ZEPHYRHILLS — Veteran James Carroll is supposed to get free and complete medical care from the Department of Veterans Affairs.
The trick is getting in the door.
Carroll, 64 and dying of chronic lymphocytic leukemia, said the James A. Haley VA Medical Center in Tampa has repeatedly refused to admit him for a reason that is no fault of his own:
Haley is too crowded.
So the Zephyrhills resident said he has been forced to get care outside the VA medical system, personally accumulating thousands of dollars in medical expenses that he thinks the VA should pay.
The VA refuses.
Some veteran advocates say Carroll is one of many veterans around the nation who have been denied access to VA health care and then forced to foot their own medical bills when they seek care elsewhere.
"I was a good soldier," said Carroll, an Air Force veteran who served four years ending in 1968. "I did what I was told. I don't want to break the VA's bank. I don't want anything that should not be mine. But the government needs to keep its word to me."
Carroll has been forced out of his rental home for lack of rent money. He is living in a trailer on family property near his sister.
The VA has told Carroll that because he has insurance — Medicare — the agency is not responsible for any costs he incurs outside the VA.
Carroll said he owes thousands of dollars — he has lost track of the exact figure — in co-pays and deductibles not covered by Medicare.
The VA said in a statement that federal law ties its hands and that it is not allowed to cover medical costs for veterans in Carroll's predicament.
"It's a disgrace," said Paul Sullivan, executive director of Veterans for Common Sense, an advocacy group frequently critical of the VA. "And it's difficult for veterans who are very ill to fight a big bureaucracy alone."
Haley officials say they cannot discuss Carroll's case because of privacy concerns.
But Carolyn Clark, a spokeswoman for Haley, said the hospital, one of the busiest VA facilities in the nation, has made great strides in reducing the times it turns patients away.
Such incidents are called "bypasses" and occur at all hospitals, VA or not, when their beds are full or if emergency rooms become too crowded.
"Space on the main hospital campus is a definite issue," Clark said in an e-mail. "We're working hard to free up additional bed space by expanding on-site, by reallocating space within the hospital, and by moving outpatient functions off-site."
Clark, while refusing to confirm or deny that Carroll has been turned away, said: "It's not a question that the VA is too busy to treat him. If he is an eligible veteran, we will treat him."
Carroll moved from North Carolina less than a year ago to be with his sister in Zephyrhills. A former hospital chaplain, he had been ill with leukemia for almost a decade. Doctors are unsure how long he will live.
Carroll hadn't realized he was eligible for VA care until his sister, Nancy McEndree, began investigating after he arrived in Florida. Soon, the VA decided he was eligible for full care at Haley.
Carroll believes his leukemia was caused by exposure to Agent Orange, widely used in Korea, where Carroll served in 1968.
But the VA, though agreeing to provide Carroll with medical care, refused to give him a higher disability pension that he would be eligible to get if he could prove Agent Orange caused his cancer.
The VA has said it will pay him a $1,500-per-month pension, though Carroll has yet to see a dime. The amount might be nearly doubled if Agent Orange is ever found to be the cause of his illness.
Carroll has been able to get his drugs from Haley without cost. And he has visited doctors there. The problem comes when he is so sick that he needs to be admitted.
In May, McEndree first called paramedics when her brother was having difficulty breathing. Paramedics told her, she said, that they couldn't take Carroll to Haley because it was too packed.
Why wouldn't the VA send Carroll to the VA's Bay Pines hospital in St. Petersburg or some other VA facility?
Carroll, relatively new to the area, and his sister didn't realize the VA had a second hospital in Pinellas. So they said they never thought to ask about going there.
And in any case, a Haley spokeswoman said, the VA prefers that in emergencies, paramedics take veterans to the closest alternative hospital.
After that first hospitalization, McEndree said, her husband called Haley the next day to ask that Carroll be transferred.
"They said they couldn't take him for at least a month," McEndree said.
McEndree said she called the VA up to 10 times in the subsequent months. Each time, she said, she was told the hospital was too full to accept Carroll. The last time she said she was told that was about three weeks ago.
Carroll's health has been up and down since he started living in Florida, and he has been admitted to a non-VA hospital up to five times for varying lengths of time.
Last week, Carroll was admitted to Florida Hospital Zephyrhills for heart problems related to his leukemia. Carroll, who has long outlived doctors' expectations, was released Wednesday after six days.
To Carroll, VA rules are a maddening injustice.
"It's blatantly unfair," he said. "There's no justification for this. Bureaucrats are making the decisions, not doctors. And they're playing God."
William R. Levesque can be reached at (813) 226-3436 or firstname.lastname@example.org