Anchorage is too far away for a sick old man to travel to see a doctor, say veterans lobbying for more health care options on the Kenai Peninsula.
Advocates from veterans' service organizations are complaining about rules that require many patients to go to the city for care funded by the federal Veterans Administration. But others say the current arrangement is adequate and cost effective.
"It's a pretty bad situation," said Glenn Schrader from the Disabled American Veterans.
His group, other veterans' groups and health care providers from the peninsula are urging the VA to change its rules. They want a peninsula VA clinic, visiting VA physicians or permission for peninsula doctors to provide eligible care.
The complaints stem from a VA policy consolidating services to its medical center in Anchorage. Before the center opened, peninsula residents could charge VA for more services obtained in their home towns.
Jerry Books, the satellite office coordinator at the Kenai Vet Center, which is funded through the VA, said health care benefits are still generous.
"I don't think there is a problem for the vast majority," he said. "There are a lot of men who are very satisfied."
Veterans who have service-connected disabilities, emergency conditions or annual incomes below $27,000 can get VA reimbursement for care obtained anywhere, he said.
But those criteria leave out many veterans with major medical needs, Schrader and others claim.
The VA's volunteer service runs a van twice a week to take people from the peninsula to appointments at the Anchorage center.
Schrader noted it takes an entire day for the van to pick up several people from their homes, drive to Anchorage, drive back and return people home. A single, 20-minute appointment can easily consume 12 hours or more.
He knows people whose medical conditions make the protracted travel time extremely uncomfortable or utterly impossible.
"If I'm pretty sick, I'll be darned if I want to go that route," he said.
The veterans have a committee working on the issue, and members have contacted Sen. Ted Stevens' office about the potential of getting a peninsula clinic. Stevens' staff advised the group to document the needs, said Herb Stettler, service officer for the Veterans of Foreign Wars and the American Legion on the central peninsula.
Meanwhile, about 30 peninsula health care providers sent a petition to the VA asking for a rule change so they could provide eligible services through the facilities and personnel already here.
Central Peninsula General Hospital supports the veterans' advocates' effort, said hospital Director Marty Richman.
"I'm trying to assist them," he said. "They are decent people who certainly deserve a shot."
Books said his position allows him to see both the veterans' problems and the administration's practical difficulties.
"I get it from both sides," he said.
The rules on what the VA will allow change frequently, he said, so modifications based on the user groups' concerns may be coming.
The VA is operating as the largest health maintenance organization in the world and is scrambling to trim costs now that the large number of World War II veterans are in their expensive senior years. Meanwhile, veterans organizations have successfully lobbied Congress to expand medical benefits, he said.
Brief military service now wins some people free medical care for life, he said.
Veterans on the peninsula in some situations qualify for the VA to pay their transportation to hospitals in Seattle, even down to the taxicab to take them from the front door to the airport.
"The VA is working hard to figure out what to do with the World War II generation," he said. "The VA has never faced this before."
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