Bill hopes to raze 'bureaucratic maze'

POST FALLS — Mike McIver admires Sen. Mike Crapo for trying to cut red tape on veterans' health care, but he also believes taking that ball across the goal line won't be easy.

"(Crapo) mentioned he's one of many in Congress trying to fix the problem," the Post Falls Navy veteran said. "We'll see how all of that coalesces."

The Idaho Republican senator spoke to about 25 veterans at American Legion Post 143 on Tuesday about his Improving Veterans Care in the Community Act, aimed at making it easier for the U.S. Department of Veterans Affairs to send vets to their local communities for health care.

The bill would consolidate eight competing programs and address concerns raised by Idaho's veterans and private health care providers.

Meanwhile, Crapo's changed position on Donald Trump for president never came up at the meeting and the senator left in a hurry for his next meeting in Lewiston. However, his office issued a statement on that topic.

Crapo rescinded his endorsement of Trump earlier this month after a video surfaced of Trump making vulgar comments about women. But Crapo then said on Monday that he'll vote for the businessman to keep Hillary Clinton from becoming president.

"The choice we have is between Donald Trump and Hillary Clinton," Crapo said in a statement. "Given that choice, I will vote for the Republican ticket, Trump and Pence. We must elect a president who will appoint strong Supreme Court justices who will interpret the Constitution as it was written and who will help lead us to a stronger free market economy and a more limited constitutional government."

Crapo said his veterans' health care bill is the result of a two-year survey by his office. About 2,000 veterans and family members responded, expressing their frustrations with health care for veterans.

Crapo said the survey indicated that veterans are appreciative of the caregivers and facilities, but their concerns are mostly with the bureaucracy to receive care.

"This bill would enhance the VA's ability to have veterans receive health care in their own communities," Crapo said. "The advice and feedback from folks in the veterans' community was invaluable and helped shape this bill into something that can really make a difference for our veterans.

"I can take this bill to my colleagues in Congress and tell them that I know this is what Idaho veterans want. I understand their needs and I'm prepared to fight for them."

Crapo said he believes consolidating the programs would be a step toward straightening out the "bureaucratic maze."

His plan is in response to problems with the Veterans Choice program created in the aftermath of the 2014 wait time manipulation scandal at the Phoenix VA.

The Choice program was created to make it easier for veterans to get health care if they faced excessive wait times or a long travel distance to VA facilities. It allows veterans living more than 40 miles from a VA facility to schedule private care.

"Many veterans like the idea of being able to get the care they need in their local community if it wasn't so bureaucratic," Crapo said.

But Crapo said many veterans still have to travel long distances for care. Some vets who live near a community-based outpatient clinic (CBOC) such as the one in Coeur d'Alene still may need to drive to Spokane if the CBOC doesn't offer the medical service needed.

Crapo's bill would change the program to make these vets eligible for the new Care in the Community program. The senator said that, while well-intended when created by Congress, the Choice program has run into multiple problems, including the VA having just 90 days to implement the program.

Crapo's bill would set up a two-year rollout of a consolidated program where one entity would replace as many as eight separate programs. It would also require the Government Accounting Office and an independent commission to study veterans' services and report directly to Congress.

"This bill, if implemented correctly, would improve wait times, scheduling of appointments, timeliness of provider reimbursement and offer better access for veterans with questions or problems," Crapo said. "Importantly, the bill would also require the VA to educate veterans about the new Care in the Community Program."

McIver agrees that improvements need to be made as both he and a friend have used the Choice program.

"The left hand doesn't know what the right is doing," McIver said about the program. "My friend has had tests rescheduled that he's already had. Every time he talks to somebody, he gets a runaround."

Veterans praised the care they receive at the Coeur d'Alene CBOC, but said it doesn't provide all necessary services.

John Brickwedel, of Post Falls and a Marine vet, said after he broke his hip skiing on a Sunday afternoon he went to the Spokane VA only to be asked to go to Deaconess Hospital because no one was available to read X-rays.

"I think that a person should be available all the time to read X-rays," he said.

Brickwedel said he also believes the VA needs more doctors and nurses rather than more administrators. Crapo said the cry for more caregivers was heard loud during the surveys.

Chuck Buttz, adjutant at the American Legion in Post Falls, said the concept of having combat veterans coming home being covered by Medicare should be explored as that would split the veteran populations up so they all don't fall into one system.

"They're the ones with the most traumatic injuries and can get care in the community," Buttz said.

Crapo responded that the idea could bring efficiencies, but there are a lot of concerns about Medicare as well.

Norman Leffler, a retired urologist and Air Force veteran, said the same bureaucracy that the VA had 60 years ago is still going on today. He said there's a shortage of doctors and suggested that retired qualified doctors who are willing to volunteer their time to the system shouldn't have to pay high fees for doing so.

Courtney Durham, a clerk at the Coeur d'Alene CBOC, said veterans' health care has been a learning curve for private practices.

"There is a gap in care," she said. "Sometimes the only way we find out something is when Mr. Smith finally says, 'Hey, where is my appointment?'"

Durham said she appreciates Crapo for trying to streamline care, cut bureaucracy and seek input.

"When you don't work in the trenches, it's important to hear from us to make the idiosyncrasies better," she said.

Bryan Bledsoe, of Post Falls and who served in the Army during the Vietnam War, said the health care situation for veterans is no different than it is for other residents with private doctors in that there are wait times and other issues with both.

"The whole system, in my opinion, is being pulled," he said. "We're going to have to change the whole system."

Crapo said the VA is one of the few federal agencies to have their budgets increase sharply in recent years.

"That needed to be done, but throwing money at the problem isn't the only solution," he said. "We need to have a deeper dive to find out what the real problems are and resolve them."