Congress is moving to reopen the Veterans Administration’s health care system to many more thousands of veterans who aren’t poor and have no service-related ailments.
Disabled American Veterans and some partner organizations support such a move but with two caveats, DAV representatives say.
First, accepting the enrollees should be gradual to protect access to care for service-disabled veterans and all other existing enrollees.
Second, adding veterans described as members of Group 8, who were suspended in 2003, should not occur without more money to ensure that the hospitals become “sufficient, timely and predictable,” said Joseph Violante, DAV’s legislative director.
Congress has refused to pass a law that would mandate full funding of VA health care based on the number of enrollees. But Violante said disabled veterans’ group has joined with eight other service organizations to back an alternative to mandatory funding that lawmakers are more likely to embrace.
Adding more people brings new urgency to issue to provide more money to VA hospitals, he said.
The Veterans’ Health Care Budget Reform Act, to be introduced after lawmakers return from recess in September, has two parts. One would advance approval of VA budgets, which traditionally don’t keep up with hospital needs.
Bob Perrault, who ran VA hospitals in several cities before retiring in 2004, said the old budgeting process never kept pace.
“We’d stopped buying equipment,” he said. “We’d stopped doing maintenance just to try to maintain (staff) as long as we could. But even then we’d reach a crucial point where we would have to freeze hiring though we needed the staff to treat increasing demands from patient populations.”
Part two of the reform package would seek to keep funding levels sufficient. Until very recently, VA health budgets were sharply underfunded, Violante said. Yet Congress declines to support a mandatory full funding law, arguing that it limits congressional prerogatives.
What the disabled veterans group and fellow organizations in the Partnership for Veterans Health Care Budget Reform now propose is that VA be directed to use a new actuarial model it has developed which very accurately can project the per capita cost of providing health care to its enrolled patient population.
The partnership’s proposal would require the Government Accountability Office to verify annually the accuracy of these VA health cost projections so everyone knows the cost of continuing to provide services to the number of enrolled veterans.
If the administration then were to seek a budget that fell short of covering those projected costs, the White House would have to explain why, both to Congress and to veterans, and the political heat could be severe.
VA now won’t share what its actuarial model shows about proper funding of VA health care, said Peter Dickinson, a consultant to the disabled veterans group and former staff member on the House Veterans Affairs Committee.
“It’s sort of behind the curtain, inside the black box. Instead they put forward a number that may or may not be based on that but also reflects other priorities” of the administration, Dickinson said.
Requiring an annual audit to force VA to reveal what health care spending must be to support full services to all VA patients would make it politically difficult to short these budgets in the future, Dickinson said.
“If we can get a budget process that’s a year in advance and based on numbers we can look at,” Dickinson said, the cost of re-enrolling the Group 8s veterans would be known and presumably fully funded.
If health budgeting isn’t reformed, and enrollment doors swing open, “we could be in danger of returning to the days of ‘03 and ‘04 when more than 300,000 veterans waited six months or longer to get an appointment,” he added.
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