Maybe Secretary McDonald Misspoke Here Too? VA Can’t Be Managed: Veterans Choice Program ID Cards

Editorial by Jerry Donnellan 

I have worked with the Department of Veterans Affairs (DVA) since it was the Veterans Administration. Most people don’t know the difference, which is part of the problem. Most folks who aren’t veterans assume that if a veteran doesn’t feel well she simply goes to the VA and is taken care of at no cost. Well, that just isn’t the case unless you have been wounded or injured while in the military – and that’s only care for the specific wound or injury. The average veteran who would now wish to enroll in the VA Healthcare System must have a combined household income below $55,000 and, if they qualify, there would still be a need for co-payments.

Not long after Vietnam I applied for a small grant to widen doorways and put grab bars in my shower. After a good deal of waiting I received a letter back advising me that I would have to go to a VA Hospital for an examination, to verify the fact I was still missing my right leg. Go ahead and laugh – I’ve gotten a lot of punch lines out of that over the years, but it’s true. It points out the lack of care or conscientiousness on the part of the System.

Finally in 1989 during the first Bush Administration, the then Veterans Administration evolved into the Department of Veterans Affairs and became Cabinet level. Mr. Derwinski was appointed Secretary. At the time we all felt good. We thought it was a step up. We had a place at the table. A very well-credentialed former Congressman from the Midwest with a great resume was now at the President’s table and speaking for us. Unfortunately nothing changed. Not even the initials VA.

I was fortunate to have a chance to meet Mr. Derwinski shortly after he was appointed, and he asked quite openly what things, did I think, could be changed to help. I suggested having the Department of Defenses computers linked to the VA computers so they could speak to each other. Reason being, when a person left the military, their records could automatically and instantaneously be transferred to the DVA. That way if the individual chose to or needed to use the VA, he/she would already have a file in place.

That didn’t happen. Maybe they’re waiting until they get new computers – after all, it’s only been 25 years. We know the technology exists. We know that suggestion would make things a good deal easier and faster, yet after further requests of the same nature, nothing has happened.

In the same 25 years, the number of veterans has dropped in half, and the VA Budget in real numbers has doubled. So in simple terms the VA has twice as much money to handle half as many people. Here again, the problem is the general public doesn’t pay any attention to the VA until every couple of years when the VA stumbles onto 60 Minutes – then there’s a flash of attention. Politicians wrap themselves in flags. People get fired. Folks run around like the Three Stooges. Maybe even the Secretary is replaced. Then everything goes back to what passes for normal.

About a year ago, everyone was focused on the VA in Phoenix where supposedly veterans were dying, waiting for medical care — their names on long waiting lists. DVA Secretary Eric Shinseki is a decorated war veteran with an impressive resume, who rose to the rank of General and finally Army Chief of Staff. Despite his connections and accomplishments to his credit, Shinseki had to ultimately fall on his sword.

Secretary Shinseki was replaced by Robert A. McDonald, West Point graduate as well as CEO and Chairman of the Board of Proctor and Gamble. In his tenure there, he raised Proctor and Gamble’s market share worldwide by a substantial margin. Again, obviously a very well-qualified individual. Secretary McDonald’s solution to the current problem was to issue the veterans Temporary Choice Program ID cards, so that if the veteran couldn’t be seen in a timely manner, or if a VA facility was too far, or if he had trouble contacting the VA, the veteran could then use this card to go to a private facility.

It sounded like a reasonable solution but as usual, the devil is in the details. A few weeks ago I got my Temporary Choice ID card. On the front of the card in big letters it says, “THIS CARD DOES NOT PROVIDE PRE-APPROVAL. VETERANS MAY BE LIABLE FOR COST OF CARE THAT IS NOT PRE-APPROVED.” So the reality, if I understand it, is that if I can’t get through to the VA and get an appointment, then I can go to a private doctor, but only if I can get through to the VA and get it authorized, which would probably be more of an endeavor than waiting for the VA. It’s kind of like losing an argument with your wife and then going to your mother-in-law for a second opinion. You’re not going to win this one!

But it gets better. The VA just put out a Press Release stating, “Far fewer veterans use Choice card and private healthcare than expected.” In the story in The Washington Post, that seems to vindicate the VA and was saying in effect that veterans really didn’t want to go elsewhere, when the reality is this Temporary Choice card might as well be your American Express.

Please understand, 98 percent of the folks who work in the VA are good, caring wonderful people – many working very hard above and beyond what they need to do, but the overall System simply can’t be managed. I don’t know who they’re sizing up for Secretary McDonald’s replacement but perhaps they should look at his cousin Ronald because he seems to have no problems serving millions of people without too much agita!  But maybe it’s just that things are easier for redheads!

Jerry Donnellan is director of the Veterans Service Agency of Rockland County