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Now, we receive hundreds of letters that back up the statements of these service officers throughout the year. Now, I would like to call your attention, Mr. Chairman, in regards to nursing homes. I heard you ask the question if there is any place in the VA budget where money could be saved. Right here, I think, is one place that money can be saved if the law is changed or the regulations of the VX were changed. I have a letter here

Senator CRANSTON. What would you do to make a savings there?

Colonel Houston. I was going into that a little later, but I will mention it now. If the VA would accept the recommendation of the veteran physician at home to go directly to the nursing home instead -having to be hospitalized and kept there for a period of time and then transported to the nursing home. I think it would be a penitence, but it would be a savings in money and time, and the hours of service at the VA while they were processing them at the Veterans Administration hospital.

Senator CRANSTON. As long as we are on the cuts, is there anywhere else in the budget or is there anywhere else in the VA budget you feel cuts could be made ?

Colonel HOUSTON. I can't see it, sir.

Senator CRANSTON. If we have to increase the VA budget and still stay within the spending ceiling, we have to make some cuts somewhere else in the budget, not necessarily in the VA, of course. Do you have any recommendations or ideas as to where we might find that room for cuts?

Colonel HOUSTON. Frankly, sir, I have not studied the overall budget enough to be able to give a good judgment on that. I might arrive at one by a more careful scrunity. But as of now, I would not pass judgment on that.

Senator CRANSTON. The President said that perhaps he would fit within his budget aid to North Vietnam.

Colonel HOUSTON. Well, I would abolish that completely.

Senator CRANSTON. What do you feel about some of the other aspects of our foreign aid, military aid to dictatorships?

Colonel HOUSTON. As long as there are needs for hospital beds for veterans, I think it should come out of that as the number one priority. Senator CRANSTON. Thank you.

Colonel Houston. May I add this further statement. I have just read an article from—İ have forgotten the name of the place where the tourists were criticizing the devaluation of the dollar, and the tourists were being penalized for the exchange rate.

In the same news account where this was being discussed—could have been Austin—the appropriation of $17 million to build some roads down there. That $17 million would help some of these veterans obtain a bed or nursing home care or some of the technical work that the previous witnesses has given. That certainly should be

Senator CRANSTON. If, again, we have to choose between cutting the money in the budget for the veterans or cutting something else out, how do you feel about the $30 billion that is going to maintain NATO and other bases overseas, at a cost of $30 billion a year? Five billion of that relates to the collapse of the dollar, because that


is money going out of the country, when our NATO allies do not pay their fair share of the cost of all of that, so that we have to put up the

money. Colonel HOUSTON. It is a little bit off the question, but I think it is connected with what you are saying. I was in Israel and in the Far East last year, and I went by and observed some of these United Nations camps where we are subsidizing the food and care for these Palestinians in these areas, and comparing them with other natives of the same area. I came away from there with the firm convictions that that should be eliminated, because they were just sitting there waiting for the dole. They were doing nothing to help themselves.

Now, my generation of veterans is firmly convinced that if a man is willing to work he should not ask for anything. These people, we are feeding them, we are clothing them, we are policing them, and I can't see it.

Now, with regard to the question that you raised, I am not in disfavor of it in principal, but in speaking for our organization, we are firmly convinced that as long as the needs of our people are as they are, and we are limited in funds, they should be used at home first.

Senator CRANSTON. Thank you.

Colonel Houston. Now, this last paper that I should comment on, it pertains to nursing homes. I didn't get into the text because it only arrived by airmail special delivery this morning.

I am referring to a nursing home now in Cincinnati, Ohio, where the statistics for the month of February showed that they received 107 applications for nursing home care in February.

One hundred four of those were just being in need of care. Fifty nine were admitted. We are asking why were the others not admitted.

I made an error, I note that further down that none of the 107 did not need care, but the 104 evidently needed, three of them evidently didn't need it as badly.

Now, that goes back to our previous statement of a moment ago, that if the law or ruling could be changed to admit these who do not require hospitalization or nursing homes, they have no homes, they are alone or they are the husband and/or the wife is unable to care for them in the home, either physically or financially. They need immediate care.

Now, as to the nursing home care on a private basis. A private nursing home will cost double the amount that the veteran receives in total income, and that is out. So, there is really only one alternative for these individuals—and the number is alarming. I can't give you the number because we have no way of knowing where to obtain an accurate figure.

But, for those individuals who have no home, who cannot get into a Veterans' Administration nursing home, because they are refused admittance into the hospital so that they can go to the VA nursing home, there is only one alternative and that is the charity hospital of the city in which they live.

Now, from my point of view or from our generation of veterans, those are the critical needs.

