Healthcare for veterans: Fixing it on many fronts

President Bush and his administration have failed to adequately plan for the aftermath of the wars in Iraq and Afghanistan. The shameful conditions at Walter Reed, lack of rehabilitative care for the brain-injured and backlogs of claims and disability determinations, are symptoms of a strained system. It is our highest obligation to heal the hundreds of thousands of brave men and women who will bear the physical and emotional scars of these wars for the rest of their lives.

We often hear about the 25,000 who have been wounded in these wars — but that figure grossly underestimates the demand that the veterans’ healthcare system faces. Since our country was attacked on Sept. 11, 2001, more than 1.5 million soldiers have been deployed to Afghanistan, Iraq and other locations as part of the global war on terror. Of these, 630,000 are now veterans and, according to the Department of Defense, more than 205,000 have already received medical treatment through the Department of Veterans Affairs (VA). A recent Harvard study on the long-term costs of treating these new veterans estimates that by 2012 more than 643,000 veterans from Iraq and Afghanistan will be using the VA system, an almost threefold increase over what the system faces now. With a significant backlog of claims currently existing, the system is in desperate need of an upgrade.

We should start by making the VA budget mandatory instead of discretionary. It is time to take the guesswork and political gamesmanship out of the budget for VA healthcare and replace it with a reliable, assured funding mechanism. Timely and full funding for the VA system is an absolute necessity for facilities to properly plan for and meet expected needs.

The secretary of the Veterans Administration must plan for the long-term care needs of the next generation of veterans. As a first step the secretary should report to Congress a plan for the next 50 years that includes the following: resources needed for rehabilitation care, psychological care, nursing facilities for both full-time and respite care, housing needs, and other areas under the jurisdiction of the VA.

There are several other measures, however, that we can implement specifically to help veterans in need of medical treatment. Currently, combat veterans returning from Iraq and Afghanistan are eligible to receive two years of free healthcare for any condition potentially related to their military service. Many of these veterans have service-related mental-health issues like post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI). In fact, TBI is the “signature injury” of the Iraq and Afghanistan conflicts. It is estimated that as many as 10 percent of those serving or who have served in Iraq and Afghanistan have brain injuries. That would mean about 150,000 of the 1.5 million soldiers who have served in Operation Enduring Freedom or Operation Iraqi Freedom have suffered a brain injury. In many cases, these injuries are not diagnosed because there is not an external wound. Depending on the severity of these injuries, returning soldiers can require immediate treatment or not have symptoms show up until several years later.

Due to the debilitating effects of these injuries, as well as other conditions that may go untreated, we should provide a five-year window for veterans to receive an assessment of mental-health needs and follow-up treatment by the VA. Extending the window for an additional three years will also allow veterans who need access to the system, but have not used the system within the two-year eligibility period, to get help they need.

One of the frustrations for soldiers who have been injured in Iraq or Afghanistan is the length of time it takes to receive a disability determination. In order to hasten the disability determination process, we need to ensure that the Department of Defense has information systems capable of communicating with those in the Veterans Administration. The VA has been a leader in implementing electronic medical record-keeping, but we have to improve the capability of the Department of Defense to send electronic medical records to the VA to speed up the disability determination process. Making the disability determination system more efficient can reduce the stress on the soldiers and their families going through the determination process.

These are just some of the areas we need to focus on to improve the services offered our veterans through the VA system. The terrible stories concerning Walter Reed and other military and VA medical facilities have reminded us of the need to be ever vigilant of our duty to the brave men and women who currently serve in or are veterans of our armed forces.

Backlogs, delays and inadequate care are inexcusable in the treatment of veterans. Planning and expanding the VA healthcare system cannot wait for the end of these conflicts. Congress must not delay in its oversight responsibility and must quickly pass measures to reduce the stress that is currently placed on the VA system.

Biden is chairman of the Senate Foreign Relations committee and the Judiciary Subcommittee on Crime and Drugs.


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