My VHA Experience

Bob Rowen

As a Marine force recon veteran, I have personally experienced America’s private healthcare system and let me tell you it’s a dismal failure. Inside the VA healthcare system, on the other hand, I have experienced health care at its best. The VA healthcare system provides a clear example of what America’s system of healthcare should look like.

My story actually begins in 1961with a horrendous parachute accident while serving in the Marines overseas. In December of that year, I was discharged from active duty. For the next several years, I received healthcare services from a multitude of healthcare providers for the injuries I suffered while in the Marines. My injuries were later exacerbated by a fall down an embankment while employed in private industry. Before I enrolled in the VA, my physicians never talked to one another or tried, in any way, to coordinate services. In 2005, I discovered the VHA could help with my mounting medical problems. I have been enrolled in the VHA since.
Since I’ve been in the VA system, I have received care in several VHA facilities including the Redding VA clinic, Mather, Martinez VA clinic, Travis AFB, Mare Island, Chico VA clinic, and the San Francisco VA Hospital. The care I have received from the VA has far exceeded what I have received over many years from private providers. I’ve been asked numerous times to explain why I have this opinion and my answers have always remained the same.

The VA healthcare system coordinates care between all providers. Radiology, pharmacy, physical therapy, laboratory, mental health, and patient care programs are well coordinated. I have had two strokes. After my second stroke I was referred to the stoke center at UCSF by my primary VA healthcare provider. The doctor there provided the most thorough consultation I have ever experienced. Following that consultation, I was referred to the SF VA hospital where I received excellent care that was coordinated with the stroke center at UCSF.

My experience stood in stark contrast to that of my first wife, who was not a veteran, was diagnosed with a terminal brain tumor in 1985, and died in 1986. Her diagnosis was a devastating bombshell that resulted in financial ruin and fourteen months of the worst nightmare imaginable.
My wife’s ordeal included care at six different hospitals during her gallant battle. We had healthcare insurance provided by my employer; the policy was considered a “Cadillac” plan known as the 365 Plus policy. I remember the president of our Board of Trustees of our school district saying, “Our employees should be grateful for the health insurance the school district provides them.”

Our medical insurance policy had a provision for a “catastrophic” illness or injury. However, we learned through hard experience that the master policy contained numerous limitations and restrictions, which resulted in the loss of our savings and a mountain of debt. One example was the limit of $1,000 per patient per illness or injury per year for speech therapy, which was one of the most beneficial treatment protocols for my wife; the healthcare providers charged $150 per session three times a week. Medical transportation was limited to $500 per patient per injury or illness per year, and an additional up to $500 if the first medical facility did not have what the patient needed. My wife had to be transported by ambulance many times during her illness. On one occasion, she was flown by air ambulance from Weaverville to San Francisco International for her second surgery. After she recovered from the surgery, she was then was flown back to Weaverville. We had to pay the bills amounting to over $6,000. There was very little coordination of care for my wife between the hospitals, doctors, and other healthcare providers. And there was no follow up by UCSF – the institution dispensed the National Cancer Institute’s experimental formulation known as BUDR (a radiation enhancer).

What I fear most is that efforts to privatize VA healthcare and Medicare will put us all at the mercy of greed and profit. Having had experiences in the VHA and private sector healthcare I know that the VHA is devoted to serving veterans and delivers care it is just impossible to get in the private sector. How will veterans with serious mental and physical conditions be able to navigate the maze that is private sector health care? My wife and I couldn’t and we had the best insurance and were treated by people with the best of intentions. We simply not could overcome the obstacles the system placed in our way.

Bob Rowen
Marine Corps’ First Force Reconnaissance Company, assigned to Pathfinder Team 43.

Diane Reppun

I served 30 years in a combination of Active and Reserve duty in the Army. My last 2 years were a culmination of both my training and the punishment my body had taken after all those miles of road marches and all those relentless push-ups. In order to send me to Iraq at age 52, the Army chose to re-train me at Fort Bragg, North Carolina to become a Civil Affairs officer. This included field exercises and a twelve-mile road exercise in full combat uniform, which equals approximately 40 pounds not counting the weight of a weapon. Then, I traveled to Fort Dix, New Jersey where I joined up with my Civil Affairs Functional Specialty Team. We spent about 6 weeks going through classes, exercises, combat simulations and weapons qualifications.

