(00:00:11) Good morning, and welcome to this Main Street radio special from the VA Medical Center in st. Cloud. I'm Rachel riebe. Minnesota has almost a half a million veterans our show today is going to look at the health care System designed to take care of them. It's struggling with record numbers of patients and limited funding at noon will discuss the impact veterans have had on their communities in many towns the VFW or Legion Post also serves as the community center and runs everything from the blood drive to the baseball league with the veteran population declining the future of these organizations is uncertain Today's show is coming to you live from st. Cloud's VA Medical Center. There are only two such centers in the state this one in st. Cloud the other in Minneapolis this facility a collection of buildings housing a 400 bed, huh? Spittle and a nursing home as well as mental health services chemical dependency programs and specialty clinics opened in 1924. We're broadcasting from the patient's dining room just down the hall from the main waiting room at the medical center, which is full of people this morning this year the VA Medical Center in st. Cloud expects to see 11,000 patients. That's a record number and an almost 20 percent increase from last year. Many of them are aging World War II veterans now in their 70s and 80s with health problems Our Guest this morning our berry ball director of the VA Medical Center in st. Cloud Bernie melter commissioner for the Minnesota Department of Veterans Affairs and Al are a staff assistant specializing in Veterans Affairs for Congressman Collin Peterson. Good morning gentlemen, welcome to Main Street morning morning listeners. Our phone lines are open for your questions and comments. You can call us this morning at one eight hundred five hundred 75252 our number. One eight hundred five 300 75252. Mr. Ball. The number of patients you're seeing at the VA Medical Center in st. Cloud continues to go up and yet your budget has not grown. How do you continue to deliver the services? Well a large portion of our budget is dedicated to Staffing about 85 percent of our funding is for employee salaries what we've done over the last three four years is redirected a lot of our resources in the facility. We we have shifted our patient care programming more to an outpatient programming than we had before utilizing other opportunities in the community at at the same time. We were closing beds that no longer needed in our facility example is in Psychiatry where three years ago we had about a hundred and fifty beds today. We have 15 beds in that area and we're seeing more patients than we were before we've done this I think with a lot of cooperation with the other va's in our Network in the community and and it certainly worked out very well. We haven't had to lay off any staff. As what's happened in some of the other va's across the nation and pretty much continue to grow as you mentioned. We've gone up almost 20 percent over last year. Our numbers are expected to continue to grow in the future. I'll are is it a major concern that we have this flat line budget that were working with? (00:03:38) Well, the Flatline budget has been a problem for the veterans administration for quite a number of years. There are four major veterans organizations in this country the AmVets the DAV the Paralyzed Veterans of America and the Veterans of Foreign Wars have developed and proposed a independent budget that independent budget outlines all the criteria for our request for three billion dollars in our need to do the provide the kinds of services that are necessary to the veterans of this great country this year. We all the organizations all the Things in this country that have responded to our to our calls. The Congress of the United States has decided that 1.7 billion would be authorized for our VA budget which does assist a great deal. However, just recently the the budget proposal was proposed and the case was made for a 1.4 percent cut across the board and all federal agencies. So what they give us they take it away. So the point is that this cut if it was to Prevail as far as health care is concerned it would cost the budget Healthcare budget of the Department of Veterans Affairs about 293 million dollars, which is not acceptable fortunately. The president of the United States has vetoed that Bill, so we're back on track. Hopefully that we can sustain ourselves at one point seven billion. It's not the total answer to our fiscal problems within the system but it does help. It's a starter. (00:05:35) Our phone number is 1-800-555-9408 Turan who has used the VA Medical Center or VA medical services. We would be interested in talking to you today. Give us a call one eight hundred five hundred 75252. You can call us with your questions or your comments. So we have increasing number of patients Flatline budgets and yet at the same time you have opened clinics in Minnesota, and I'm assuming that's nationally that this push to put the services where the veterans are and the thought Barry is have it within 75 miles and the the goal ultimately will be to have one. Within 50 miles from any maintenance of tution as you realize we just opened a clinic in Brainerd this last month and that is certainly started off to be very very positive for the patients and that area I understand there have been problems though getting a doctor to staff the Brainerd Clinic. We've had several applicants for for the the full time position. We did pick up a half-time