US spending on veterans’ healthcare could double in three years under the Senate’s proposed solution to the long waits experienced by thousands seeking medical care at government-run veterans’ hospitals and clinics, US congressional budget experts said.
Analyzing a bill the Senate passed on Wednesday last week, the US Congressional Budget Office estimates the measure would add US$35 billion over the next three years to the US$44 billion the government now spends annually on medical care for veterans.
Both the Senate bill and a House of Representatives version also passed last week would dramatically expand government-paid healthcare. They would require the US Department of Veterans Affairs (VA) to pay private providers to treat qualifying veterans who cannot get prompt appointments at the VA’s nearly 1,000 hospitals and outpatient clinics or who live at least 65km from one of them.
Once the program was in place, the budget office said it expected that veterans “would ultimately seek additional care that would cost the federal government about US$50 billion a year” — double current spending, the report said.
The bills are the congressional response to a growing uproar over patients dying while awaiting VA treatment and mounting evidence that workers falsified or omitted appointment schedules to mask frequent, long delays. The resulting election-year firestorm forced former VA secretary Eric Shinseki to resign two weeks ago.
An audit released last week showed that more than 57,000 veterans have had to wait at least three months for initial appointments. An additional 64,000 veterans who asked for appointments over the past decade never got them.
The VA has confirmed that at least 35 veterans died while awaiting appointments at VA facilities in and around Phoenix, Arizona, although officials say they cannot say whether not getting VA treatment caused any of the deaths.
More than 8 million of the nation’s 21 million veterans are enrolled in VA healthcare, although just about 6.5 million seek VA treatment every year. The budget office analysts said the VA now covers about 30 percent, or an average US$5,200, of those veterans’ annual healthcare costs, excluding long-term care.
The Senate bill would open up VA healthcare to as many as 8 million veterans who now qualify for VA healthcare, but have not enrolled, the budget office said. By making it easier to get outside care, the Senate bill and a companion measure in the House also would encourage veterans to seek VA coverage for a bigger portion of their healthcare, the report said.
Both bills would make it easier to fire or demote senior agency officials, and both would end bonuses to regional VA officials and other administrators based on meeting patient scheduling goals — a practice investigators say led some to forge lists to “game” the system.
However, the Senate bill also would devote at least US$1 billion to leasing 26 facilities in 17 states and Puerto Rico for use as new VA hospitals or clinics and US$500 more million for hiring more VA doctors and nurses. Declaring the long waits an emergency, the Senate averted having to raise taxes or find spending cuts elsewhere.
The Center for a Responsible Federal Budget, a bipartisan policy group devoted to cutting US federal deficits, criticized the Senate’s bill in a blog post, saying that the legislation would swell the government’s debt with an unfunded entitlement program bigger than Congress’s 2003 Medicare expansion.
“We can’t just write a blank check and think it will solve these problems,” Republican Senator Jeff Sessions said after voting against the bill, alongside two others.
Independent Senator Bernie Sanders, the chairman of the Senate Veterans’ Affairs Committee, said that the bill was expensive, but so were the wars that veterans have served in.
Wars in Iraq and Afghanistan alone will have cost at least US$3 trillion, he said.
“If we can spend that kind of money to go to war ... surely we can spend [less than] 1 percent of that amount to take care of the men and women who fought those wars,” he said.
The budget office did not provide a complete cost estimate on the House bill, which includes no provisions for new hospitals or clinics or for hiring more VA doctors and nurses.
House Veterans’ Affairs Committee Chairman Jeff Miller said there would be negotiations with the Senate over final legislation.
“We’re not just accepting the Senate bill,” he said.
Sanders was optimistic that a quick deal could be reached.
“I’ve worked with Jeff Miller. I think we can work things out,” he said.
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