The members of this distinguished Subcommittee will recall a situation last year when, despite evidence to the contrary, VA officials made similar denials of the need for additional funds to operate the hospital and medical program. When the true facts were placed before the Congress, however, a conclusion was quickly reached that there was a clear and pressing need for additional funds, and for far more resources than had been requested by the Veterans Administration.

Finally, in the face of vigorous opposition from the Administration, the Congress, in the Appropriations Act for Fiscal Year 1973 (P. L. 92-383), authorized an increase of $54,580,000 to insure an adequate level of medical care for the Nation's veterans. This law required the VA to maintain an average daily patient census of no less than 85,500 and an average staff to patient ratio of no less than 1.49 to 1 in all VA hospitals during fiscal year 1973. The VA, however, proposes to achieve this Congressionally requested staffing ratio by reducing the average daily patient census to 82,000. The budget request for fiscal year 1974 proposes still further reductions, with an average staff to patient ratio of 1.5 to 1 based on an average daily census of only 80,000 patients.

Moreover, instead of increasing the number of its medical employees by 3,725, as provided for in the fiscal year 1973 Appropriations Act, the VA plans to reduce its inpatient care employment by 1,832 in fiscal '73, and by another 2,180 in fiscal '74.

These reductions in medical personnel and the average daily patient census not only abolish the efforts of Congress to improve hospital staffing and medical care, but also impose unrealistic employment levels at a time when many VA hospitals are facing serious shortages of employees and hospital beds to provide direct medical care for the increasing veteran population.

Other deficiencies in the VA medical budget would result in a reduction of $6 million for medical and prosthetic research, and a reduction of $81 million in hospital construction. No funds are available in the budget for the 8 new medical schools authorized by the Congress last year under Public Law 92-541.

Mr. Chairman, the DVA feels very strongly that the Veterans Administration must proceed urgently with the expansion of its hospital facilities, its medical services, and the scope of its research projects. Much valuable work remains to be done, and adequate funds must be made available to assure a high standard of care in VA hospitals. We feel that the VA must go forward with positive programs that provide greater health services to more patients with increased effectiveness. In our opinion these things can be accomplished, in large measure, by enactment of S. 59, the Veterans Health Care Expansion Act of 1973.

This bill, Mr. Chairman, which you introduced and which was co-sponsored by your Committee colleagues, passed the Senate March 6th by a vote of 86 to 2. It contains a wide variety of provisions designed to strengthen the VA hospital system and enhance the quality of care in all VA medical facilities.

We salute the Committee for initiating this useful and necessary legislation, and for working so effectively to achieve its passage by the Senate. We also take this opportunity to commend and thank the Committee members for their untiring efforts which brought to passage on March 6th, the National Cemeteries Act of 1973.

We are all keenly aware of the fact that the cemeteries and health care measures were both passed unanimously by the House and Senate last year, in essentially the same form. Unfortunately, these measures-along with 10 other bills not related to veterans' affairs-were, in the name of economy, pocket vetoed by the President after Congress had adjourned in late October. This package of bills, which the President again threatens to veto, has been described as an extension of benefits associated with "social service" programs. While this description may correctly be applied to some of the programs involved, the system of benefits for the country's war veterans cannot, in any sense of the word, be classified as a "social service" program.

The American people have been constant in their recognition of the fact that war veterans are in a special category, and one to which the Nation owes a very special debt. Indeed, the measure of the Nation's gratitude is its ability and willingness to pay the price of reasonable benefits for those who served in times of war, and for those who took unprecedented risks to preserve our heritage and way of life. They did these things without counting the price which they were called upon to pay, and have since paid for every day of their lives.

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Mr. Chairman, as I mentioned earlier, the DAV is deeply distressed by the extent to which the Administration's budget priorities distort and frustrate the intentions of this Committee and the Congress.

In our view, the President has available to him many other, and better, ways of fighting inflation than vetoing urgently needed VA appropriations for research and health services.

Even in a period of serious inflation the VA hospital and medical care program, which represents a long term investment in the health and well-being of our sick and disabled war veterans, should not only be preserved, but should also be enlarged as the needs so require.

We feel that the insensitive cuts thoughtlessly ordered at a time when the needs of our veterans are the greatest, poses a real threat to the present and future operation of the hospital and medical care program.

We are certain, Mr. Chairman, that you and the members of the Committee will not allow the program to deteriorate, that you will continue your efforts to see that sufficient funds are available to enable the VA hospital system to effectively fulfill its stated mission of providing medical care “second to none”. In closing, Mr. Chairman, I again want to express our grateful appreciation for giving us this opportunity to express our views on a subject of vital importance to America's war veterans.

