In an internal study obtained by the Associated Press last week, the Veterans Administration found that female veterans aren’t being as well taken care of as male veterans. The same study found the general quality of health care at the VA to be good when measured against standard benchmarks. Place that grade B overall assessment against the many complaints raised against the VA and one can only imagine how much worse the situation really is for women veterans than the study shows.
In 2007, the VA treated 255,000 women, some 5 percent of them veterans of Iraq and Afghanistan. That percentage is expected to double soon. Some 180,000 women have served in those two wars. While VA officials say they’re doing a better job, Washington Sen. Patty Murray sees it otherwise: "They aren't ready. Absent a proactive, concerted effort and knowing their limited resources, they are struggling with so much this might get lost."
[According to the AP, the] review of the quality of care at VA facilities, which was mandated by Congress, found that at about one-third of its facilities, the quality of outpatient care given to women wasn't as good as what was offered to men.
It said that the VA has made strides in improving care for women veterans, such as creating onsite mammography services and establishing women's clinics at most of its medical centers. It also said the VA is attempting to recruit clinicians with training in women's care and broadening its approach to better address diseases prevalent among women such as lung cancer.
However, it said that there were barriers that remained, such as the need to train more physicians in women's care and for more equipment to meet women's health needs.
The VA has begun a long-term study of 12,000 female veterans to see how serving in Iraq and Afghanistan has affected their physical, mental and reproductive health and how well the VA is dealing with their problems. But what happens right now, today and tomorrow, as more women enter a system unprepared both financially and in so many other ways to receive them? The VA is, after all, practically notorious for the number of studies it completes and shelves.
What's worse than this failure to meet women's veterans needs is a deeply rotten attitude in the highest reaches of the VA. For instance, as McClatchy's Les Blumenthal wrote on May 22 of hearings by the Senate Veterans Affairs Committee:
The Department of Veterans Affairs said Wednesday that it opposes much of Sen. Patty Murray’s bill to improve care for female veterans, even as the number of women seeking VA medical services is expected to double within the next five years.
A top VA official admitted during a Senate Veterans Affairs Committee hearing that the agency might not be prepared for the anticipated influx of female veterans.
"We recognize there may well be gaps in services for women veterans, especially given the VA designed its clinics and services based on data when women comprised a much smaller percentage of those serving in the armed forces," said Gerald Cross, the VA’s principal deputy undersecretary for health. ...
The agency’s concerns cover new studies of the physical and mental health problems female veterans faced and how the department was dealing with them. Cross said that would overlap with existing studies under way and would cost millions of dollars that could better be spent on health care services.
The VA also opposed sections that would require mental health workers to get special training on how to care for female victims of military sexual trauma and post-traumatic stress disorder, to require additional staff to deal with female veterans and to provide child care for veterans seeking VA care.
The committee is scheduled to vote on Murray’s bill June 26.
Senator Murray, whose father was a disabled World War II veteran and who worked as a physical rehabilitation intern in a Seattle veterans hospital near the end of the Vietnam War, has become a key advocate for health care for veterans from her perch on the Senate Veterans Affairs Committee. She’s the first woman ever to serve on the committee, where she has been assigned since 1995. It’s a job she takes seriously, as VA secretaries have discovered when they try to cut clinics or low-ball budgets, and Idaho Senator Larry Craig learned a year ago when they butted heads last June over her effort to increase veterans eligible for care by 200,000.
As reported in an April story in which Murray's anger was undisguised, she accused the VA of lying about the number of attempted suicides by veterans. Until internal e-mails were publicly exposed by CBS News on April 21 as a consequence of a class action suit, the VA put the number of attempted suicides at 790. The e-mails, which were part of an internal VA debate over whether the number should be downplayed, said the total was around 12,000, 15 times what the VA was claiming publicly. Six months previously, CBS had learned that the suicide rate for veterans was more than twice the national average of 8.9 per 100,000 population.
"The suicide rate is a red-alarm bell to all of us," said Sen. Patty Murray, D-Wash. Murray also said that the VA's mental health programs are being overwhelmed by Iraq and Afghanistan war veterans, even as the department tries to downplay the situation.
"We are not your enemy, we are your support team, and unless we get accurate information we can't be there to do our jobs," Murray told Deputy Secretary of Veterans Affairs Gordon Mansfield during the Senate Veterans Affairs Committee hearing.
Mansfield told Murray and the other senators that he didn't think the VA had deliberately tried to mislead Congress or the public.
Murray remained skeptical, however, saying that the VA has demonstrated a pattern of misleading Congress about the increasing number of soldiers who served in Iraq and Afghanistan and are now seeking help and straining Defense Department and VA facilities and programs. ...
