Despite $10B 'Fix,' Veterans Are Waiting Even Longer To See Doctors : Shots - Health News A $10 billion program to eliminate long wait times and other problems for veterans' health care hasn't worked out as planned. More veterans wait even longer for care now than they did a year ago.
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Despite $10B 'Fix,' Veterans Are Waiting Even Longer To See Doctors

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Despite $10B 'Fix,' Veterans Are Waiting Even Longer To See Doctors

Despite $10B 'Fix,' Veterans Are Waiting Even Longer To See Doctors

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RENEE MONTAGNE, HOST:

Veterans are still waiting to see a doctor. You may remember the news from two years ago - long wait times at VA clinics across the country were a scandal. Congress and the VA came up with a fix, a program called Veterans Choice. But the fix is broken. Reporters from NPR member stations have been talking to veterans and doctors and the officials who run Veterans Choice. And we're going to hear from them about how badly the fix is broken and why. We'll start today with Quil Lawrence.

He covers veterans for NPR, and he's in our studio now. Good morning.

QUIL LAWRENCE, BYLINE: Good morning, Renee.

MONTAGNE: The summer of 2014 - why were veterans then having to wait so long to see a doctor?

LAWRENCE: The root cause was that the VA didn't have enough doctors and nurses at a time when millions of Vietnam and Korea vets are getting old and needing more care, and also a lot of Iraq and Afghanistan vets were entering the VA system. The scandal that summer, which cost the VA secretary his job, was that some VA clinics were cooking the books to hide the fact that vets were waiting so long.

MONTAGNE: So Congress and the VA tried to fix this. So tell us more about what they did.

LAWRENCE: Congress passed a big reform bill. It included $10 billion for the Veterans Choice program, which was supposed to fix this problem. They even sent out a card to all these vets so that they could take that card and go see a private doctor if they live 40 miles away from a VA facility or they'd already been waiting 30 days for an appointment. So it was supposed to be a very simple idea. It didn't turn out all that simple. Despite seeing 3 million appointments outside the VA system in the past year, wait times are worse.

Compared to one year ago, there are 70,000 more vets right now who have waited more than a month to get an appointment.

MONTAGNE: Quil, how did wait times actually go up?

LAWRENCE: The VA says it's because they had a massive increase in demand for care. But when we've been looking at vets trying to use this Veterans Choice system, it doesn't look like the program really made things go smoother for them. From the start, it was so confusing that veterans didn't understand it, doctors didn't understand it and even the VA administrators were admitting that they couldn't really always figure it out. We've been talking to veterans and doctors across the country about this.

MONTAGNE: And we've got two reports coming up right now.

LAWRENCE: Yes, and the first is from my colleague Eric Whitney. He's with the Montana Public radio.

ERIC WHITNEY, BYLINE: Montana has more veterans per capita than any state besides Alaska. This winter, Montana Senator Jon Tester sent his staff to meet with veterans in 28 towns from one end of the state to the other. Scenes like this one were typical.

(SOUNDBITE OF ARCHIVED RECORDING)

BOBBY WILSON: The VA can't do it in seven months, eight months - something's wrong.

WHITNEY: That's Bobby Wilson, a Navy vet who served in Vietnam. He's trying to get his hearing aids fixed, but can't get approval for an appointment to do that.

(SOUNDBITE OF ARCHIVED RECORDING)

WILSON: Three hours on the phone with her. I'm waiting, talking for three hours trying to get this thing set up for my new hearing aids.

WHITNEY: Tony Lapinski is a former air craft mechanic. He's also spent a lot of time on the phone with Health Net, the VA contractor that's supposed to be helping him.

(SOUNDBITE OF ARCHIVED RECORDING)

TONY LAPINSKI: You guys all know the Health Net piano? You know what I'm saying?

(LAUGHTER)

LIPINSKI: They haven't changed the damn elevator music in over a year.

WHITNEY: Interviewed after the hearing, he says sometimes he actually gets through.

LIPINSKI: Oh, they're the nicest, you know, boiler room telemarketers you've ever spoke to. That doesn't get your medical procedure taken care of.

WHITNEY: Lapinski has a growth on his spine. He's been trying for months to get authorizations to see specialists to get it diagnosed.

LIPINSKI: Some days I wake up and go, am I wasting time where I could be on chemotherapy or getting a surgery to take this thing out - you know? - or six months from now when I still haven't gotten it looked at and I start having weird symptoms and they look and say, boy, you know, that's cancer. You know, if you'd have come in here six months ago, we probably could have done something for you. But it's too late now.

WHITNEY: When the VA contractor finally connected Lapinski to a neurosurgeon, he says he didn't exactly feel like his Veterans Choice card was carte blanche. Doctors, it turns out, are waiting too - for payment, says Lapinski.

LIPINSKI: You get your procedure done and you find out that two months later that the people haven't been paid? They've got $10 billion that they have to spend. And they're stiffing doctors for 90 days, 180 days, maybe a year. No wonder I can't get anyone to take me seriously on this program.

WHITNEY: Lapinski used to do part-time work fixing cars. He says he understands why his neurosurgeon may not be thrilled to see him.

LIPINSKI: I had a list of slow-pay customers - you know, I mean, slow-pay over 90 days. I might work for them again. But everybody else came before them. So why would it be any different with these healthcare professionals?

