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Surgeries back on after VA letter hits Web

The Register-Guard

The Portland Veterans Affairs Medical Center has reversed a decision to postpone surgeries for about 100 patients, a cost-saving measure that would have denied care to people needing procedures such as hernia operations or joint replacements. The move might have gone unnoticed if a Vancouver, Wash., veteran hadn't posted a copy of the letter about the decision on his Web site.

Larry Scott, a partially disabled veteran who maintains a Web site designed to help veterans navigate the federal agency's labyrinthine bureaucracy, received an anonymous copy of the letter in mid-August.

"The first thing I did was verify the authenticity of the letter," Scott said. "But nobody could give me numbers on how many went out."

The blank form letter he posted was dated July 28 and signed by James Edwards, chief of surgery.

"I regret that your surgery scheduled for (blank) must be postponed. We apologize for the inconvenience and frustration this may cause you," the letter begins.

It goes on to explain that an increase in the demand for care forced the hospital to prioritize:

"To provide these urgent surgeries, we have had to temporarily reduce the amount of operating room time available to treat those conditions that are not life-or-limb threatening. This has resulted in cancellation or postponement of many cases such as yours."

After posting the letter on his Web site, Scott started spreading word about it on various military bulletin boards. He eventually received a call from Military.com, a Web site devoted to military issues, and was asked to write a story about it, which appeared in the site's Sept. 7 newsletter.

By Sept. 8, Scott said, "All heck broke loose." He started fielding e-mails from all around the country from veterans who had experienced similar problems or who were afraid of being denied care because of financial cutbacks.

The Military.com story also caught attention in Washington, D.C., where staff from the office of Rep. Nancy Pelosi, D- Calif., alerted Oregon Rep. Peter DeFazio's staff, who contacted the Portland Veterans Administration office to find out more about the agency's budget problems, DeFazio spokeswoman Kristi Greco said.

Both Scott and DeFazio received an e-mail from the Veteran Affairs Washington office on Friday stating that the Portland decision to postpone care had been reversed.

A spokeswoman at the Veterans Affairs Northwest Health Network Office in Vancouver, Wash., confirmed the change.

"In retrospect, the decision was premature," spokeswoman Megan Streight said.

The initial letters went out three weeks ago to nearly 100 patients, she said.

None of those whose surgeries were postponed were in any danger of dying or in extreme pain, she said. The agency was responding to an enormous increase in demand for services, she said.

But the postponed surgeries weren't elective, either, and another spokeswoman for the VA who spoke with Scott earlier in the week gave examples such as hernias or joint replacements as the kind of procedures that were being postponed.

Letters and phone calls will be made to the veterans whose procedures had been postponed, allowing them to reschedule, Streight said.

Meanwhile, the national VA office will be reviewing the Portland hospital's budget and finding additional resources to help with funding, according to the e-mail sent to Scott and DeFazio from the VA's deputy assistant secretary for public affairs in Washington.

Scott, who has received care for the past 18 years for a service-connected injury to his hands, said the Veterans Administration is staggering under an influx of people seeking care for the first time.

The economic downturn has sent newly unemployed veterans who once had health benefits from their employers to the VA, Scott said.

"These are vets that haven't used the system before," he said.

And senior citizen veterans are learning that they can get much cheaper prescription medicine through the VA than through Medicare, he said.

"You have a ton of vets that qualify that are straining the system," Scott said.

The additional pressure from injured soldiers coming home from the Iraq war is only beginning to be felt, he said.

"My brothers and sisters over there fighting a war, their biggest battle is going to be with the Veterans Administration for health care," he said.

The quality of care isn't the problem. It's top-notch, Scott said. "It's just a matter of working your way through the bureaucracy."

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