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Reagan's War Budget Proposal: VA System Threatened

By Pete Zastrow

It is a rare veteran who has not had some bad experience with the VA. Late checks under the GI Bill, endless red tape in getting almost any of the vets benefits we were promised, disability pensions suddenly cut, or lines that seem to go on forever in a VA hospital. With all the problems, however, veterans have always know that, in case of need, the VA had the medical facilities to take care of the country's veterans.

But today, with the rush to preserve military spending at the cost of every other program, the Reagan Administration is preparing to dismantle or, at least, dismember some of the vital features of the VA system. As is often the case, veterans will be sacrificed for something or other which politicians decide is more important.

The attack on the VA is coming from several directions at once. The Reagan Administration has already floated out a trial balloon to bounce from VA care any veteran who is receiving treatment for non-service-connected disabilities. At present, under a 1971 law, veterans over the age of 65 will receive free VA hospital care on a bed-available basis. Other veterans with problems not directly service-connected may receive care (if it is available—a service-connected problem will be dealt with first) if they say they haven't the necessary funds to pay for private care.

Only about 30% of present VA patients are being treated for conditions which are service-connected. Removing all other patients would mean the end of the VA system; as one VA official was quoted saying, "There would be a lot of hospitals going up for sale cheap." The Reagan Administration has long favored the report of the Grace Commission which advocated dismantling the VA system in favor of private healthcare facilities: that report suggests that the number of patients treated by the VA be cut drastically, and the few remaining patients then be placed in private nursing hospitals.

The immediate cause for much of the concern about the future of the VA system in the release of a report entitles "Caring for the Older Veteran." This document has been circulating inside the VA for some time, but has recently escaped into the outside world. It recognizes what should have been obvious some years ago: since VA care for the older veteran is more expensive (more older vets need VA care and also need more of it), and since the age of World War II vets is well into the sixties (even a vet who was 20 an the end of the war in 1945 will be 60 this year, and many World War II troops were considerably older than 20.) By 1990, six of every ten American men over the age of 65 will be veterans since, unlike Vietnam, World War II was fought by a large cross-section of the American population.

Forecasts say that in 15 years there will have to be a 70% increase in VA staff, 22 new geriatric centers, and a doubling of the VA budget to $18 billion. The Reagan Administration wants no part of this kind of build-up and, to the contrary, wants to slash away at what VA care still remains.

Faced with a clear situation a few years down the road, with a large population which cannot afford private healthcare and which will increasingly need that same healthcare, the Reagan Administration does what it always does with groups not among the particular Reagan cronies: it says bite the bullet. We will send you to private healthcare facilities where the VA will quit paying the bill after 6 months; then you can rot. Whatever promises made to you years earlier, well, forget them!

One cost-cutting concept being pushed by some inside the government is called "mainstreaming." This idea would provide the veteran with vouchers which could be used for contract services outside the VA. Such a program, vigorously opposed by traditional veterans' groups, points directly toward the end of the VA as a medical care system. It would, on the other hand, be a great shot in the arm for private doctors and hospitals who have always regarded the VA with some suspicion.

According to Dr. Donald Custis, one-time medical director of the VA, and now medical director for the Paralyzed Veterans of American, he "wouldn't be surprised by consideration given to vouchering for veterans' care. No matter how you look at it, the VA simply can't expect the resources that it's going to take to accommodate the huge numbers of aging veterans that are just a few years ahead."

For the immediate future the veteran with a non-service connected disability will bear the brunt of the attack. More and more we will hear that in this period of great budget deficits, the government cannot afford to treat veterans whose ailments cannot be proved to be directly caused by military service (like Agent Orange exposure?). The government can, of course, afford MX's.

And one more attack: putting taxes on disability pensions is yet another Reagan Administration idea being tossed into the hopper to see who will yell and how loudly. Like older vets, the disabled may be a group which Reagan and Co may feel it can afford to disregard.

What it all adds up to is a simple situation: as more and more vets need the VA, when cuts Medicaid and medicare will make the VA more and more essential for older veterans, VA medical services will be taken apart and handed over to powerful private interests. A major battle awaits vets; we must stop cuts wherever they occur in the smallest local program. We have to let our communities know that we are a part of them—vets are not just some far-off group. Fight the cutbacks; make the government and the VA live up to the promises to veterans.

—Pete Zastrow
VVAW National Office