Washington Post Examines VA Health System Overhaul

The Washington Post on Thursday examined efforts by the Department of Veterans Affairs to carry out a "major overhaul of its sprawling health care system." The reform process, called the Capital Asset Realignment for Enhanced Services, was prompted by a 1999 General Accounting Office report that found the VA spends more than $1 million per day on unused or unnecessary facilities, according to Robert Roswell, VA undersecretary for health. Changes in health care administration, outdated facilities and a population shift of veterans to the South and West of the country have influenced some of the planned changes (Walsh, Washington Post, 10/9). Under the CARES proposal, announced in August, the VA would close seven hospitals, open two others and add 48 new clinics to eliminate old or underused facilities and shift the focus of the department health system to outpatient care. The proposal would cost an estimated $4.6 billion over 20 years (California Healthline, 8/5). Roswell said the plan "eliminates unused space, adds clinics and hospitals and improves access."

Everett Alvarez, a Navy veteran and the head of a 15-member commission that is holding public hearings on the plan, said veterans around the country have shown a "mixed reaction" to the proposal, according to the Post. John Brieden, national commander of the American Legion, said the group is "not opposed to closings as long as vets have access to care. That's the key point." However, Rick Weidman, director of government relations for the Vietnam Veterans of America, and Steve Robinson, executive director of the National Gulf War Resource Center, said the VA health system "has been seriously underfunded for years, resulting in reduced services that discourage visits by potential patients," the Post reports. Robinson said, "This is a patch; it isn't a fix. The demand [for health care among veterans] is still going to be there." The commission is close to finishing the public hearings and expects to submit recommendations on the proposal to VA Secretary Anthony Principi in December. Principi has said that he would "accept or reject the commission's final recommendation in its entirety," according to the Post (Washington Post, 10/9). NPR's "Talk of the Nation" on Wednesday interviewed Principi about the proposed restructuring (Coleman, "Talk of the Nation," NPR, 10/8). The full segment is available online in RealPlayer.

In other veterans' health news, the House Veterans' Affairs Health Subcommittee on Wednesday by voice vote unanimously approved a bill sponsored by Rep. Steve Buyer (R-Ind.) that would increase oversight of VA research, CongressDaily/AM reports. The bill would create an Office of Research Compliance and Assurance to monitor and regulate VA research for ethical guideline adherence. Under the bill, the office's director would be required to regularly inspect research facilities, investigate allegations of misconduct and immediately report to Congress findings of any improprieties (CongressDaily/AM, 10/9).