Last year the country was shocked to learn the extent of the systemic problems the Department of Veterans Affairs had in delivering adequate health care generally, and, specifically, the grossly long periods vets had to wait to get an appointment.
It’s not getting better.
Department officials told the New York Times that the number of vets on waiting lists of at least one month is 50% higher than it was during the height of last year’s problems.
Because the VA has a budget shortfall of nearly $3 billion, the outlook continues to look bleak.
Despite last year’s reports of insufficient medical staffing, the VA might put people on furlough, freeze hiring and take other personnel-reduction steps to address its financial problems. In addition, according to The Times, it might ration some expensive medical costs, which invites all sorts of unpleasantness about who deserves what.
Is this any way to treat people who have served their country? Is this any way to treat anybody?
Sloan D. Gibson, deputy secretary of the VA, told The Times, “Something has to give. We can’t leave this as the status quo. We are not meeting the needs of veterans, and veterans are signaling that to us by coming in for additional care, and we can’t deliver it as timely as we want to.”
In addition to the waiting-list scandal that broke last year, the VA has come under fire for several breaches of ethical and/or medical standards. Even if they’re not directly related to the shortage of caregivers for this needy population, you have to believe lack of money and clinical staff compromise care on all levels.
Since last year’s news broke, the VA did respond to the need for faster access to health care, handling 2.7 million more appointments than in any previous year. It also authorized 900,000 more patients to see physicians outside of the VA system via a program called Choice Card that permits veterans in rural areas who languish on waiting lists to seek care from private doctors outside the department’s health system.
Agency officials told The Times that they have increased capacity by more than 7 million patient visits per year, double what they originally thought they needed.
So why have the waiting lists continued to grow?
It appears that the need expanded to surpass the supply – the department didn’t expect the demand to soar so much beyond the ability of physicians to handle the workload over the last year.
The Times got VA budget information showing that physician workloads grew by 21% at hospitals and clinics in parts of the South, for example, and by 20% in the Southern California and southern Nevada. The taxpayer-funded physician care provided outside of the department grew by 50% in Pennsylvania, and by 36% in some parts of the Midwest.
Those numbers reflect multiple appointments by individual patients, and patients often schedule more appointments than they used to. Still, the number of people being treated has jumped significantly in many areas, and the VA was stunned by the number of new patients seeking treatment.
The boom in patients seeking appointments is not the only factor driving the VA’s inability to keep up with demand, nor is it responsible for all the excess costs. The increasing need for prosthetic limbs and the outrageous price for new drugs to treat hepatitis C (approaching $100,000 for a single patient) are huge contributors.
The more things change at the VA, it seems, the more they remain the same.