Veterans Choice is a federal program intended to reduce the length of waiting times for medical appointments. We continue our series, “Veterans Choice: Making it Work” by hearing from the people these benefits were designed to help.
There are more than 20,000,000 military veterans in the U.S. More than 700,000 of them live in Illinois. Their health-care needs can be more complicated than the needs of civilians, with exposure to war-zone toxins, complex physical injuries, and the trauma of combat.
Providing health care to veterans living in northern Illinois is as much a matter of logistics as it is medical appointments. Veterans can receive their medical care at the nearest VA hospitals. In Rockford, that usually means a trip to the William S. Middleton Memorial Veterans Hospital in Madison, Wis., or the Edward Hines, Jr., VA Hospital near Chicago. Either way, it’s an all-day commitment.
Some can make the hour-plus drive themselves; others count on friends, family, or volunteers -- volunteers like Lisa Ditzler of Rockford.
At least once a week, Ditzler drags herself out of bed much earlier than she’d like and heads to a parking garage in downtown Rockford. Unlike most of the volunteer drivers, she is not a veteran herself. She’s retired, likes to drive, and wanted to do something for people who served the country.
Ditzler had a full load during her recent shift, stopping at three points in the Rockford area to pick up seven vets who needed to get to the VA hospital in Madison. It's a 75-mile trip each way in the big, comfortable blue van provided by the Winnebago County Veterans Association. They’re able to deliver an average of 100 people a month to their appointments.
Ditzler pulled the van into a spot in front of Rockford’s Public Safety Building, put the flashers on, and waited for her first passenger of the day. Jeff was there, right on time. Actually, he had gotten there by bus, half an hour early.
Jeff served as a Marine in Desert Storm. He spends a lot of time in the van to Madison. Some of those long-distance VA hospital appointments could be replaced by care from local doctors under Veterans Choice. But Jeff isn’t sure what Veterans Choice is. He thinks he received a letter about it at some point, but didn’t follow up. He says it’s fine with him, because it seems like he is getting all of his medical care in Madison, anyway.
Too many veterans still are unaware of the program that allows them to visit a local doctor if they live too far from VA services or can't get an appointment within 30 days.
Chris is another regular on the Rockford-to-Madison van. The Navy vet from Loves Park has brain cancer and needs the specialized care the Madison VA hospital offers. But he also uses Veterans Choice to get less-serious medical issues treated locally.
“It’s a work in progress,” he said. “But it’s gotten better since I joined, and I've been doing this for about 10 years.”
Kimberly and Tyrone also are Gulf War-era vets in the van to Madison. But they've found Veterans Choice is a great option for eye care. Tyrone said Veterans Choice made it possible for him to go to Northern Illinois Optical, just two blocks from his home. Same for Kimberly. She made an appointment at the VA hospital but is going to call the local eye doctor to see if they can get her in sooner. Then she’ll cancel the VA appointment. It’s something many veterans have learned to do to make the system work for them.
Coordinating the Rockford-to-Madison van service is no easy task. One van makes the round trip every day, so every rider is there until the last of them finishes his or her appointment. In the spirit of the military code of “No Man Left Behind,” they look out for each other, making sure everyone is back in the van before they head home. The Winnebago County Veterans Association went as far as to buy red baseball-style caps for their drivers so riders could spot them more easily after leaving the doctor’s office.
John Kline is the head coordinator of the WCVA’s ride service. He works out of a small office in the basement of Rockford’s Memorial Hall to make sure drivers, riders, and paperwork all are where they need to be at the right time. His long career in computer systems helps. He created the forms that help schedule rides, get the information to drivers, and are used to compile the monthly statistics required by the VA.
Kline also is a veteran of the Vietnam War, and that's the experience that counts most when it comes to helping other veterans -- especially those coming to grips with their Post-Traumatic Stress Disorder, like him.
He works with a number of local organizations to try to make sure veterans know their health options. And, although he says he doesn't know all the facts, many vets using the ride service open up to him about their fears, including their doubts about Veterans Choice.
“It needs to be well administered,” said Kline. “We can't get mixed signals. There needs to be a unified signal from the VA and the people running it. They have to have the confidence that, once they're in it, they won't get stuck with the bill.”
That’s what Dave Davis hears, too. He’s commander of the American Legion Post in Rockford.
