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problems have almost always originated in the executive branchthe budget makers, the high policy planners, and the officials who help establish national priorities. What can we expect from the executive branch regarding the establishment of a national health insurance system? We fear, and justifiably so, that a national health system contemplated by the administration will do grave injury to Veterans' Administration hospitals. As I stated, we do not know for sure what this administration's national health policy is regarding veterans. We do know, however, the contemplated national health system is interrelated with veterans medical care. For example, the then Office of Management and Budget Director George P. Shultz wrote to Members of the 92d Congress there would be no new Veterans Administration hospitals built until, and I quote from one of the letters:

The President has recently introduced national health insurance proposals, which could have profound implications for the VA hospital system. These initiatives are a new element that require consideration before coming to decisions on new hospital construction proposals. Therefore, we cannot niove ahead with any new hospital construction proposal until there is a careful evaluation of the role, size, and geographic distribution of the VA hospital system in the light of these proposals.

We further know that in the memorandum of disapproval on H.R. 10880, it was stated :

The bill runs counter to this administration's national health strategy which would provide national financing mechanisms for health care and sharply reduce the Federal Government's role in the direct provision of services.

Since the Veterans’ Administration provides practically all of the Federal Government's hospital and medical care directly to veterans and it is the stated policy to sharply reduce the Federal Government's role in this regard, is it any wonder the Veterans of Foreign Wars fear a national health system will swallow up in whole or at least in great part the Veterans Administration hospital and medical system? We know where the Office of Management and Budget stands on this issue. We'll be leaning heavily on the Congress and this committee to maintain, improve, and strengthen the integrity and independence of the Veterans Administration's hospital and medical system.

Mr. Chairman, one of the most important provisions of the vetoed H.R. 10880, 92d Congress, mandated the Veterans' Administration to improve the staff patient ratio in Veterans' Administration hospitals to approach the staff patient ratio in comparable community hospitals. The Veterans' Administration controls the number of veterans being admitted to Veterans’ Administration hospitals by rejections, postponement of admissions, and other actions to hold down the average daily patient census below the minimum mandated by Congress. By holding down the average daily patient census, the Veterans Administration has been able to maintain and even improve very slightly the staff patient ratio. Even so, it is a shockingly low of 1.5 to 1— far below the staff patient ratio in comparable community hospitals, which is about 3 to 1.

It is no wonder, Mr. Chairman, that more and more veterans are complaining to the Veterans of Foreign Wars of the long waits before being admitted to VA hospitals, housekeeping problems once they have been admitted, practically no service of any kind in some Veterans' Administration hospitals on weekends, and similar complaints, all of

which are rooted in the low staff patient ratio or inadequate personnel in Veterans Administration hospitals?

Mr. Chairman, the veto of the National Cemeteries Act was another tragic and unwarranted action. Here was a bill which had been developed over a period of several Congresses and would have been a giant step in carrying out the Veterans of Foreign Wars goal of at least one national cemetery in each State so that every veteran who so desires may be buried in a national cemetery reasonably close to his home.

Bills have been introduced in the 93d Congress identical to the two vetoed measures. I hereby pledge the total support of the 1,800,000 members of the Veterans of Foreign Wars in the efforts of this committee and the Congress as you consider H.R. 2900, the Veterans Medical bill, and H.R. 2828, the National Cemetery bill, and similar bills which contain the provisions of the two veteran bills which were pocket vetoed last October 27.

Mr. Chairman, the antiveteran sentinent manifested in the two vetoed veterans bills approved by the 92d Congress rears its ugly head in many of the provisions of the 1974 Veterans' Administration budget, which I can characterize as most distressing and discouraging; in fact, many of its provisions show a callous disregard for the needs of veterans and their families. The official view of our organization regarding the 1974 Veterans Administration budget is contained in my statement of January 30, 1973. It will be deeply appreciated if a copy of the Veterans of Foreign Wars position and its reaction to the 1974 Veterans' Administration budget, as contained in my statement, be made a part of my remarks at this point in my testimony.

Mr. Dorn. It is so ordered, without objection. [The documents referred to follow:]

News RELEASE-VETERANS OF FOREIGN WARS OF THE UNITED STATES WASHINGTON, D.C. (Oct. 31, 1972).-Patrick E. Carr of Metairie, Louisiana, Commander-in-Chief of the Veterans of Foreign Wars, has denounced the vetoing of two veterans bills as a callous disregard of the needs of veterans and their families. Speaking for the 1.8 million members of the Nation's largest organization of overseas war veterans, Carr warned that the battle lines have now been drawn. “The vetoing of these two bills which carry out so many VFW goals proves beyond any doubt,” Carr stated, “the enemies of veterans programs are in high and influential places.” The veterans leader went on to state "it was just outrageous to indicate that these bills were vetoed primarily for budget reasons.” The truth, Carr indicated, “is that the anti-veteran people in the Office of Management and Budget and certain high policy-making officials had an opportunity to get their way and kill off some of the most comprehensive and needed veterans legislation Congress has ever approved.”

