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[Congressional Record Volume 141, Number 78 (Thursday, May 11, 1995)]
[Extensions of Remarks]
[Pages E1014-E1015]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

          WHY AMERICA NEEDS A DEPART- MENT OF VETERANS AFFAIRS

                                 ______

                      HON. G.V. (SONNY) MONTGOMERY

                             of mississippi

                    in the house of representatives

                         Thursday, May 11, 1995
  Mr. MONTGOMERY. Mr. Speaker, I am pleased to share with my colleagues 
a letter written by the Honorable Jesse Brown, Secretary of the 
Department of Veterans Affairs, to Mr. Stuart Butler, Vice President of 
The Heritage Foundation. The letter is in response to The Heritage 
Foundation's proposal to eliminate the Department of Veterans Affairs 
and establish it as a bureau within the Department of Defense.
  I believe Secretary Brown's remarks point out how important it is to 
maintain the Department of Veterans Affairs. In the wake of all the 
``myths'' being printed in the media about the Department's facilities 
and the services it provides, the facts laid out in Secretary Brown's 
letter make for very compelling reading.

                            The Secretary of Veterans Affairs,

                                         Washington, May 10, 1995.
     Mr. Stuart Butler,
     Vice President, The Heritage Foundation, Massachusetts Avenue 
         NE., Washington, DC.
       Dear Mr. Butler: I was rather perplexed when I read your 
     proposal to eliminate the Department of Veterans Affairs and 
     establish it as a bureau in the Department of Defense. 
     Likewise, I was mystified by some of the specific program 
     recommendations in your report on ``Rolling Back 
     Government.'' About the only statement that I agree with is, 
     ``The care of Americans who have served their country in the 
     armed forces is a core function of the federal government.'' 
     At least you are right in that regard.

                             Cabinet Status

       VA was elevated to Cabinet status in 1989 after years of 
     congressional deliberation. President Reagan agreed with 
     Congress that the agency charged with administering benefits 
     and services to our veterans and their dependents (who now 
     number 26 million and 44 million, respectively) belongs at 
     the Cabinet table when issues are being formulated and acted 
     upon. President Reagan was right. Your report portrays VA as 
     an inefficient bureaucracy while offering no evidence in 
     support of such a statement. I am curious how you arrive at 
     the conclusion that the existing structure for providing 
     veterans benefits and services would become more efficient 
     with another layer over it, that of the Office of the 
     Secretary of Defense, and possibly others. Further, if VA 
     were to be made a bureau within DoD, the Nation's obligations 
     to our veterans would constantly be at risk of being 
     subordinated to National defense and security needs, 
     particularly in time of conflict or great danger. The lack of 
     wisdom of placing veterans programs in such a precarious 
     position has been obvious to Congress and Presidents for many 
     decades. How could you possibly fail to realize--or even 
     address--the fact that a separate VA assures that veterans' 
     needs are addressed on their own merits and not based on 
     whether our Nation needs to spend more or less on defense?
                        disability compensation

       Turning to the proposals you make for specific VA programs, 
     I found it extremely ironic that, in the name of ``allowing 
     veterans to enjoy the benefits of privately provided . . . 
     retirement services'' and modernizing the VA disability 
     compensation program, you simply propose taking away 
     compensation from certain veterans. One group who would 
     [[Page E1015]] ``benefit'' from your efforts to bring VA up 
     to the private, modern standards you admire are veterans with 
     service-connected injuries or illnesses rate 10% or 20% 
     disabling who do not meet an economic-need test that you 
     failed to disclose and, thus, would lose their benefits. 
     These veterans could have lost two fingers or four toes, or 
     they might have persistent, moderate swelling of a foot as a 
     residual of frostbite, or any of a wide range of other 
     impairments--for which VA pays about 1.2 million veterans 
     monthly compensation in the amount of $89 (the 10% rate or 
     $170 (the 20% rate). These veterans, the target of your 
     efforts to provide the ``benefits'' of what the private 
     sector provides, will certainly be grateful for your efforts. 
     I am also certain that they will find dismaying, as will all 
     disabled veterans and all other Americans with disabilities, 
     your unfounded conclusion that ``[d]isabity is no longer a 
     major hindrance in finding work.''
       You also urge that disability compensation payments be 
     limited to those disabled as a result of ``direct'' active 
     duty experiences. This apparently would mean that 
     compensation would no longer be paid for disabilities 
     incurred during military service unless it can be shown they 
     were caused by the performance of official duties. However, 
     military personnel are considered to be on duty 24 hours a 
     day and are subject to military discipline and the military 
     system of criminal justice around the clock every day of the 
     year. Unlike civilian employees, who can refuse assignments 
     and leave their jobs, service members cannot refuse orders 
     sending them to remote or unfamiliar areas in the United 
     States or overseas. Doing so would subject them to criminal 
     prosecution, as would unauthorized absences. In addition, our 
     people in uniform are often subjected to unusual physical and 
     psychological stress, including the special dangers involved 
     in training for combat and the horrible risks and unique 
     hardships of armed conflict. In a very real sense, whatever 
     happens to them during their period of service is in the line 
     of duty.
       Given these unique circumstances of military service, it is 
     only fair and reasonable that the package of pay and benefits 
     for our military personnel includes comprehensive health care 
     during service and, thereafter, a system of disability 
     compensation and medical benefits for any disabilities 
     incurred during service. I see these benefits as essential to 
     the maintenance of our All-Volunteer Force.
       Moreover, I believe it would be a disgrace, as well as very 
     harmful to recruitment, if our military were to take a young 
     man who was left paralyzed from an off-base accident, for 
     example in Thailand or on an icy road in New England, and 
     simply send him back to his parents and tell them that the 
     Government was not going to be responsible for his medical 
     bills or pay him compensation to make up for his lost earning 
     power. To me, that would be a tragic reversal of our current, 
     very sound policies.

