"I feel stronger every day," Sen. John Boozman told me on his first full day back in harness, 48 days after a trip to the emergency room, and subsequently the operating room, saved his life. His flawed aorta was quickly diagnosed and immediately repaired, and now he says his agenda, as a member of the Veterans Affairs Committee, includes helping cleaning up the mess — the latest mess — at the Department of Veterans Affairs. That would include $500 million that would finance additional doctors and nurses at veterans’ hospitals and authorize additional facilities.
The bill includes no funds designated specifically for DVA facilities in Arkansas — three hospitals and some satellite clinics. The agency is disputing one calculation of its Little Rock facility as delivering substandard care. But Arkansas came off fairly well in the report by the agency’s Inspector General, as compared to those states in which some veterans waited for months to secure appointments and where others — as many as 64,000 — were simply never scheduled. And where DVA personnel, evidently pressured by their local superiors, cooked the books to make it appear that services were being provided more promptly than was the case.
The Arkansas statistics: A vet seeking his or her first primary care appointment at a DVA hospital or clinic at Little Rock or Fayetteville would expect to see the doctor in approximately eight weeks. Patients already entered in the system, however, could usually schedule a visit within three days. Not so bad, perhaps better than you or I could arrange with our private-sector family physician.
Specialty care including mental health counseling at Arkansas DVA facilities was on the better end of the scale as well, at or near the national average of a month for incoming patients and a fraction of that for follow-up appointments.
The picture that emerges from the DVA Inspector General’s review is a little brighter, a little, than initial fears. Any administrative chicanery involving patient records occurred in a comparative handful of DVA hospitals. Only about one percent of DVA-eligible patients endured delays of 90 days or longer before seeing a physician. That is of no comfort, none, to the survivors of the 18 veterans who died while awaiting DVA services in the Phoenix area. Nor is it reassuring to the million service personnel whose health needs originated in Iraq or Afghanistan, nor to the Baby Boom generation’s Vietnam vets, a demographic whose clinical care is only beginning to be felt.
Perhaps the situation was best summarized by MSNBC’s Rachel Maddow, who abandoned her customary hard-left histrionics to speak of the "modern American dysmorphia" regarding our military veterans. "We see things that aren’t really there. We tell ourselves that we’re doing things that we’re not really doing," Maddow said. "We have a poetry in this country about our love and respect for veterans that is not matched by the prose of how veterans are actually treated."
As noted earlier in this space that impaired vision is hardly new; it has afflicted the DVA (and its predecessor offices) since its founding almost a century ago. The political myopia was, for example, especially acute in March 2003: in the very month the U.S. began the Iraq war from which it only now is disengaging the House of Representatives sliced $14 billion from the DVA’s budget. In 2005, with war casualties mounting and the influx of wounded personnel beginning to surge, the DVA director informed the nation that the department had no need of "additional resources." Not long after Congress was compelled to give it an emergency $1.5 billion.
Now another quick infusion of cash, a measure of prose to augment the poetry. And if history is any indicator the outrage, congressional and public, will subside, and the DVA will motor on until it lurches into the next ditch, its brakes worn and its tank empty. At that time Congress and perhaps the administration in power will again express outrage and demand some heads on a pike, pretending the accident was the fault of the driver when in fact it is they who are behind the wheel. To believe otherwise is to argue that tens of thousands of DVA employees are sadists who delight in tormenting American veterans or slackers utterly indifferent to their mission.
An answer, what might eventually prove more than a stopgap solution, is to be found in the package of legislation now before Congress. Veterans living more than 40 miles from a DVA medical installation would be authorized to present themselves at facilities — hospitals or clinics, private or non-profit or governmental — and obtain treatment, with the providers reimbursed by the government.
Boozman was into the ER and then the OR and then ICU and then home and then back to the Senate in less time than it takes some veterans to schedule a chest x-ray. Not every vet’s complaint is an emergency, certainly, but we can do better than we’re doing. A lot better.