Facts support guaranteed funding for VA health care.

The Department of Veterans Affairs medical system is one of the few federal health care programs that is discretionary, which means Congress annually arbitrarily sets the funding limit for those programs. If the funding is exhausted before the end of the fiscal year, the services are curtailed. What is needed is a mandatory or guaranteed funding mechanism that ensures veterans get the health care they need.

Among the federal programs that receive mandatory or guaranteed funding are food stamps, Medicare, Medicaid administration, and VA compensation and pensions. They don't run out of money, and they meet the needs of those eligible.

As veterans urge Congress to enact legislation to guarantee VA health care funding, they are sometimes met with a barrage of arguments that a change in funding would not be beneficial to veterans. The facts do not support the arguments that it is too expensive, too expansive, or won't help veterans. There's a big difference between accuracy and argument. Here are some answers to questions about guaranteed funding for veterans health care:

Q: Would guaranteed funding create an individual entitlement to health care?

A: No it wouldn't. It merely guarantees the funds necessary for VA to fulfill its mission. Each veteran would have to meet the same eligibility requirements. Guaranteed funding does not expand eligibility for VA health care, current benefits, or the VA's mission. Under guaranteed funding, sick and disabled veterans would benefit from adequate funding to treat their health concerns. They wouldn't have to wait for months for a medical appointment because the VA runs low on funding. Veterans also would not leave to annually tight during the budget process to get adequate funding. VA health care funding has been less than adequate for most of the last decade.

Q: Would guaranteed funding open the VA health care system to all veterans?

A: Congress has been there and done that. Lawmakers opened VA health care to all 27 million veterans in 1996, but they didn't appropriate the funds to pay for the large number of veterans who enrolled in the system. So when more veterans enrolled, the demand on services began to grow, putting a strain on the system. Under guaranteed funding, the Secretary of Veterans Affairs would retain the authority to manage enrollment in the VA health care system, such as he did earlier this year when he temporarily halted enrollment of non-service connected veterans able to pay for their own health care. Guaranteed funding would provide adequate services to trait those enrolled in the system, not all veterans.

Q: Wouldn't guaranteed funding for VA health care prove too costly?

A: Actually VA health care is uniquely cost-effective. Washington spends an average of three times as much on individual Medicare recipients than veterans, yet Congress has guaranteed federal funding of Medicare. Veterans suffer from wounds and disabilities incurred during times of war, which private physicians do riot normally have the expertise to treat. Private medical care for service-connected disabilities would be vastly more expensive than that provided by VA. In addition, guaranteed funding would utilize a formula based on the number of unrolled veterans multiplied by the cost per patient, with an annual adjustment for medical inflation.

Q: Are veterans in Priority Groups 7 and 8 using up VA health care resources, making it too costly to treat these veterans?

A: About 2.1 million veterans, or 30% of those enrolled in the VA health care system, are Priority Groups 7 and 8. Yet the VA reported that treating these veterans cost about $2 billion--only 10.5% of its health care budget. Priority Groups 7 and 8 veterans use the VA health care system less than higher priority veterans. About half of Priority Group 7 and 8 veterans are eligible for Medicare. In effect, it costs the government less to treat Priority Groups 7 and 8 veterans in the VA health care system than Medicare. Guaranteed VA health care funding would save the government money, even for Priority Groups 7 and 8.

Q: is it true that Congress could no longer control the VA health care system if funding was guaranteed?

A: Congress would retain oversight of VA programs and health care services, and VA would still be accountable to Congress for how it spends its money and how it runs health care programs. Congress guarantees disability compensation, but it retains and employs strong oversight control. Because VA health care funding currently is discretionary, Congress is able to siphon money from VA to pay for pork-barrel projects. VA health care should not be a piggy bank for pet projects and special interests.

Q: Can the viability of the VA health care system be maintained if it treats only service-connected veterans or Priority Groups 1-6?