                              medical care

       Your assertion that the VA health-care system provides poor 
     care to American veterans is totally unsubstantiated--except 
     for a newspaper article by a disgruntled former VA employee 
     (hardly the type of scholarship expected of a prestigious 
     policy institute). Our accreditation scores are consistently 
     substantially higher than those in the private sector. You 
     say that ``most telling is that only 9.6 percent of eligible 
     veterans rely exclusively on the VA system for their health 
     care.'' What this tells is not that VA provides poor service. 
     Rather, it says that VA does not have the resources to treat 
     many veterans who are not service-disabled or poor. Veterans 
     groups tell us that many of their members who are locked out 
     by current constraints would prefer to use VA health-care 
     services.
       You cite as evidence of poor medical care successful 
     malpractice suits against VA of $254 million during the 
     decade 1983-1992. That comes to an average of about $25 
     million per year. Our data indicate a slightly higher number, 
     about $30 million annually. However, in the absence of any 
     comparative data regarding the private sector, these numbers 
     have no significance. In fact, when you consider that VA runs 
     the largest health care system in the country and annually 
     provides care to 2.5 million veterans, including 1 million 
     episodes of inpatient care and 26 million outpatient visits, 
     that figure does not seem out of line.
      Perhaps, your figures show just the opposite; that VA is 
     providing high quality care.
       You advocate a voucher system to provide health care for 
     veterans. You say that this would permit veterans to choose 
     their own insurance plans and that this would help save $7.9 
     billion over five years. I would really like to see the 
     economic analysis underlying that ridiculous projection. To 
     whom would you provide vouchers: The 2.5 million veterans who 
     receive VA care in any given year; the 5 million who receive 
     care over a five-year span; or the approximately 12 million 
     service-disabled and low-income veterans who have entitlement 
     to VA care? How much would these vouchers be worth? Would 
     they be sufficient for our veterans with a history of heart 
     attacks or cancer to purchase comprehensive health care? 
     Would they enable veterans with chronic mental illness, 
     diabetes, or epilepsy to obtain all the care they need? Would 
     your vouchers cover the complete health-care and 
     rehabilitation needs of veterans with spinal-cord injuries, 
     missing limbs, and blindness? Would you provide vouchers for 
     World War II veterans needing long-term care? Or would your 
     vouchers shift major costs of care to sick and disabled 
     veterans or simply leave many of them out in the cold?
       Have you examined the several studies suggesting that VA 
     care is less costly than private care? How did you arrive at 
     your apparent conclusion that private care would be more 
     economical?
       I believe you also need to realize that about 1 million of 
     our patients have Medicare eligibility but have chosen VA as 
     their health-care provider.
       You want VA to close many of its hospitals, and you claim 
     that the majority of VA buildings are under-used. Our 
     hospitals run at an occupancy rate of 75 percent, compared to 
     the private sector average of 67 percent. Our nursing homes 
     have an occupancy rate of over 90 percent; and our 
     domiciliaries, 83 percent. What kind of survey enabled you to 
     reach the preposterous conclusion that most VA facilities are 
     underused? Again, I would like to see the underlying research 
     and analysis.
       You call for a halt to all new VA construction. You 
     obviously haven't seen the things that I have--veterans 
     housed in open wards, communal bathrooms,
      inadequate facilities for female patients. These 
     deficiencies need to be corrected; and we need to meet the 
     growing need for modern outpatient facilities and fill 
     major gaps in inpatient care in certain areas. We can't 
     just terminate our construction program, unless we wish to 
     close down the VA system. Unfortunately, that appears to 
     be your goal.
       You also mistakenly took a swipe at VA construction as 
     ``pork barrel spending.'' Very little pork creeps into VA 
     construction, and your unfamiliarity with veterans' programs 
     is revealed by your silly, mistaken reference to the 
     appropriation of $5 million for bedside phones ``in Virginia 
     medical centers.''
       The appropriations conference report item you referred to 
     used the expression ``VA medical centers.'' The money was to 
     assist in VA's national effort to provide bedside phones in 
     all VA hospitals. In the veterans' area, ``VA'' usually means 
     the Department of Veterans Affairs, not Virginia. If you 
     continue to work in this field, this is one of the many, many 
     things with which you'll need to become acquainted. Most are 
     more consequential, such as the extent of the Nation's 
     obligation to those who have served and sacrificed so much 
     and the gratitude that the American people feel for their 
     defenders.
       Because of your reputation as a think tank, your report 
     will receive serious consideration in Congress. It's a shame 
     that it is as lacking in concern for our Nation's veterans as 
     it is in rigorous analysis and pertinent data. I wish you had 
     done a better job.
           Sincerely,
                                                      Jesse Brown.
     

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