‘We Can’t Help You’: The Message To Rural Vets About Health Care

Gloria Hoeppner, 89, is a Navy veteran who lives with her husband in the San Juan Islands. To see a doctor, she usually has to take a ferry from her home on Friday Harbor. It can take hours.

During World War II, she was part of an all-female division of the Navy known as the WAVES. “You know today people don't even know what a WAVE is! It's so different now. But I'd like to say that it was a marvelous experience,” Hoeppner said.

Hoeppner recently had a heart attack. As she was discharged from the hospital, the staff set up follow-up appointments with a cardiologist on the island. But when Hoeppner called a program set up last summer for rural veterans, she was told she didn’t qualify for local care, even though it takes her hours to get to the nearest Veterans Affairs facility 38 miles away.

That program, called the Veterans Choice Program, was a $15 billion promise by Congress. Its premise is straightforward: When a veteran lives far from a Veterans Affairs hospital, or can’t get an appointment with a VA doctor within a month, he or she may seek care with a provider outside the VA.

As it turns out, Hoeppner does qualify for the Choice program, as do all veterans in the San Juan Islands. Sen. Patty Murray made sure that people who have to ride ferries to get to the VA are included.

But despite several phone calls to the VA and the Choice program, Hoeppner is still waiting to hear whether she can keep her cardiology appointment at the end of the month.

The Daily Show segment "Doctor When" notes this KUOW story:

The Daily ShowDaily Show Full Episodes, More Daily Show Videos, Comedy Central Full Episodes“When I talked to the lady, that’s the intermediary, she says I have to cancel that appointment. It’s not proper. And when you get OK'd with Choice you call them and make another appointment,” Hoeppner said.The VA has been mailing out ID cards for the Choice program for months. To date nearly half a million veterans have tried to take advantage of the benefit.But a lot of vets are having trouble getting those outside appointments when they call the number on their card.John Beckham, the director of Health Plan Management Services at Puget Sound VA, said they’re working to fix the glitches, but he understands it’s difficult right now for veterans who call in and can’t get medical care.“The message that the veteran hears is, 'We can't help you,'" Beckham said. "I think that's really the frustrating part."He said about 1,000 vets in the area are getting care under the Choice program. Still his office receives about 100 calls a week from veterans.“Everyone at the hospital thinks we’re covered if we have to take a ferry,” Hoeppner said. “There’s quite a few people at the VA who think that, so people don't know what's really happening.”He said in some cases the Choice program doesn’t yet have the veteran’s medical records. Other veterans are being turned down even though they have to drive more than 40 miles to a VA facility, the distance that’s supposed to qualify them for the program.“That 40 miles is calculated in a straight mile fashion as the crow flies," Beckham said. "Especially with our geography here in the Northwest, a lot of veterans live in areas that aren't very accessible. They might live 20 miles from a community-based clinic, but they have to drive 80 miles around to get to it.”The intermediary that Hoeppner and other vets are calling is TriWest, an Arizona-based company the VA contracts with to manage the Choice program. TriWest CEO Dave McIntyre concedes there’s a lot of confusion about the program. He blames it on the short timeline congress gave for the roll out.“What it took to do this would blow people’s minds,” McIntyre said. “We had to stand up a contact center with about 850 people in it and we had 10 days to go from hiring to training to go live.”McIntyre said TriWest is taking 10,000 calls a day from veterans, and despite the problems thousands are getting care through the Choice program.But some members of Congress aren’t sympathetic. They say the Choice program’s issues are part of the VA’s longstanding resistance to providing care outside its own facilities.Sen. Murray said problems with the Choice program is another example of how difficult it can be for veterans to get access to VA care.“Clearly, there’s more work to be done, so I will keep pushing the VA to improve services and support for our veterans as this new program gets off the ground,” Murray said.Last month Sen. Jerry Moran of Kansas questioned VA Secretary Robert McDonald during a hearing.“The problem is when you call you’re often told, 'You don’t qualify, you’re not on our list,'" Moran said. "But then there’s nothing the veteran can do about it to say, 'Wait a minute, I should be, I am.' And the end result is our veterans are still waiting."McDonald said the agency doesn't oppose the Choice program and is working to help veterans better understand their health care options.In the meantime, there’s growing talk in Congress about easing the rigid 40-mile rule, which Congress itself wrote into the Choice program last year.Correction: An earlier version of this story misspelled Gloria Hoeppner's name.