One of the Department of Veterans Affairs' first major attempts to become more competitive with private-sector providers has been killed, or at least put on hold, by pressure from Congress.
The plan, which would have divided the system's four current regions into 16 locally run regions called "Veterans Service Areas," was designed to allow those regions to reorganize their delivery systems to compete with local systems on more even terms. The plan also would have saved an estimated $18 million a year by cutting more than 250 employees, according to the VA's plan, which was submitted to Congress in March.
The decision, revealed in a May 25 letter to the chairmen of the House and Senate veterans affairs committees, has angered veterans groups, which supported the plan as a first step toward the formation of viable veterans healthcare networks.
"This was one of the things that (the VA) could do to at least start to decentralize, to allow decisions to be made at the local level rather than all done in Washington," said David Gorman, assistant national legislative director for medical affairs at the Disabled American Veterans.
The VA's decision to stop the plan came after the chairmen and ranking Republican members of both the House and Senate VA committees sent a letter to VA Secretary Jesse Brown asking him to withdraw his request for a congressional waiver that would have been needed to implement the plan.
In their letter to Mr. Brown, the members said the plan should be put on hold until "no sooner than 120 days after" the VA has an undersec- retary for health in place. That position has been vacant since last year, and veteran groups charge that the White House's inaction on the nomination has made the VA health system a rudderless ship.
Mr. Brown told the lawmakers that to wait for a new undersecretary would mean the "postponement of implementation until almost a year from now," and that "our inability to move ahead with the effectiveness that the VSAs would make possible could put us at a disadvantage as we enter into a competitive environment."
Veterans groups speculated that leaders of the VA committees in Congress were skittish about going along with an untried plan such as the VSA program. They said the plan's demise is another example of the lack of leadership at the VA>