MILITARY UPDATE
Service-related ailments, disabilities get priority
Military Update focuses on issues affecting pay, benefits and lifestyle of active and retired servicepeople. Its author, Tom Philpott, is a Virginia-based syndicated columnist and freelance writer. He has covered military issues for almost 25 years, including six years as editor of Navy Times. For 17 years he worked as a writer and senior editor for Army Times Publishing Co. Philpott, 49, enlisted in the U.S. Coast Guard in 1973 and served as an information officer from 1974-77.
By Tom Philpott
Veterans' hospitals and clinics have been ordered to give patients with service-connected disabilities of 50 percent or greater, and veterans seeking care for service-connected ailments, priority over all others in the scheduling of doctor appointments and inpatient care.
The major policy shift, effective Sept. 17, replaces open access rules adopted by the Department of Veterans Affairs four years ago.Ê Open access for all veterans, even those without service-related disabilities, is blamed for an explosion in patient loads and logjams in appointments. In some areas of the country, even severely disabled veterans with service-related injuries must wait more than a year to see a VA physician.
Anthony Principi, secretary of Veterans Affairs, vowed in July to replace the first-come, first-served system of appointments for nonemergency VA care with one that would restore priority access to the most seriously disabled, particularly combat veterans.
Principi told Military Update in July that he had tested access to VA healthcare by asking his deputy for legislative affairs, Gordon Mansfield, who uses a wheelchair because his legs are paralyzed from a combat wound, to seek care at VA clinics in two states. Four of six clinics in Florida, and two in Colorado, turned Mansfield away, saying they were too busy.
"If we can't take care of our service-connected disabled first, then, as far as I'm concerned, we may as well close the doors," said an angry Principi, "because that's why we exist."
Veteran service organizations usually get a background briefing from the VA secretary before a major policy change. Not this time, said one VSO representative. On Sept. 17, the VA quietly published an interim final rule in the Federal Register that revises "priorities for outpatient medical services and inpatient hospital care."
The changes took effect immediately but with no official announcement from Principi, and not even a press release from the department. By Sept. 25, VA spokesmen still were sketchy on implementation details including whether VA will invite veterans who fall into the new priority categories to reschedule existing appointments.
A worker at the VA medical center in Minneapolis said the new priority rules already have been explained to staff there.
Disabled American Veterans, in a statement, called the new rules welcome news for many veterans but warned that "our government still has a long way to go toward solving the crisis in veterans health care."
"Secretary Principi is to be commended for improving access to health care for disabled veterans," said Edward R. Heath, DAV's national commander. In a written statement, Heath called the rule changes a bold initiative.
Though the changes take effect immediately, VA will consider all public comments received before Nov. 19. That's a shorter review period than normal. VA said it has good cause to dispense with notice-and-comment provisions of federal law and procedures, given that "hundreds of thousands of our core constituency veterans are currently on waiting lists causing delays in their receiving treatment."
It used to be that only veterans with service-connected ailments or low incomes received VA healthcare. Then, in October 1998, the Clinton administration used new authority under the Veterans' Health Care Reform Act of 1996 to open VA hospitals and clinics to all 25 million veterans.
The married force
In recent years, the Department of Defense has enhanced military benefits and support services to take account of a standing force with more married members and more dependent children than during the draft era.
But the General Accounting Office, in a new report, said DoD should look at improvements in two areas: employment assistance programs for spouses and giving military parents extended time off to care for children.
GAO reviewed military benefits to answer congressional concerns that benefits perhaps haven't kept pace with force demographics or even with private sector benefit packages used to compete for quality personnel.
Military benefits overall are competitive, auditors found. But DoD has failed to track the effectiveness of its spouse employment programs, or the costs and benefits of giving members time off to raise children and, possibly, improve retention of trained, experienced personnel.
Up to 10 percent of military women become pregnant each year. More of them might decide to complete careers if they could take extended time off after children arrive, GAO suggests.
Forty-five percent of active-duty members today have children.
Questions, comments and suggestions are welcome. Write to Military Update, P.O. Box 231111, Centreville, VA 20120-1111, or send e-mail to: milupdate@aol.com.
