http://66.225.205.104/JR20081111.mp3
Zane Robertson organized a protest at the VA hospital in Salisbury not because he's unhappy with the treatment he gets here. But rather, because he doesn't want it to change a bit. "If it's not broke, don't fix it. And we don't have anything broke here," says Robertson, standing at the gates of the hospital with a few dozen other veterans. "Our doctors and nurses here are caring, they know what to do, they know how to treat us? So why should we give that up?" Robertson's message runs contrary to the stereotype that health care for veterans is sub-standard. But it's the crux of tension over proposed changes at the Hefner Veterans Medical Center in Salisbury. Back in September, the Veterans Administration announced plans to start outsourcing emergency room and intensive care services from the Salisbury center to private hospitals around the region. "This would actually put this acute care for veterans close to their home," says Carolyn Adams, administrator of the VA Hospital in Salisbury. "We have some veterans that drive 70 miles to get to the emergency department here, and this would put access to that care close to their homes." Adams says the bulk of the treatment offered at the Hefner Center is outpatient care, along with nursing home facilities and psychiatric care. The ER and the ICU are only about 10 percent of what the hospital offers. And even then, she says veterans often use the ER for non-emergency care like colds. So why not beef up outpatient care at the hospital and regional veterans clinics and send the true emergencies elsewhere? Well, for one thing, Veteran Willie Right says when he comes to the ER, he needs more than medicine. "We have to be understood, first of all," says Right. "Before you can treat us, you have to understand where we're coming from. And they really don't teach that in medical school." And Right says regular hospitals aren't set up to handle veterans like him who suffer from Post Traumatic Stress Disorder. "Our patience and tolerance levels are very low - not that we want them to be. But our nerves are always on end," says Right. "Civilian emergency rooms, typically what I find when you go in there is a lot of kids. You find a lot of unruly people. And veterans with war injuries really don't take well to that." Not to mention the wait times. Patients at the Salisbury VA say they can usually get right in to see a doctor, compared to the hours-long wait they encounter in emergency rooms elsewhere. Hospital Director Carolyn Adams says she already contracts with private hospitals for a lot of the specialized needs that come through her doors. She's confident the private sector would quickly adapt to the needs of veterans, and promises their coverage wouldn't change. "Veteran eligibility remains the same," says Adams. "If their emergency's an emergency in a layperson's terms, then that bill would be the responsibility of the VA." But the hospital's patients are skeptical. They worry they'll have to negotiate with doctors for their care, whereas right now they can walk right in and get everything they need at the Salisbury Center. Their concerns got the attention of the city and county councils, which both passed resolutions opposing the changes. Congressman Mel Watt went a step further and asked the Secretary of the VA in Washington to put the changes on hold. "I'm really suspect of referring veterans to hospitals that themselves have four, five, six hour waiting times in their emergency rooms," says Watt. "How that would be more efficient for veterans is beyond me." The Secretary of the VA did put the changes on hold, pending an evaluation of the veterans' concerns. It's due this Saturday. Hospital Director Adams says she'll respect the outcome, but hopes the changes will move forward. "I think change is always difficult," says Adams. "And I think it's gratifying that our country allows individuals to voice their opinions and to make sure that we hear what they have to say." By exercising that right, the patients at Hefner VA Medical Center hope they can keep their hospital just the way it is.