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Caring for Veterans on the Cheap

How the Veterans' Administration has been shortchanging soldiers who come back wounded.

| Fri Apr. 28, 2006 2:00 AM EDT

Listen to the VA's own national advisory board on PTSD in a report released in February, 2006:

"[The] VA cannot meet the ongoing needs of veterans of past deployments while also reaching out to new combat veterans of [Iraq and Afghanistan] and their families within current resources and current models of treatment."

The VA is now paying out $4.3 billion a year for PTSD disability to 215,871 veterans. The report also found that a returning war veteran suffering from emotional illness now has to wait an average of 60 days before he or she can even be evaluated for diagnosis, let alone treated. Forty-two percent of VA primary care clinics had no mental-health staff members and 53% of those that did had only one. Eighty-two percent of new patients needed to be in the most intensive PTSD treatment programs, the VA report found, but 40% of those programs were already so full that they could only take a few more patients; 20% said they were too full to take any at all.

"VA's data show a 30% increase in the number of [Iraq and Afghan War] veterans who have an initial diagnosis of post-traumatic stress disorder from the end of FY 2005," says Rep. Michael Michaud (Dem.-Me). "I applaud the courage of these veterans who have sought help, but the administration refuses to acknowledge fully the demand and need for mental health services."

Further down the line: How many Iraqi veterans will eventually join the ranks of the 400,000 homeless vets on the streets of American cities? (Right now the VA takes care of only 100,000 such vets, according to the National Coalition for Homeless Veterans.)

This dire situation has only encouraged the budget cutters and anti-government radicals like Norquist, who once joked that he hoped to shrink the government enough so that he could drown it in a bathtub. With PTSD rates soaring among vets, the hatchets have been out not just when it comes to treating them, but even when it comes to the diagnosis of PTSD itself. In 2005, the VA, under White House pressure, announced that it was reopening 72,000 long-approved PTSD disability claims for review, many of them for Vietnam veterans. Right-wing columnists quickly swung into action with op-ed pieces insisting that many PTSD claims were fraudulent. The VA backed off -- but only after a New Mexico newspaper reported that a troubled Vietnam veteran with a 100% PTSD disability killed himself upon fearing that the VA might review his case and a firestorm of criticism from Congress and veterans' organizations followed.

Other White House ideas for cutting back the VA, including making vets pay insurance premiums, higher co-pays and doubling Vets' costs for prescription drugs, have also been beaten back by Congress. One VA response to its huge backlog of claims has been to limit enrollment for its services. In January 2003, the White House ordered the VA to create a new temporary cost-cutting category of "affluent" vets who would not be eligible to use the VA. But the new category seems headed for permanency. And it sets the cut-off level for eligibility for VA care so low -- around $30,000 for a so-called "affluent" family of four -- that many vets who have been cut off can't possibly afford health insurance and medical care on the private market.

In World War II, 12 million Americans fought on behalf of a nation of 130 million. Twenty-five percent of American men served in that war. They came back heroes to a country more than willing to give them the latest medical care, compensate them for their wounds, send them to college, and help them buy homes.

Fifty years later in Iraq -- an unpopular war -- only 1.3 million are fighting for a nation of 300 million. "Never have so few sacrificed so much for so many," one Desert Storm veteran said recently. Iraq may be the wrong cause for sacrifice. But Vietnam veterans taught us that once war starts we must be willing to take care of everyone who gets hurt in it.

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