As debate heats up over healthcare reform, military veterans are fighting for another kind of improvement: the expansion of health services for female vets.
Nearly 8 percent of the veteran population is female. But the Department of Veterans Affairs' health system was designed for a male military, and it shows. A Government Accountability Office report released this month found that two of 19 facilities audited did not offer even basic gender-specific services like cervical cancer screenings, and none fully complied with the VA's policy on privacy for female veterans. Overall, "none of the facilities had fully implemented VA policies pertaining to women veterans' healthcare," the report said. Critics say those shortfalls have deterred women from using the system. And statistics bear that out. While 22 percent of male veterans use VA healthcare, 15 percent of women do.
Because of the military's changing demographics, the VA expects the number of female veterans enrolled in the system to double within four years. Advocates argue that improvements are needed—and fast. The House unanimously passed a bill in June to address some of the inadequacies by, for example, requiring that the VA produce a report on the problems women face in the veterans' health system and creating a child care pilot program for women receiving VA healthcare. Companion legislation in the Senate is on the floor now, where Senate Veterans' Affairs Committee Chairman Daniel Akaka of Hawaii is working to build consensus for passage. But some lawmakers worry that a bill alone isn't enough. "It is more complex than just legislation," says Sen. Patty Murray of Washington, one of the Senate bill's main sponsors. "It's cultural."
One particular problem is that in order to keep them out of combat, women in the military are barred from serving on the front lines. But that policy is meaningless in places like Iraq and Afghanistan, where there are no front lines and attacks can happen virtually anywhere. "One of my closest friends was told by a VA doctor that she could not possibly have [post-traumatic stress disorder] for just this reason: He did not believe that she as a woman could have been in combat," Kayla Williams, a former Army sergeant who came under fire multiple times while serving alongside men on patrols in Iraq, told the Senate Veterans' Affairs Committee at a recent hearing.
Some injuries are even harder to prove as service-connected. One of the thorniest is mental trauma caused by sexual assault while in the military, since the assault itself can be nearly impossible to prove. "I am always hearing from women who have experienced rapes and sexual trauma, and they're not getting the treatment that they need," says Wanda Story, national commander of the United Female Veterans of America. They're being denied treatment and benefits, she says, because "they can't prove it." And the treatment itself is sometimes inadequate, with no guarantee, for example, that mental health professionals have been trained for such trauma.
The bill would address that deficiency by mandating additional training. Overall, critics worry that the legislation relies too heavily on the VA to correct its own problems. "They're doing the basics, but I don't think that they've researched it enough," Story says. "I don't think that that bill should be passed until they really get it right." The VA has already taken steps in the right direction by, for example, requiring that managers of women's veterans' programs be full-time employees. Even so, the measure could prod the department to move more quickly.