Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, July 2, 1995                   TAG: 9507060003
SECTION: EDITORIAL                    PAGE: F-2   EDITION: METRO 
SOURCE: RICHARD GRANT
DATELINE:                                 LENGTH: Medium

VETERANS' HEALTH CARE IS COMING UNDER THE BUDGET KNIFE

Despite statements from some quarters that veterans' programs have escaped the budget ax, these programs have been hit hard! Cuts in veterans' health care and benefits contained in the deficit-busting budget proposed by Congress go far beyond the fair share expected by most Americans to help this nation get its fiscal house in order. In fact, cuts proposed for veterans' programs will be disastrous.

Budget proposals being considered by Congress would result in significant cuts in veterans' entitlement, construction and support programs - $8.3 billion in the House and $15 billion in the Senate. But largely unreported due to budget gobbledegook, these budget proposals also would freeze total funding for the Department of Veterans Affairs hospital system for the next seven years. Medicare and Medicaid get nominal, if inadequate, increases under both budgets over that same time period. The result to the VA system, according to Senate and House budget resolutions, would equate to losing nearly one-quarter of the VA work force and up to 41 300-bed hospitals.

VA critics also say veterans' programs were immune from cuts in recent years. This isn't true. In 1986, Congress means-tested health care for veterans with nonservice-connected disabilities, all but denying access to the system to 17 million of the then-28 million veterans. The action saved government billions of dollars by drastically rationing care for the growing number of aging World War II and Korean War veterans.

Subsequent federal budget cuts have reduced veterans' entitlement and discretionary spending by more than $10 billion. At the same time, some veterans were required to pay for using VA services through their own insurance, user fees, copayments and deductibles. These payments, designed to offset the cost of VA care, will go straight to the U.S. treasury and reduce the deficit by some $5 billion during the next seven years. Budget reductions have forced VA to reduce its work force by some 3,500 hospital workers in the past two years, and to close more than 32,500 acute operating beds in the past 15 years.

Media reports routinely repeat statistics from VA critics who use distorted calculations to state that "only" 10 percent of the veteran population utilize and therefore somehow ``like'' to go to the VA. This ignores the fact that only 41 percent, approximately 11.5 million of our country's 27 million veterans - mostly veterans with service-related disabilities and means-tested low-income veterans - are even eligible for most VA services. Of those, according to the VA patient-treatment file, nearly 4.9 million individual veterans relied on VA services during 1987 to 1992, or approximately 50 percent. Simple logic indicates that multiyear usage of a hospital system is a far more accurate gauge to determine true use and need than the one-year snapshot critics consistently quote.

The debate also ignores the fact that VA is a unique national resource, providing care to a population that is older, suffering from chronic disabilities, and in need of expensive long-term acute and sustaining care. Closing VA hospitals would shift the burden for that care to already overburdened Medicare, Medicaid and the private sector. For our country's most seriously disabled veterans, specialized services in areas such as spinal-cord injury, blind rehabilitation, prosthetics and mental health generally aren't available elsewhere, even if a way could be found to pay for them.

Veterans' groups share the concern that federal expenditures must be brought under control, and have conducted studies on how to make VA more efficient. To our disappointment, a VA reform plan developed and widely circulated by our organization, AMVETS, Disabled American Veterans and Veterans of Foreign Wars hasn't been considered seriously by Congress. Our proposal would streamline VA health care, provide flexibility to shift care from inpatient to more efficient outpatient settings, and save $2 billion next year.

We're not suggesting that VA shouldn't be scrutinized, but feel that media coverage of veterans' programs should reflect VA health-care services as they really are - not just as VA critics state they are.

Richard Grant is national president of the Paralyzed Veterans of America in Washington, D.C.