Joined: Sat May 29, 2004 11:46 pm
House's new VA chairman tightens purse strings
Inclusion of all veterans threatens health care system, Indiana congressman says
By Tom Philpott
U.S. Rep. Steve Buyer, R-Ind., chairman of House Veterans Affairs Committee, says the medical and rehabilitation needs of a new generation of war veterans leave him more certain than ever that Congress erred in 1996 when it opened VA health care to any veteran willing to pay modest fees.
"While some veterans organizations like to create a theme, that 'a veteran is a veteran and there is no difference,' I disagree," Buyer said.
A decade ago in the wake of a Persian Gulf War, which saw relatively few U.S. casualties, the Department of Veterans Affairs went back to worrying about an aging patient population and underused VA clinics and hospitals, Buyer said. Those concerns, along with wishful thinking about the VA billing private-sector insurance plans for the cost of care, led Congress to open VA facilities to veterans who were neither poor nor disabled.
Time has shown that to be a mistake, Buyer said. Today, the VA has $3 billion in uncollected debt for health care rendered that insurance companies have not paid.
"And we find ourselves now in protracted wars in Iraq and Afghanistan, and the war on terror all over the world. So, the sense from 1996 that we could open up the VA to protect the bricks and mortar because of a declining population of veterans," Buyer said, is replaced by "the reality that we have more veterans now that have to come into the system."
Buyer's comments came days after his committee voted to impose an enrollment fee of $230 to $500 a year on 2.4 million veterans in priority categories 7 and 8, those who are not poor and have no service-connected disability.
In January, Republican leaders removed Rep. Christopher Smith, R-N.J., as committee chairman for being too close to veterans groups, too supportive of expanding benefits and too dismissive of Bush administration plans to slow VA spending and impose fees on low-priority veterans.
His replacement, Buyer, 46, is a blunt-spoken attorney who was deployed in first Gulf War as an Army Reserve lawyer. With oversight responsibility now for the second largest department in government, Buyer said he has three short-term priorities:
* Refocus VA health care on its traditional core constituency of service-disabled, indigent and special-needs veterans.
* Develop a "seamless transition" process for veterans moving from active duty to VA care. So far, more than 10,000 have been wounded in Iraq and Afghanistan, and as many as 100,000 could have post-traumatic stress, Buyer said. "The VA needs to prepare to receive them."
* Improve VA rehabilitation and vocational training to ensure that even the most severely injured veterans return to rewarding lives.
"For a lot of years," Buyers said, "it was, 'Here's your check. Good luck in your life. And if you find it in a bottle, we'll try to get you in a program.' I want the system to be far more personal."
Buyer also said he expects a new bipartisan Veterans Disability Benefits Commission, which will hold its first meeting soon, to review whether Congress went too far in allowing concurrent receipt of military retirement and VA disability payments. Buyer said that as chairman of the House subcommittee on military personnel a few years ago, he "found $25 million" to lift the concurrent receipt ban only for 100-percent, combat-disabled retirees.
Buyer also expects the commission to consider whether to change the way disability ratings are set or to tighten the definition of service-connected injuries or ailments.
"There is something bothersome in the system where you can have a soldier blow out his knee from a roadside bomb and end up with a disability (benefit) that's the same as a guy who blew out his knee sliding into home plate at church league softball on Sunday," said Buyer. "Is that the type of disability system that is just and fair?"
Buyer said he wouldn't want to assure current veterans with disability ratings that they will be excluded from commission recommendations. "Everything should be on the table," he said.
An idea Buyer wants considered is offering lump-sum payments to veterans with disabilities rated 20 percent or less as settlement of all future compensation claims.
"Part of the problem is there's gamesmanship in the system whereby veterans consistently over their lifetimes keep reapplying for their ratings, trying to get bumped up higher and higher," Buyer said.
Veterans organizations that claim all veterans have earned the right to VA health care, and use what Buyer sees as inflammatory rhetoric to attack proposals they dislike, are abandoning values such as duty and sacrifice, he said.
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