McCain Plan Moves Some Out of VA Care

SAN FRANCISCO -- If John McCain is elected president, wounded veterans could be in for a world of hurt.

On the campaign trail, the Republican's presumptive nominee has talked of a new mission for the Department of Veterans Affairs, suggesting that veterans with noncombat medical problems be given vouchers to receive care at private, for-profit hospitals. In other words, McCain is seeking to cut off the kind of universal health care that the government has guaranteed to veterans for generations.

"We need to relieve the burden on the VA from routine health care," McCain told the National Forum on Disability Issues last month. "If you have a routine health care need, take it wherever you want, whatever doctor or health care provider, and get the treatment you need, while we at the VA focus our attention, our care, our love, on these grievous wounds of war."

The Republican senator had argued that giving veterans a VA card that they can use for private doctors would shorten the long wait times that many veterans face in seeing government doctors, who are nearly universally viewed as among the best in the world.

A recent study by the RAND Corporation found that "VA patients were more likely to receive recommended care" and "received consistently better care across the board, including screening, diagnosis, treatment and follow-up" than that delivered by other U.S. health care providers.

Virtually all veterans groups oppose McCain's plan. The Veterans of Foreign Wars' national legislative director has said the VA card would "undermine the entire system."

According to the Center for Responsive Politics, Democrat Barack Obama has received nearly six times as much money from troops deployed overseas at the time of their contribution than has Republican John McCain.

This may seem odd to some since McCain is a former naval officer, prisoner of war, and Vietnam War veteran.

However, Paul Sullivan, a Gulf War veteran and executive director of the nonpartisan Veterans for Common Sense, said that for McCain, free market ideology is more important than providing care for former Soldiers.

"Ideologues like John McCain and George Bush hate the fact that the VA exists," Sullivan said, noting that the Republican candidate also wants to partially privatize social security and offer private school vouchers to students currently enrolled in public schools.

"They hate the fact that there's a functional example out there of the government providing better care at a lower cost than the private sector," Sullivan said. "The problem that the VA faces now is that the Bush administration failed to hire enough doctors and disability claims adjusters when they chose to go to war with Iraq. If these doctors had been hired, the VA would be an example of the government doing good work. Bush and McCain don't want the public to see that."

McCain has also never spelled out what he means by a "combat injury," leading many veterans worried they could be left out in the cold.

"If I'm driving a Humvee in Iraq and a roadside bomb explodes and I veer off the road and crush my arm and end up losing it and needing a prosthetic, is that a combat wound according to Sen. McCain?" asked retired Air Force Colonel Richard Klass, the president of the Council for a Livable World's VETPAC, which has endorsed Obama.

Official Pentagon policy calls such an incident a noncombat injury. Technically speaking, the only Soldiers "wounded" in combat are those hit by direct enemy fire. As of Aug. 5, Department of Defense statistics showed that 32,799 U.S. Soldiers had been "wounded" in Iraq and Afghanistan. Another 10,685 had sustained "non-hostile" injuries which required a medical evacuation, while 29,881 were classified as ill enough to be airlifted out of the war-zone.

Veterans are also skeptical of McCain's plans because as a senator, he has repeatedly voted against fully funding veterans' health care. In 2005 and 2006, McCain voted against expanding mental health care and readjustment counseling for service members returning from Iraq and Afghanistan. He also voted against efforts to expand inpatient and outpatient treatment for injured veterans, and against proposals to lower the copayments and enrollment fees that veterans must pay to obtain prescription drugs.

McCain's vote also helped defeat a proposal by Sen. Debbie Stabenow that would have made veterans' health care an entitlement program such as social security, so that medical care would not become a political football to be argued over in Congress each budget cycle.

The Iraq and Afghanistan Veterans of America gave McCain a D+ when they scored his voting record, whereas Obama got a B+. In addition McCain has voted with the interests of Disabled American Veterans only 20 percent of the time.

"If McCain would work to properly fund VA care, there would be no issue about a VA card," said Larry Scott, who edits the Web site VAWatchdog.org. "McCain, by wanting to give vets private care, is walking away from the VA and ignoring the problem. He is admitting that he will not properly fund the VA to the level where it can care for all qualified vets. "

Scott is sharply critical of the VA's often cumbersome and ineffective bureaucracy, but like most veterans' advocates, believes the VA system needs to be strengthened. He sees McCain's plan as a way to phase out the government's commitment to those who've served.

"For every vet who would get a VA card, that would be one less vet using the VA," he wrote in an e-mail to IPS. That "would mean, in a short period of time, a smaller budget, fewer locations ... and the eventual dismantling of the best health care system in the country."

“yes aside from service connected injuries. Government run health care does not work. Save the resources for those coming off active duty and who really need the care.”