doctor right away. So as the beginning of the program is in Brainerd is growing right now. Our staffing is appropriate for the numbers of patients that were saying will that be less expensive to do or more expensive? Less expensive to have these outpatient satellite clinics across the state. Is that a way of maintaining services within your current budget or does that actually put more of a pinch on the money you have available to spend the the first month's numbers that I was looking at showed that it's probably about the same as what what it's currently costing us here at the facility per patient as the numbers grow. Hopefully that will decrease lots of that will depend upon how much really acute usage will be generated from that area. If some patients are hospitalized in the community that we couldn't see here that's where the cost of go up that tremendously but as long as we can just provide the basic Primary Care Medicine in that area, it should be comparable to we're doing here, but you are correct that the funding for the outpatient clinics does come from the mother Hospital. (00:07:55) If I may add to this, I think it's also important to note that the veterans throughout this country have asked and have received and a positive response to the question of how far can we travel at our age for the most part these outpatient clinics are set up to accommodate the veteran and take care of some of the more critical transportation problems that we have. You take a veteran that's in his late 80s World War Two veteran for an example. It's very difficult for that veteran to provide for transportation. I have attended a number of meetings where the requests were made for additional outpatient clinics. However, the Veterans Administration needs to be extremely careful in terms of developing more outpatient clinics. I would say because of the Much but I think one of the big issues is to accommodate the veteran so that he is assured and she is assured that there will be a transportation Factor built into these outpatient clinics. When when there's when they're suggesting (00:09:14) our phone number this morning one eight hundred five three 75252. You can call us at that number and join our conversation Bob standing by in Minneapolis with the question. Good morning Bob. Welcome to mainstreaming. I'm a Korean veteran on the occupation before that and I've used the VA hospital, but I have a question. I'm what they call a category C veteran those of us with less than 50 percent disability and were means tested out of access a couple of years ago. I've since signed up to pick up the co-pays myself, but many veterans I would say most of us in our 70s and 80s eligible for Medicare would be much better off financially if subvention Kurt I'm sure you gentlemen know what it means in our and I've talked to both Senators staffs and for Congressman staffs and it just seems to dive in the committee some place so that the money that we and I pay the natural Medicare amount that we Supply to Medicare could be sub vented to the VA and then our Medigap policies would kick in and it would be economically feasible and it certainly would help the VA hospital here, which I believe I'm visiting a buddy over there came an emergency from anemia a couple of weeks ago and he was operated on a Saturday night, I guess but it would be nice if the hospital here had a fully full load for economies of scale and the research possibilities. It's one of the few institutions that knows how to study and treat old men. I wonder if you just comment please. Let's give our guests a chance to respond to that who'd like to (00:10:48) start Bob. It's it's very interesting to note. That the major veterans organizations for the last 10 years have been talking to the Congress of the United States about Medicare subvention. The question is passed in the house. It's gone to the Senate and it hasn't been actually explored totally on the Senate side. However, I agree with you. I think that being your a category 7 veteran nonservice-connected veterans and you need to have medical care that if we had Medicare subvention in place. This would indeed be very helpful not only to you as a veteran but to the VA and Department of Veterans Affairs, my good colleague is with us here today. It would be an important advancement in the process of providing care for our veterans in this country. So the system needs work. Well Rachel there is a there is a DOD at Department of Defense. Initiative on Medicare subvention that they are testing was the military hospitals and certain sites around the around the country and I think that they can extrapolate that information and apply it to the VA without happened the VA go out and do a duplicate tests and waste time. So we hope Congress will take a look at the information that's coming back from the dod tests apply it to the VA. I don't think you'll find anyone that's familiar with VA medical care. That would not think that Medicare should mention would be a boon to the medical center directors like Barry and the steep climb glass down in Minneapolis because they would be able to draw that money and apply it within their facility. They could keep the money wouldn't have to go back to the federal Treasury. (00:12:40) Bob this is Barry from the VA. I agree with you that this has been a long time coming and we're anxiously waiting to see what happens with us. We from the medical side are very interested in seeing all veterans. And certainly we feel that you know, it's a great family here and