Veterans Lobby for Better Health Care

American Legion delegations are lobbying Congress to increase VA health care spending, using survey results showing an average seven-month wait to see a primary care doctor.

The Legion conducted its first-ever survey of waiting times from early November through Feb. 21, and timed its release Tuesday for a conference of 1,500 leaders visiting congressional offices this week. The Associated Press had obtained survey results Monday.

The survey was not a scientific sample, but an effort to give the grass roots lobbyists ammunition to argue for more VA health care money.

The Department of Veterans Affairs says home health care visits, interactive chats between patients and doctors and home monitoring equipment are improving waiting times by making some visits unnecessary, but the VA agrees it still takes too long to see a doctor.

The Legion's national commander, Ronald Conley of Pittsburgh, said a new Persian Gulf War could place future strains on the veterans health system by creating additional patients - just as the 1991 Gulf War did.

In addition to the seven-month average wait to see a doctor, the 3,100 responders told the Legion:

-The average wait to see a doctor after arriving at a Veterans Affairs clinic is 1.6 hours.

-About 58 percent of respondents had an appointment rescheduled by the VA, triggering an average wait of 2.6 months for the new appointment.

-About 11 percent of respondents said they were denied long-term care. That result was based on 2,800 responses.

"There's no question that waiting times are a significant problem, but we're trying to resolve them," said Dr. Robert Roswell, the VA's undersecretary for health.

In July 2002, a VA survey found nearly 318,000 veterans who were likely to wait more than half a year to see a doctor, a number that dropped to nearly 236,000 by December and 202,000 last month.

In more than half the cases on all three dates, veterans could not be given an appointment date, but were placed on a waiting list for longer than six months.

Roswell said that in addition to home health visits, interactive chats and monitoring equipment hooked up to VA facilities, the agency is ensuring that all primary care doctors carry a full load of 1,200 patients.

If budget requests are met, the VA wants to hire 1,000 additional physicians and increase the salary scale.

Ernesto Tafoya of Pueblo, Colo., who spent 40 years in the Navy and Navy Reserve, said he's been waiting 2 1/2 years for a physical.

"They just kept telling me they would call when they had doctors available," said Tafoya, 76. "The only thing I got from them was a couple of flu shots."

George Bargmann, 66, a farmer from Madison, S.D., said he's been waiting for an appointment since December 2001. He originally was told an appointment was possible last December, but that date was postponed until last month. Then, the VA canceled that appointment, too, and no new date could be rescheduled.

Conley, who has been visiting facilities across the country, said that in Cheyenne, Wyo., veterans who signed up for a primary care appointment in September received appointments for this June.

In Minneapolis, he found that 11,000 veterans waited a year to see a primary care doctor. At the Togas, Maine, VA Medical Center, 1,800 veterans waited up to two years; in Bay Pines, Fla., about 16,000 waited a year.

Demands on veterans health care facilities have risen dramatically in recent years, growing by 54 percent since a 1996 law made all veterans eligible to receive medical care. The secretary of Veterans Affairs, Anthony Principi, said last month the system is expected to serve 4.8 million patients in the fiscal year beginning in October.

President Bush's 2004 budget includes $27.5 billion for veterans medical care, a 7.7 percent increase over the current fiscal year.

Principi has proposed to increase out-of-pocket costs for veterans with higher incomes, including an annual enrollment fee of $250 for medical conditions not connected to active duty; an increase in copayments for primary care visits from the current $15 to $20; and a boost in the pharmacy copayment from the current $7 to $15. For lower-income veterans, the pharmacy copayment would be eliminated.