Tuesday, May 5, 2015

VA chief predicts 'another crisis' in health care without full funding

Without congressional approval of the full budget for the U.S. Department of Veterans Affairs, there will be another crisis in veterans' health care, according to VA Secretary Robert A. McDonald.

He lambasted a House subcommittee for cutting $1.4 billion from his proposed 2016 budget, saying it would prompt another crisis as the future needs of service members returning from Iraq and Afghanistan swell the numbers seeking health care at the VA.
"That effect has not yet been felt," he said, speaking at the annual conference of the Association of Health Care Journalists last week.
McDonald said the aging of Vietnam veterans caused the 2014 crisis that led to the former Procter & Gamble CEO's appointment to lead the troubled agency. In the past 40 years, he noted, the number of veterans older than 65 has more than quadrupled, rising from 2.2 million in 1975 to a projected 10 million by next year.
McDonald predicted that the congressional cuts from his requested $168.8 billion budget would eliminate care to 70,000 veterans, foil the building of an outpatient clinic and halt cemetery expansions.
"You either give the budget or cut the benefits," he said. "This is what we need to meet the demand."

Last week, the House approved a 5.6 percent increase for 2016, including $76.6 billion in discretionary funding, an increase of $4.6 billion. McDonald had requested a 7.5 percent increase. The bill now goes to the Senate.
McDonald described the VA as the largest health care system in the country, one of vital importance to the country for the innovations it provides in medical care.
He said its research, education and clinical care have earned three Nobel prizes and are responsible for the nicotine patch, liver transplants, prosthetics controlled by brain waves, bar codes on patient bracelets and open source electronic health records, among other innovations. He noted that 70 percent of all U.S. doctors receive training through the VA system, which is the country's largest employer of nurses.
McDonald pointed to several challenges faced by the VA health system, including an influx of patients affected by Agent Orange; the number of veterans with catastrophic injuries from a 10-fold increase in battlefield survival; greater recognition of post-traumatic stress disorder and its symptoms, often exacerbated by aging; the increase in the number of women requiring services; and a shortage of both clinical space and providers.
He said 20 percent of veterans care took place in the community even before last year's passage of the Veterans Choice Act. The act, implemented in late 2014, allows those with more than a 30-day wait or living beyond a 40-mile radius from a VA facility the option to seek care in the community.
In his nine months at the helm, McDonald said, the VA has opened 93 buildings and 1.4 million square feet of space and hired 11,000 new medical employees.
He touted the VA's efforts to "change the culture from Kremlin-esque," noting that it publishes its data every two weeks. He also announced the formation of an 11-member Special Medical Advisory Group to help improve the delivery of medical care. And he noted that within weeks there would be an announcement regarding care for the crews — mostly National Guard reservists — of C-123s who were exposed to Agent Orange in Vietnam.

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