the more that we can do for our veterans. That would make us very happy. Let's go back to the phones. We have art standing by in Brainerd. Good morning art. Welcome to Main Street. Hello. Yes art. Go ahead with your eyes. Can you can you speak up a little bit? I can hardly hear you. Yes. Go ahead with your question. Do you want me to go over it again? Yes. Go ahead with your question. I'm a veteran of World War Two no service-connected disability. Last summary friend told me the rules have been changed and I should be eligible for VA health care. I applied through my County service officer and was enrolled at st. Cloud I call st. Cloud for an appointment. And was told they were so short of doctors would take six months to see a doctor shortly. After that. I read in the paper Brainerd now has a st. Cloud satellite, but the clinic doesn't have a doctor yet. I'm also told that Brainerd Medical Center was some thirty five doctors and excellent facilities offered to take care of the Brainerd vets on a contract basis with a VA but was turned down now here's my question evidently Congress is not providing adequate funding for VA. So why make more that's eligible if they can't be taken care of on a timely basis. Also instead of opening a clinic in Brainerd with no doctor wouldn't have made more sense to use Brainerd Medical Center with less cost to the taxpayer and better service to the vet. Thanks for listening. Thank you very much. Let's start with the first question, which is the question of opening up the eligibility the rules changed last. Burr more vets became eligible for services at the VA Medical Center is that like opening the doors and inviting everybody to a party but you only have a table for five and all the chairs are filled. Well certainly right now that that's what we're going to experience for the first year or two years of this all seven enrollment groups. When you look at the long range demographics of what's going to happen with the numbers of veterans that you'll begin to see probably next year sometime that the number of new people applying for care in the VA nationally will equal the number that are dropping out of the VA do two deaths and that sort of thing. So right now it's difficult to make that initial hurdle, but I believe we're working our way towards that so this is a crunchier set right right now is the crunchier it's let me also address the other issue. We do have a physician at Brainerd down that that position is working on halftime. And we are covered there. We do have some nurse practitioners that are also working on that area. So we have ample number of clinicians to meet the patient care workload the issue of what happened in st. Cloud for the weight was really a very short period of time where we had several positions retire and then a couple had some health health issues. But since then we have hired I think about six new replacements for all those positions in our weights are getting getting shorter. So that very just a small little blip you think that a six-month wait is excessive. Absolutely. Yeah, we our goal is to keep keep it less than 30 days for any any new patient coming on board. The other thing is that if anyone needs to be seen right away due to an emergent need we will see them that day. We have enough slots that aside for that so a routine New patient coming into the system will take a little bit longer right now, but very shortly we'll have that down to less than 30 days. So it might have been a better idea to hold off on opening the eligibility door until your numbers sort of peaked and started to go down that might have been a better idea. Well from the other standpoint, we're seeing a lot more veterans now than we ever have before and that and that's good. Uh-huh. Great. Anybody else want to comment on either the well, I just like to say (00:17:09) that something to bury me not be able to say is that that decision was made at the to open a category 7. This was made by the Secretary of Veterans Affairs in Washington DC and I don't think that was made with concurrent knowledge of the directors out who were actually doing the work and in such as often happens as and it came down down the hill and the brunt of people are bearing the brunt of the directors and the members of have Vision 13 (00:17:36) Liberty. Have you heard a lot of similar concerns from art from people like art and Brainerd who say yes. Now you tell me I can come but I cannot come I can't wait six months. (00:17:47) Oh, yes, and that's a continuing recurring theme that we here in the veterans organizations as well as I here at the state level and and again, they send this comes down from Washington and and our directors are Forced to do Miracles with very little as you very aptly put up front. (00:18:06) Let's go back to the phones. We have Gene in Eagan standing by good morning, Jean. Welcome to Main Street. Thank you. My comment is my father my late father and all my uncle's served in World War Two miraculously, they all came back and I think it's reprehensible that there is not enough funding or Staffing at the veterans hospitals and a point. I'd like to make was to ask your listeners and government officials to ask themselves the question. Would you be here if it hadn't been for these veterans. Do you know whether a veteran may have saved the life of your father or grandfather in some previous war and I'd like to tell you about my uncle Kermit who served as a medic in World War Two earning two purple hearts and many other commendations in his 