Saturday, November 17, 2007

Next Municipal Tsunami? Another Third Rail?

At each of the last several Town Meetings, Middleboro voters, after the explanation of the BOS, have appropriated funds for the Veterans' Agent with the explanation that the funds are needed for Veterans' medical expenses and if the Town doesn't pay those expenses, the state will deduct 100% from the Cherry sheet. Funds expended by the Town are reimbursed the following year 75%.
Because this is a Third Rail issue, no questions are asked.
No one asks what steps have been taken to ensure that each Veteran AND HIS DEPENDENTS acquire health coverage. No one asks what measures have been taken!
No one questions.
Doesn't the Commonwealth now have mandatory medical coverage?
Some of us naively believed that the lessons of Vietnam had been learned and our returning Veterans would be adequately cared for. Since this Administration has abandoned those who have served, the silence among the Veterans' groups is disappointing.
Transportation is being provided to Providence, RI and W. Roxbury VA Facilities, bypassing the Brockton VA Hospital that was deliberately under-staffed.
Since this Administration has abandoned our Veterans and refused to accept responsibility to provide adequate care, if each municipality provides care, what will the escalating costs be? Should those costs be borne by municipalities or even the Commonwealth?
Is anything being done or will this become a local budget buster?
Veterans Without Health Care
Published: November 9, 2007
Although many Americans believe that the nation’s veterans have ready access to health care, that is far from the case. A new study by researchers at the Harvard Medical School has found that millions of veterans and their dependents have no access to care in veterans’ hospitals and clinics and no health insurance to pay for care elsewhere. Their plight represents yet another failure of our disjointed health care system to provide coverage for all Americans.
The new study, published in the American Journal of Public Health, estimated that in 2004 nearly 1.8 million veterans were uninsured and unable to get care in veterans’ facilities. An additional 3.8 million members of their households faced the same predicament. All told, this group made up roughly 12 percent of the huge population of uninsured Americans.
Most of the uninsured veterans were working-class people who were too poor to afford private insurance but not poor enough to qualify for care under a priority system administered by the Veterans Affairs Department. Some were unable to get care because there was no V.A. facility nearby, or the nearest facility had a long waiting list, or they could not afford the co-payments required of some veterans.
There is little doubt that lack of coverage was deleterious to their health. Like other uninsured Americans, the uninsured veterans report that they have delayed or forgone care because of costs. Half had not seen a doctor in the past year, and two-thirds got no preventive care.
And the situation has been getting worse. Despite a shrinking population of working-age veterans, the number of uninsured veterans increased by 290,000 between 2000 and 2004, propelled by a steady erosion of health care coverage in the workplace and a tightening of enrollment criteria for veterans’ care.
The V.A. has long focused on caring for recent combat veterans, those with service-connected disabilities or special needs and the poorest veterans. Other veterans were served to the extent that resources were available. Unfortunately, in recent years enrollment of higher-income, nondisabled veterans shot up so fast that long waiting lists developed and budgets failed to keep pace, forcing a freeze on enrollments in this category.
One solution would be to make all veterans eligible for care in appreciation of their service to the nation. Bills pending in Congress would end the freeze, opening the way for hundreds of thousands of veterans, possibly even a million or more, to qualify for V.A. care at a cost that could reach above $1 billion the first year and almost $9 billion over five years. An even better solution would be some form of universal health coverage for all Americans. Then even veterans who live far from a V.A. facility, and a host of dependents who are not now eligible, could get the care they need. NYT


The Plight of American Veterans
Published: November 12, 2007
As an unpopular, ill-planned war in Iraq grinds on inconclusively, it can be a bleak time to be a veteran.
There is little outright hostility toward returning military personnel these days; few Americans are reviling them as “baby killers” or blaming them for a botched war of choice launched by the White House. Indeed, both Congress and the White House have been hymning their praises in the run-up to Veterans Day. But all too often, soldiers who return from Iraq or Afghanistan — and those who served in Vietnam or Korea — have been left to fend for themselves with little help from the government.
Recent surveys have painted an appalling picture. Almost half a million of the nation’s 24 million veterans were homeless at some point during 2006, and while only a few hundred from Iraq or Afghanistan have turned up homeless so far, aid groups are bracing themselves for a tsunamilike upsurge in coming years.
Tens of thousands of reservists and National Guard troops, whose jobs were supposedly protected while they were at war, were denied prompt re-employment upon their return or else lost seniority, pay and other benefits. Some 1.8 million veterans were unable to get care in veterans’ facilities in 2004 and lacked health insurance to pay for care elsewhere. Meanwhile, veterans seeking disability payments faced huge backlogs and inordinate delays in getting claims and appeals processed.
The biggest stain this year was the scandalous neglect of outpatients at the Walter Reed Army Medical Center and a sluggish response to the needs of wounded soldiers at veterans clinics and hospitals. Much of this neglect stemmed from the Bush administration’s failure to plan for a long war with mounting casualties and over-long tours of duty to compensate for a shortage of troops.
Thus far, more than 4,000 American soldiers have been killed in Iraq or Afghanistan, many more than died in the almost-bloodless Persian Gulf war, but only a fraction of the body counts in Vietnam (58,000) or Korea (36,000). A higher percentage of wounded soldiers are surviving the current conflicts with grievous injuries, their lives saved by body armor, advances in battlefield medicine and prompt evacuation. A study issued last week estimated that the long-term costs of their medical care and disability benefits could exceed the amount spent so far in prosecuting the war in Iraq.
To their credit, Congress and the administration have poured billions of added dollars into veterans’ programs and streamlined procedures in a scramble to catch up with the need. That is only appropriate. The entire burden of today’s wars has been carried by a voluntary military force and its families. The larger public has not faced a draft, paid higher taxes or been asked to make any other sacrifice. The least a grateful nation should do is support the troops upon their return. NYT

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