A Leander veteran, who had a kidney transplant this past summer, is outraged at the VA. One of its top officials recently told a news station in Atlanta, that Charles Nelson had been well taken care by the VA. But, Nelson and his wife told FOX 7 that hasn’t been the case.
"Dr. Gunnar is obviously out of touch with what veterans' needs are,” said Tamara Nelson, Charles Nelson’s wife. She’s talking about Dr. William Gunnar, the VA’s National Director of Surgery.
Dr. Gunnar recently told WXIA in Atlanta, in reference to Charles Nelson: "I have knowledge about the sequence of events were there. I can tell you in good faith, the VA made every attempt to purchase that care for that individual.”
"I am just very upset with his lack of – he (Gunnar) never has called us to ask us did we have any issue,” said Tamara Nelson. “He's just, ‘I'm very familiar with their case.’ Um, no, obviously he's not. "
The VA denied coverage, through its Choice Program, for Charles Nelson’s living donor transplant at University Hospital in San Antonio in June – forcing him to use Medicare.
The reason for denial: his son Coty isn’t a veteran.
"It's not really a choice for the veterans,” Charles Nelson said. “It's a choice of where the VA is wanting to send you to and the coverage they think you need and where you should be getting it."
The chairman of the House Committee on Veterans’ Affairs, Representative Jeff Miller, is one of the principle authors of the Choice Act of 2014 – meant to expand healthcare to veterans. It allows veterans who live more than 40 miles from a VA hospital to choose their own facility. Miller said, denying coverage for living donor transplants was not his intent.
"It's unfortunate that somebody is manipulating a program that was designed to help veterans and using it for VA's benefit,” said Miller. He and others believe: by denying coverage for veterans to be transplanted locally, Dr. Gunnar is trying to protect the VA transplant program – with centers in 13 states that, in most cases, farm the actual surgery out to non-VA partner hospitals.
"Obviously, donor transplants are very expensive and rather rare,” Miller said. “And, so for VA to be treating a patient as a commodity, to keep their doors open, defies logic."
As for the VA’s claim that it made a good faith effort to pay for Charles Nelson’s transplant, University Hospital said it received a contract one day before his surgery – giving their attorneys no time to review it. So, the contract was declined.
"What they (VA) were trying to do was either postpone his transplant, which was a much needed transplant - he'd already been on dialysis and needed to have his transplant – or, he (Gunnar) knew the hospital was going to deny the contract, because the hospital has to have their attorneys look at it,” said Tamara Nelson.
It’s a sentiment shared by Jaime McBride, the Solid Organ Transplant Manager at Audie L. Murphy VA Hospital in San Antonio and a VA whistleblower. "The thing is, the VA knew these cases were coming ahead of time,” McBride explained. “They know this has been an issue. So, they had an opportunity to have a payment in place previous to that."
McBride said the VA’s Central Business Officer and Dr. Gunnar don’t take into consideration, the undue burden and financial hardship traveling to out of area VA transplant centers puts on veterans and their families.
"The veteran themselves, being an honorable person, a lot of them are saying – ‘you know what, instead of going and doing these other things, I'll die here locally. At least my family won't be bankrupt, they'll receive my benefits and life goes on,” said McBride.
In terms of what’s best for the patient’s health, both McBride and Miller said veterans shouldn’t be forced to travel for transplants that can be done at home. "Statistics will show in every study, that the closer to home the veteran receives their healthcare, initial contact and follow up healthcare, they get better quicker,” said Miller.
McBride agrees and said, “I think with the VA, especially in the Central Office, they don't associate people with names with the information they're seeing. They continue to stick to their guns. They say, ‘this is what's best for us as the VA, not what's best for the patients. This is what's best for our surgical program, this is what's best for my friends at the transplant centers that we have. And, they put the veteran last.”
That is something the Nelsons said they will continue to fight, because veterans’ lives are on the line.
“Our Veterans Affairs doesn't know common sense,” said Tamara Nelson. “They want to look out for the administration instead of the veterans. And, I'm not going to have that."
McBride added, “I think that people who continue to stand in the way: Central Business office executives, legal, whoever it might be, and Chief of Surgery Dr. Gunnar - if you continue to stand in the way and not help veterans, I think you should be out of your job."
In a recent email to FOX, the VA continues to stick with its story, saying in part:
“VA did not interpret the Choice Act, it specifically outlines the eligibility for those who can receive care under it to veterans…VA is not authorized to pay for the expenses related to the donor’s treatment under the Choice Act, even if the recipient would be a Choice-eligible veteran."
However, the VA sent a letter to Rep. Miller that said the Choice Program is an option for transplant patients.