Citing stagnant funding in recent years, Congress and veterans groups are pressing the Clinton administration for a more generous increase in the Department of Veterans Affairs' healthcare budget for fiscal 2000.
A group of veterans organizations wants a 17.3% increase, to $20.3 billion. The VA's healthcare budget for fiscal 1999, which began Oct. 1, is $17.3 billion. Since fiscal 1996, it has crept up by only 4.2%, from $16.6 billion.
In a report sent in mid-November to the White House Office of Management and Budget, the groups said "chronic underfunding" of the VA has led to layoffs, reduced access and lower-quality care for veterans.
The groups-Amvets, the Disabled American Veterans, the Paralyzed Veterans of America and the Veterans of Foreign Wars-note that the buying power of the 1999 VA healthcare budget is worth only 82% of what it was in 1985.
The groups said the VA has exhausted one-time administrative savings from a restructuring of facility management into 22 integrated networks and from a shift of care from inpatient beds to outpatient settings.
"With few inefficiencies left to squeeze out of the system, continued budget inadequacies are forcing VA administrators to eliminate important services or reduce the quality of care delivered to veterans," according to the report.
Support for a funding increase came in October, when 74 members of Congress signed a letter asking for a 9.8% increase in the VA's healthcare account for 2000, to $19 billion.
The letter, to President Clinton, was signed mostly by lawmakers from the Northeast, where veterans' healthcare networks have lost money under the VA's capitation formula. Seven networks, all in the Northeast and upper Midwest, lose money under the formula. The rest gain money.
The money-losing networks are "just getting ravaged," said Richard Wannemacher, associate national legislative director for the Disabled American Veterans.
Under legislation passed in 1997, the VA was given the power to collect and keep third-party insurance payments for treating veterans eligible for but not entitled to healthcare. (All veterans are eligible for healthcare; entitlement to different types of care varies according to a veteran's income and disability or illness.) Federal budget planners have used that increase in VA funding to justify their small increases for the system.