Senator CRANSTON. Our final witness will be Francis Stover, director of National Legislative Service, Veterans of Foreign Wars. I might explain that Ed Golembieski of the national veterans affairs and rehabilitation commission, The American Legion and Charles E. Mattingly, deputy director, national legislative commission, the American Legion, were scheduled to appear, but because of time problems they have submitted their statements for the record. The same holds true of Kenneth R. Hubbs, national legislative director, Military Order of the Purple Heart of the U.S.A. We are grateful to them for their statements. They will appear in the record, and I regret that we are not able to ask them some of the questions that their testimony will provoke and the general situation invites.

Frank, we are delighted to have you with us, and thank you so much for being willing to be switched to the end.

Mr. STOVER. Thank you for the opportunity to be the anchor man or the man who winds it all up, and put it all together, I hope.

Senator CRANSTON. Let's see if you can outdo our previous man.

STATEMENT OF FRANCIS STOVER, DIRECTOR OF NATIONAL LEGISLATIVE SERVICE, VETERANS OF FOREIGN WARS

Mr. STOVER. First, Mr. Chairman, I would like to reiterate that the Veterans' Administration hospital system is a great national asset. It has 168 hospitals, as you know, 16 domiciliaries and a large group of other buildings. And, of course, its primary purpose is to take care of veterans, which it does.

But it also has an educational and training program which was eloquently described by previous doctors and members of the medical school facilities, and other witnesses. The VA also has an excellent research program which has made a significant contribution, not only to the health of the patients, but to the health of the Nation.

So, what I am trying to say is while the Veterans' Administration hospital system is primarily for veterans, it is doing a tremendous job and is a national asset for all. It does perform a service for all Americans, especially when we realize that over half the doctors of the Nation received some training from the VA at some time during their educational process.

The same is true of nurses and other so-called paramedical personnel or health manpower personnel. The VA helps train a large number of these and, of course, this was the reasoning behind Public Law 92-541, the VA medical school assistance law. The medical assistance bill, H.J. Res. 748, 92d Congress, got impetus from the fact that these 168 VA hospitals, were an ideal national asset to conduct these kinds of educational programs contemplated by this law.

With a shortage of 50,000 doctors, this is what is being cited, plus 250,000 other people that are needed in the civilian health world the VA could do an awfully good job in helping to reduce this medical health personnel shortage as envisioned in Public Law 92-541.

So, the VFW, by national mandate, supported that legislation, H.J. Res. 748, and we were very, very pleased when the President did sign it. However, we now think that maybe he signed it reluctantly because, as you know, there is not one thin dime in this year's 1974 budget to implement this law that would help establish eight new medical schools in conjunction or in cooperation with the Veterans' Administration.

I may add also, Mr. Chairman, that the record should show, and I believe that this is correct, I just remembered it today, that you did and were successful in having added an amendment to an appropriations bill, I think it was $40 million last fall, in the waning days of the 92d Congress to fund this bill, H.J. Res. 748, before it was actually signed by the President.

Senator CRANSTON. That's right. With your help we did.

Mr. STOVER. And it did pass the Senate, but the House refused to leave it in the bill because it had not been signed. So, it does show that the Senate does want Public Law 92-541 funded and we are still working on that. We are very, very unhappy that it has not been funded as yet.

An outstanding example for funding immediately the VA medical school assistance program is in New Jersey. The State of New Jersey needs a VA medical facility in South Jersey, and this kind of an authorization for a new medical school in conjunction with VA facilities in New Jersey would be very helpful in getting that off the ground, and would lend salary assistance on a declining basis for 6 years until the medical school got going.

But the second point I wanted to make is of serious importance to VFW, Mr. Chairman, because we know from experience in previous Congresses, and I think the last 4 years, you and your Subcommittee on Veterans of the Labor and Public Welfare Committee, and the Health and Hospital Subcommittee here have built up a record which could not be denied by any reasonable person. And this record has been extremely helpful with the Appropriations Committee. And we want the record to show that VFW highly commends you, personally for holding these hearings today and as chairman of the subcommittee going before the Senate Appropriations Committee in previous years which demonstrated to your colleagues that extra money was needed if the veterans of this Nation are to receive the highest quality medical care. We are confident these hearings will adduce sufficient evidence to demonstrate beyond any doubt to a reasonable person that veterans' hospitals need more funds and staff.

Now, you asked the previous witnesses about-no, before I address myself to that point, I want the record to show that over $450 mil

lion was added to previous VA budgets, above and beyond that amount which was requested. So that the veterans care would be maintained and the quality would not be weakened or deteriorated. And most of that money has been spent.

I believe, to sum it all up, that we really have two problems. We have this year's 1973 VA budget and we have next year's proposed 1974 VA budget.

