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William Enyart is a retired Army major general and a U.S. representative from Illinois. He wrote this column for the Chicago Tribune.
Unless stopped, the Department of Veterans Affairs is set to knock over a domino that may drastically harm veterans’ health care and then spread to the general community.
In a cost-cutting measure on track to take effect early next year, the VA plans to sever a critical link between veterans and medical facilities by significantly slashing reimbursements for the ambulances that transport them. Today, many veterans rely on ambulances for transportation because they are staffed by emergency medical technicians trained to monitor their medical condition.
Too many veterans simply do not have the financial resources or the support network necessary to arrange and pay for transportation to a medical facility where treatment is provided. Confronted with costs that run into thousands of dollars — the Chicago Fire Department charges more than $1,500 for a one-way ambulance ride — many or our neediest veterans may simply forgo receiving care.
Veterans in rural areas will be most affected because a disproportionate number of our service people come from rural places where a trip to the hospital is far more challenging. Rural areas have experienced an epidemic of hospital closures over the last 30 years — more than 130 hospitals have closed since 2010 — as overall population density has decreased. As a result, a trip to hospitals and medical facilities has become longer, more expensive and more difficult for veterans and other residents.
Should the VA move forward with its plan and cut ambulance reimbursements, making that same trip to the hospital will become much more difficult, if it happens at all. Should payment become a barrier to use ambulances for veterans, ambulance companies will likely be forced to contract their service offerings, exiting rural areas that are no longer profitable and decreasing service in urban areas.
As a former major general and an Air Force and Army veteran, I was taught along with my fellow soldiers to leave no one behind. To move ahead with this cut would likely have the effect of leaving many thousands behind. Confronted with a cost they can ill afford, our veterans may choose to delay or put off the care they require. The same may happen throughout the communities that lose ambulance services when the remaining alternatives are insufficient or too costly for many.
It’s obvious to those who served in the military and in government that what the VA appears to be doing is shifting the cost of ambulance services from its federal authority onto state and local government entities. The problem with this is that no plan has been developed, local governments have not been engaged and such a move negatively affects hundreds of thousands in Illinois where I live and millions more throughout the U.S.
Good military and government planning is required to fix this existential threat to the health and well-being of veterans. The cuts must be paused and a study must be conducted to explore the real effects on veteran health and the likely impact to ambulance service in rural and urban areas. And, most importantly, state and local governments throughout the U.S. must be engaged to determine if shifting this federal responsibility for care from the VA to local and state responsibility is even possible.
We will not abandon our veterans, and so we will not let this occur without insisting on full transparency and, ultimately, a rock-solid guarantee that veteran health care will not suffer any ill effects.
This crisis in the making is happening now, and the cuts are scheduled to take effect at the end of February. We can and should let our federal lawmakers know we oppose this.