Senator CRANSTON. Thank you very much. I appreciate your very, very helpful statement.

Colonel Houston. Thank you for the opportunity for appearing before you and presenting my statement, sir.

Senator CRANSTON. Will you and your organization stand with us in our efforts to restore to the VA budget the funds for medical care, construction, and research needed to insure the veterans receive first quality care?

Colonel Houston. 100 percent, sir.

Senator CRANSTON. Thank you. Do you have any comments on today's VA testimony or any other testimony which you have heard ?

Colonel Houston. I just put it down as a disagreement with them, we can't see any justification for it, I have heard it three times.

Senator CRANSTON. From the VA?

Colonel Houston. Yes; and I have not found any justification. If I compare it with about 20,000 others that I have heard, a third just does not add up.

Senator CRANSTON. You have given us several examples of veterans turned down for care. Can you give us, and I understand a number of veterans organizations are working on this project, for the subcommittee's files examples of veterans turned down for care, who then wind up in community hospitals?

Colonel HOUSTON. There is one in this testimony, not in a community hospital. He was able to get it done in another hospital. But that is something that we are in the process of obtaining now.

Senator CRANSTON. Would you please, as soon as possible, submit it to us?

Colonel Houston. These letters were obtained by telephone, and that is the only thing that we can give you at the moment.

Senator CRANSTON. Thank you. I appreciate your testimony very much. We will place the letters in the subcommittee files.

Colonel HOUSTON. Thank you.
[The prepared statement of Col. Houston, follows:]


SERVICE, VETERANS OF WORLD WAR I OF THE U.S.A., INC. Mr. Chairman and Members of this Distinguished Committee:

We want to thank you for the opportunity of appearing before you for the purpose of expressing the views of the Veterans of World War I of the United States of America concerning the V.A. hospital program.

Our organization is vitally concerned in three aspects of veterans benefits authorized by the Congress and administered by the Veterans Administration ; compensation, pensions and medical care for veterans. This does not mean that we are disinterested in other programs designed for younger veterans. We are interested in and support benefit programs for any age veteran whether or not our membership is eligible or not.

Over the years the Congress has enacted laws to provide the best hospital facilities for the Veterans of America than any nation. These were passed because our people were patriotic and concerned in providing health care for the veterans who had given of their time, during the most creative years of their life, in the service of their country. The Congress reflected the feeling of the nation that veteran compensation, pension and hospitalization was an obligation of the government to those who have fought in America's wars, and is a part of the cost of war. The entitlement for these benefits provided by the Congress has been of great comfort to those whose services to their country has preserved this nation from those who would destroy us.

The Veterans Administration has been authorized by the Congress to maintain 125,000 hospital beds. It has not, however, reached that number. In 1972 its operating beds averaged 98,352 and is at approximately 82,000 at the present time. In 1958, 121,000 were maintained, then the attrition began.

There has been a gradual reduction in hospital services since the late fifties. Not because there are no patients seeking medical care, for there have been; rather, it has been because of a movement in our country to downgrade the uniform service of this nation, and the failure to recognize that veterans have made any special contribution to the maintenance of this nation.

This movement has had advocates in the Bureau of the Budget, now The Office of Management and Budget. These individuals who are not subject to the will of the electorate have built up a bureaucracy so powerful their recommendations influence the President and tie the hands of the Congress.

It is obvious the aim of this group of influential bureaucrats is to abolish the Veterans Administration. They would abolish compensation and pensions provided for veterans. An attempt was proposed recently by the plan worked out to downgrade service connected veterans returning from Viet Nam by lowering the degree of ratings of disability. This attempt was thwarted by an alerted public and the Congress and retracted for the present.

It would be their hope that the Congress would not restore the reduction in pensions brought about by the increase in Social Security, and even advocate greater reductions in pension.

The assumption being that the greater portion of veterans are given credits for Social Security during active service. They would advocate some form of readjustment assistance for all veterans and permanent aid for those suffering permanent injury would somehow be worked out. Under this grandiose plan the older veterans, principally those of World War I, are evidently to be written off since they were born too early to qualify for enough Social Security payments to enable them to live, so their only recourse would be the humiliation of Public Welfare.

They would abolish the special consideration now provided for veterans as an award for service in the uniformed forces of our country whose service and sacrifices have protected and preserved this nation from her enemies throughout her history. Discarding this time proven method and substituting a new concept where the patriot and the renegade would be considered equal and offered the same consideration.

Instead of the V.A. hospital system designed by the Congress to provide medical care for veterans, they visualize some comprehensive health insurance plan where all citizens would participate. They have not proposed who is going to pay for this plan.

