Veterans gain from access to more health care options

Timely, quality health care is an inalienable right that we owe to our veterans. Any dereliction of this responsibility is unconscionable. The burden to treat the men and women who have come into harm’s way while protecting our freedoms falls not on a single administration or branch of government. Rather, it is a collective, social responsibility. For many veterans, care has been too little or come too late.

The Choice Card program, initiated toward the end of last year, is a welcome attempt to remediate systemic deficits. It is beginning to work. Not only that, but the Veterans Health Administration covers integrative care, including acupuncture and chiropractics.

The Choice Card program enables veterans who wait too long or live too far from Veterans Health Administration facilities to obtain health services from the civilian sector.

In April, CNN reported that U.S. veterans were dying while awaiting care at the Phoenix Veterans Health Administration. Last year was marked by multiple investigations, including those conducted by the Veterans Affairs Office of the Inspector General, the House Veterans Affairs Committee, the Obama administration, the Office of Special Counsel and the FBI. Public outrage grew as these investigations revealed manipulation of records to meet performance goals and widespread cover-ups of excessively long wait times.

Kauai-born Gen. Eric Shinseki, former Department of Veterans Affairs secretary, said, “That breach of integrity is irresponsible; it is indefensible, and unacceptable to me.”

Beginning late last year, millions of veterans across the country, including thousands in Hawaii, were issued Choice Cards to ensure access to civilian, non-VA health facilities.

Until last year, with the exception of brisk referrals to the Niolopua Sleep Wellness Center at Manakai, the flow of VA patients had been modest. With the Choice Card program, VA referrals to Manakai o Malama Integrative Healthcare Group and Rehabilitation Center have stepped up significantly.

More important, we have found that the veteran population has been highly engaged and deeply appreciative of the collaborative, multidisciplinary care that is the marrow of integrative medicine. So many of our vets suffer from dual diagnoses of chronic pain and post-traumatic stress disorder. After undergoing a comprehensive diagnostic work-up, a substantial portion go on to receive physical therapy and psychological services. We have also seen high utilization of our occupational therapists to treat chronic pain and traumatic brain injury, and to help manage the challenges of readjusting to civilian life. Vets often request the addition of acupuncture and chiropractic services, which has been authorized by the Choice Card program.

For many, once a clear set of diagnoses is established and underlying conditions, particularly sleep apnea and major depression, are addressed, the fog begins to clear, and they begin to make rapid progress with their customized integrative treatment regimens. Nothing is more gratifying than to see our vets heal, regain normal function and successfully reintegrate into civilian life.

The Choice Card program is not perfect, but it is working, and in places where the Veterans Health Administration is either overwhelmed by demand or too far, our vets are finding more timely and comprehensive access to needed services through the civilian health care sector. As a society it’s the least we can do for those who have sacrificed so much on our behalf.

Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrated Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Submit your questions to info@manakaiomalama.com.