Tag Archives: VA

Veterans Die from Lack of Health Insurance

From the web site of Physicians for a National Health Plan comes this summary of a new study on American veterans’ limited access to health care. These figures are an estimate, extrapolated from an earlier study–but if they are right, they dwarf the number of deaths from combat, and rival the suicide figures I wrote about earlier today.

A research team at Harvard Medical School estimates 2,266 U.S. military veterans under the age of 65 died last year because they lacked health insurance and thus had reduced access to care. That figure is more than 14 times the number of deaths (155) suffered by U.S. troops in Afghanistan in 2008, and more than twice as many as have died (911 as of Oct. 31) since the war began in 2001.

The researchers, who released their analysis today [Tuesday], pointedly say the health reform legislation pending in the House and Senate will not significantly affect this grim picture.

The Harvard group analyzed data from the U.S. Census Bureau’s March 2009 Current Population Survey, which surveyed Americans about their insurance coverage and veteran status, and found that 1,461,615 veterans between the ages of 18 and 64 were uninsured in 2008. Veterans were only classified as uninsured if they neither had health insurance nor received ongoing care at Veterans Health Administration (VA) hospitals or clinics.

Using their recently published findings in the American Journal of Public Health that show being uninsured raises an individual’s odds of dying by 40 percent (causing 44,798 deaths in the United States annually among those aged 17 to 64), they arrived at their estimate of 2,266 preventable deaths of non-elderly veterans in 2008.  

As the PNHP piece points out, many veterans do not have free access to government-funded health care through the VA system:

While many Americans believe that all veterans can get care from the VA, even combat veterans may not be able to obtain VA care, Woolhandler said. As a rule, VA facilities provide care for any veteran who is disabled by a condition connected to his or her military service and care for specific medical conditions acquired during military service.

Woolhandler said veterans who pass a means test are eligible for care in VA facilities, but have lower priority status…Veterans with higher incomes are classified in the lowest priority group and are not eligible for VA enrollment.

So after these men and women risk their lives in the military, we throw them on the mercy of the private system of medicine-for-profit, which is touted as a cherished part of the American way of life. It all gives a whole new meaning to dying for your country.

War Wounds: VA Ignores an “Epidemic” of Veteran Suicides

This Veterans Day, tributes continue for the 13 soldiers killed last week at Ford Hood, gunned down by one of their own. It was a shocking and terrible event, which warranted the outpouring of sorrow it inspired. Yet every single day, on average, more current and past members of the U.S. armed services die by their own hands than were killed on November 5 at Fort Hood.

According to the Department of Veterans Affairs’ own calculations (which it tried to conceal from a CBS News probe, and from the public), there are “about 18 suicides per day among America’s 25 million veterans.” That’s well over 6,000 a year. In addition, the VA admits that “suicide prevention coordinators are identifying about 1,000 suicide attempts per month among veterans we see in our medical facilities.” Rates are highest among young men in their twenties, veterans of our current wars. And these numbers do not include suicides by active duty members of the military. In 2008, these numbered nearly 250 (Army 128, Navy 41, Marines 41, Air Force 38)–five every week.

There are no public outpourings of grief for these servicemen and women, whose deaths must often have followed prolonged suffering from PTSD, traumatic brain injury, depression, or plain old despair. There are no weeks of nonstop media coverage, no tributes at Veterans Day parades, and no memorial services with eulogies by the president. In fact, it has been a longstanding policy that the families of soldiers who commit suicide do not even recieve a letter of condolence from the president.

At best, there are sporadic news reports noting the high rates of suicide, and the occassional Congressional hearing. And while increasing lip service has been paid to improving mental health care for veterans, in reality, the VA has set up multiple obstacles to such care.  As The Nation reported last year, the VA has delayed or denied disability and medical benefits to thousands of Iraq and Afghanistan veterans because they couldn’t “prove” that their conditions were “service-related.” In addition, “a recent Inspector General report found that 70 percent of VA facilities don’t have a system to track suicidal veterans. Only a handful of VA hospitals have rehab programs that include families. And soldiers injured today face a benefits waiting list more than 650,000 veterans long.” One doctor in the VA’s leadership who publicly criticized these shortcomings was summarily fired.

Even the true statistics on veteran suicides would never have come out were it not for a class action lawsuit by Veterans for Common Sense (VCS) and Veterans United for Truth, who sued the VA in federal court. According to the veterans’ groups:

Many veterans who have fought in Iraq and/or Afghanistan, as well as those who served in earlier conflicts, are not being given the disability compensation, medical services and care they need. A much higher percentage of these veterans suffer with Post Traumatic Stress Disorder (“PTSD”) than veterans of any previous war, due to the multiple tours many are serving, the unrelenting vigilance required by the circumstances, the greater prevalence of brain injuries caused by the types of weaponry in use, among other reasons. Despite this, the Department of Veterans’ Affairs (“DVA”) is failing to provide adequate and timely benefits and medical care.

