BY JOHN MITERKO, CHAIR, GOVERNMENT AFFAIRS COMMITTEE, WITH
GOVERNMENT AFFAIRS STAFF
Enlisting in the cause heralded by
the Partnership for Veterans Health Care Budget Reform, the
American Federation of Government Employees (AFGE) launched
a nationwide radio campaign urging Congress to provide full,
mandatory funding for veterans health care. In the ad, AFGE
urged the presumptive Republican nominee for President, Sen.
John McCain, to support this effort.
“As the nation’s highest profile veteran and
a ranking member of the Senate Armed Services Committee,
Sen. McCain now is in a position to do something that will
have long-range impact on the health care of his fellow veterans,” AFGE
President John Gage said. “AFGE strongly feels that
recent proposals by Sen. McCain are misguided.”
McCain’s proposals are simple: Give veterans vouchers
to receive care at private, for-profit healthcare facilities.
That move, according to AFGE, which represents thousands
of VA employees, would be tantamount to dismantling the Veterans
Health Administration. If implemented, it could very well
mean the beginning of the end of the Department of Veterans
Many veterans living far from VA Medical Centers
or community-based outpatient clinics do have a legitimate
beef in accessing care. Yet right now, one out of every ten
healthcare dollars spent by the VA goes outside the system
in what is known as fee-basis care. This is understandable.
What is not understandable is the logic behind Sen. McCain’s
“That would be the end of the VA,” AFGE member
Phil Glover says in the ad. It would mean “the end
of the promise and the start of a huge boondoggle for big
“While it has been argued that the VA has not been
responsive to the growing needs of the burgeoning veterans’ population,
many of the shortfalls can be directly attributed to a lack
of funding,” said J. David Cox, AFGE national secretary-treasurer,
a former VA nurse. “Vouchers could cripple the system
by diverting much-needed funds away from veterans’ health
We couldn’t agree more with Cox. VVA and
the other VSOs have expended much time and energy to help
transform the VA healthcare system into perhaps the finest
integrated managed care system in the world. While we understand
the frustrations of some veterans who live far from VA facilities,
a wholesale system of vouchers will not benefit them. Rather,
it will result in less care for a lot more money.
of Iraq, where privatizing services such as transportation
and providing food and fresh water has led to waste, corruption,
inefficiencies, and egregious costs, ought to be a red light
to any who would seek to reform the VA through privatization.
Sen. McCain needs to meet with, and listen to, the VSOs.
His promise of vouchers could derail his campaign among veterans
and their families.
LAWLESS & IRRESPONSIBLE BEHAVIOR
The VA continues to refuse to complete the re-survey of the
original participants in the National Vietnam Veterans Readjustment
Study, which was done more than twenty years ago, even though
it is mandated by law. If this was done, we would have a
good picture of the chronicity of PTSD and of the psychosocial
long-term effects of service in Vietnam, and we would have
a robust mortality and morbidity study of Vietnam veterans.
the second study of the same participants, and a review of
the death certificates of those who are dead, we would have
an immensely valuable longitudinal study that would allow
policymakers to plan properly for the health care that will
be needed for Vietnam veterans in the future, and it will
also be invaluable in planning for the proper shape of health
care for those fighting today.
The VA refuses to
do the study and thumbs its nose at the law. It is the view
of VVA that public officials do not get to pick the laws
they obey. It is our view that these officials are violating
the public officers’ oath they took when
they act in a lawless manner like this.
For the VA to maintain
that the methodology used in the original NVVRS is “controversial” because
one hired hand at the American Enterprise Institute says
it is, can only be compared to saying that the fact of the
Holocaust carried out by the Nazis is “controversial” because
a few right-wing nuts say it is.
Further, we cannot abide
the increasing secrecy of deliberative processes at VA, particularly
by the secret, closed-door meetings of the Advisory Committee
on PTSD and the mostly secret deliberations of the Advisory
Committee on Serious Mental Illness, coupled with memos that
say “Shhhhhh!” in
regard to letting real numbers on veteran suicides become
public, even to Congress.
This includes the now infamous
memo from a program chief, directing clinicians at the PTSD
program at Temple (Texas) VA Medical Center not to take the
time or effort to properly diagnose PTSD, but to instead
give it a made-up term that is not even a diagnosis.
the above, plus the VA’s continued refusal to
treat the veterans community as a serious partner in the
process of addressing serious problems with the systems for
delivering healthcare and for adjudicating claims for service
connection, bespeaks of a patronizing behavior that would
be unacceptable in any case, but is certainly unacceptable
in light of the increasing failures of the VA.
It is time
for the VA leadership to take patients and veterans’ advocate
leadership seriously. It is time for the VA to uphold all
of the laws of the United States, and way past time for the
VA to start holding its officials, managers, and supervisors
WAY TO GO, SEN. WEBB
In a most welcome surprise, some two dozen GOP senators broke
rank to vote for Virginia Democratic Sen. Jim Webb’s
S. 22, the GI Bill for the 21st Century, solidifying an overwhelming
75-22 margin of victory for the bill in the upper chamber.
By the time you read this, the GI Bill should be the law
of the land, despite the President’s vow to veto it.
Bush, who is always praising our brave young women and men
in uniform, is not being true to them in opposing this legislation.
S. 22 is the right thing to do for those who have been promised
an education. It will allow veterans to attend college and
no longer be forced to go to work rather than go to school.
It is a bill that Vietnam veterans should have had, but never
A wrong will be righted when S. 22 becomes the law of
“The hardest thing for me to do,” one of our
colleagues said, “is to give up smoking. That’s
harder than losing weight, and harder than beginning an exercise
Because smoking is heavily involved in the
top four causes of death in this country, and because helping
veterans to kick the habit can improve their health, the
VA, thanks to the initiative of Dr. Bopper Deyton, has funded
the work of the Committee on Smoking Cessation in Military
and Veteran Populations, under the auspices of the Institute
its meeting on June 2, the committee heard testimony about
why active-duty troops and veterans smoke and what the military
services and the VA are doing to encourage people to quit.
Keith Haddock of the University of Missouri discussed the “social
pull” of smoke breaks. Smoking, he said, “is
one of the only reasons a member of the military can take
a break or leave a duty area.”
Haddock and the other
presenters discussed the lure of smoking as well as methods
that are effective in encouraging smoking cessation. Unfortunately,
there is no overriding policy on smoking in the military;
there are, in fact, 218 different policies concerning tobacco
Col. G. Wayne Talcott, who
discussed Air Force policies and procedures for tobacco use
control, opined that a “top-down
buy-in” is needed to meet the challenge of how to promote “a
tobacco-free lifestyle and culture” in the military.
the VA side of the ledger, Dr. Tim Carmody, who runs multi-level
smoking cessation programs at the VA Medical Center in San
Francisco, promoted the creation of a Center of Excellence
for Tobacco Use Cessation. W. Clint McSherry, his colleague
at the VAMC at Perry Point, Maryland, noted ongoing budgetary
constraints in funding programs for tobacco control. He also
decried the attitudes of too many VA employees who smoke.
But it was VVA’s Tom Berger whose impassioned
plea to the committee really resonated. If you want to know
why active-duty troops and veterans smoke, he said, talk
to them. Go over to Walter Reed Army Medical Center and Bethesda
Naval Hospital and meet with the newly wounded and those
who have been recuperating for a year or more. Spend some
time with them, if you want to be enlightened.