Vice President Al Gore and Veterans Affairs Secretary Jesse Brown said Thursday a new round of “reinventing government” proposals for the Department of Veterans Affairs would save $209 million.
The plan would eliminate the need for 9,310 existing jobs over the next five years through greater efficiency and shift 20 percent of the patient load in veterans’ hospitals to less-costly outpatient care.
An official said some of the savings and job slots might be used to provide added services.
Taking a slap at Republican budget plans for veterans’ programs, Gore, speaking at the VA medical center here, said, “There is a wrong way” to make savings. “The wrong way would be to close VA hospitals and deny care to veterans as some on Capitol Hill are proposing.”
“The right way to change government” and save, Gore said, is the way the Clinton administration “reinventing” plan goes about it: coordinate services better, eliminate archaic rules that require a veteran to be admitted to costly hospital care for services that can be handled easily at an outpatient clinic, consider allowing the department to charge Medicare for health services to certain Medicare-eligible veterans, and eliminate paperwork monstrosities like the “93-question hour-long interview that many veterans have to endure each year to establish eligibility for free health care.”
“The first change is to get rid of the rule that often forces VA doctors to hospitalize veterans who only need outpatient care,” said Gore. “VA doctors can’t treat a veteran’s high blood pressure or diabetes without putting him or her into a hospital bed” even when “hospitalization isn’t needed medically. It just drives up the cost and disrupts the veteran’s life. … Suppose you break a leg and need a cast and crutches. … The VA outpatient clinic can put your leg in a cast, but under the old rule they can’t give you crutches unless they put you in the hospital.”
So the first change is to abolish such rules and establish that every patient will be treated in the simplest, most appropriate and economical setting.
A second change would allow the VA to experiment with projects in which it could bill Medicare for the health care of Medicare-eligible veterans who are not poor and do not have service-connected disabilities but wish to receive care in VA facilities.