We support moving veterans health care from a discretionary to a mandatory funding method. This would neither change current eligibility requirements nor create a new entitlement benefit. Providing quality, timely health care services for veterans disabled as a result of military service should be a top priority. Guaranteed funding would eliminate the year-to-year uncertainty about funding levels that have prevented the Department of Veterans Affairs (VA) from adequately planning and meeting the growing needs of veterans seeking care.
- VA can deliver a comprehensive health care package in a timely and cost-effective manner to all eligible veterans who choose VA as their health care provider.
- VA health care funding is sufficient for VA to carry out all its missions.
The current discretionary funding method for veterans health care is broken. The needs of our nation's sick and disabled veterans are not being adequately met. Continued funding shortfalls, combined with rising costs for care and increased demand for medical services, have resulted in unprecedented waiting times nationwide for routine and specialized medical services.
VA's enrolled patient population surged from 2.9 million in 1996 to 6.8 million in 2003, a 134 percent increase. However, appropriated funding for VA medical care only increased 44 percent from $16.6 billion in 1996 to $23.9 billion in 2003. VA has received on average a 5 percent increase in appropriations over the last eight years. However, VA's Under Secretary for Health has testified that VA requires, at a minimum, approximately a 14 percent increase annually just to maintain current services. In addition, VA projects enrollment will exceed 7 million in 2004.
- VA health care funding has failed to keep pace with medical inflation and the changing needs of the veteran population.
- VA has been forced to ration care by denying services to eligible veterans and curtailing needed medical treatment.
- VA has had to forgo the modernization of many of its facilities and the purchase of necessary state-of-the-art medical equipment.
- Veterans are unfairly subjected to the annual funding competition for limited discretionary resources.
In May 2001, President Bush signed Executive Order 13214 creating the President's Task Force to Improve Health Care Delivery for Our Nation's Veterans (PTF). Former Administrator of the Centers for Medicare and Medicaid Services Dr. Gail Wilensky, and former Congressman John Paul Hammerschmidt were appointed as Co-Chairs.
The PTF identified a significant mismatch between demand for VA services and available funding which, if left unresolved, would delay veterans' access to care and threaten the quality of care provided. Under Recommendation 5.1, the PTF states,
The Federal Government should provide full funding to ensure that enrolled veterans in Priority Groups 1 through 7 (new) are provided the current comprehensive benefit in accordance with VA's established access standards. Full funding should occur through modifications to the current budget and appropriations process, by using a mandatory funding mechanism, or by some other changes in the process that achieve the desired goal.
In January 2003, the Secretary of VA suspended new enrollments of Priority Group 8 based on an insufficient budget. The PTF stated, "Individually [these] veterans do not know from year to year whether they will have access to VA care, and as an organization, VA cannot effectively plan or budget, given the uncertainty." The PTF declared the current situation with regard to Priority Group 8 is unacceptable, and recommended the President and the Congress work together to resolve the status of this group of veterans.
The Partnership for Veterans Health Care Budget Reform, made up of The American Legion, AMVETS (American Veterans), Blinded Veterans Association, Disabled American Veterans, Jewish War Veterans of the USA, Military Order of the Purple Hart of the U.S.A., Inc., Paralyzed Veterans of America, Veterans of Foreign Wars of the United States, and Vietnam Veterans of America, strongly believes that all enrolled veterans should be included under a mandatory funding mechanism.
Based on their findings, the PTF recognized that even if VA were operating at maximum efficiency, it would be unable to meet its obligations to enrolled veterans with its current level of funding.
The Administration and Congress must move forward on the recommendations of the PTF, and support a permanent solution to resolve what has become an untenable situation.
Health Care Provider:
The Veterans Health Administration (VHA), the health care arm of VA, is the nation's largest health care provider, encompassing 162 hospitals, more than 850 community and facility-based outpatient clinics, 206 counseling centers, 137 nursing home units, and 43 domiciliaries.
Specialized Care:
VA Provides a wide range of specialized services unmatched by the private sector, tailored to meet the unique needs of veterans: spinal cord injury medicine, blind rehabilitation, amputee programs, advanced rehabilitation, prosthetics, traumatic brain injury and posttraumatic stress disorder treatment, extended mental health and long-term care programs.
Cost-Effective Care:
Studies continue to show that the VA health care system is more cost-effective than comparable private-sector health care.
Long-Term Care:
VA provides long-term care for thousands of veterans annually. VA is also the nation's leader in geriatric research, education and training.
Health Care Saftey Net:
Last year, 4.5 million service-connected disabled and low-income veterans relied on VA for all or part of their health care. As an added benefit to states, the veterans health care system acts as a safety net for these veterans, keeping them off state programs.
Research:
VA is the nation's most clinically focused setting for medical and prosthetic research; VA scientists have been awarded three Nobel Prizes. Major breakthroughs pioneered at VA include the cardiac pacemaker, the CAT scan, and the development of radio-immune assay techniques.
Medical Education:
VA partners with 107 medical schools and 2,000 colleges or universities. More than half of the nation's practicing physicians receive all or part of their training in VHA. VA's academic affiliates train more than 85,000 health care professionals each year. Affiliations bring first-rate health care providers along with state-of-the-art medical science to the service of America's veterans. Veterans get excellent care, society gets well-trained doctors and nurses, and the taxpayer pays a fraction of the market value for the expertise the academic affiliates bring to VA.
Special Missions:
VA offers comprehensive mental health services, including programs for substance abuse and the chronically mentally ill. VA is the largest provider of health care for veterans with HIV/AIDS and hepatitis C. One-third of the nation's homeless are veterans, and VA has developed broad-reaching programs to address their psycho-social needs.
National Emergency Back-Up:
By statute, VA serves as a back-up to the Department of Defense and the National Disaster Medical System in times of national emergency or period of war.
Savings For Other Federal And State Programs:
The acute and long-term care services VA provides subsidize Medicare and Medicaid programs at great savings to the Medicare Trust Fund and the taxpayer.
Jobs:
VHA employs 180,000 full-time health care professionals and support staff in cities and communities across the United States.
Myth: Mandatory funding would create a new entitlement.
Reality: Mandatory health care funding would only change the way funds are provided for VA health care. It would neither create an individual entitlement to health care, nor change VA's current mission, eligibility requirements nor medical benefits package.
Myth: Mandatory funding would result in run-away costs.
Reality: Mandatory health care funding would ensure that VA only receives sufficient resources to care for veterans who use the VA health care system. It would allow for an appropriate annual adjustment for medical inflation so that VA can maintain adequate staff levels and keep pace with increased costs for medical equipment, supplies and pharmaceuticals. The price of veterans' health care is a continuing cost of our national defense.
Myth: Congress would lose oversight over the VA health care system if VA shifted from discretionary to mandatory funding.
Reality: As it does with other federal mandatory programs, Congress would retain oversight of VA programs and health care services. VA would still be held accountable for how it spends its money and who well it runs its health care programs.
The above information was compiled by The Partnership for Veterans Health Care Budget Reform.
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