When we cut through all the rhetoric, what you’re proposing would not free up any doctors to provide more care to those with service related injuries. Those injuries require very specialized treatment that require very specialized doctors.

I’ve been eligible for VA care for a few decades, but have used it only for about three years of that time. I went to GPs (primary care physicians) and gastro specialists. That care is not taking any physician time away from service related injuries because they are not trained to treat such injuries.

All you’re proposing is getting rid of much general care for veterans, with no assurance that the highly specialized care needed by those with service connected problems would have their needs met.

I meant to post this when I did the article but I had to answer the phone. Apologize for the delayu.

I usually think of Veterans for Common Sense as a Democrat led organization. Tonkin had to drive 200 miles to get his care. He didn’t like it. I am glad somebody is seeing how to help the Vets when they need it because Bush hasn’t impressed me on this subject.

I’m skeptical of the “voucher” option. We have tricare prime as my husband is active duty and tricare pays out so little that more and more providers have stopped treating tricare patients. It’s changed so much that even care at the AFB hospital many times won’t provide service based on what tricare won’t pay FOR CARE ON BASE. It never used to be this way.

Luckily, we are all very healthy in my family. I couldn’t even get my sons’ sports physicals done on time on base because when I called to make the appointment, the clerk tells me “tricare won’t pay for the physical until it’s been a year since the last one”. So I waited a few weeks and when I called back, they had no openings with the one pediatrician they have left and said I wouldn’t get in for something like that for months. So I just went and paid for it myself.

I’ve never worked for a VA hospital but I can tell you about the kinds of things that happened at the civilian hospital I worked at when it came to VA patients. We would have to fight and fight the VA to get basic things covered. Right next to the room of a VA patient who we can’t even get discharged because we can’t get him the meds he needs, were illegals that got everything, no questions asked because they fall under a different system which is basically the federal govt reimbursing the hospital for care provided to the illegals.

So this “voucher” might not adequately cover the cost of care, in which case many providers will not accept the VA patient. The only ones that will are the ones that are so bad, that they need to take VA patients just to have some patients. This is already happening with Tricare. The only physicians that are being left that will take us are those you wouldn’t want touching your dog. And my husband is active duty. He still can get care on base without a hassle but I sure hope he never becomes disabled in the line of duty because I already know the hell we’ll face if he does.

‘All you’re proposing is getting rid of much general care for veterans, with no assurance that the highly specialized care needed by those with service connected problems would have their needs met.”

PFFFTTTTTT nonsense, if its service related then the VA can care for it or provide you a voucher to see a specialist. If its not service related then you or I can pay for it ourselves.

Why should the govt pay for my non-connected medical care?

I was talking about this kind of thing with the Mrs last night. Remember how Ron Paul wanted to get rid of most government agencies? I agree with him because I have yet to see a government agency do anything as efficiently as a private business. Public schools require $10k to educate a child yet a private school can do it for $3K to $5k and do a better job.

Hospitals are the same. A private hospital can deal with injuries and disease better than a government agency can. Why? Because they are always afraid of being sued for their mistakes where the government agency just gives us the middle finger and walks off.

Politicians make a lot of points pushing what they’ll do for us Vets when elections come around. I remember what they did when Agent Orange was the big issue, not a fucking thing! They ran and hid because the war was over and the contaminated Vets were dying off at a pretty fast clip. When we get the troops home from this war they’ll turn their backs on us again, I swear they will because the disabled Vets won’t be a large enough group to be worth courting for votes.

Get what you can now and don’t expect any politician to hold true to their word.

The Republican senator had argued that giving veterans a VA card that they can use for private doctors would shorten the long wait times that many veterans face in seeing government doctors, . . .

The VA clinic in Las Vegas has a sign in the waiting room: "If you are still waiting 15 minutes after your appointment, come to the front desk." Does ANYBODY's doctor's office have a similar one? Because I drive a long way to get there, I often arrive 15-20 minutes early. I check in then, and many times I am taken in BEFORE my appointment time. Again, has that happened . . . ?

When I take my wife to her doctor, we routinely wait for at least a half-hour past her appointment - sometimes more. We've changed docs about twice a year as they come and go in this small town. Every one has been the same. Many of them act like my wife is a source of revenue rather than a person to heal - I don't get that feeling at the LV VA.

Besides, my Medicare is taken into account there, which helps defray the VA's expenses, so I don't see any benefits of this plan other than shuffling things around to no advantage. The "long trips" seems to be a smoke screen and I always get nervous when a politician wants to do something for my benefit. I have to drive 80 miles one way to the clinic, but thankfully it is only twice a year. They have a deal with the local hospital to take blood samples so we don't have to go down for that - no voucher involved. We also have a van service, courtesy the Elks, to LV twice a week for those vets who are unable to drive - again with no voucher.

