Excellent Health Care For Vets

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Wednesday - May 30, 2007

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Except for the huge window overlooking the shining Pacific to the south, his walls are covered with diplomas, plaques of appreciation and a lifetime of photos - some shoulder to shoulder with presidents and well-known generals. From his fourth-floor office in Tripler Army Medical Center (TAMC), retired Army Brig. Gen. James Hastings, or in his current role, Dr. Hastings, directs the Hawaii and Pacific Islands Health Care System for the Veterans Administration (VA).

Essentially, he is responsible for the primary care, mental health and geriatric services for the 30,000 veterans registered in the Pacific area from the total 130,000 eligible.

Hastings’ qualifications for this mission are impeccable. Born at Walter Reed Army hospital to parents both stationed there, he was reared in a military environment and educated at New York University, the University of Virginia and Vanderbilt University. With the latter’s close association with the VA in Tennessee, he has been involved with veterans’ medical care since the beginning of his 30-year career as an Army cardiologist; he commanded three Army hospitals, including Walter Reed, and finally Tripler, retiring from active duty there in 1995.

For the next eight years, Hastings used his extensive training background at the University of Hawaii’s John A. Burns School of Medicine, where he brought about a closer association between the the university medical school and the VA. He expresses satisfaction in helping to bring both state and federal resources into the UH/VA community-based partnership for the benefit of Pacific-area veterans.

In great part because of Hastings’ leadership, Hawaii’s veterans are extremely well-served. A $130 million annual operating budget - funding the Spark Matsunaga Veterans Health Clinic, in partnership with Tripler right next door, VA clinics on four Neighbor Islands and a fifth soon to be added in Samoa, and the Veterans Hospital in Palo Alto, Calif. - provides comprehensive in/out-patient services. These run the gamut from primary care to surgery to dental to pharmacy to physical rehab to mental health, and most recently, a seven-week residential post-traumatic stress disorder (PTSD) treatment program.

This “intensive treatment” PTSD program is, of course, in response to the well-publicized increase in cases among not just active duty vets, but now also National Guard and Reserve vets returning from Iraq and Afghanistan. Extended and repeat combat tours also have increased this need. Job protection and family support during treatment are also included.

Contrary to the mainstream media’s incessant message of mass cutbacks in funding veterans’ heath care, Hastings insists the problem is not money, but the availability of qualified practitioners. And the need is increasing here in the Pacific by 5 percent each year as more vets survive combat wounds which once would have been fatal, and more existing vets grow older and turn to VA health benefits as civilian health insurance costs continue to rise.

Few are more qualified than Hastings to comment authoritatively on the recent difficulties at Walter Reed in accommodating returning vets. He points out that Walter Reed has been hit by the “perfect storm.” Targeted by the DoD’s Base Realignment and Closure (BRAC) to close within the next few years, there has been a natural reluctance to allocate money for capital improvements. The complexity of the DoD’s expanding policy to subcontract maintenance activities to civilian firms with bidding, legal and union issues resulted in delays in needed upkeep and maintenance. This, combined with the surge of wounded personnel from the Middle East conflicts, resulted in a bureaucratic meltdown - hence the scandalous ward conditions in parts of the hospital.

One of Hastings’ current challenges is overcoming the disconnect between the DoD’s and the VA’s computerized record systems (wouldn’t you know!), which is making the desired synergy between the Matsunaga VA Clinic and Tripler more difficult to achieve. But he says he is learning to “work around” the system, thereby increasing the quality and convenience of the care for the vets he serves.

As a veteran with a cumulative 320 percent physical disability (as defined by VA criteria), this writer can personally attest to the efficiency, convenience and compassion of the local VA health care available under Hastings’ leadership. And I encourage - as my readers should - all Pacific area vets to take advantage of the superior care available to them.