Max
06-12-2002, 12:23 PM
VA hospitals may be closed
By Laura Meckler
Associated Press
Web Posted : 06/06/2002 12:00 AM
WASHINGTON Veterans' hospitals in cities across the country could be closed as the Veterans Affairs Department shifts its focus to outpatient care and works to bring services closer to people who need them.
The massive restructuring, being announced today, would touch every community where the VA operates, though decisions about specific cities and hospitals won't be made for more than a year. In some cities, hospitals are likely to be closed or operations scaled back; in others, new services will be added.
"This is not about the closure of facilities. It's about continuing the change in VA health care and changing it for the better," Deputy Secretary of Veterans Affairs Dr. Leo Mackay Jr. said.
Decisions about where to cut and where to add will be made after analyses of demographics and services available at 163 hospitals and more than 1,000 clinics, nursing homes and other health care facilities.
How the decision will affect the San Antonio area wasn't clear Wednesday afternoon. No one could be reached late in the day at Audie Murphy VA Hospital.
Opened in 1973 and named after the nation's most-decorated World War II hero, the facility has 434 hospital beds, a 90-bed Extended Care Therapy Center and a 30-bed Spinal Cord Injury Center.
The facility houses the only National Institutes of Health sponsored research program in the VA and one of 16 Geriatric Research, Education & Clinical Centers.
An independent nine-member commission is to make recommendations to the VA secretary in August 2003.
As with recommendations on military base closings, the secretary must accept or reject the plan as a whole an attempt to minimize the politics surrounding the closure of sometimes cherished institutions.
Some veterans are concerned the VA might be dismantling an infrastructure that's part of the national security plan. And they worry that some vets will lose access to care.
"While they keep saying they're improving services, they are drastically cutting services," said Bruce Parry, 55, of Veterans for Unification, a Chicago advocacy group. "The result will be the VA serves fewer veterans, and as people find it less attractive, they will have further excuses for shutting more down in the future."
The national overhaul, recommended by government auditors in 1999, is aimed at shifting dollars away from aging inefficient facilities in communities where the number of veterans is shrinking in order to provide modern medicine closer to where vets of the future will live.
The 1999 audit, by the General Accounting Office, predicted that, without change, the VA would wind up spending billions of dollars to operate unneeded buildings with as much as one of every four VA health care dollars devoted to the maintenance and operation of facilities.
It's easier said than done. In a pilot program in one region, the VA opted to cut inpatient service from a downtown Chicago hospital and expand services at other facilities.
Veterans' groups were outraged, and VA officials are pledging to consider their opinions as the market analyses begin across the country.
The GAO suggested the greatest potential for savings is in 40 cities where there is more than one VA hospital. These hospitals have a significant number of empty beds and compete with one another to serve "rapidly declining veteran populations," auditors said.
VA officials declined to speculate as to which hospitals might close and said their goal is not to cut services but to redeploy them to areas where they are needed more.
They emphasized hospital beds aren't needed for the VA's new emphasis on outpatient care, which follows a national shift spurred by better drugs and more outpatient surgeries.
"We're looking to allocate our resources more efficiently, in ways that keep pace with the American medical system," Mackay said.
The plan is years overdue, but will be challenging to implement, said Cynthia Bascetta, who oversees veterans health care issues for the GAO. She noted that private hospitals, veterans groups and community leaders all have a stake in what services are offered and where.
"Deciding to do it was hard enough. Actually getting it done is the really hard part," she said. "These are very dicey decisions whenever money is involved. It's going to take a lot of courage to make sure all of the stakeholders keep their eye on making sure what's done is ultimately in the benefit of the veteran."
The initial analyses will be done on a market-by-market and then a regional level, but in the end, Mackay said, dollars could shift from one part of the country to another.
"It's a national plan," he said.
For example, he said, like the overall population, veterans have shifted from Northern cities such as Chicago, Detroit, Boston and New York to Sun Belt states like Texas, Florida and Arizona.
In Chicago, for instance, he said the veterans population is expected to shrink from 77,000 to 43,000 over 10 years.
"Those are the kind of demographic and geographic shifts we're trying to accommodate," he said.
Veterans' groups are skeptical. The American Legion worries that current health care needs, which often aren't met by an overtaxed system, will be ignored in the face of restructuring, said Mark Regan, assistant director for program management.
