April 10, 2019
by Murray Feldstein, M.D.
Americans will surely recall the scandalous Veterans Health Administration scandal several years ago: In many hospitals, there were long waiting times for appointments due to physician shortages, as well as squalid conditions in some facilities. That is why recent legislation and the accompanying proposed rule to significantly expand the number of patients eligible for private healthcare under the Department of Veterans Affairs (VA) are an important step in the right direction.
As a veteran and a physician, I had the privilege to work alongside the dedicated doctors, nurses, and other clinical personnel who staff the VA during my 56-year career in medicine. Unfortunately, the reality is that the system too often fails our veterans. I have seen it firsthand as a physician, and this is why, even though I am a veteran, I use the private system.
While much has improved since the shameful headlines that first emerged in 2014, many new patients are still waiting more than 30 days for a primary care appointment. Perhaps even more troubling, veterans are still facing long waits for specialty care. I have seen the devastating consequences of what these long wait times mean for our nation’s heroes.
I will never forget the heartbreaking case of a patient who may have died because of delayed care. Shortly before my retirement from active medical practice, I was on the staff of a major medical center in Phoenix, Arizona. Our department saw a substantial number of veterans referred for urologic specialty care from the Phoenix VA.
One veteran we cared for saw blood in his urine but had to wait several months before being referred for a CAT scan by a primary care provider at the VA. Any urologist would recommend that such a patient be evaluated within days.
But more time passed before the VA processed his primary care physician’s referral for a CAT scan. The scan showed a disseminated kidney cancer which could not be cured.
What took the VA months should have been completed in matter of days.
I have often wondered if we could have saved him if he had been seen sooner. I will never know, as many kidney cancers are found to be incurable even when evaluated more promptly. But I do know the delay this patient experienced took a toll on his physical and mental health. And it is outrageous that this veteran unnecessarily suffered because of these delays.
Under the new law and its proposed rule, patients would have the option to obtain private care if they had to wait 20 days or more or drive more than 30 minutes for a VA appointment, or 28 days or more or drive more than 60 minutes to obtain specialist care. This rule will allow more VA patients, if they choose, to access care in a timelier manner.
Allowing our nation’s veterans, to whom we owe an immeasurable debt of gratitude, the option to seek care privately, when time is of the essence and when it cannot be obtained through the VA in a timely manner, should not be politicized.
It is time to set aside partisan differences and put the well-being of our nation’s veterans ahead of politics. It is time to put these patients first.
First appeared at RealClearPolicy.
Murray Feldstein, M.D. is a visiting fellow in healthcare policy at the Goldwater Institute.