70s. He was a patient at a VA hospital because of kidney failure. Lawyer and he was in poor health and you know, it wasn't the greatest place in the world for him to be but his his care was taken care of and while he was being moved from one building to another to get his dialysis where they were going to put them in a Medi van or something. Some poorly skilled most likely underpaid undertrained orderly did not set the brake on his wheelchair in the wheelchair rolled down the cement sidewalk tipped and my uncle didn't die of kidney disease. He died of a severe brain injury as a result of the orderlies mistake and so there should be better funding and and and the value of the veterans can't be You know down plate and that's just what I wanted to say. Thank you so much for your call today. Our phone number one eight hundred five three 75252 are we less patriotic as a civilian population are we less tied in to Veterans? There are families. Now that do not have a grandfather or a father who fought in a war. Is there a growing Gulf between the two? I know there are less members serving Us in Congress that our veterans than ever before. What would you say to that Bernie? (00:20:20) Well, I think that's absolutely true both in the state legislature and the National Congress. There are fewer people who have a direct link to military service most of our as you know, the World War II veterans are declining and they were one time the largest veteran population because of the sheer numbers 600 million people are 60 million people throughout the United States were involved in World War. To now we have the Vietnam veterans of the largest group and they're not as as politically astute. I think as World War Two veterans were in passing the legislation in continuing to maintain the GI Bill legislation that coupled with the fact that we just don't make Veterans as you know, the Gulf War was a short hundred our war not that they don't have specific problems of their own and the Vietnam veterans have those problems and we're we're to bitterns continued have problems, but I just think that there are fewer folks out there that have a military Heritage background John O'Neill a good friend of all of ours once said that military service is hereditary and you can look at I had five uncles in World War Two. My father was in World War 1 the back half of were one and I have five children and for those were military service, so it is I think there's a link but it's just not popular to be in the This anymore the Armory last week offered a 6000 bonus just for enlistments, you know, if you come in and list will give you a six thousand dollar bonus. And so it's a different mindset. Yes. It is and people I don't think it's a lessening degree of patriotism. I think people still stand and salute the flag and that sort of thing is my country right or wrong but my country but I think it's the problem is is that it we're not getting that into the legislative process. I think also that excuse me, there's so much prosperity of the country today that many of our good Americans don't really understand and comprehend the absolute need that we have for care for veterans in this country. If the American people would only respond to the needs of our veterans today, there'd be no question in my mind that the political leadership. Of our country would would recognize that immediately. It's it's easy to be critical about activities within the process. But if you do not participate in the process, nothing happens and this is one of the things we find in our organizations when we talk to our membership, please help us talk to your political leadership in congress in the state legislators the administration Etc. That's how the message is accepted. Let me give you a prime example in 1965 when I was appointed to this wonderful permission of my colleague holds burning melter the president United States at that time Linda Johnson put out a directive to close 33 hospitals Regional Offices and nursing homes around the country. The veterans of this nation responded so vigorously after that executive order that the president finally made a public statement on television. Please was draw your concerns about the closing of those facilities. I have appointed a blue ribbon commission to travel around the United States of America with representatives of the major veterans organizations to address those issues and that executive order just kind of dissipated. (00:24:15) You're listening to a special Main Street radio broadcast from the VA Medical Center in st. Cloud. I'm Rachel rebe. We're talking about Minnesota veterans and the challenge of providing them with Health Care Our Guest this morning are buried bald director of the VA Medical Center in st. Cloud burning melter commissioner for the Minnesota Department of Veterans Affairs. And Al are a staff assistant specializing in Veterans Affairs for Congressman Collin Peterson. Mpr's Main Street radio coverage of rural issues is supported by the blandin foundation committed to strengthening communities through grant-making leadership training and convening will be back with more of Main Street after a look at news and weather membership is the single largest percentage of Minnesota public radio's Revenue budget our three-day fall membership Drive begins Wednesday because your time is important. We want to raise the same amount of money in less time together. We can make this happen one listener at a time. So don't wait call now to become a member or renew your membership 1-800 