06/06/2002
Click here to return
By Laura Meckler
Associated Press
Web Posted : 06/06/2002 12:00 AM
WASHINGTON Veterans' hospitals in cities across the country could be closed as the Veterans Affairs Department shifts its focus to outpatient care and works to bring services closer to people who need them.
The massive restructuring, being announced today, would touch every community where the VA operates, though decisions about specific cities and hospitals won't be made for more than a year. In some cities, hospitals are likely to be closed or operations scaled back; in others, new services will be added.
"This is not about the closure of facilities. It's about continuing the change in VA health care and changing it for the better," Deputy Secretary of Veterans Affairs Dr. Leo Mackay Jr. said.
Decisions about where to cut and where to add will be made after analyses of demographics and services available at 163 hospitals and more than 1,000 clinics, nursing homes and other health care facilities.
How the decision will affect the San Antonio area wasn't clear Wednesday afternoon. No one could be reached late in the day at Audie Murphy VA Hospital.
Opened in 1973 and named after the nation's most-decorated World War II hero, the facility has 434 hospital beds, a 90-bed Extended Care Therapy Center and a 30-bed Spinal Cord Injury Center.
The facility houses the only National Institutes of Health sponsored research program in the VA and one of 16 Geriatric Research, Education & Clinical Centers.
An independent nine-member commission is to make recommendations to the VA secretary in August 2003.
As with recommendations on military base closings, the secretary must accept or reject the plan as a whole an attempt to minimize the politics surrounding the closure of sometimes cherished institutions.
Some veterans are concerned the VA might be dismantling an infrastructure that's part of the national security plan. And they worry that some vets will lose access to care.
"While they keep saying they're improving services, they are drastically cutting services," said Bruce Parry, 55, of Veterans for Unification, a Chicago advocacy group. "The result will be the VA serves fewer veterans, and as people find it less attractive, they will have further excuses for shutting more down in the future."
The national overhaul, recommended by government auditors in 1999, is aimed at shifting dollars away from aging inefficient facilities in communities where the number of veterans is shrinking in order to provide modern medicine closer to where vets of the future will live.
The 1999 audit, by the General Accounting Office, predicted that, without change, the VA would wind up spending billions of dollars to operate unneeded buildings with as much as one of every four VA health care dollars devoted to the maintenance and operation of facilities.
It's easier said than done. In a pilot program in one region, the VA opted to cut inpatient service from a downtown Chicago hospital and expand services at other facilities.
Veterans' groups were outraged, and VA officials are pledging to consider their opinions as the market analyses begin across the country.
The GAO suggested the greatest potential for savings is in 40 cities where there is more than one VA hospital. These hospitals have a significant number of empty beds and compete with one another to serve "rapidly declining veteran populations," auditors said.
VA officials declined to speculate as to which hospitals might close and said their goal is not to cut services but to redeploy them to areas where they are needed more.
They emphasized hospital beds aren't needed for the VA's new emphasis on outpatient care, which follows a national shift spurred by better drugs and more outpatient surgeries.
"We're looking to allocate our resources more efficiently, in ways that keep pace with the American medical system," Mackay said.
The plan is years overdue, but will be challenging to implement, said Cynthia Bascetta, who oversees veterans health care issues for the GAO. She noted that private hospitals, veterans groups and community leaders all have a stake in what services are offered and where.
"Deciding to do it was hard enough. Actually getting it done is the really hard part," she said. "These are very dicey decisions whenever money is involved. It's going to take a lot of courage to make sure all of the stakeholders keep their eye on making sure what's done is ultimately in the benefit of the veteran."
The initial analyses will be done on a market-by-market and then a regional level, but in the end, Mackay said, dollars could shift from one part of the country to another.
"It's a national plan," he said.
For example, he said, like the overall population, veterans have shifted from Northern cities such as Chicago, Detroit, Boston and New York to Sun Belt states like Texas, Florida and Arizona.
In Chicago, for instance, he said the veterans population is expected to shrink from 77,000 to 43,000 over 10 years.
"Those are the kind of demographic and geographic shifts we're trying to accommodate," he said.
Veterans' groups are skeptical. The American Legion worries that current health care needs, which often aren't met by an overtaxed system, will be ignored in the face of restructuring, said Mark Regan, assistant director for program management.
06/06/2002
Click here to return