August 13, 2009 - President Barack Obama not only wants to improve the treatment of America's veterans, but also to reach out to homeless veterans, as well as those who have turned their backs on - or are unaware of - the benefits they've earned.

"What we're trying to do is just break down the hurdles that exist between veterans and VA," Obama told Military Times and a small group of other defense reporters in an Aug. 4 meeting in the White House Roosevelt Room.

But lowering one of those hurdles - creating what Obama called "a VA that is consumer-friendly, that is oriented not towards keeping people out but bringing people in" - will not happen quickly, he said.

"It's fair to say that this is a multiyear project," Obama said. "We are going to be working vigilantly. We're going to keep on pushing. We're going to keep on prodding to make sure that both VA and DoD understand these very human issues are dealt with in the most thoughtful and effective way as possible."

As evidence of that effort, Obama and Veterans Affairs Secretary Eric Shinseki touted a boost in VA funding, an increase of 4,000 claims adjusters since January 2007, a total of 18,000 mental health providers, a national suicide hotline, technological improvements in the benefits claims process, the ongoing effort to create electronic medical records that VA and the Pentagon can easily share and a more proactive and helpful attitude at both agencies.

But while hundreds of thousands of vets seek VA care and assistance, Obama said hundreds of thousands more need help but, for a variety of reasons, haven't sought it.

Shinseki said one thing Obama has asked him to focus on "is homeless vets - 131,000 sleeping on our streets tonight. It's about jobs; it's about education."

It's also about changing the way VA views its mission, Obama said.

"I think a lot of the reason people fall through the cracks is historically sometimes VA has sat back and waited for people to come to them," Obama said. "And part of what [Shinseki] has been doing is to make sure that VA is reaching out to them."

Mental health problems have been overwhelming VA, however, and caregiver demand could outstrip supply despite the recent hires. According to a 2008 Rand Corp. study, an estimated 31 percent of returning war veterans suffer from mental health issues. Only about half of those who need treatment seek it, and only a bit more than half of those who seek treatment get "minimally adequate care," Rand concluded.

Tackling that problem calls for a multipronged approach, Obama said.

One of the best ways of reducing incidents of PTSD, he said, "is to reduce the amount of time in theater without a break." To that end, the administration is seeking ways to increase "dwell time" between deployments, has increased the size of the Army and Marine Corps, and is ending the Army's stop-loss program, through which soldiers' duty can be involuntarily extended.

Obama also wants better screening of returning troops and for commanders to keep working on reducing the stigma some feel over reporting such problems.

All of this will cost money; his administration has boosted VA's budget to the tune of $25 billion over the next five fiscal years.

While expenditures won't solve all the problems, Obama said, "money helps," particularly in providing enough mental health care - to include ensuring that services for female veterans are available at all VA health centers.

Another potential VA health care challenge in coming years may be the rising tide of respiratory illnesses and blood cancers resulting from exposure to smoke from open-air burn pits used for waste disposal in war zones.

Obama said he is familiar with the issue. Acknowledging the long denials of past administrations over concerns such as atomic radiation tests, Agent Orange exposure in Vietnam and Gulf War illness, he said he wants an objective assessment of the burn-pit problem - the "best science possible."

"I don't want us hiding the ball if there's a real problem there," Obama said. "I am absolutely convinced that our commanders in theater are doing everything they can to protect their men and women. The key is to understand that our scientific knowledge and our medical knowledge may evolve. And if we find out that something's wrong, even ... it might not have been anyone's fault ... nobody is served by denial or sweeping things under the rug."

Army Time