House, Senate disagreeon how to fix V.A. system

Conference committee now seeks resolution

6/19/2014

McCain

ANDY KROPA/INVISION/AP

WASHINGTON — Hire more doctors, build more medical centers, or expand the use of outside providers of medical care for veterans.

The House and Senate can’t agree on the best way to address long wait times for care that were exposed recently in a scandal involving allegations of falsifying records at Veterans Affairs medical centers.

However, lawmakers universally agree something must be done to ensure veterans receive in a timely manner the health benefits earned through their military service.

The House on Wednesday rejected the Senate’s proposed fix, preferring its own plan. That triggered a conference committee whose work eventually will get an up or down vote in each chamber without amendment.

Sponsored by Sen. John McCain (R., Ariz.), and Sen. Bernie Sanders (I., Vt.), the Senate bill would have funded the opening and staffing of 26 additional V.A. medical centers to meet demand. Until the new centers are running, it would have permitted veterans to seek private treatment at government expense whenever the agency cannot provide timely and local care.

It also would have made it easier for the V.A. secretary to fire employees for poor performance and would have provided funds to hire more doctors and nurses and open new facilities to meet the demand for services.

The House fix, meanwhile, would direct the agency to contract with non-V.A. facilities when government facilities cannot provide timely service within 40 miles of a patient. It also includes a two-year moratorium on bonuses for agency employees and a provision making it easier for the secretary to fire or reassign top-level employees.

Earlier Wednesday during a committee hearing, Veterans Affairs Chairman Jeff Miller (R., Fla.) pressed for increased use of private facilities to treat veterans.

Others pointed out that the agency already uses outside providers when it can’t provide the needed services, when late times are exceedingly long, or when it would be impractical for veterans to travel long distances sometimes required to obtain services at government facilities.

Mr. Miller said V.A. leaders haven’t prudently used their authority to augment agency services with private care.

“The V.A. has made it disturbingly clear it is unwilling to use existing V.A. authority when and where it should … and thousands of veterans have paid the price,” he said during Wednesday’s committee hearing.

Mr. Miller said his goal is to augment agency capabilities, not dismantle the system. Contracting for additional outside services would be much faster than hiring more staff and building new facilities, he said.

The agency spent about $4.8 billion on outside care, or 11.6 percent of its medical services budget.

The Block News Alliance consists of The Blade and the Pittsburgh Post-Gazette. Tracie Mauriello is a reporter for the Post-Gazette.

Contact Tracie Mauriello at: tmauriello@post-gazette.com, or 703-996-9292.