Educating Congress: mandatory funding for veterans health care.

Joined by several other veterans service organizations, the DAV continues an all-out grassroots campaign in support of federal legislation to guarantee adequate funds for veterans health care.

"This is an election year and a golden opportunity for Congress to fix the veterans health care funding problem," said DAV National Commander Alan W. Bowers. "DAV members have been urging their Senators and Representatives to support legislation to make veterans health care funding mandatory and we need to ramp up our grassroots efforts on this crucial issue, which is one of our top legislative priorities."

"Bills introduced during the first session of the 108th Congress have bipartisan support in boot the House and Senate," said National Legislative Director Joseph A. Violante. "What's needed, though, is for the congressional leadership to allow, the House and Senate Veterans" Affairs Committees to hold hearings on the two bills so that lawmakers can learn more about the VA health care crisis and our solution to the problem. That means disabled veterans and their families will have to do even more to educate their lawmakers about the importance of mandatory funding for veterans health care and call on them to urge the powerbrokers on Capitol Hill to hold hearings on this vital budget reform."

The Assured Funding for Veterans Health Care Act of 2003 (H.R. 2318) and the Veterans Health Care Funding Guarantee Act (S. 50) both call for a fundamental change in the way government funding is provided for the VA medical system.

"This shift in VA health care funding from a discretionary to a mandatory mechanism would guarantee adequate resources to care for sick and disabled veterans," said Violante, "That's because the current system of discretionary funding has failed to provide adequate resources to meet the growing demand for VA health care."

Soaring medical costs, decades of inadequate appropriations, and increasing demand for medical services have severely hampered timely access to quality health care for our nation's sick and disabled veterans. The President's Task Force to Improve Health Care Delivery for Our Nation's Veterans noted in its final report that if the mismatch between demand for care and available funding is not resolved, it will delay veterans' access to care and could threaten the quality of VA health care.

To solve the problems the task force recommended using a mandatory funding mechanism or some other changes to the current budget and appropriations process.

"Mandatory funding would eliminate the year-to-year uncertainty about resources that has prevented the VA from being able to adequately plan for and meet the constantly growing needs of veterans seeking treatment," said Violante,

"DAV members should contact their Senators and Representatives and urge them not only to support legislation to make veterans health care funding mandatory but to tell the congressional leadership to hold hearings on f 1.R. 2318 and S. 54," Violante said. "America's sick and disabled veterans deserve a fair hearing on this important legislation so lawmakers can make an informed decision on the issue."

"The following position paper, developed by the DAV and other major veterans service organizations. makes a compelling case for why Congress should act to reform the budget for veterans health care," Violante said. "Use it when you talk to your members of Congress or their staffs to help educate them on this vital issue."

Mandatory Funding Will Provide a Comprehensive Solution for VA's Health Care Funding Crisis

We support moving VA health dire from a discretionary to a mandatory funding method. This would not change current eligibility requirements or 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 has prevented the VA from adequately planning for and meeting the growing needs of veterans seeking care.

Congress must enact mandatory funding to ensure:

* VA can timely deliver a comprehensive health care package to all eligible veterans who choose VA.

* VA health care funding is sufficient for VA to carry out all its missions.

Why Is the VA Health Care System in Crisis?

The current discretionary funding method for veterans health care is broken. The needs of our nation's sick and disabled veterans are not being met. Continued funding short-falls, combined with rising costs for care and increased demand liar medical services, have resulted in unprecedented waiting times for routine and specialized medical services nationwide.

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 1990 to $23.9 billion in 2003. VA has received on average only a 5 percent increase in appropriations over the last eight years. However, VA's Under Secretary for Health 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 12004.

Under the current discretionary funding; method:

* 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 modernisation of 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.

President's Health Care Task Force Agrees on the Need for Funding Reform

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 R. 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 (now) 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.

The Task Force also suggested mandatory funding as one option for the government to address the present uncertain access status and funding for Priority Group 8 veterans.

We strongly believe that all enrolled veterans should be included under a mandatory funding mechanism.

In addition, based ore their findings, PTF members believe that even if VA were operating at maximum efficiency, it would be unable to met 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.

Why Is VA Health Care Important?

Health Care Provider: The Veterans Health Administration (VHA), the health care arm of VA, is the nation's largest federal health care provider, encompassing 162 hospitals, more than 850 community-based outpatient clinics, 137 nursing home units, 206 counseling centers, 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 Safety 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, as part of its basic benefits package. 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 Backup: By statute, VA serves as back-up to the Department of Defense and the National Disaster Medical System in times of national emergency or periods 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.

Myths and Realities

Veterans have earned the right to timely access to VA medical care as a continuing cost of national defense. Discretionary funding creates an inherent conflict between open enrollment and constrained resources. Neither Congress nor the Administration has been willing to resolve this issue.

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 not create an individual entitlement to health care or change VA's current mission, eligibility requirements, or 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 using the VA health care system. It would allow for an appropriate annual adjustment for medical inflation so that VA can maintain adequate staff levers 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 how well it runs its health care programs.