Leave things the Hell alone.

I’ve heard such complaints about the VA, but have to say, my experience has been good. I think part of the change has been in creating healthcare clinics to serve areas not close to VA hospitals. Where I live, I was given the option (in 1994) of having either VA North Chicago or VA Madison, WI as my provider. I chose Madison because it was a far easier shot up the Interstate than trying to get to North Chicago from where I live (in Northern Illinois, BTW). But they also opened a facility in Rockford which is 30 miles away. And that’s where I go for virtually everything now.

Sure, when you go there they’re busy. But I’ve had to wait at most 10-15 minutes beyond my scheduled appointment, and that’s infrequent. And I’m also happy with the quality of care. Frankly, I could tell you more horror stories about private healthcare than I can about the VA.

“Why should the govt pay for my non-connected medical care?”

So, what you’re proposing is a VA system that provides no care but care for service connected problems? If a vet with service connected problems develops, years after active service, health problems with no connection to service, that would not be covered?

Good luck finding any who agree with your ideas.

There’s a couple of ways of looking at that. The VA has scheduled X number of patients for X number of hours. They will do that.

The private doctor is under no contract to see that you don’t have to wait. If a patient comes in and requires more time than scheduled, so be it. This is a person who could sue the doctor for not treating the injury properly.

Not so with the VA Doc. Lawsuits are forbidden unless you get permission from the government first.

“I’m skeptical of the “voucher” option.”

During my two active years in the Navy (Reserve), I was single and never went for any sort of medical care. But I assumed that the military physicians and hospitals just provided full care as needed for active duty personnel and their families.

I’ve since heard about some problems, but active duty families shouldn’t have to put up with the all the hoops and loopholes you describe. It does seem that anyone purportedly receiving medical care reimbursed by the government is subject to getting less care than needed. They should definitely correct the problems faced by active duty families.

The illegal alien thing is beyond unjust. There are so many insanities surrounding our gov’t dealing with illegal aliens, that it would be entirely just if all the presidents and members of Congress who’ve allowed this to develop spent several years in prison. And I’m not joking, but of course they make sure they have immunity for any and everything.

So, you’re fine with abandoning the promise made to service members for at least 50 years, that VA health care would be available to them after active service?

No such "promise" was ever made. The VA exists to serve vets with service-connected disabilities. Vets with nonservice-connected disabilities are seen on a space-available basis, and they pay a small copayment for services rendered. Anything wrong with that? And don't confuse the situation by bringing up military retirees -- that's a different kettle of fish altogether. Retirees (20+ years of service) are taken care of by TriCare, a low-priced HMO.

“No such “promise” was ever made”

LOl, are you serious? It was definitely made by military recruiters of every branch, all over the US. The promise was made to me.

All those folks were/are government employees, who represented the conditions of service and after service for those who chose to join.

‘So, what you’re proposing is a VA system that provides no care but care for service connected problems? If a vet with service connected problems develops, years after active service, health problems with no connection to service, that would not be covered?”

If its service connected it would be covered.

If its not service connected it wouldn’t. Whats so hard about that. Why does my service entitle me to free medical care for life?

“If its not service connected it wouldn’t. Whats so hard about that. Why does my service entitle me to free medical care for life?”

LOl, you’ve just condemned they way the VA medical system has operated at least since WWII. I know many veterans from WWII who received medical care for all sorts of non-service related conditions until their death.

Start writing your representatives and try to get that policy implemented.

Wrong! He is not trying to cutoff medical care for vets like me. He is suggesting giving acess to outside care.

And to all those who proudly claim that they have never stepped inside a VA, shame on you. I’ve had two operations there in the last year, and was treated great. They also, saved my Dad’s life. I’ve noticed that vets are really good at a few things, drinking coffee, smoking, and complaining. I’m all for complaining when it is warranted, but don’t make it a habit. Give credit where credit is due.

“Recruiters lie!?!?!?!? No tell me it aint so!”

And you have no problem with that practice? If that’s the way you think people should be treated, and if that’s the sort of country you want to live in.

Recruiters are also the designated representatives of the US government, presenting the conditions of service to prospective enlistees. But you are just fine with lying.

“Interesting. So my guess wasn’t entirely correct. Thanks for setting me straight.”

I didn’t intend to ‘set you straight’ but have found the whole issue of govt agencies doing business with vets a farce.

Seems if you are a flag officer they will do business with you. Anyone else has to compete with everyone else. Minority owned, women owned or 8a business can get contracts with little to no competition. A service disabled vet company gets no consideration even from the VA.

Theres a lot of lip service, executive orders, and so forth. It comes down to the contracting officers find it easier to do business with the big companies and will every chance they get.

Heck the DHS small business representative got pissed off that I bothered him with an email.

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.