to to 728. Do it today. Good morning. It's 11:31. And in the news this morning as expected. It's not a good day on Wall Street for Microsoft. The computer Giants Shares are down following a federal judge's finding that Microsoft is a monopoly that's hurt consumers. But the broader Market remains generally unhurt by the decision Searchers are getting some more high-tech help at the site of the EgyptAir flight 990 crash. They plan on using a second underwater robot to search for the planes flight recorder boxes. Once the Seas calm enough for deployment. President Clinton makes his online debut tonight Clinton a self-proclaimed computer illiterate will be participating in a 90-minute cyber chat sponsored by the Democratic Leadership Council. You can chat with the president at town hall meeting dot excite.com, Minnetonka based UnitedHealth Group. The nation's number two Health insurer is giving more power to its doctors a Texas newspaper reports that the HMO is expected to announce tomorrow. It will allow doctors the final say in treating patients UnitedHealth covers more than 10 million people a teenager from Burnsville was the biggest surprise of the Ranger M1 Millennium bass tournament in Winter Haven, Florida sixteen-year-old Ross Taylor finished fourth yesterday in the co-angler division earning $12,500 Taylor plans to turn pro after completing high school. Well, there's a weather Ridge building in the center of the country in that is what's responsible for Minnesota's and seasonably warm November weather record high temperatures are forecast across much of Minnesota today and tomorrow cooler weather expected by the weekend, but we may see another warm up next week State officials are predicting a heavy deer harvest after a deer opening weekend featured warm weather and ideal hunting conditions across much of the state conditions were especially good in farm country where much of the Corn Harvest has been completed temperatures that reach the upper 50s in northern Minnesota also made for comfortable hunting. Although dry conditions in that region created noisy woods today sunny and seasonably warm highs ranging from 60 in the Northeast 80 in the southwest a record high of 74. Cast for the Twin Cities, that's the latest from The Newsroom. I'm Mary Ann Sullivan. Welcome back to our Main Street special live from the VA Medical Center in st. Cloud. I'm Rachel riebe. We're broadcasting in front of a live audience in the patient dining room this medical complex includes a hospital nursing home and numerous outpatient specialty clinics. It's one of two va's in Minnesota. The other is located in Minneapolis. Our guests again this morning Barry ball director of the VA Medical Center in st. Cloud Bernie melter commissioner for the Minnesota Department of Veterans Affairs and Al are staff assistant specializing in Veterans Affairs for Congressman Collin Peterson listeners. Our phone lines are open for your questions and comments. You can call us this morning at one eight hundred five three 75252 one eight hundred five hundred seven 52 52 and we go to gym who is patiently waiting in North him on the phone lines. Good morning, Jim. Welcome to Main Street. I'm good morning. I'd like to just talk about Travel for elderly veterans this morning and in North Alma van came down from International Falls. It's sponsored by the International Falls VFW in our VFW northome kicks in money for insurance, and they pick up veterans in North home that, you know can't drive and they go down to Minneapolis. Also II know if you're a veteran and you're going to Minneapolis or st. Cloud for your disability that you're rated for you can get mileage, but the mileage is at 11 cents a mile, and that's what it was when I get on a service and 69. And also I'm a hundred percent disabled veteran for two years. I've been trying to get a primary care physician in Minneapolis and and they just tell me that you don't have enough doctors to get me one and I'll hang up and take it off the phone. Thank you. Thank you would like to respond to that. Well, I'll take a shot at this year the agree with it. The traveler beneficiary travel issue is one that that we do hear about, you know, occasionally that that is a lot that set that figure and that's something that we in the VA really can't do anything about we can just you know, pay whatever the amount that we're legally authorized to do. So the other issue about 100% service-connected and waiting for a primary care appointment in Minneapolis. They're working very hard and on that. I've been at numerous meetings in the last several months where they are are going through their whole scheduling system and changing the way they're doing things and I'm optimistic that that should be improving in the in the very near future (00:30:09) Bernie, you know Rachel we in the state of Minnesota are so fortunate to have County veterans service officers in the Network of event and most of the County veterans service officers provide Vans for transportation for veterans to and from most of the Hospitals and Clinics. We have a great Triad Minnesota. The county veteran's service officer State Department of Veterans Affairs in the federal department better and I think this hundred percent service-connected better and I can't answer to the clinic appointments but these right local posts do provide the county service officers of the mechanism for transportation and they don't have to remember or not required this beneficiary traveled at Barry's just talked about that. He's required