One of the vetoed bills, the comprehensive Veterans Health Care Expansion Act of 1972 (H.R. 10880) contains over 20 separate provisions, all of which will improve and expand the capability of the Veterans Administration to deliver quality health care for the Nation's veterans. The VFW is deeply disturbed that the Administration may not intend to live up to its previous announcements regarding the independence and integrity of care of veterans in connection with National Health care for all citizens. The official statement released by the White House when H.R. 10880 was rejected assigned as one reason for the veto "the bili (H.R. 10880) runs counter to this Administration's national health strategy which would provide national financing mechanisms for health care and sharply reduce the Federal Government's role in the direct provision of services.”

The majority of direct medical care furnished by the Federal Government is provided by the Veterans Administration and the Department of Defense. “It can only be presumed the anti-veteran policy planners are committed to a policy

of further sharply reducing VA hospital and medical care when a National Health Insurance system is established,” Commander-in-Chief Carr stated. "Such a policy could lead to wholesale closings of VA hospitals,” he stated.

"It is hoped the vetoing of the National Cemetery bill, H.R. 12674, does not doom the National Cemtery System which the VFW has worked for so long to have established. The Congress spent many years developing this bill which substantially carries out VFW recommendations,” Carr stated.

"The anti-veteran sentiment which exists at the highest levels of Government manifested itself in the vetoing of these two important measures. For corrective action, I will be calling upon every VFW member to contact his Congressman and Senators to have the provisions of these two comprehensive vetoed veterans bills reintroduced and approved as one of the first pieces of business of the 93rd Congress,” the veterans leader declared.



WASHINGTON, D.C. (January 30, 1973).—“The recent request for Fiscal Year 1974 budget by the Veterans Administration shows a complete disregard for the needs of America's former fighting men—particularly the Vietnam veterans."

Patrick E. Carr, Commander-in-Chief of the 1.8 million member Veterans of Foreign Wars of the U.S. termed the VA budget proposal “inadequate and insulting.” Carr said that “at a time when additional staff and funding are desperately needed for medical care for this country's veterans, VA budget slashers have ignored the men and women who gave so much for their nation.”

The V.F.W. leader pointed out the following cuts and proposed changes under the false cry of "savings":

Medical care is being cut by reducing the average daily patient load in VA hospitals by 2,000 less than this year. This cut comes after a Congressional mandate to the VA to take care of 85,500 veterans each day. If this reduction is approved, the difference between the mandate and this proposal is equivalent to closing over 20 community-sized (250 bed) hospitals.

Operating expenses have been reduced causing a cut of about 1,500 at VA regional offices. “This is exactly where the VA needs more people to serve those who are now returning from the Vietnam war,” said Carr. The V.F.W. commander also noted that money for already approved hospital construction and medical schools was not requested.

Compensation and Pensions are also the target of so-called "economy.” “What is most disturbing about the VA's cuts are the proposals to change the compensation ratings and to take money out of the pocket of the veteran,” said Carr. “They would lower the payment in most cases for the same disability. The VA would also include a wife's earnings in the computation of the veteran's income for his pension.”

Carr called for all Americans, as well as the members of the Veterans of Foreign Wars, to protest these cuts by writing their Senators and Congressmen.

“We cannot turn our backs on the veteran now that the guns of war no longer sound. This country has always realized its obligation to those who have served her well. False economy will not buy real savings. America may need her sons and daughters again.”

Mr. CARR. Mr. Chairman, many Veterans' Administration programs are proposed to be cut back drastically in this 1974 Veterans Administration budget or the very modest funding increases proposed are woefully inadequate to meet the cost of inflation and increased needs for additional services, such as veterans hospital care.

The most distressing cut is in the area of medical care. As indicated, the congressional mandate is being contemptuously ignored by the Veterans Administration regarding the 85,500 average daily patient load which the Veterans' Administration is mandated to maintain in its 168 Veterans Administration hospitals. The current level is about

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82,000. Further reductions are slated in 1974 to a figure of 80,000. When we realize that the Veterans' Administration always lags behind or operates less than the contemplated average daily patient load, it can be expected that the Veterans' Administration is probably shooting for an average daily patient load of 78,000 or thereabouts. In any event, the difference between the congressionally mandated 85,500 and the contemplated 80,000 for next year is the equivalent of closing down 11 500-bed Veterans Administration hospitals. As previously stated, we believe that the Veterans Medical Care Act (H.R. 2828) which contains the provisions of the rejected H.R. 10880, 92d Congress, will go a long way toward forcing the Veterans' Administration to at least halt further cuts in veteran hospital care.

