When contemplating reform, it's difficult to ignore the Department of Veterans Affairs, which just keeps rolling along, oblivious to the need for cost-containment. Its $16.6 billion health budget for fiscal 1995 approved by the Senate Appropriations Committee boosts spending by $612 million.
Congress has spent most of 1994 talking about ways to reduce the federal budget deficit, but when it comes to action we get more spending and political grandstanding. Only a few months ago, the House voted overwhelmingly to bar the VA from firing any of its 212,000 full-time workers for the next five years. The largest non-Defense federal agency should not be spared the sacrifice expected of others, like hospitals and taxpayers.
Come to think of it, the VA might offer a vivid example of what a government-funded healthcare system might look like. The system is antiquated, bureaucratic and serves less than 10% of the veteran population.
So instead of worrying about bigger budgets to rebuild an acute-care hospital network, the VA should preoccupy itself with nursing home care, outpatient services and patient-focused care. Let this government-run system prepare for managed competition before mandating it to the private sector. Then, maybe the nation can achieve real healthcare reform.