A: No. In fact, just the opposite is true. It is all economy of scale. VA health care is cheaper by the dozen. The VA health care system must treat a sufficient number of veterans to remain viable. Reducing the number of veterans receiving health care jeopardizes VA's leadership in prosthetics, spinal cord injuries, blind rehabilitation, mental health, and traumatic brain injuries. A proper mix of severely disabled patients and those with less severe conditions allows medical care providers to retain a comprehensive range of health care skills. VA health care should offer preventive, primary, and specialty care, as well as acute care when needed. Since the growth rate for Priority Groups 1-6 veterans is only 5% annually, compared to a 25-30% annual growth rate for Priority Groups 7-8 veterans, limiting VA health care solely to service-connected veterans could ultimately lead to the dismantling of the VA health care system altogether.

Q: Is it true that providing guaranteed funding for VA health care would not solve the problem of health care shortages and long waiting times?

A: It is not a case of trying to solve the problem by throwing money at it, as some in Congress often say. The lack of adequate VA health care is a problem of inadequate resources. After decades of flat-lined, inflation-eroded appropriations, the VA health care system is effectively on life support. VA needs adequate funds to hire health care professionals to care for veterans in a timely manner, to effectively manage its health care programs, and to prepare for contingencies, such as the War on Terror and the Iraq War. Congress would retain oversight and hold VA accountable for the operation of its health care system, but VA must be given the tools to adequately do its job.

Q: Shouldn't veterans health care be privatized because it is too big, inefficient, and unresponsive to veterans?

A: The fact is that there are no cost savings, but cost increases, when veterans are sent to private physicians and hospitals. The quality of care would not improve because the private sector is not well versed in treating the unique injuries suffered by veterans. For example, the cost of transplants paid by private insurance companies and Medicaid is much higher than the VA's, but the VA patient survival rate exceeds the private sector averages, even though VA's patients are generally in the higher risk category. In addition, private sector physicians would not want all VA patients, who are often elderly, have multiple disabilities, or are chronically ill. They would pose too great an underwriting risk for private insurers and health maintenance organizations. The VA, however, offers a wide range of very specialized care to meet the unique needs of veterans. Further, VA provides one-third of all care provided for this nation's chronically mentally ill. It is the largest source of health care for AIDS-related disorders. No one in the private sector would want to assume those huge missions.

Q: Are veterans a national priority for Congress and the Administration?

A: Yes and No. Uniformly Congress and the Administration broadly support veterans programs. It's just when it comes time to pay the bill that both get stingy. Congress is quick to authorize necessary and vital new health care programs for veterans, but it rarely backs it with funding. Congress was quick to authorize programs to provide long-term care for severely disabled veterans, emergency care for certain veterans, and treatment for hepatitis C, but it has failed to fund these programs. VA has been forced to take funds from other programs to fulfill the will of Congress. This problem would be eliminated under guaranteed VA health care funding. It's difficult to witness Congress and the Administration spend billions on pet projects while veterans must wait months for proper health care.

Q: Doesn't the government already provide mandatory health care funding for veterans under TRICARE for Life?

A: True. But it is available only to those veterans who are Medicare eligible military retirees. Most veterans are citizen soldiers, who did not enjoy a military career. TRICARE for Life only affects one class of veterans, those Medicare-eligible military retirees, although the Administration has recommended that the mandatory military health care program be expanded to all military retirees.

Q: With 2.3 million disabled veterans, why should the government guarantee health care for all enrolled veterans?

A: Pearl Harbor, Guadalcanal, Tarawa, Normandy, Okinawa, The Bulge, Korea, Vietnam, Beirut, Somalia, Panama, The Persian Gulf, Afghanistan, Iraq. While not all veterans were injured in service to our country, we all served with honor and fulfilled our commitment to our nation in its time of need. Congress has determined that all veterans are eligible to receive health care from the VA.

Again, it serves the needs of service-connected disabled veterans to have other veterans enrolled in the system so that we can receive the full continuum of care, now and in the future, when our newest disabled veterans from Afghanistan and Iraq will need health care services.