The judge who heard the case in federal district court in San Francisco–himself an 86-year-old veteran of World War II–said he was sympathetic to the plaintiffs’ cause, but he found against them. According to VCS, “In his decision, Judge Conti held that although it is clear to the Court that the VA may need ‘a complete overhaul’ the the power to remedy this crisis lies with the other branches of government.” In other words, if the VA can’t or won’t fix itself, it’s time for Congress and the White House to step up and do something about this travesty.

Dr. Dean’s Health Care Prescription: “The Free Market Just Doesn’t Work in Medicine”

On a book tour in southern California recently, Howard Dean–the ex-governor of Vermont, 2004 presidential candidate, and former DNC chair, who is himself a medical doctor–makes a few points about health care that are worth keeping in mind through the bitter partisan debate (if you can still call it a debate). His book from Chelsea Green is called Howard Dean’s Prescription for Real Healthcare Refom.

Remember that it was Dean who, as governor of Vermont, got through a provision guaranteeing health care covering to all of the state’s children. He was ridiculed on the stump in 2004 as an out of control lefty–which is about as true as the accusations that Obama is a socialist. Dean is a moderate-to-conservative New Englander who has never proposed anything faintly resembling socialized medicine. 

But Dean does believe, as he pointed out at one book tour appearance: “The free market just doesn’t work in medicine. You can’t be an informed consumer. I never saw someone with severe chest pain jump off the table and say, ‘Doctor, I’m going to the cheaper guy down the street.'” And he doesn’t favor compromising on a public option, because “the public option is the compromise.”

The above quote was supplied by Miriam Raftery, editor of the East County Magazine, who  provides a fine precis of Dean’s book and the talk he gave last month at a San Diego bookstore: 

Dean noted that public healthcare in Europe was established not by liberals, but was in fact championed by conservative statesman Winston Churchill. “Disease must be attacked, whether it occurs in the poorest or the richest man or woman simply on the ground that it is the enemy; and it must be attacked just in the same way as the fire brigade will give its full assistance to the humblest cottage as readily as to the most important mansion,” Churchill once stated.” Our policy is to create a national health service in order to ensure that everybody in the country, irrespective of means, age, sex, or occupation, shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available.”

Cost savings would occur by moving to a wellness-based medical model that emphasizes prevention, lowering current costs for treating patients who wait and go to the emergency room in a crisis. Eliminating administrative overhead would also save money in a public option. . .

“To fix the economy, we need to begin by fixing our healthcare system,” his book states, noting that General Motors spends more on healthcare insurance for workers than on steel to build automobiles. He cites a Kaiser Family Foundation survey which found that 58% of all small businesses have difficulty keeping up with healthcare costs. “If you want to help small businesses,” he argues, “let them pay lower health insurance premiums.”

Dean has practiced what he preaches. As Governor of Vermont, he led the state’s expansion of Medicaid eligibility to children under 18 in families earning under $65,000. “Basically we made Medicaid a middle class entitlement for children,” he says, adding that the shift saved businesses money and increased profit margins for those that opted to have employees’ children covered by the public plan. Vermont also increased Medicaid reimbursements to assure that doctors would not opt out of the system.

Dean now advocates what is basically a public option, achieved by opening up Medicare to people under 65, while allowing anyone who chooses to keep their private insurance. 

“Americans ought to be able to decide for themselves: Is private health insurance really health insurance? Or is it simply an extension of the things that have been happening on Wall Street over the past five to ten years, in which private corporations find yet new and ingenious ways of taking money from ordinary citizens without giving them the services they’ve paid for?”

Dean dispells myths promoted by the healthcare industry. “There is no country in the world with a public option that doesn’t also have private insurance,” he noted. “A public option allows you to sign up for Medicaid [Medicare] before 65. All the Republicans who’ve been whining and complaining all have a public system,” said Dean, former head of the Democratic National Committee, citing the high-quality government healthcare program that Congress has given its own members. Moreover, satisfaction ratings are high for two other government healthcare programs: Medicaid and Veterans Administration healthcare, Dean noted.

He believes true healthcare reform must include five core principles. Everyone must have the option of coverage. No one should be forced to declare bankruptcy because of medical bills. Health insurance should be portable, meaning you can’t lose your health insurance even if you change jobs, move, retire or have a pre-existing condition. Plus the quality and efficiency of care must be improved. . .

“My bottom line is not single-payer,” he said, noting that most Americans like to have choices. But he added that supporters of single payer should continue to lobby their legislators to prevent healthcare reform in Congress from being watered down to remove a public option. “Public option is the compromise,” he noted.

Dean noted that all countries in Europe now have a public option, except Switzerland and Netherland, where insurance companies are tightly regulated similar to public utilities. Americans spend more on healthcare per capita than any other nation, yet the U.S. ranks dead last in ratings of healthcare quality, access and affordability…