MILITARY UPDATE
Full VA health budgeting sought
Military Update focuses on issues affecting pay, benefits and lifestyle of active and retired servicepeople. Its author, Tom Philpott, is a Virginia-based syndicated columnist and freelance writer. He has covered military issues for almost 25 years, including six years as editor of Navy Times. For 17 years he worked as a writer and senior editor for Army Times Publishing Co. Philpott, 50, enlisted in the U.S. Coast Guard in 1973 and served as an information officer from 1974-77.
By Tom Philpott
The House Veterans Affairs Committee chairman, Republican Rep. Chris Smith of New Jersey, has introduced a bill to require full financing of Department of Veterans Affairs health budgets to ensure timely care to almost all enrolled veterans, including many with no service-connected ailments.
Smith's bill, HR 2475, would create an independent panel of economists to set healthcare financing levels for the Department of Veterans Affairs based on needs of patients enrolled in Priority Groups 1 through 7. Group 7 is made up of vets with no service-related ailments who have incomes above a national VA means test but whose earnings still fall below a government index of pay adequacy for their geographic area.
The President's Task Force to Improve Health Care Delivery for Our Nation's Veterans released a report in late May saying veterans deserve predictable access to care. One way to do that is to mirror full-financing protections that Congress set for Department of Defense budgeting to ensure care to elderly military retirees under TRICARE for Life.
A second part of HR 2475 would force the VA to meet its own access-to-care standards. If a patient seeking nonemergency care can't be seen within 30 days, for example, the VA would have to contract for a non-VA provider.
Rep. Rob Simmons, R-Conn., health subcommittee chairman, joined Smith in launching the bill. Despite a 49 percent rise in VA healthcare budgets since 1996, hundreds of thousands of patients still wait six months or more to see a primary-care physician, Smith said, because the system has seen a 70 percent rise in patients during the same period.
Not all that growth is from open enrollment. The VA made a dramatic shift in care delivery, expanding from 170 VA hospitals into hundreds of local, more accessible clinics.
Rep. Steven Buyer, R-Ind., blames the clogged VA healthcare system not on a lack of money but on a mistake he and other committee members made in 1996, voting for open enrollment to keep the new clinics full.
Buyer said rosy predictions by committee leaders and veterans groups that the move would be 'budget neutral' because of system efficiencies, co-payments charged to Group 7 and 8 enrollees and collections from employer health insurance plans for VA-provided care proved wrong.
Priority 7 and 8 veterans added $2 billion, about 10 percent, to VA healthcare costs last year. Buyer said many of these veterans sought care to get VA drug discounts.
Robert W. Spanogle, national adjutant of the American Legion, is one of three task force commissioners to dissent on the full-financing recommendation.
Spanogle criticized arguments made by Buyer and others that VA healthcare was intended only for "core veterans" — those disabled through service or in financial need.
"Contrary to comments made during commission meetings, there are no core veterans," he said. "A veteran is a veteran. The traditional veteran treated in VA medical facilities is any veteran needing medical care."
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