VA CARES Plan and You

By: Melanie Bussel
Executive Editor

A great deal has been written in the last few days about the VA’s CARES (Capital Asset Realignment for Enhanced Services) initiative. Editorials all over the country have been screaming about the potentially disastrous consequences of closing this hospital or moving that clinic. And veterans across the country are worrying that their health care will be impacted.

The draft calls for the following hospitals to close: Brecksville, OH; Canandaigua, NY; Gulfport, MS; Lexington, KY; Livermore, CA; Pittsburgh, PA; and Waco, TX.

Plans call for new hospitals to open in Las Vegas, NV and Orlando, FL; as well as spinal cord injury centers to open in Albany or Syracuse, NY; Denver, CO; Little Rock, AR; and Minneapolis, MN; and centers for the blind in Biloxi, MS and Long Beach, CA.

In looking at all these local proposals, it is important to remember several things:

• * Health care has changed dramatically since the Veterans Administration took over the old Army Hospitals after World War II. Think of all the procedures that are now being done on an out-patient basis which used to require a stay of several days in the hospital. Hospital beds are really not the issue now, but access to health care is.

• * The VA is a huge organization. It’s the federal government’s second-largest department, employing more than 220,000 workers. With the rising costs of providing health care, it must look to the future and evaluate how well each of its facilities serves its clientele. How many of us have moved from the family home where we raised three or four children to a smaller, easier-to-maintain retirement home or condo. The VA has to look at its finances the same way.

• * These preliminary proposals were not cooked up by some VA committee. Veterans’ groups all over the country have been meeting to come up with suggestions about the future of VA health care. And the VA has encouraged, even begged all of us to contribute our input to this process. (At the end of this editorial, there will be information on how you can comment.)

• * Most importantly, however, remember that none of this is going to happen without money. Even closing a facility costs money and enlarging or upgrading a clinic or hospital takes real money. Estimated costs to implement this entire proposal is roughly $50 billion dollars. The VA’s annual construction budget (if it isn’t cut) is $250 million. That’s a $493/4 billion shortfall. Without funding, which will involve Congress, not much can happen quickly. And you can bet that every Representative whose area hospital is slated for closing will be fighting a turf war to keep that from happening. Read your local paper; it’s certainly happening in New York and checking the Web shows that it’s going on all across the country.

So remember, planning is basically a good thing, but it doesn’t seem as if anything drastic will happen for some time.

The CARES plan was presented on August 6, 2003. We have 60 days to comment before it is sent to Secretary Principi for his evaluation. You can submit your comments to the VA at: www.carescommission.va.gov. Click on “Submit plans or hearing comments” then “Submit comments for hearing,” scroll to the bottom and type in your ideas. If you don’t have access to the web, send mailed comments to:

Comments
Richard E. Larson
Executive Director, CARES Commission
810 Vermont Avenue NW
Washington, DC 20480

You can also fax comments to: 1 (202) 501-2196