"I used to teach preschool, and when you bring up a 3-year-old and tell them they have to stop lying, they understand the consequences," Murray said. "The VA doesn't.
They need to stop hiding the fact this war is costing us in so many ways."
Other costs, as detailed in the Rand Corporation’s Invisible Wounds of War are the large number of veterans returning home from Iraq and Afghanistan with post-traumatic stress disorder and traumatic brain injury.
Visiting Alaska in late May at the behest of Ted Stevens – whose Senate seat is vulnerable to a takeover by the Democrats this year – VA Secretary Peake, who replaced the previous Secretary in part because of Senator Murray’s pressure, belittled some of these psychological and health injuries as overblown and akin to football injuries. As Brandon Friedman noted at VetVoice at the time:
Frankly, Peake's casually dismissive attitude sucks. Being hunted by other humans every day for 15 months, watching your friend bleed to death, and having your brain flattened like a pancake from a thousand-pound detonation are not comparable to football injuries.
It's also quite clear that this was neither a mis-speak nor a quote taken out of context, as this was the second day in a row that Peake has belittled the combat injuries sustained by those fighting in Iraq and Afghanistan. On Saturday, Peake suggested that PTSD was being "overdiagnosed." He then continued:
"Just because someone might need a little counseling when they get back, doesn't mean they need the PTSD label their whole lives."
Might need a little counseling? This fundamental lack of understanding of both combat injuries and their treatment is inexcusable coming from the individual charged with leading the VA.
In this context, however, it's no wonder that the VA is under Congressional scrutiny for downplaying the extraordinarily high number of suicides among veterans. Likewise, it comes as no surprise that VA officials have recently been caught instructing caregivers to diagnose returning troops with "Adjustment Disorder" instead of PTSD in order to save money.
This is clearly a pattern that reflects an overarching strategy on the part of the VA to disregard the injuries of Iraq and Afghanistan veterans.
Low-balling budgets? Running operations like the Walter Reed annex? Downplaying PTSD and traumatic brain injuries? Is it any shock that the VA falls short when treating female veterans?
As Blumenthal wrote in May:
Two nightmares haunt Robin Milonas.
While serving in Afghanistan in 2004 as an Army Reserve civil affairs officer, the former lieutenant colonel got lost in a minefield while leading a small convoy delivering school supplies to civilians.
Even more troubling is the memory of a man who arrived at the main gate of Bagram Air Base carrying a young boy whose leg had been blown off by a land mine.
"I was an outgoing, energetic, determined good soldier who wanted to make the Army a career," said Milonas, of Puyallup, Wash., who just turned 50.
"Now I am broken."
Milonas has been diagnosed with post-traumatic stress disorder and receives therapy at the veterans center in Tacoma, Wash. But three times she's been denied a disability rating from the VA, which says Milonas hasn't proved her problems are related to service in Afghanistan.
Milonas believes that the VA has yet to recognize that even though women are barred from combat, it's hard for them to avoid the trauma associated with serving in a war zone like Afghanistan.
"The battle is everywhere," she said. She thinks the government's attitude is that "because women aren't allowed in combat, they can't have PTSD. It must be depression or women's issues like PMS."
VA officials say there's no double standard when it comes to disability ratings for PTSD.
"This is the first group of women's vets we have seen with this intensity of experience," said [Patricia] Hayes [the VA's national director of women's health care issues]. "We are not sure what the long-term effects will be."
Certainly women veterans in this war, who perform a much greater range of jobs, will are facing a different set of circumstances than the women of the Vietnam era. But we do have some idea of what the long-term effects will be. The National Vietnam Veterans Readjustment Study, which looked at 432 women who served in Vietnam from 1964-1975 – mostly as nurses, found that 27% suffered from PTSD sometime during their postwar lives.
As in so many other areas, the VA needs to get up to speed, with all due speed. However, as the Cheney-Bush Administration has repeatedly shown, it is incapable of providing the leadership to get us there. As with so much else, new marching orders will have to wait until January 2009.
Yesterday, the 25th, a ruling came down from the judge hearing the case, in San Francisco, 82 pages long, and not a surprise to this Vet. In the ruling the judge sided with the Veterans but had to push it to where it belongs, In Congress. Only Congress and the Excutive Branch, of the Peoples Government, can bring about the way to long overhall of the Veterans Administration. Everything that is being reported about the care to the returning Veterans, of the Wars and Occupations of Choice, is actually Old News, just ask the thousands of my brother, and sister, Veterans of Korea and Vietnam, and it's happening once again while these conflicts rage as it did back than. We call the present Military the Professional Military yet we continue the foulups that take place within the Government Agencies, Veterans Administration and DoD Health, that are charged with it's care, especially the Mental Trauma War brings on in the Soldiers and the Civilians in these Theaters of Occupation.