The Veterans of Foreign Wars is apprehensive that some VA regional offices are going to be closed in the not too distant future. I am referring to a contemplated reorganization of Veterans' Administration regional offices which this year's Veterans' Administration budget calls for, so that the Veterans Administration field structure will be realined to fit the 10 standard Federal regions. We have been unable to learn details of this structural reorganization, but we do know that this year's Veterans' Administration budget calls for a wholesale reduction of Veterans' Administration employees in Veterans' Administration regional offices, estimated to be up to 1,500 in the Department of Veterans Benefits. Many are convinced that this restructuring will result in the closing of many Veterans Administration regional offices.

Mr. Chairman, none were more shocked and amazed than the Veterans of Foreign Wars to learn of the outrageous provision in the 1974 Veterans Administration budget which would have literally taken $160 million out of the pockets of combat, disabled veterans of the Vietnam war. Precisely at a time when the President was trying to negotiate a final settlement of the Vietnam war, the prisoners of war were coming home, and the missing in action still to be accounted for, the faceless officials of the Office of Management and Budget sent to Congress a proposal which was aimed directly at making the disabled Vietnam veteran a second-class citizen.

The Veterans of Foreign Wars is proud of bringing this matter to the attention of our membership and the Nation. We must not let such a proposed revision rear its ugly head again. That is why the Veterans of Foreign Wars strongly supports H.R. 4185, and similar bills which will freeze the existing rating schedule as it applies to Vietnam veterans and other veterans who have not had their disabilities rated for 20 years and require the concurrence of Congress before any proposed revision of the rating schedule can go into effect.

It is further noted in this 1974 VA budget that there will be a reduction in medical research, reduced outreach, and other efforts to contact returning Vietnam veterans, a slash in the hospital construction budget, and not 1 dime for the Medical School Assistance Act which was authorized by the Congress last year to help reduce the acute shortage of doctors and other badly needed medical personnel.

Lastly, there is no money in the 1974 budget to offset the cut in veterans pensions caused by the 1972 social security increase. Hundreds of thousands of veterans and their dependents have suffered a loss in their veterans pension payments because of the 20 percent social security increase of 1972, or equivalent increases in income. I can unequivocally state that more mail, phone calls, and communications have reached the attention of the Veterans of Foreign Wars on the pension cut caused by the social security increase than any veterans issue in many years. These older veterans in the main are existing for the most part on social secụrity and similar retirement income and their veterans pension payments. Every dollar counts. In fact, every dollar is crucial. It came as a shock to many of these older veterans or their widows to learn that when their social security pension was increased, their veterans pension payment was being cut. Not only is there no money to offset the 1972 social security increase but the 1974 budget spells out it is going to save $237 million out of the pockets of elderly disabled veterans and their dependents by doing nothing about the social security increase the balance of this fiscal year of 1973 and next year. Unless the Congress acts in this area, veterans and their dependents will have their VA pension checks reduced $237 million in the months ahead.

Even more incredible and to the astonishment of almost everybody, the 1974 Veterans' Administration budget calls for including a wife's earnings in computing a veteran's entitlement to a Veterans Administration pension. If the Congress would approve this budget recommendation, the Veterans' Administration would reduce the pension program by taking $223 million from very disabled, sick, and elderly veterans. The Veterans of Foreign Wars totally opposes any and all bills which may be introduced to carry out this request.

The Veterans of Foreign Wars commends all sponsors and cosponsors of pension bills which will carry out the Veterans of Foreign Wars' objective of protecting veterans and their dependents from a veteran's pension loss because of the 1972 social security increase. We urge your favorable consideration of one of these bills as soon as practicable.

The Veterans of Foreign Wars, as indicated in our priority legislative programs and digest of resolutions, is extremely concerned with veterans’ programs, rights, and benefits. The Veterans of Foreign Wars will be working closely with your committee for the favorable consideration and approval of bills carrying out these objectives. The Veterans of Foreign Wars is proud of its sponsorship, participation, and support of legislation which has sharply increased the GI bili rates resulting in liberalizations and improvements which are helping the Vietnam veteran in his return to civil life. Public Law 92–540, the GI rate increase law, has done much to place Vietnam veterans on a comparable basis with veterans of previous wars so far as readjustment assistance is concerned.

Mr. Chairman, the Veterans of Foreign Wars has spent much time and effort trying to help reduce the staggeringly high number of unemployed veterans. The GI bill unquestionably has done more to help reduce this high unemployment list than any other single veterans' programs. The Veterans Employment Service of the Department of Labor and the National Committee on Jobs for Veterans, headed by a member of this committee for over 20 years, the Honorable William Ayres of Ohio, are doing an admirable job trying to

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