Marshall or Moon plan: Help for VA needs big fix

Each time another new scandal breaks involving shoddy health care practices at the Department of Veterans Affairs does it seem a case of deja vu arises.

That the newest VA scandal, in which patients are allegedly dying because specialty care has not come quick enough as well as the “secret lists” regarding that specialty care seems as if the scope would indicate a large-scale scandal. And since the Republican opposition is always hunting the new “Watergate” or “Benghazi,” if you will, this counts as the first major VA scandal for the Obama administration.

The truth, sad to say, is that similar albeit smaller-scale scandals have occured for years. Take for instance a personal anecdote.

From middle 2000 to the same time in 2001, I was suffering from a very painful and near disabling episode of a couple of ruptured cervical discs. I was taking several pain-numbing opiates which left me in a cloud, all the while my neck and arm pain was not abating and my left hand had nearly gone numb. I had a job with insurance then although my meds were more affordable at the time with the VA than through civilian doctors.

I later would be diagnosed with depression but at this time, the pain and the opiates were leading me down the path to Crazyville. I finally asked to see a VA neurosurgeon, though that was much more easier said than done. I was told that the Dallas area VA system — I had to ask there because the Temple (Texas) VA hospital that was my hospital said they didn’t have a neurosurgeon at the time– had but one neurosurgeon. I found that incredible to say the least. I knew for fact that Dallas, like most large VA hospitals, operate in conjunction with big medical centers and medical schools. In the case of Dallas it is the University of Texas Southwestern Medical School. The Temple VA Hospital is the clinical campus for the Texas A & M University medical school. Nevertheless, I ended up going to the Dallas VA hospital where I was told it would be six months until I would get to see a neurosurgeon.

Eventually, I relented after the pressure from my boss. I saw a civilian neurosurgeon in Waco and I was able to give this doctor all the test information including a MRI, that was done by the VA. About a month after first seeing the neurosurgeon, I received a call from Dallas VA saying an spot had opened so I could see a VA neurosurgeon early. Could I possibly come to Dallas on Aug. 9? As it so happened, I was scheduled for neurosurgery in Waco on that date.

My major concern with having surgery performed by a non-VA doctor was the price. I had already wrecked my personal finances with an initial cervical spine surgery. I was not sure how I could keep from going into another fiscal black hole with what would probably be an even more expensive surgery. But I was pleasantly surprised in the financial sense at least. With the VA paying for all my expensive tests and a co-insurance taking care of added expenses, I probably spent no more than $1,000 out of pocket for my operation. That was astonishing. It was also probably the only bright light of this dismal experience. Well, that and the fact the surgery gave me a couple of years without pain and my hand no longer was numb.

By the time of my surgery I had begun covering the VA as part of my beat as a reporter. I also wrote a weekly column on veterans issues. The column was distributed internationally through The New York Times News Service. I was once visiting one of my brothers in East Texas and I happened to see a column of mine on the op/ed page of the local daily. I called it to my brother’s attention.

“Yeah, you’re getting to be a regular Cal Thomas,” my brother wisecracked. Not the comparison I would have preferred, but it was a notice nonetheless.

I began to study what was happening nationally with the VA, not just in my local hospital — where Washington had by then threatened the shuttering of our local hospital along with some others in the nation.

I found then as now, the biggest problem facing the VA — given the past and this most recent scandal — is money. Or rather the lack of a steady funding stream and the wise deployment of funding.

No doubt, I have been disappointed with Gen. Eric Shenseki and his stewardship of the VA as secretary. The former Army Chief of Staff came at a time when firm leadership and innovative thinking was needed more than ever. Unfortunately, Shenseki did not seem to offer any such qualities.

The VA under the Bush Jr. administrations tried the tired old Republican ploy of shrinking resources as a way to manage fiscally. The wars that Bush pushed the country into — the types of war in general leading to many disfiguring amputations, brain injuries and PTSD — all began taxing the VA health care systems. By the time the wars were nearly over the VA tried to offer all the services to its expanding and an existing patient populations as if it were an everyday operation. It isn’t. A true crisis has hit the VA. Years of merely funding part of the VA’s needed dollars has finally come back to bite them in the ass. The problem of long waits for care has caused some administrators to do when they are truly backed into a corner: hide the problem.

These budget problems will continue until Congress finally comes to its senses — a truly scary wish — and makes funding for all VA programa mandatory. Currently, slightly less than half of VA expenditures comes from discretionary funds from Congress. Programs such as disability pensions and other programs are mandatory but the meat on the bones for medical care requires a mandatory funding system. Once that is accomplished, the VA needs a George Marshall Plan or a man on the moon-type program to make the VA function as it should. A seamless transition of care between the military and VA should also be established.

The problems with the VA are many but are solveable.