As VA hospitals struggle to meet rising demands, the Red Sox Foundation and Mass General have found a way to shore up care for local vets.
complain about is a capital-B bureaucracy of endless paperwork and automated messages. Appointments are hard to get, especially for younger vets, and they’re brief, she says.
Many of Matthews’s vets expect more of hospitals associated with Harvard, Boston University, and Tufts. And in fact Massachusetts’ VA facilities are, in many respects, first-rate. Their care outperforms that of other VA hospitals nationally, internal studies show; and VA Boston beats 96 percent of all hospitals that serve poor and aging patients, according to HealthInsight, a nonprofit group that analyzes Medicare and Medicaid statistics. VA Boston’s psychiatrists are nationally recognized. In 2007, for instance, Dr. Jonathan Shay won a MacArthur Fellowship, the so-called genius grant, for his work tracing PTSD to ancient cultures.
Yet stellar care means nothing if you can’t get access to it. Although the VA says it sees almost all its patients within 14 days of a call for an appointment, vets complain about excessive wait times: One in four veterans waits at least 30 days to see a doctor in the system, the most recent Office of Inspector General report showed. One highly regarded mental health professional working at the VA Medical Center in Bedford says the waitlist for therapy sessions is about five months. And a psychiatrist in Greater Boston says he recently left the VA in part because his hourlong sessions kept getting squeezed down to shorter increments, and because he was told to meet "productivity guidelines" in terms of number of patients seen. "Basically…[the expectation is] for the psychiatrist’s door to open and close every 15 minutes," he says.
The system is swamped because more Iraq and Afghanistan vets are seeking out treatment than federal policymakers projected, veterans groups say. Forty-six percent of returning troops have enrolled in VA care nationwide, already exceeding policymakers’ estimates. New England’s VA hospitals are treating 22,000, and that’s only four percent of the region’s overall patient load.
The costs have outstripped the VA’s resources. The agency had to request $1 billion in emergency funding to cover unexpected needs in 2005, and another $2 billion the next year. By 2008, Congress was asking for $3 billion more in emergency funding to cope with rising demand. The VA’s struggles to meet needs led veterans to file a class-action lawsuit. The plaintiffs didn’t want money; they wanted the VA to acknowledge its shortcomings. The federal judge who heard the case decided the problems were so large they required legislation, not adjudication.
Under President Obama, the VA’s budget has grown by 27 percent – and it has asked Congress for $125 billion for next year – but the increase doesn’t make up for past lags. "We’re still behind the curve on staffing," says the mental health professional in Bedford.
Access is what the Red Sox’s Werner wanted to offer – otherwise, what a waste for suffering vets to go untreated in a city with some of the finest healthcare in the world.
ONE NIGHT TWO YEARS AGO, Gary Smith awoke to the sound of his back door