever before. When combat veterans return stateside, they are met by friends and family, as well as a VA representative to help them sign up for health care.

"Fifteen years ago, getting out of the service meant you get your discharge papers and left," Doherty said. "Now they have briefings and transitional assistance programs."

Staff Writer Josie Huang can be contacted at 791-6364 or at:

jhuang@pressherald.com



Copyright © 2007 Blethen Maine Newspapers