Commission on Veterans’ Care Recommends Measures to Improve Treatment at Home

By JACQUELINE PALANK
WASHINGTON, June 29 — The presidential commission investigating problems in health care for military personnel wounded in Iraq and Afghanistan held its final hearing Friday, and focused on problems with moving patients through various stages of aid, from Defense Department hospitals to those run by the Veterans Administration or private health care, to home care and to jobs.
Today’s veterans are more likely than those of previous conflicts to suffer from “polytrauma,” including burns, brain injury and shrapnel from explosives, members of the commission said, making their treatment more complicated.
The health care system should also take into account the strain that puts on family members, commissioners said, and should make more use of contractors who can help in out-patient care.
The commission, led by Donna E. Shalala, a Democrat and former secretary of health and human services, and Bob Dole, the Republican presidential nominee in 1996, was established in March after articles in The Washington Post described poor conditions at the Walter Reed Army Medical Center here.
“We’re very solution-driven,” Ms. Shalala said of the panel. “We will not be issuing a report that points fingers.”
Because today’s wounds are different and the families of the veterans are different — many are older, with homes and spouses to return to — more veterans should be allowed to return home for treatment, commissioners said.
Returning patients to their homes can relieve the strain on some families, said commissioners, who reported that some relatives must now leave their homes and jobs to assist with their service members’ treatment in distant hospitals run by the Departments of Defense or Veterans Affairs. But caring for injuries at home requires support from the V.A., they said, and support offered now is often insufficient.
Another consideration is that the patients’ physical wounds are also accompanied by post-traumatic stress disorder, commissioners said.
The hearing on Friday was the commission’s seventh, and several members of Congress who have introduced legislation on veterans care came to testify. Mr. Dole and Ms. Shalala asked if they would include the commission’s recommendations in pending legislation.
“We would welcome suggestions, absolutely,” said Senator Carl Levin, Democrat of Michigan and chairman of the Senate Armed Services committee.
Mr. Levin said the Senate’s veterans bill, which is scheduled for the floor, seeks to improve medical record sharing between the military and the Department of Veterans Affairs as well as address discrepancies in the disability ratings each department uses to determine how much in benefits a service member is paid each month.
Representative Steve Buyer, Republican of Indiana and the ranking member of the House Veterans’ Affairs Committee, said he was concerned that the departments did not adequately use private contractors to provide outpatient treatment, which could allow patients to receive care at home rather than have to travel to a veterans hospital.
“If we’re patient-centric, we should allow the transition of that patient to occur,” Mr. Buyer said.
Ms. Shalala said, “This is a different war in which we have people who have families and they want to go home.”