Will Veteran Care Be There?


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SINCE HER FIRST DAYS on Capitol Hill in January 2001, San Diego Congresswoman Susan Davis has been an advocate for veterans. A former military spouse, Davis, whose 53rd District includes some 60,000 former soldiers, was an active member of the House Veterans Affairs Committee. She helped secure $72,750 during last year’s appropriations process for the Vietnam Veterans of San Diego organization to expand its homeless shelter.

The Veterans Benefits Improvement Act, which the House passed unanimously last year, incorporates provisions from three Davis-sponsored bills. Her efforts led the Department of Veteran Affairs (V.A.) to link its home-loan limit for the first time to the Freddie Mac national standard guaranteeing annual increases.

Davis, a Democrat, was unceremoniously removed from the influential Committee on Veterans Affairs by Republican congressional leadership after last November’s election. Her dismissal, which she referred to as a “great disappointment,” still stings. But it hasn’t quieted the congresswoman, who remains an outspoken critic of the Bush administration’s funding of veterans’ services.

“In the San Diego region, we already have 4,000 veterans who fought in Iraq and Afghanistan, and many more will be returning home over the next few years,” she says. “The V.A. does not have the resources to care for these new veterans.” The Bush administration says the president has demonstrated a deep commitment to veterans’ issues. According to recent figures from the White House, the president has increased healthcare funding for veterans 47 percent since 2001, and the prospective budget increase for the V.A. this year would provide care for more than 5.2 million veterans of Operation Iraqi Freedom and Operation Enduring Freedom.

“This budget demonstrates the president’s ongoing commitment to provide the very best healthcare and benefits to those veterans who count on the V.A. the most,” Veterans Affairs Secretary Jim Nicholson said in a prepared statement.

Joe Brunner, chairman of the United Veterans Council of San Diego and a Vietnam veteran, believes President Bush has been a champion for veterans. “The Bush administration has done more for veterans in the last four years than any previous administration has done in American history,” says Brunner, adding that the administration has addressed a number of things, including the concurrent-receipt problem (a practice of using monthly retirement retainers to pay for V.A. costs). He says the administration has also finally addressed promises made about career military retirees getting full healthcare coverage.

“If you run the numbers, you see Bush has done a lot for veterans,” Brunner says. “I think the veterans should get as much as we can give them. But it’s just never enough for some people.

Bush is especially concerned, as he should be, with helping veterans wounded in combat, the ones who need V.A. care the most.”

a man in a wheelchairJAIME KOCHER, 25, a Marine Corps sergeant from Camp Pendleton who just returned from Iraq, was injured on duty there and filed a medical claim with the V.A. in February. While she says her experience with the V.A. has been “a very good one” and that they’ve “treated me really well.” Kocher, who made the transition from active duty to veteran in January, believes more could be done.

“I support my president 100 percent,” she says. “But I do believe that we as a country could do more, especially when it comes to V.A. services and programs for wounded veterans.”

The numbers can be widely interpreted. President Bush’s V.A. budget recently presented to Congress represents about a 2.7 percent increase in funding for healthcare, paid for, in part, by raising copayments and instituting user fees for veterans.

Under this budget, as many as 2 million veterans could find themselves paying more for their healthcare. The Bush administration has tried twice before to raise veteran copays and institute the enrollment fee, but veterans’ organizations loudly complained, and Congress shot the proposals down.

At Congressional hearings earlier this year, administration officials defended this year’s proposed budget, saying it would increase spending by $880 million and refocus services on the most financially needy and seriously injured vets. “This is a fair, thorough and doable budget, which reflects this administration’s priority for vets,” the V.A.’s Jim Nicholson said during the hearing.

But the chairman of the Senate Committee on Veterans Affairs, Senator Larry Craig (R-Idaho), conceded during the proceedings that the proposed budget is “lean” and acknowledged funding levels would “not be sufficient to allow the V.A. to continue to operate as it has.”

Most agree the looming torrent of newly injured disabled veterans represents a challenge for the V.A.—a challenge not seen since troops returned from Vietnam in the 1960s and early 1970s.

In the V.A. San Diego Healthcare System, more than 1,200 veterans of fighting in Afghanistan and Iraq have already enrolled, and thousands more are expected to sign up.

According to Congresswoman Davis, the V.A. needs funding increases of at least 7 percent to keep up with medical inflation and yearly payroll increases for medical personnel—not to mention the impending avalanche of veterans returning from the current war.

“We’ve seen increases closer to 3 percent since President Bush has been elected,” she says. “Without enough funding to even keep pace with inflation, the V.A. has no choice but to cut back on services, add veterans to waiting lists and turn away certain veterans.”

Most staff members at the local V.A. are careful not to discuss funding or politics. Cindy Butler, public affairs director for the V.A. San Diego Healthcare System, says, “We’re doing all we can to meet the needs of veterans here; we’re trying to be as efficient as possible. We’re finding new and creative ways to treat patients with our available resources. We are meeting the national standard for veteran healthcare, and in most cases we surpass it.”

One local V.A. executive is less diplomatic. “We constantly hear how much President Bush cares about our military, but the truth is the president is cutting our funding to almost zero,” says the executive, who requests anonymity for fear of being fired. “The care here is excellent; the staff is outstanding—but we’ve already been told this is going to be a very lean budget year.”

AMONG THE NATIONAL STANDARDS San Diego V.A. staffers are trying to meet is ensuring that veterans are seen by their doctor within 30 days. Often, that standard is met. But in some areas, like orthopedics and urology, the wait is longer because doctors aren’t on staff. The V.A. in San Diego, and other centers, often must put veterans on painfully long waiting lists for treatment.

“We’re hearing about waiting lists of six months to a year,” says Davis. Among the areas that will need the most support in the coming years is the diagnosis and treatment of post-traumatic stress disorder (PTSD). Many of the soldiers who’ve served in Iraq and Afghanistan —as many as one in six, according to one study—report symptoms of depression, anxiety or PTSD.

“We definitely have stress,” says Sergeant Kocher, whose husband, Eric, is also a Marine sergeant. He was ambushed in Iraq, lost part of his elbow and saw his friend killed. Jaime says that caused considerable anxiety for her husband—and for her.

“Eric recovered, and he’s back in Iraq fighting,” she says. “He’s a strong soul. But there were nights after the ambush when he couldn’t sleep, when stress was definitely a factor for him. It’s a major issue for combat veterans, but it’s something that isn’t talked about very much.

I know the V.A. is dealing with this with regard to Vietnam veterans now, and to some extent with us. But I think they could do more to address this with veterans just getting out—to get to them right when they get out instead of waiting.”

With additional funding, Representative Davis says, the V.A. could study PTSD and learn new ways to help and treat America’s returning soldiers. “We all saw what happened to our Vietnam veterans after they returned,” she says. “A lot of them suffered from PTSD and other mental health conditions, leading to homelessness, drug and alcohol addiction and high suicide rates. We have an opportunity to avoid losing another generation of veterans to mental conditions, but we must provide the funding for treatment and new research. We’ve not significantly increased the budget for veterans’ mental health treatment in recent years.”

Cindy Butler notes that the San Diego V.A. has a verbal approval for a grant to beef up its care for PTSD patients. There’s no timetable. Butler hopes it will be implemented in the next year or so.

“This grant will provide a clinic that will thoroughly screen new patients for both physical and psychological damage,” she says, again careful not to sound political.

“This will assist us greatly here.”

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