We deployed to Iraq in 2009 and spent the next 10 months working at Camp Victory, Baghdad. I was a staff officer.  I didn’t go on patrols or on fire missions, but we did have to travel armed into the Green Zone and we were subject to random missile attacks. One occurred on New Year’s Eve. I had to throw my body armor over my head and run to a bomb shelter which injured my shoulder. I was also exposed to the bad air conditions and a toxic battery fire that burned for at least 24 hours a few miles from my building and Container Housing Unit. I developed asthma. The doctors in Iraq said they thought it would go away a few months after I arrive home.  It didn’t. I have had to take asthma medication daily ever since.

When I arrived back at Fort Dix, I was held over from returning home because of my shoulder injury. This was when I experienced the worst bureaucratic nightmare. The US Army kept me at Fort Dix with no treatment for six weeks. I was finally transferred to a home based warrior transition unit, still 80 miles from my home in California. I could go home and get the surgery I needed as long as I reported to the unit and completed their paperwork requirements.

One of the requirements was that I apply for a VA disability rating. Having already had many, many medical tests and my complete medical records, with my Line of Duty paperwork completed, I was quickly scheduled by the VA closest to my home, for my medical evaluation. They didn’t just evaluate my shoulder and asthma conditions, they did a thorough medical history and evaluated the long term damage that had taken place to my joints after years of running and marching. Within about six weeks I had my 60% rating in writing and they told me to schedule an initial appointment to see a Primary Care Physician as soon as I was released from Active Duty.

Once again the Active Army let me down, promising to keep me on Active Duty until my recovery was complete, but when my mandatory retirement date came, they gave me about a weeks’ notice that they had not filed for an extension and that I was going to be cut off from all military services and medical support.

Luckily the VA was right there to take over. I was given a great Primary Care Physician at the VA Palo Alto, and they immediately re-issued my prescriptions and scheduled any follow up appointments and regular medical appointments I needed. I was sent to Stanford for Mammograms, at no cost to me, and referred to the Women’s Health Center and given any information I might need for medical and psychological support I wanted.

More importantly for me, my disability payment started the first day of the month after my Active Duty orders ended.

So, my VA experience was outstanding, especially given the poor treatment I received from the military. I suspect that a large percentage of young soldiers that have problems with the VA disability system also stem from the inefficiency and poor processes by the military transferring paperwork to the VA, but to them it is all one big mess, so it is just as easy to blame the VA.

I have been happily receiving all my care from the VA since 2010. I have the same great Primary Care Provider.

Until the Choice Act appeared to muddy up the waters, I had no problem being referred to Stanford for anything that the VA Healthcare System could not offer me. Once the Choice Act started, I was given the phone number to call to schedule a mammogram. They told me they did not have my information and would have to get back to me in a week or so. I called Stanford and they scheduled me the next day. About 3 weeks later I got a letter in the mail with an appointment for a mammogram somewhere in San Jose, on a specific date and time; I was not even consulted. I called and told them to cancel it, but I got a call from the clinic asking why I didn’t show up.

I look at friends in their late fifties who have never been in the military.  They are very concerned about how they are going to be able to afford healthcare when they retire. I am so happy that I have the VA. I also have friends that are already only able to afford Medicare, they share the problems they have had just finding a doctor that would take Medicare. So when I am told that the possible result of privatization of the VA would be to ‘allow’ me to go to any doctor that takes Medicare, I am very concerned. The idea that I would have to go out and find my own doctor, and then coordinate any specialty care and re-introduce someone to my military medical history, and hope that they understand because they may have never treated any other veterans, scares me. I hope it never comes to that.

Diane Reppun

LTC (Retired)

Christian Leicham USAR

In 2013, I was medically retired from the United States Army for injuries related to my time in combat. As a medical retiree, my health care was transferred to the VA once my active duty ended. Before I left active duty, I was depressed, anxiety ridden and frightened about my future. I had heard stories about long waits, inadequate care, and an indifferent attitude by VA employees. As soon as I was a civilian again, I set up an intake appointment with the VA.  Two weeks later I was introduced to my medical team and was assigned a doctor and nurse. They were professional and caring; it was a wonderful first experience with the system. When I had an issue, I could message my team and usually receive a response the same day. All of my care providers are very professional and seem to genuinely care about my well being. I have never had a negative experience with VA Healthcare, never had an extraordinarily long wait to get an appointment, and never been treated in a less than professional manner. They have always been available to help me and I don’t think I could receive the same level of care, for my particular condition, anywhere else. Without my care from the VA, I wouldn’t be where I am today; enjoying my new family, gainfully employed and looking forward to the future.