The Veterans of World War I can only see one thing clearly, the proposals are designed to degrade the veterans to which we are opposed.

This philosophy of government manifested its efforts on a national scale in the early sixties, demonstrated by resisting service to the country; by desecration of the flag, burning of draft cards, fleeing to other nations to evade military service, disrespect to the President of the United States, and a general disregard for constituted authority.

The Veterans of World War I whose average age is 78.2 now number approximately 1,190,000. Of this number approximately 40% of them were drawing a pension prior to January 1, 1973 which when added to their other income still left them classified as in the poverty class.

These veterans, and the widows of veterans, have to look to some form of other benefits to provide them with medical care.

A short period of illness will deplete their medicare benefits in a hospital and after that they are at the mercy of the elements unless cared for in the Veterans Administration hospitals.

An increasing number of these veterans need nursing home care, and cannot afford the expense of entering one. The monthly cost of nursing home care is double the entire income of many of these veterans. Their only hope is to get in a V.A. nursing home, or contract facility. Only a small percentage of these needing this service can enter one. A larger percentage cannot because they cannot enter a V.A. hospital so they can be transferred to a V.A. nursing home.

If the V.A. hospitals would receive all those who apply for hospitalization who only need nursing home care they would not have enough available beds to care for them. Any Veterans Service Officer can attest that the V.A. hospital will not accept a nursing home case, and they cannot be entered into a V.A. nursing home by their family physician. Their only recourse is a County charity home, which is a sad tragedy for a veteran who gave of himself for his country.

We are submitting copies of some letters received in our headquarters for the record attesting to the lack of admissions in V.A. hospitals which reveal service which could be rendered if adequately funded to utilize facilities now existing, and authorized previously by the Congress.

The first letter is from a County Veterans Service Officer in Cleveland, Tennessee, marked #II, with an accompanying letter from Dr. James R. (Bob) Thurman of Cleveland, Tennessee marked Appendix A for #II.

The Service Officer states that he could not furnish us with names of cases and comply with our request for speed. He also states how he had cases on record where he had had applicants refused hospitalization and states another problem he is having is in getting out-patient care for service connected cases.

The doctor in Appendix A for II reflects disgust in his efforts to deal with the physicians in the V.A. hospitals.

A Service Officer in Dayton, Tennessee expresses his experience in efforts to enter patients in V.A. hospitals marked #III.

Mr. Ross Fine, a County Service Officer expresses a thought mentioned in letters to our headquarters where veterans have tried to enter a V.A. hospital and the application was delayed, in what some refer to as stalling until the veteran died. Mr. Fine states this delay in his cases run as high as 40 days.

It is obvious these cases are delayed due to some pressure from somewhere and is a strong indictment against any institution created for the purpose of aiding those in need of medical care.

Letter marked #IV is from a disillusioned veteran of World War I. This veteran states that he has sought to be admitted three times to be examined and has been denied. Dr. Thurman in letter marked Appendix A for #II states that “The Doctors here say that no matter what the local doctors say the patient won't be admitted to the V.A. hospital without the doctors there evaluating the patient and making his own decision.” Dr. Thurman is writing representing the County Medical Association.

Letter marked #V pertaining to a nursing home from Mr. Pike, a World War I Service Officer in Ohio working in Cincinnati, Ohio Veterans Administration hospital. His letter reflects the same appeal we received in letters from veterans throughout the year stating they need help and cannot help themselves.

We submit a letter marked #VI from a World War I veteran which is similar to hundreds of letters we receive from veterans who are trying to live and care for themselves and do not have the funds to do so.

The Veterans Administration hospitals should provide the medical care these veterans need. Here is an example that Medicare under the Social Security program does not provide the medical care these aged veterans need. The only thing they have to look forward to is to wait until they die without having their medical needs attended. They read of the entitlement provided for them by law, and have given up in disgust at trying to obtain admittance in a V.A. hospital because so many are turned away with the excuse there are no avail. able beds.

The Veterans of World War I appeal to the Congress to appropriate adequate funds to provide the medical care our aged veterans need, and that increased provision be made for nursing home care under the V.A. for American veterans.

Thanking you again for the privilege of presenting our views on this critical subject, and we assure you of our cooperation in providing further assistance whenever we are able.

Senator CRANSTON. Our next witness is Mr. William J. Flaherty, deputy national director of legislation, Disabled American Veterans. Bill, we welcome you, glad to have you with us.

. Mr. FLAHERTY. Mr. Chairman, we have prepared a statement setting forth pertinent data with respect to certain items in the VA medical budget fiscal 1973 and 1974. With the chariman's permis

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