by law. We've lost that in the past. They just cut it off and threw the human Cry of veterans we've gotten it back and maybe it's only 11 cents, but that's a heck of a lot better than 0 and and we need to maybe mitigate for more or higher Benny travel, but we have lost that in the past. I would agree with the commissioner melter that you know, there was a long period of time when no Transportation funds were available because of shortage of budget problems Etc. But I guess I want to make a comment regarding the veterans service officers and estate. We in Minnesota probably have one of the most outstanding records in terms of service to Veterans by our County veterans service officers system under the leadership of our commissioner Bernie melter. It's very rare that a veteran who has gone to his local County veteran's service officer to get a question responded to regarding any issue that he may have that he wasn't covered Jim. I want to certainly commend you for going through your service officer in this particular issue and expressing your comments, but keep working hard. We need your support. Out there so we can continue to provide the service that our veterans need in this (00:32:17) country. And we do have an 800 number with somebody with veterans questions specific cases specific questions. You could call 1-800-827-1000. 1-888-201-1014 is a very complicated system on a federal level on a state level on a county level. Sometimes it's very difficult to know who you can call that is a number which acts as a referral base. So if you have any questions about any of the issues were talking about this morning for specifics call one eight hundred eight two seven one thousand in our number here on the air one eight hundred five three 75252. We are in the patient's dining room of the VA Medical Center. You can hear the clatter in the background. They are serving lunch in here at this hour and we do have a live audience. Our reporter maresa Helms is in the audience with us this morning. Good morning. Maresa (00:33:08) Rachel (00:33:11) Bob a From the Vietnam War has a question about availability of doctors. (00:33:18) I guess I'm concerned. I like I lost my doctor now and I finally had to call in to get the blood work done ask. For an appointment to just have my blood work done. What should be done every month or two and because I know my levels they check on my lipids and stuff (00:33:36) and the doctor left to go to a private facility (00:33:39) and I'm concerned at the VA isn't keeping up with the outside benefits of pain probably more to doctors or something. I don't know what's going on. But I got a feeling that's part of it or (00:33:49) something. Should it be this difficult Bob? She'll be this difficult or do you feel like I served my country. I'm entitled to these things. Well, I need them. Well, I think the VA system is Pretty good overall. It just like I said, I'm a what I'm concerned about is I got a feeling at the top level. They're not (00:34:09) paying (00:34:11) enough to the doctors to keep it keep them in the system once they're here and my concern is is that I don't think they're treating (00:34:19) me badly. I mean, I'm a hundred percent permanent connected. So, I mean that that part I mean treated okay, but it my concern is the doctors. Are you getting what I don't have it. (00:34:28) After eight know that bothers me, you know, let's talk about that very ball. Is it difficult for the VA to hold on to doctors? Because you can't pay competitive salaries. Have you seen a large turnover? You've talked about the problem of finding a full-time physician in Brainerd. Is it a system-wide problem? Actually, it had not been a problem for st. Cloud for many years and we were very stable in our physician stand Staffing but what happened this last summer was some of the specialty pay that we pay our physicians counted towards their retirement for the first time. So we had numerous Physicians that were staying on board up until that could happen and then they retired and took the additional higher retirement level overall. When you look at our salary structure though for the VA. It is somewhat lower than what you'll find in the community, but it does also offer some benefits a lot of our physicians don't have the every other night call that Might have in the community a little more stable schedule that they can plan. They have some bargaining chips. Yes. Okay. We're going back to the phone Sharon and Minneapolis. Good morning Sharon. Welcome to Main Street. Hi. I have a couple of first a comment and then I guess a question for somebody to make a the answer. First of all, I think the veterans of our country have gone to fight for our like to support our way of government and our way of life. They need the prime Healthcare that is due them. I'm wondering if our veterans are suffering the loss of our attention for their medical needs as more and more people. Perhaps are growing tired of armed conflict and you know, and even in peacekeeping missions there becomes situations where armed conflict takes place. In other words people are getting really sick of war and our veterans who have done their best to serve our country is suffering that kind of General mood that people are just tired of War not solving any problems over the centuries respond to that Sharon. Good good point. What do you think Al (00:36:55) sure and let me just say this that The response to your question of having lost her question though. (00:37:09) She was talking about are we less interest now