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With VA Hospitals Overtaxed, Vets May Have To Go Private


Following General Shinseki's resignation is as head of Veterans Affairs came the questions - the big questions about how to fix the VA and who's best to lead it. NPR's Tom Bowman covers the Pentagon. He's been speaking with veterans' groups and VA watchers and joins us in our studios.

Tom, thanks so much for being with us.

TOM BOWMAN, BYLINE: You're welcome, Scott.

SIMON: We've heard so much over the past couple of weeks about these treacherously long waiting lists and poor access to care at the VA. Don't a lot of these issues predate General Shinseki?

BOWMAN: You know, they do. Government investigators have been looking at this for a decade, and they've done 18 reports on these very issues. So this is not a new problem by any means. And also, across the board at the VA, you have all sorts of problems. They have outdated software systems, they have poorly trained people putting the names into the systems here, and they don't have enough hospitals or clinics. So there's all sorts of problems here at the VA, not just the long wait times.

SIMON: Give us an example, if you could please, of what is deeply broken and what can or needs to be done to begin to restore the VA?

BOWMAN: Well, people like say one of the problems is the lack of hospitals. Veterans Administration recently opened a hospital in Las Vegas. That was the first hospital they opened in 20 years. So with all these veterans coming back from Iraq and Afghanistan, the question comes, are you going to have to open more hospitals or more clinics? And I put that question to Derek Bennett, he's Chief of Staff at the Iraq and Afghan Veterans of America. And we talked a bit about that. And he said, well, how do you care for these folks? Maybe you have to turn to the private sector - to private hospitals.

DEREK BENNETT: Part of it is coming up with public-private partnerships in a way that is smart so that there are more, basically, vouchers that allow veterans to go and have primary care visits or specialty consultation visits in the private sector and not have to physically be at a VA facility for every single appointment. You'd have to figure out how to do it in a way that allowed the VA to still be the primary giver of care and coordinator of care, but still leveraged things that were in the local community.

BOWMAN: So he wants to have kind of two systems here - that the veterans could go to the private sector for some procedures and also still go to the veterans' hospitals. But clearly, you're going to have to build more clinics and more hospitals, there's no question about that.

SIMON: Don't a lot of the veterans, though, want a government-run veterans' health service?

BOWMAN: They do. And Senator McCain, when he was running in 2008, actually suggested, you know, turning this over to the private sector, and the veterans groups said we're against it. And one of the reasons, Scott, is they have particular concerns and particular needs - they have PTSD and traumatic brain injuries. A lot of them are amputees and have problems that, you know, specialists in the VA have to be able to deal with that perhaps private hospitals just don't have the skills for.

SIMON: Well, what do some of the vet groups with whom you've spoken say needs to be done immediately and then mid and long-term?

BOWMAN: I think immediately is dealing with these long wait times. As was been reported, 1,700 people at the Phoenix hospital were not on any list at all. And this isn't just Phoenix. It's at 42 veterans' hospitals all around the country. So I think that's the number one issue right now - is to eliminate those long wait times and to get them care.

And what's interesting about all of this is once you get into the VA health care system, people love the system. They say it's quite good. The care is good. Even people who are critical of Shinseki say it's a pretty good system once you get in the door.

SIMON: General Shinseki's resigned that the Phoenix leadership has been fired. Would you anticipate more changes in leadership? And more to the point, what do veterans say to you about what kind of people should be in there?

BOWMAN: Well, clearly, people were manipulating the lists here, they were cooking the books saying that veterans weren't waiting that long. And this is at 42 veterans hospitals all around the country, so I'm sure you're going to see some others removed from their jobs in the coming days and weeks. And the veterans just want to unclog this system.

SIMON: NPR's Tom Bowman. Thanks so much.

BOWMAN: You're welcome, Scott. Transcript provided by NPR, Copyright NPR.