 

V/R,
1LT Christian Leicham USAR

Giving Back
Samuel Jay Keyser

July 7, 2014 was my 79th birthday. I spent the morning in an ambulance. As ominous as that might sound, it was a blessing. I was being transferred from a not-for-profit private rehabilitation hospital to the Veterans Administration (VA) hospital in West Roxbury, Massachusetts where, over the course of the next year and a half, as an inpatient and outpatient, I would receive the best possible care a spinal cord injured person could hope for.

Two months, two weeks and two days earlier I had suffered a fall. In a nanosecond, I was transported from the bipedal world into the world of tetraplegia. My arms and legs were paralyzed. I had no control over my bowels. I was, for all intents and purposes, an infant.

What caused that transformation couldn’t have been more ordinary. I was stretching my left leg on a staircase. I had done it countless times before. Suddenly my right leg collapsed. I fell flat on my back. A masterful neurosurgeon at the Massachusetts General Hospital (MGH) and his team performed a laminectomy. It was needed to relieve pressure on my spine. He told me I had “the crappiest spinal column” he had ever seen. It was half the diameter of a normal one. The forest of bone spurs that sprouted along it bruised the nerves between the 3rd and 6th cervical. A doctor at MGH told me I would never walk again.

Why was I in an ambulance on my birthday speeding toward a VA hospital? After a month at MGH, I had been transferred to a private rehabilitation hospital. It was one of the best in the country. Unfortunately, they had to discharge me because of the “length of stay” problem. My Medicare insurance was running out. The hospital planned to send me to an assisted living complex with little or no rehabilitation capability. Why? I couldn’t afford to pay $3,170.75 a day to stay.

The next facility would house me for three weeks. Then my United States healthcare insurance would again run out. After that, I was on my own. It did not matter that, as time would tell, with the proper rehabilitative care, my body would be able to defy the pronouncement of the doctor who said I would never walk again. I would be able to walk a mile a day with the help of a walker. I would regain control of my bodily functions. My wife would not be the widow of a husband who wasn’t dead.

Before my accident I had an active life as a jazz trombone player. I played Dixieland music with the New Liberty Jazz Band. We played on a firetruck and did 4th of July parades. I played in the Aardvark Jazz Ensemble, the oldest continuous jazz ensemble in the United States. When the VA therapists were finished with me, I was able to have to a musical life again.

Obviously, I am an incredibly lucky guy. At the last minute a caseworker at the private-sector rehab hospital realized that I had served in the US Air Force. It occurred to her—as it had not to me—that, because my injury was catastrophic, I might be eligible for admission to a health care system that would provide me with free medical care for the rest of my life.

When the ambulance drivers rolled my gurney inside the West Roxbury VA, it was close to noon on my birthday. The first person I spoke to was the admissions clerk. I sensed immediately that something was very different. It took me a month to get it. One day I wheeled myself into an elevator. Hospital workers I didn’t know were already there. As I was about to exit at my floor, they said, “Thank you for your service.” Shortly after that, Eddie, a painter in the hospital, invited me to listen to the jazz he was playing while he worked in the corridor outside the gym. A week later a CD player and a stack of jazz CDs showed up in my room next to my bed. Eddie had put them there.

That I am able to walk now and to live a relatively normal life is evidence that the staff at the West Roxbury VA are superb at what they do, from my primary care provider, to the nurses in my ward, to the extraordinary physical and occupational therapists who showed me how to use my body again. But on top of this expertise they bring something else. Helping me was their way of thanking the thousands of veterans who had sacrificed so much on behalf of our country. The VA hospital people have a unique perspective. They see what they do as a way of giving back. No wonder they are so good at it.

Marine Partner:

I am the partner of a Vet who served proudly in the Marines from 1961-1964. He suffers from service connected injuries, including foot, leg and back issues which require physical therapy and major surgery, and a variety of other conditions including high blood pressure, damaged eyesight, chronic pain, recurring sinus infections, mobility issues and past substance abuse issues.  As a result, he is seeing his GP, a neurologist, a vascular surgeon, radiology, physical therapist, pain management, optometrist, and pharmacist.  He needs new glasses and special shoes every year, and additional canes and walkers as his mobility decreases.  All of his medical issues are beautifully and timely handled at the Loma Linda facility in San Bernardino, and frequently several concerns can be handled on the same day.  Because we are older and not wealthy, it means so much to us that we can travel to one place to take care of multiple issues and that we can speak to doctors and staff who understand my veteran’s experience.  We hope we do not start getting farmed out to doctors and facilities all over Southern California.  Thank you.

Holly