we getting so tired of conflict that people just think forget about the (00:37:16) veterans. I would only say this Sharon that the United States of America the most benevolent nation and the in the world. I certainly should have the wherewithal and the physical wherewithal to do the job for the veterans that served this country and saved our country during many conflicts, but I guess it goes all back to what I said earlier that we need the American people to respond to those to those issues if we're going to send our men and women in We're going to send our men and women In Harm's Way, we as a benevolent Nation should be ready to provide the necessary Health Care to those veterans that have served us honorably in this country. (00:38:08) I don't one of the veterans I was talking to I was asking him about veterans benefits. He was very quick to correct me and say don't talk benefits you use the word entitlement not benefits Rachel. I'd just (00:38:21) like to say to Sharon that there's an old saying that that we use a lot in its, you know, you hate the war but not the lawyer and I can tell you as a Native American that and having just come back from Fort Sill Lawton at a very big powwow that Native Americans honored their Warriors from all wars and right after the elders and right after the flag at all powwows, the veterans are honored and so it's again that you may not like war and I don't like the idea of sending our kids over play. It's like a Servo and it's not a declared war and Congress has not given more powers to the president and etcetera. But everyone on those Sons and Daughters particularly of Minnesota are our representatives and when they come home, we need to be respectful of their service to this country. Well (00:39:10) on the question is if we can't do the job during this boom economy what happens when we get going on a bust economy. I mean if we've had a flat line and VA health care for five years times of never been better in this country. Does it scare you bear to think when things start to tighten up? You're not getting any money now and they started tighten up what's going to happen. It definitely will be a bigger challenge than it is now. Yes, you mentioned that the spirit of the nation and as Bernie said, you know, when when there's Wars and things like that people really, you know step forth. But when there's a bit of a lull in the action, so to speak they go and look elsewhere. We are always looking for more volunteers and Certainly as we've gotten further away from the World War II folks. We're not seeing the younger people coming in like the World War two people did so so you don't want to be a silent forgotten population. We need to get the message out. (00:40:07) I think something that's very interesting. That should be expressed here. Is that today? We're losing a thousand World War veterans. In death each day 30,000 a month so we can probably see our veteran population decreased to something like 16 million, which is a factor. (00:40:30) We're going now to Wisconsin where Cliff is standing by on the phone. Good morning Cliff. Welcome to Main Street. Good morning. I'm a family practice physician rule of Wisconsin just crossed the border and we see a lot of veterans here obviously and they end up going to get some of their services in Minneapolis. And I've got a very simple solution that has been suggested in the past but always seems to get shot down under the auspices of the flag. Now, obviously, we have to give our veterans the best care in the world and very simple solution to this I think would be to give them all a v a gold card where they just go and get their medical care wherever they want and we could really I think we should probably Do away with most of the VA system and keep a you know, a hospital for a couple hospitals our own country for research and Gulf War syndrome specific type stuff that really isn't seen or can't be addressed in the private medical hospitals that almost all my veterans have you know, the common typical problems that everybody else does and could be taken care of in the system. I know in the Reagan Administration, I believe the OMB put out a estimation that it cost two and a half times what it would cost in the Private Industry to take care of our veterans in the VA system. And it seems to me we would solve this not all our problems with access to care and the inefficiencies and inconvenience and unresponsiveness of the VA system despite, you know, the best efforts of people like yourself who are really, you know, good people trying to do their best job. It just I think it would work much better and we'd be doing our veterans has tremendous benefit if we just let them go down to their local doctor and get their medical care. So the question you're bringing up Cliff is the one we heard from our earlier in the hour, which is we have a Health Care system in this country. Why not issue these cards or have a voucher system while you work on the national level with legislative issues. Is this something that continually comes up that we could do it better and we could do a cheaper if we didn't have this VA (00:42:36) system. I think this has been part of our agenda for as long as I can recall. I've been involved since 1955 and just those very issues that you referred to have been part of our legislative goals and priorities. (00:42:52) Why is it so difficult to get that past when we think about and we think well, that's (00:42:55) logical. Well, I guess there's a change in political leadership. There's