THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Monday, June 5, 1995 TAG: 9506010015
SECTION: FRONT PAGE: A6 EDITION: FINAL
TYPE: Editorial
LENGTH: Medium: 55 lines
The tough budgets proposed by House and Senate Republicans are supposed to be evenhandedly attacking wasteful and outmoded government programs, but one has conspicuously avoided the ax. It's VA, particularly its health-care component.
The VA budget is $38 billion. About half of that goes to hospitals and clinics. If private, its 171 hospitals would constitute the largest health-care chain in the country. Is this money well-spent?
There's reason to doubt it. VA's patient base is shrinking as old soldiers fade away. The VA medical system was created before other government programs that now outperform it. Today, 89 percent of veterans get their health care elsewhere. VA treats 56 percent fewer inpatients than it did 25 years ago, yet its budget rises annually.
In part, that's because the average VA patient costs almost 60 percent more to treat than the average patient on Medicare or Medicaid. At a time when the private sector is closing hospitals that don't attract customers, VA is considering opening new ones. Yet existing facilities are underutilized. Though private health care is becoming more efficient, VA is regularly cited for waste and inefficiency.
That should make VA a ripe target for budget cutters. And it is, in theory. The conservative Heritage Foundation says veterans should be given vouchers for private health care or simply shifted to existing programs. The AMA says VA hospitals are dinosaurs and ought to be phased out. In practice, however, even Heritage admits there's no serious support for cuts or reform in Congress or the White House.
Vice President Al Gore has unveiled a reinventing government proposal that would cut $209 million from VA by streamlining paperwork and cutting inefficient rules, like one requiring expensive inpatient care when outpatient services would do. But these proposals are a drop in the bucket.
Republicans don't go much further. The House budget proposes a 3 percent cut over seven years. The Senate would cut 5 percent. But that's tinkering around the edges of the problem. The reason for the reluctance to cut isn't hard to determine.
Veterans have clout. Reform is all too easy to portray not just as reneging on a deal but as an unpatriotic act. Politicians have no stomach for tangling with an interest group able to deploy that kind of heavy artillery.
That leaves a program essentially untouched that even veterans have largely turned their backs on. Hippocrates, the father of medicine, said that for extreme ills extreme treatments are most fitting. VA health care is in an unhealthy condition that contributes to a killing deficit. Drastic remedies are called for, but so far neither party has prescribed more than a Band-Aid. by CNB