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GOP senators say management, not money, is the problem at VA

North Carolina Sen. Richard Burr and three Republican colleagues on Tuesday announced support for legislation they say would tackle the root causes of treatment delays at veterans medical facilities by giving former service members the option of choosing private health care.

Their measure would allow veterans unable to get an appointment in a timely way or who live more than 40 miles from a Department of Veterans Affairs facility to receive care from any doctor in Medicare or the military's TRICARE health program.

The legislation, which the Republican lawmakers unveiled at a press conference at the Capitol, also would establish penalties for VA workers who falsified data and would give the VA secretary the power to fire senior officials who performed their jobs poorly.

"This bill is very targeted," Burr, the ranking Republican on the Senate Veterans Affairs Committee, said at a news conference. "It's focused specifically on fixing a short-term problem, which is how do we get veterans the care they deserve and allow the VA leadership to make systemic changes."

Meanwhile, in his first comments since taking over the agency last week, acting VA Secretary Sloan Gibson said that "not all veterans are getting access to the health care that they have earned." He pledged to make addressing the problems quickly the VA's top priority.

Gibson became acting secretary when Eric Shinseki resigned the top post at the VA following reports of treatment delays and other problems at VA hospitals across the country. Gibson said in a statement that "systemic problems in scheduling processes have been exacerbated by leadership failures and ethical lapses. . . . I will use all available authority to swiftly and decisively address issues of willful misconduct or mismanagement."

He also expressed appreciation of Shinseki on behalf of veterans, noting that they'd benefit from the transformation begun in the past five years under the retired four-star general's leadership.

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No recent investigations have shown that the VA needs more money, Burr said. Since 2010, the agency has carried more than $4.6 billion in its health care account, and this year it is estimated to carry over an additional $450 million, he said, referring to funds that Congress appropriated but went unused.

Sen. John McCain, R-Ariz., said at the press conference that an alternative measure from independent Sen. Bernie Sanders of Vermont, chairman of the Senate Veterans Affairs Committee, would not address the "root causes of the current VA scandal." Sanders plans to hold a hearing Thursday on his bill to prepare it for a floor vote. In February, Republicans blocked an earlier version of Sanders' bill.

His latest version also would give the VA the authority to remove senior officials for poor job performance and give veterans who can't get timely appointments the option of going to military or private doctors. It would authorize the VA to lease 27 new health facilities and would provide funding to hire more doctors, nurses and other staff to make up for what Sanders says are shortages created at many VA facilities as more veterans enter the health system.

Sen. Tom Coburn, R-Okla., denied that a shortage exists. A physician, Coburn cited a 2012 report in the Annals of Family Medicine that he said showed that the average practitioner in a VA hospital sees half the number of patients that the average non-VA practitioner sees.

The study found the average U.S. primary care physician has about 2,300 patients. It cited another study that said the VA had a target of 1,200 patients per primary care physician, and added that that would be a reasonable load because the patient population in the VA is older and has more chronic illnesses than the patient population seen by the average private physician.

Burr said that Congress doesn't have the data it would need to determine whether VA hospitals and clinics are understaffed, which the GOP bill would require the VA to provide. In addition, Congress should wait before making any additions to staffing until the VA inspector general's report on the long wait times is finished, Burr said, adding that lawmakers also probably should require an independent audit.

He also said that Republicans supported adding more VA outpatient clinics.

The bill he and the other Republican senators proposed was "not encompassing everything that Congress would like to pass as it relates to VA legislation, but it addresses the urgent things needed right now," Burr said.

The bill Sanders introduced also includes many other provisions for veterans, including more help to end backlogs in processing disability claims, in-state tuition rates for college costs for all veterans eligible for the Post 9/11 GI Bill, and restoration of a 1 percent cut in retirement cost-of-living adjustments for current military members.

Sanders on Monday told reporters he found it "distasteful that the Republicans now say this may be too expensive."

"Well you know, if it's too expensive to take care of veterans when they come home from war don't send them to war in the first place," he said. "This is a cost of war."

By Renee Schoof

McClatchy Washington Bureau

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