change in political party. It makes a difference in those kinds of things have an impact on what will be heard what will not be heard. What will probably be considered as a priority as opposed to something. That will address at a time when it's necessary very what would you say to this? And (00:43:21) of course you're very involved in the system, but you're also a veteran does it make sense or give us your best argument for having a VA medical system instead of as Cliff suggest get a gold card go to whatever doctor you want in your own community. Now there's some long and short things. We could talk really for hours on this a couple of years ago. There was a gentleman that came through our hospital. Is it psychologist doing a tour down in Australia and exactly what you're describing is what they did in Australia where they issued cards to folks and what happened over a period of time was more patient started going to the community and then they said well, they no longer need the the medical facilities for the veterans there and they were closed and then shortly thereafter. They ended up having a crisis in their economy and the payment systems changed and all of a sudden veterans were waiting as long or longer than the the rest of the folks in the community and they all wanted their VA facilities back. So, you know their colors of the way. Yeah, it can go both ways. There's a huge number of patients that only want to receive Care from the VA even though they are entitled to be seen elsewhere. We're going back to Marissa in our audience with a question recent. Go ahead. Hi. We have Warren determine. He's a Vietnam War veteran from st. Cloud. He has a question. I was just wondering if you're thinking of that maybe the VA Hospital might close somewhere down the line and they have more of these centers like they have in Brainerd you could pay for a lot of those types of centers with the money. They spend at the VA and st. Cloud. Do you see that happening? Five? Ten years down the road. Thank you. What is the future of the VA we talked about in the year 2015 the need for services dropping off as the World War II veterans vanish is their talk. Is there a plan someplace on the books to perhaps downsize or closed part of the system very There is really no plans on the books, you know, a lot of it depends upon again the national budgets and where we're going to go. I think what you're going to see in the in the next 10-15 years though is a continual mimicking of what's happened in the community going to one day surgery. So the smaller hospitals in larger outpatient programs the continued growth of outpatient clinics. And so every patient be can be seen a lot quicker and faster in their own community. So so you'll see the VA hospital system gradually decrease in size pending any unforeseen Wars or other (00:46:02) external pumps Rachel. I'd like to say I'm 61 years old and I'm a Vietnam vet. I'm a very old Vietnam vet and my needs are getting worse as I age and I think there's some specialty the good doctor in Wisconsin alluded to people coming and I think what he's talking about is mostly ambulatory healthy veterans that are coming for Some odd things but as we age and as World War Two veteran class has indicated we are going to have more needs for long-range long care long-term Healthcare and St. Cloud as a facility fits that model and Minneapolis to a lesser extent and I think that if we were to take all of the World War II veterans that are remaining and those that have have senility problems and as we age we get that way, I have a lot of senior moments during the day, but we get to the get get to that we would not be able to on fact we would overload the facilities that are available in the community (00:47:05) well and it's interesting to note that we talked about the number of World War Two veterans dying at the rate of about a thousand a day, but it's interesting to note almost a third of this nation 70 million people including veterans and dependents and spouses of deceased veterans are eligible for VA benefits their widows and children of Civil War. And Indian War veterans who are still drawing VA benefits. They're 939 children widows of Spanish American War veterans receiving VA compensation or pension benefits. So that goes on long after the veterans are gone. (00:47:40) Oh and there's a saying for that too. And at the cost of war is not just the immediate cost and Bun and bullets bandages and and and the like it's long term when we must take care of the warrior long after that war and must provide for him and his children and that's an Abraham Lincoln saying that we will provide for the warrior and orphaned children and wife and widows and we do that with a compensation and pension program. Most of this program has been devoted to Medical Care needs and that but we need to maybe just take a look at the compensation. Responding gentlemen, thank you. We (00:48:17) are out of time. Those were halfway through this Main Street broadcast from the VA Medical Center in st. Cloud Our Guest this morning a lair Bernie melter and Barry ball. I'm Rachel riebe next hour. We're going to turn our attention to the organization's built by World War Two veterans VFW in American Legion Post across the country became the place where returning soldiers could talk about their War experiences and socialize. But what happens now that World War Two veterans are moving into old age. We'll talk about that next hour. It's all ahead. Is this Main Street special from st. Cloud continues?