WHITNEY: Hospitals, clinics and doctors across the country have complained about not getting paid or only paid very slowly. Montana Senator Jon Tester says Billings Clinic, a network of 12 hospitals, never even signed up to be part of Veterans Choice.

JON TESTER: Biggest healthcare provider in the state of Montana won't deal with Choice. That should tell you something's wrong with the program.

WHITNEY: The VA and its contractors point out that when Congress passed the Veterans Choice law, they only gave them 90 days to get it up and running. And the VA was requiring tons of extra paperwork before outside doctors could get paid. Still, Senator Tester has little sympathy.

TESTER: Ninety days is three months. And all they had to do is schedule appointments, develop partnerships with medical providers and pay them on a timely basis. And they haven't done that.

WHITNEY: Health Net declined to be interviewed for this story. But in a statement, the company says the VA has recently reduced the paperwork requirements, and that's helping to streamline Veterans Choice. Vietnam veteran Bobby Wilson, though, is almost at the end of his rope.

WILSON: If I knew half of what I knew now back then when I was just a kid, I'd have never went in the military. I see how they treat their veterans when they come home.

WHITNEY: For NPR News, I'm Eric Whitney in Montana.

MICHAEL TOMSIC, BYLINE: I'm Michael Tomsic in North Carolina. The Salisbury VA kept army veteran Archie Barrow waiting two months for shoulder surgery, so he got referred to Choice. But when he took the next step, trying to schedule care through Health Net...

ARCHIE BARROW: The first couple phone calls they said I wasn't authorized. I said, well, how am I not authorized? I've got two Choice cards here saying I am. And then I finally called back about the third or fourth time and I got somebody that was able to help me.

TOMSIC: It took another two months for Health Net, the VA, Barrow and a private doctor to get everything sorted out. He had surgery a year ago.

BARROW: And they have still - have not paid for it.

TOMSIC: That puts Barrow's doctor in good company. At least 30 doctor's offices throughout North Carolina are dealing with Veterans Choice payment problems, some that have lasted more than a year, according to the North Carolina Medical Society. It's become a frustration within the VA, too.

TYMALYN JAMES: The fact is that people are waiting months and months. And it's like - we call it the black hole.

TOMSIC: That's Tymalyn James, a nurse care manager at the VA clinic in Wilmington. When she and her colleagues are swamped and refer someone to a doctor outside the VA, it's supposed to help them get care more quickly. But James says the opposite is happening.

JAMES: As long as the Choice program has gone on, we've had progressively longer and longer wait times for choice to provide the service. And we've had progressively less and less follow-through on the Choice end with getting the service for the patient.

TOMSIC: In Gastonia, that leaves Kelly Coward dialing yet another veteran with bad news.

KELLY COWARD: Just calling to let you know that I still have not received your authorization from Health Net Federal. As soon as I get it, I will give you a call and let you know that we have it and we can go over some surgery dates.

TOMSIC: Coward works at Carolina Orthopaedic & Sports Medicine, which treats about 200 veterans. Dealing with Health Net has become a consuming part of her job.

COWARD: I have to fax and re-fax and call and re-call. And they tell us that they don't receive the notes, and that's just every day. And I'm not the only one here that deals with it.

TOMSIC: Carolina Orthopaedic's business operations manager, Toscha Willis, is used to administrative headaches. That's part of the deal with health care. But Willis says she's never seen something like this.

TOSCHA WILLIS: Multiple phone calls, multiple re-faxing of documentation, you know, being on hold for 1 to 2 hours at a time to be told we don't have anything on file. But the last time we called about it, they had it but it was in review - that's the frustration.

TOMSIC: It can take 3 to 4 months just to line up an office visit. Veterans ask if they can even go to Health Net in person.

WILLIS: (Laughter) I mean, they tell - we have patients that say, I'm going to drive there. They get that upset about it, and they don't give their address out.

TOMSIC: For the record, Health Net has regional call centers in eight states, including South Carolina and Florida. The whole process makes Carolina Orthopaedic CEO Chad Ghorley, a veteran himself, furious.

CHAD GHORLEY: The federal government's put the Band-Aid on it when there's such a public outcry at how the veterans are taken care of. All right, well, they've got the Band-Aid on it to get the national media off of their backs. But the wound's still opening. The wound is still there. It's just a Band-Aid.

TOMSIC: Congress is now working on a solution to the original solution. There's a bipartisan bill working its way through the Senate. For NPR News, I'm Michael Tomsic in Charlotte.

MONTAGNE: And NPR's Quil Lawrence, who covers veterans, is still with us. And Quil, we just heard reports from two states where vets and doctors say the program to let vets see a private doctor faster isn't working. Is that pretty typical?

LAWRENCE: Well, some vets have had good luck with the Choice program. But the stories you just heard are pretty typical of what we heard in the half-dozen states we visited for this series. And the bottom line is that the wait times have gotten worse, not better. And this is a program that Congress had the VA try and set up - a $10 billion program in just 90 days.

MONTAGNE: We'll hear more details about what happened in those 90 days on tomorrow's program. Quil, thanks very much.

LAWRENCE: Thank you.

MONTAGNE: And the stories you've just heard are part of a collaboration with NPR's Back at Base project, local member stations and Kaiser Health News.

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