“The veterans are always afraid of having to pay for something,” he said, sitting in the back meeting room in the Post’s headquarters on Alpine Road. “From what I’m getting from the folks that provide the services, they’re afraid they might not get paid in a timely manner. So both sides have this fear about payment. The hospitals, clinics, places like that; if they don't see something from the VA right away, they'll pursue it with the veteran. And that's not good. Medical are some of the first to put you into collections.”
Like John Kline, Davis wears a lot of hats in different veterans’ organizations, so he hears the concerns straight from the vets -- especially those who served in Vietnam. Some say they can't get Veterans Choice to work for them; others are thrilled with it. So Davis, who has other medical insurance options, gave Veterans Choice a shot so he could understand the system better.
Davis needed a medical procedure, but the VA couldn’t get him in in less than 30 days. “So they said they would put me on Veterans Choice,” he said. “Six weeks later, no appointment. I said, 'This is weird.' I called and they said, 'That place won't accept Veterans Choice so you have to start over, Mr. Davis.' It's been four months now.”
One of the groups Davis is very active in is VietNow, an organization founded and still headquartered in Rockford. He was busy on the eve of the VietNow National Convention recently, held at a hotel and conference center in Crystal Lake. The stalwarts had been there all day, setting up the displays, attending board meetings, and just getting things in order to welcome their fellow veterans to a weekend of camaraderie. Naturally, the service members and spouses gathered in the hotel bar, though most sipped sodas instead of the hard stuff.
Bob Gutsche drove down from Tomah, Wis. He's a retired VA social worker and spent 21 years in the Navy. He said he thinks a lot of problems people are having with Veterans Choice come down to user errors, with vets blaming the system when they find themselves stuck with medical bills. Gutsche said that, if you follow the program’s rules, “I think the program is a good thing. It opens up the opportunities for veterans to get help closer to home.”
You will not find a bigger fan of the Veterans Choice program than Al Hogland of Rockford. Instead of driving 80 miles to the Madison VA hospital for an eye appointment, they found an ophthalmologist four miles from his home and scheduled everything for him.
“The hassle of going to Madison, in the rush-hour traffic? It is just a piece of cake compared to the ordeal of going all the way up there and down again,” he half-shouted to his companions, over the din of the bar. “And I found a better doctor! I’m not saying that they have bad doctors there, but I found an exceptionally competent doctor.” Hogland then shared his eye doctor’s business card with everyone at his table.
Mary Tendall is the go-to expert on PTSD for VietNow and a speaker at the convention. She said that more veterans in their 60s, 70s, and 80s are finally getting the treatment they need in the rural area of California where she lives. She credits Veterans Choice because the vets don't have to travel as far for medical services -- and many of them were afraid to set foot in hospitals run by the Department of Veterans Affairs.
“It's very important symbolically,” Tendall added. “We want to help; we want to make it easier for you. Because they've been fighting for any help they can get from day one when they came back, so there's more to it than just the medical.”
And, while some don't trust the federal government with their health, others are afraid Veterans Choice is the first step toward privatizing all health care for veterans. Sandra Davis of DeKalb chairs VietNow’s Agent Orange Herbicide committee and is married to a Vietnam veteran.
“The more people that use their civilian doctors, the less we are going to have VA facilities. We are going to lose our VA doctors if people aren’t going to the VA. It's a Catch-22,” she said. “I think that the veterans have earned the right to have their health care, so I don’t want to see us lose the VA health system. I don't want to see non-veterans using the VA health system.”
Davis has a point about veteran medical needs vs. civilian medical needs. Christine Molina is a nurse and one of four case managers helping patients navigate their choices at Middleton Veterans Hospital in Madison. In a phone interview with three of the four Madison case managers, Molina said, “We know the veterans, we know the military culture. We are the best to serve the veterans.”
Melanie Ross added that she and the other nurses still spend a lot of time educating patients and other hospital staffers about Veterans Choice. She said, in her opinion, “The program was confusing in the beginning. It didn't really have a good roll-out in terms of patients and their understanding of how the program worked.”
But both say the program is still evolving. Their hospital administrators are taking their concerns to HealthNet, the company coordinating the program in the eastern U.S. Ross said she understands why the roll-out has been so challenging. “A company of any sort that goes from 100 clients to 100,000 clients will have growing pains over the first one to three years,” she said. “And you learn from those mistakes to make it better. And I think HealthNet is trying to do that.”
Meanwhile, vets are reminded to make sure they get their Veterans Choice card before they try to use the program. Follow the rules. This is the military, after all.