ADMINISTRATION PROPOSALS RELATING TO

VA HEALTH CARE

HEARING

BEFORE THE

COMMITTEE ON VETERANS' AFFAIRS

UNITED STATES SENATE

NINETY-NINTH CONGRESS

FIRST SESSION

53-267 O

JUNE 20, 1985

Printed for the use of the Committee on Veterans' Affairs

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON 1985

ANTHONY J. PRINCIPI, Chief Counsel/Staff Director JONATHAN R. STEINBERG, Minority Chief Counsel/Staff Director

85-603317

CONTENTS

Opening statement of Hon. Frank H. Murkowski, chairman of the Senate

Committee on Veterans' Affairs.....

Testimony of:

Everett Alvarez, Jr., Deputy Administrator of Veterans' Affairs, Veter-

ans' Administration, accompanied by Dr. John A. Gronvall, Chief Medi-

cal Director, Department of Medicine and Surgery; Marjorie R. Quandt,

Assistant Chief Medical Director for Administration; and Donald L.

Ivers, General Counsel

Dr. Nancy M. Gordon, Assistant Director for Human Resources and

Community Development, Congressional Budget Office, Washington,

DC, accompanied by Dorothy Amey, analyst; and Nina Shepherd, ana-

lyst..

A panel of health insurance representatives consisting of: Mary Nell

Lehnhard, vice president, office of Government relations, Blue Cross

and Blue Shield Association, Washington, DC; and Philip Briggs, execu-

tive vice president, Metropolitan Life Insurance Co., and representative

of the Health Insurance Association of America, Washington, DC.............

Richard L. Fogel, Director, Human Resources Division, General Account-

ing Office, Washington, DC, accompanied by James Linz, Group Direc-

tor; David Baine, Associate Director; and Nancy Findley, Office of

General Counsel.........

Written statement of:

Hon. Strom Thurmond, a U.S. Senator from the State of South Carolina...

Everett Alvarez, Deputy Administrator of Veterans' Affairs.

Hon. George J. Mitchell, a U.S. Senator from the State of Maine.

Hon. Jeremiah Denton, a U.S. Senator from the State of Alabama.

Hon. Arlen Specter, a U.S. Senator from the State of Pennsylvania

7

11

22

25

61

Dr. Nancy M. Gordon, Assistant Director for Human Resources and

Community Development, Congressional Budget Office...

Mary Nell Lehnhard, vice president, office of Government relations, Blue

Cross and Blue Shield Association, Washington, DC.

Hon. Alan K. Simpson, a U.S. Senator from the State of Wyoming..

Philip Briggs, executive vice president, Metropolitan Life Insurance Co.,

and representative of the Health Insurance Association of America,

Washington, DC.

103

131

174

178

Richard L. Fogel, Director, Human Resources Division, U.S. General Ac-

counting Office, Washington, DC

220

Bob Moran, associate legislative director, Paralyzed Veterans of America .

Questions and answers:

283

Response of the Veterans' Administration to written questions submitted

by:

Hon. Frank H. Murkowski, chairman of the Senate Committee on

Veterans' Affairs..........

Hon. Alan Cranston, ranking minority member of the Senate Com-
mittee on Veterans' Affairs..

Arlen Specter, a U.S. Senator from the State of Pennsylvania
George J. Mitchell, a U.S. Senator from the State of Maine.
Response of the Congressional Budget Office to written questions submit-
ted by:

Hon. Frank H. Murkowski, chairman of the Senate Committee on

Veterans' Affairs......

116

Hon. Alan Cranston, ranking minority member of the Senate Com-

mittee on Veterans' Affairs.

121