Thursday, March 6, 2008

Our veterans deserve full commitment to care


Felina Franklin

ARTICLE TOOLS: Email Article | Print-Friendly Format HOUSTON - A 36-year-old male, non-service connected Gulf War era veteran visits the Veterans Administration Medical Center (VAMC) with a toothache. X-rays in the dental clinic determine two teeth need extraction due to infection.
However, he is ineligible at the VAMC; he is not a "service-connected disabled veteran." If the infection was life-threatening, the extraction would cost him $200.00 out of pocket. Since it is not life-threatening he is given pain medicine, antibiotics and referred to the county emergency room.

After 22 hours in the emergency waiting room, the veteran is given pain medicine, antibiotics for infection, and an appointment (two weeks later) for tooth extraction. This is only one example of the hundreds of thousands of veterans referred out, given delayed treatment or denied services based on current policy and eligibility for veteran healthcare.

Currently, Title 38 of the U.S. Code states veterans injured or diagnosed while "in line of duty during a period of war" will be paid compensation. Veterans are placed in priority groups based on their level of disability and the Geographic Means Test Threshold. Most disabilities are rated less than 50 percent, making veterans ineligible for VA services. Low-priority veterans are restricted from services based on income and zip code.

Title 38 also promises preventative care, but most provisions treat veterans for service connected disabilities only. Most ailments are hard to prove as service connected and more difficult for veterans with physical or psychological ailments that take months or even years to become symptomatic. The same is true for income-eligible requirements. Many veterans are not working as much as they want or are able to in order to receive benefits. Those who earn above the income limit become ineligible for services and pay out of pocket.

In January 2008, the Department of Veterans Affairs projected there are 23,532,000 veterans; 8 percent of the total U.S. population. Of those veterans, 7.8 million were enrolled in the VA healthcare system in 2007. A 2004 study showed about 1.8 million veterans did not have healthcare coverage and/or were not eligible for VAMC services.

The VA provides healthcare to about 100,000 (25 percent of 400,000) homeless veterans each year and estimates 200,000 veterans are homeless on any given night. The National Coalition of Homeless Veterans reports one of the top three reasons veterans are homeless is inaccessibility to healthcare.

I suggest a Full Coverage Veteran Act (FCVA) to replace Title 38 and establish the use of veterans' DD-214 Form (discharge orders) to guarantee government payment for all services rendered. Veterans will receive treatment for any ailment at any medical facility they choose. Facilities providing treatment to veterans will receive tax cuts for services. Doctors will be able to serve veterans with adequate resources and without cost worries. Rural veterans also will have better access to care.

FCVA will reduce the number of homeless veterans due to lack of healthcare, increase employment for those with treatable health conditions and reduce costs. Preventative care is less expensive than treatment of any condition. A study in the American Journal of Public Health (1988) reported outpatient care cost less than inpatient care. Without limitations to preventative services, veterans are less likely to have severe illnesses and more likely to be treated on an outpatient basis. Therefore, decreasing absenteeism from work. Citizens that make more money, spend more money; stimulating the economy.

A country is only as good as it treats its veterans; those who put their lives on the line for freedom. There are billions of dollars allocated for the war, but limited funds, cut periodically, used for veteran healthcare.

We serve only part of the veteran if we allow this policy to limit healthcare given solely based on disabilities acquired while in service. Do you want less than 50 percent of a soldier standing post tonight?

Felina Franklin is a University of Houston doctoral student. She was reared in Amarillo and is a 2001 Highland Park High School graduate. Franklin currently is a social work intern at the Michael E. DeBakey VA Medical Center in Houston.

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