MILITARY UPDATE
The crisis in veterans' healthcare
By Tom Philpott
Rep. Steve Buyer, R-Ind., new chairman of the House Veterans Affairs Committee, says the medical and rehabilitation needs of a new generation of war veterans leave him more certain than ever that Congress erred in 1996 when it opened VA healthcare to any veteran willing to pay modest fees.
"While some veterans organizations like to create a theme, that 'a veteran is a veteran (and) there is no difference,' I disagree," Buyer said.
A decade ago, in the wake of a Persian Gulf War that saw relatively few U.S. casualties, the Department of Veterans Affairs went back to worrying about an aging patient population and underused VA clinics and hospitals, Buyer said.
Those concerns, along with wishful thinking about the VA billing employer-provided insurance plans for the cost of care, led Congress to open VA facilities to veterans neither poor nor disabled.
Time has shown that to be a mistake, Buyer said. Today, the VA has $3 billion in uncollected healthcare debts for services that insurance companies have not paid.
"And we find ourselves now in protracted wars in Iraq and Afghanistan, and the war on terror all over the world. So the sense from 1996 that we could open up the VA to protect the bricks and mortar because of a declining population of veterans," Buyer said, is replaced by "the reality that we have more veterans now that have to come into the system."
His comments came in an interview for this column days after his committee voted to impose an enrollment fee of $230 to $500 a year on 2.4 million veterans in priority categories 7 and 8, those who are not poor and have no service-connected disability.
Buyer, 46, is a blunt-spoken attorney and Citadel graduate who was deployed in the first Gulf War as an Army reserve lawyer. He said he has three short-term priorities:
• Re-focus VA healthcare on its core constituency of service-disabled, indigent and special-needs veterans.
• Develop a "seamless transition" process for veterans moving from active duty to VA care. So far, more than 10,000 have been wounded in Iraq and Afghanistan, and as many as 100,000 could have post-traumatic stress disorder, Buyer said.
• Improve VA rehabilitation and vocational training to ensure that even the most severely injured veterans return to rewarding lives.
"For a lot of years," Buyer said, "it was: 'Here's your check. Good luck in your life. And if you find it in a bottle, we'll try to get you in a program.' I want the system to be far more personal."
Buyer also said he expects a new bipartisan Veterans Disability Benefits Commission, which will hold its first meeting soon, to review whether Congress went too far on allowing concurrent receipt of military retirement and VA disability payments.
Buyer also expects the commission to consider whether to change the way disability ratings are set or to tighten the definition of service-connected injuries or ailments.
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