The 1973 VA budget, the Administration, the VA is impounding or not spending, depending on how you define the word impounding, about $135 million. Of this, $64 million represents medical care. And this is very unfortunate, because, as you know, Mr. Chairman, as has been stated here so many times today, the congressional mandate of a minimum 85,500 census is not being carried out. The VA, in effect, is violating the law.

And the other big impoundment is $65 million for new construction. Again, this is most unfortunate, and we hope that these moneys will carry over and will be eventually spent. We are urging the President to release these impounded funds as I have incorporated in my statement here. Our Commander in Chief, Patrick Carr, is urging the President to release these funds before the end of this fiscal year.

Now, as far as the VA's testimony today, Mr. Chairman, as my statement indicates, the head of the VA, as we say is Casper Weinberger. We like to think it is Donald Johnson, but I don't know if it really is. Mr. Weinberger, the "Supercrat" from your State of California, is now running the VA, and it is rather distressing.

We also realize he is the head of HEW, and we have long held that the VA should remain independent of HEW. But we feel that Mr. Weinberger, who has responsibility over the VA medical program, together with Mr. Ash, the head of Office of Management and Budget, these two gentlemen together make VA policy. Remember, Mr. Weinberger was just previously the head of OMB-and I might add he is the one whose nickname is "Cap the Knife" for his budget cutting propensities. This budget cutter and head of HEW is the man who is calling the shots. He is the gentleman who has told the VA "Now you tell it like it is, this is the budget that has been handed to you and we want you to sell it."

And this is what we heard here today from these very highly regarded people on the VA, Mr. Wilson, and his associates. And we know the Congress wants to find the truth. The VFW is going to furnish this committee and the Congress with a lot of cases, a lot of examples of how the VA has managed to hold down the number of veterans being admitted to VA hospitals. So that the staff/patient ratio continues to look good or even better. This is the name of the game. We are going to supply you with rejected cases of hospital applications, Mr. Chairman.

A recent study indicates that 1,000 veterans who applied for veterans hospital care, about half of these people never made it to a VA hospital. They were rejected to begin with, they were put on pre-bed care, then they were rejected later or they got tired and withdrew or they could not wait and they went to a community hospital nearby or in some extreme cases they died.

So, these, Mr. Chairman, are the views of the VFW. We are up in arms about this. We feel that this is no time to be cutting veterans programs. Six million Vietnam veterans have come home in the last 5 or 6 years. As you have stated so many times, this is the most crippling war in our history. These disabled veterans will require longterm, sophisticated care, very extensive, and they need a lot of rehabilitation.

And, in addition to that, the VA budget has been swollen by over $2 billion for G.I. bill assistance, which is probably starting to level off. So, when you talk about cutting, what would we say is the cost of war? Veterans benefits are a cost of the war, an extension of the cost of war, and with that in mind, the war is still going on insofar as veterans programs are concerned. And we don't feel that our programs are in the same category as so-called nonwar programs. In other words, programs carried out by most other agencies.

I would say this in response to questions I heard you ask here today. We do have about 300 solutions, but we do not have any which recommends cuts in other agencies.

When this year's VA budget proposed a $160 million cut in the compensation payments to Vietnam veterans, the VFW was stunned. Since that time, I have noted a rising discussion in the VFW about aid to North Vietnam and Southeast Asia, vis-a-vis cutting benefits for Vietnam veterans and veterans in general.

So, we don't have a position on that at the moment, but we will have a national convention next August.

Senator CRANSTON. Do you have any recommendations for any cuts within the VA budget itself?

Mr. STOVER. No, we have looked through the VA budget and, unfortunately, of course we don't know whether there might be some excess fat, but just on the basis of the overall figures we don't see any basis for any cuts this year.

Senator CRANSTON. There probably is some fat somewhere, if you could find it.

Mr. STOVER. I am sure that in $12 billion there probably is, but we hope that there is not.

Senator CRANSTON. Maybe they don't need to pay Donald Johnson's salary, since either Cap Weinberger or Roy Ash is director. I don't know which.

Mr. STOVER. Maybe he does not need that limousine either, that Senator Proxmire talked about.

Senator CRANSTON. I wonder if they have air-conditioning down there. There is another place we should shut off their air.

Mr. STOVER. I think that they do including the limousine.

Senator CRANSTON. That could be saying that we found two items in 1 minute. Let's keep at it. Where else?

I know that the organization that you represent will stand with us in our efforts to restore the VA budget to insure the veterans receive their fair due.

Mr. STOVER. We certainly will, Mr. Chairman.

Senator CRANSTON. I want to ask you the same question I asked others. Would you please get to us any information about veterans denied admission to a VA hospital, who wound up in a community hospital?