By Tom Philpott
Why do the departments of Defense and of Veterans Affairs conduct separate, duplicative physical exams of veterans, one before and one after discharge?
Why do these government health programs have separate purchasing systems when medical supply needs are nearly identical?
Why are their medical record systems incompatible when the populations served overlap?
Why is the VA health care system, which is under strain just to care for the most deserving, forced to make room for thousands of veterans who have decent outside incomes and no service-connected ailments?
Answers to all of the above vary but, according to a new presidential task force report, it’s time for Congress and the president to end the nonsense and demand closer coordination of staff, facilities and other resources between two mammoth health care systems.
The 129-page report of the President’s Task Force to Improve Healthcare Delivery of our Nation’s Veterans, delivered to President Bush on May 28, recommends aggressive collaboration between departments to control the combined $50 billion cost and to ensure a “seamless transition” for veterans from military to VA health care.
One of the more controversial recommendations calls for future VA budgets to be set high enough to ensure full funding of healthcare for enrolled veterans in Priority Groups 1 through 7.
Group 1 is veterans with service-connected disabilities rated 50 percent or more disabling. Group 7 is veterans having no service-connected ailments but having incomes or net worth that fall below a poverty line set locally by the Department of Housing and Urban Development.
If mandatory funding is approved, Group 1 through 7 veterans, whose numbers climb by 360,000 a year, should see access and services improve. Left out of the funding scheme would be Group 8 veterans, those who have no service-connected ailments, and incomes or net worth above the HUD geographic index. These veterans first were offered access to VA healthcare in 1998 in return for agreeing to co-payments. Their enrollment has grown by 220,000 a year and was suspended last January to ease an access problem for all veterans.
The report urges the president and Congress to work together to end this “unacceptable” access status and an obvious mismatch between demand and resources.
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Both chambers of Congress support a long-sought package of tax breaks for military personnel including provisions to restore capital gains protection for service homeowners and new deductions on travel expenses for drilling reservists.
But every time the House, which by law must initiate tax legislation, approves a “military tax fairness” bill, it seems the Senate improves upon it, usually to the benefit of one more group of service members, and the bill must go back to the House for modification.
In mid-May, with the Senate backing more new ideas, it sought a short cut to passage by folding the “military tax fairness” bill into what remained of the president’s original $750 billion tax cut and economic stimulus bill. But a host of last-minute amendments were dropped and President Bush signed a $350 billion tax bill without military provisions on May 28.
Senators now are revising their strategy. Senate action, when it comes, will dictate whether the House again must revise its military tax bill or whether a final compromise can be worked out in a House-Senate conference committee.
Tom Philpott can be contacted at Military Update, P.O. Box 231111, Centreville, Va. 20120-1111, or by e-mail at: