Research - Rehabilitation - Re-Employment

Sgt. Shaft 07/29/2002

Dear Sgt. Shaft:
This letter is prompted by your column of July 15th on the need to coordinate Medicare benefits for veterans aged 65 and above. I wanted to share with you recent activities of the House Committee on Veterans’ Affairs on this topic.

Like you, I am concerned that federal funding for veterans’ health care is in danger of falling dangerously below the needs of our nation’s veterans. While the House has approved significant budget increases the past two years, including a record $2.8 billion increase in VA discretionary health care spending for the next fiscal year, the demand for services continues to outstrip the resources available.

Earlier this month I chaired a Congressional hearing to examine a simple, but profound idea regarding health care for Medicare-eligible veterans: federal health care funds should go to the actual provider of health care services, including VA. 

With Congressman Lane Evans of Illinois as co-sponsor, I have introduced bipartisan legislation, H.R. 4939, which would allow Medicare-eligible veterans who choose to receive VA health care to have their Medicare Part B premiums follow them to the VA health care system. After all, this isn’t the government’s money, this is the veteran’s money.

With more than 2.2 million VA health care users now eligible for Medicare, and many more coming as the veterans population continues to age, the effect of this legislation would be substantial. Furthermore, it would be a more efficient use of our federal health care dollars because it is less expensive for Medicare-eligible veterans to receive health care at VA facilities than through the Medicare system. Both VA and external studies have estimated that VA health care is 25% to 30% less costly than comparable care provided by the private sector.

The principle which my bill reflects is not new. Since 1986, VA already has had the authority to collect payments from private health insurers. Furthermore, Medicare already does reimburse for care provided through the Indian Health Service and there is a new program under which Medicare would reimburse military hospitals for the care of older military retirees. Our legislation simply takes the next logical step.

H.R. 4939 could provide a new, steady, dependable stream of funding for VA health care to prevent the annual funding crises of the past decade. It is a simple, logical and equitable proposal to help ensure that resources allocated for health care go where the patient is receiving that care. 

There may be other proposals, such as making VA health care an entitlement, or so-called ‘Medicare subvention’, and we are certainly open to discussing them and others that may be put forward.

Thanks for helping to stimulate this debate for the benefit of all our nation’s veterans.

Congressman Chris Smith (R-NJ)
Chairman, House Committee on Veterans’ Affairs

Dear Chairman Smith:
Your legislation is surely a step in the right direction. One other area that must be addressed is a reimbursement of bucks by the Department of Defense to the VA for the care it provides through its medical system to the thousands of TRICARE for Life military retirees. As you can see, Mr. Chairman, this is not a Peter robbing to pay Paul scenario. It is dealing with enhanced, deserved medical care for our nation’s veterans. Read on …

Dear Sargeant Shaft:
The following situation of a group of Idaho veterans has been brought to our attention.

At a special meeting on June 11 of the administration officials of the Idaho State Veterans Home in Boise (ISVHB) with the veterans living there, Mr. Bernard Bufford, ISVHB Administrator announced that by order of Idaho Governor Kempthorne all veterans domiciled at the home would be expelled by August this year. The reason given was to make way for construction to expand the number of nursing beds available at the home financed by Veterans Administration grants. .

Under Code of Federal Regulations 38 & 42, and Idaho's contractual obligations to the VA via its numerous construction grants for veterans homes, Idaho is mandated to maintain a specified number of domiciliary beds in the state veterans homes. Idaho is also mandated under CFR 35.59.40 (b) to use VA grant funds for construction of beds above the maximum specified number for an increase of both domiciliary and nursing beds. Meanwhile, Idaho eliminates all domicile beds for veterans in the veterans homes-a direct violation of federal law.

These veterans are all suffering from various medical problems that have made it impossible to live on their own. Some need ongoing medical care provided by the VA Medical Center just across the street from ISVHB and have been placed in the home by the VA due to their need to be near medical care. Others have been diagnosed by the VA as mentally unable to maintain a lifestyle on their own and have great need for the structured living environment of ISVHB. Some have been institutionalized in the state home for so many years they have no skills with which to function in the world. Most are being forced out into a world with which they cannot cope. Some of the more verbal veterans have been told they will be shipped out of state despite their requests and needs to stay in Idaho to be near their families. And others are being told they will have to find lodgings on their own.

These veterans need your immediate assistance to force to them the country for which they fought will not allow the State of Idaho to violate their rights and throw them to the wolves.

Sincerely,
Michael B., former VN-POW

Dear Michael:
I am positive that Senators Crapo and Craig would not think that this would be a prudent and judicial black eye to Idaho’s most needy veterans.

Send letters to Sgt. Shaft, c/o John Fales, P.O. Box 65900, Washington, D.C. 20035-5900; fax to 301-622-3330; call 202-462-4430 or email sgtshaft@bavf.org.

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