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long-range planning. It has been operating too much from crisis to crisis.
We are very hopeful that the recent action of the Veterans Administration in deciding to change its organizational pattern to a major product system will be the forerunner of administrative decisions designed to make the Veterans’ Administration a greatly respected Government agency. Certainly an agency administering benefits for 19 million veterans and their dependents—almost one-third of our population-requires the most up-to-date administrative methods and procedures.
We are pleased that the Committee on Veterans Affairs has planned hearings on this subject. When those hearings are held, AMVETS would appreciate the opportunity to appear and present detailed testimony on Veterans Administration reorganization.
The Veterans' Administration's medical program is of major concern to our organization.
We have established as a major legislative priority, adequate appropriations for the Department of Medicine and Surgery of the Veterans' Administration. Never in our history have we been so alarmed by any situation as that now existing within the Veterans' Administration Medical Service. In the face of repeated public statements that veterans will receive second to none” medical care, we have seen the finest medical program in the world become diluted, stagnated, and tottering on the brink of disaster. This deplorable situation is a direct result of unrealistic, hasty and ill-conceived economy attempts-attempts which on one hand provide funds for new Veterans' Administration hospitals and on the other hand take away funds to properly operate existing facilities. And even more important, we are deeply concerned at the whittling away of the veterans medical program without even taking into account congressional investigations and consideration by this committee, the Veterans' Committee.
Last year we witnessed legislation by appropriation which has greatly weakened a program that has been established, nourished, and maintained by this committee for many years. AMVETS have made a nationwide survey to determine the effects of this action. Briefly this is what we found :
Very low morale in Veterans' Administration hospitals.
Curtailment of the Veterans’ Administration medical research programs.
Loss of 2,800 beds at a time when Korean war veterans demand more and more beds.
Prolonged hospitalization; a delay of surgical operations; and fewer veterans treated.
The cost of veterans hospital care increased.
Entire new wards in Veterans' Administration hospitals unopened because of lack of funds.
Extensive medical equipment lying dormant and unused.
Hometown medical treatment programs for service-connected disabilities severely curtailed.
Dental-care program on the verge of elimination.
Admission to Veterans' Administration neuropsychiatric hospitals virtually stopped.
Qualified scientists, surgeons, outstanding physicians, and consultants in the Veterans' Administration drifting away.
Evidence of very little planning in the placement of Veterans' Administration hospitals.
Teaching and residency program of physicians curtailed to such an extent that it is either eliminated or not effective in many hospitals throughout the country.
Equal adverse effects on service-connected and non-service-connected veterans alike. And public demand for a clear-cut congressional policy decision on this matter for the future.
The findings brought out in AMVETS survey become much more significant when dovetailed with specific examples from specific areas of the country. I have seen a large number of them in traveling over the country. I would like to call your attention to one particular State.
In New York, a report made by the senior medical consultants group to the deans committee to the Veterans' Administration hospital in the Bronx established conclusively that a cut of 105 personnel has resulted in serious curtailment of medical services which the hospital had been rendering. We feel this report to be typical in varying degrees of a nationwide situation. We believe it clearly indicates the present position of the Veterans Administration Medical Service.
Briefly, it states that 125 beds were closed. The surgical service suffered the loss of 3 out of 8 operating rooms which could not be staffed. Orthopedic surgery was reduced by 50 percent; plastic surgery by 60 percent. The backlog of patients awaiting operation in the surgical service has shown a definite increase. Curtaisment of valuable laboratory and diagnostic tests cut down on care of medical patients. The psychiatric service was formed to reduce its facilities for shock treatment by 33 percent, and its bed capacity for the care of new acutely disturbed mental patients, including Korean battle casualties, by 50 percent, or half.
As an example of false economy, an X-ray therapy machine costing $350,000 stands idle because no funds are available to hire personnel for its operation. Only 6 of the 8 available X-ray diagnostic rooms can now be used, resulting in delay in diagnosis, increase in bed-days, and cost for each patient. Four hundred-odd paraplegics in the area who depend on this hospital for surgical treatment for recurrent pain, urinary infections, skin ulcers, and so forth, are all "seriously and dangerously affected.” A special tuberculosis service just completed at a cost of $100,000 is not in use because of lack of funds and personnel intended for its operation.
We are well aware that a controversy exists on the subject of nonservice-connected hospitalization and perhaps this fact has had much to do with cuts in the VA medical services. However, it must be realized that a blanket reduction in funds without a change in basic
policy has equally adverse effect on service-connected and non-serviceconnected patients alike.
I think there can be no question but that this survey shows the dire results of the cut in the VA program.
The followup clinic for the purpose of continuing treatment of veterans, initiated while they were bed patients, had to be closed, thus depriving many cancer patients, for instance, of followup X-ray treatments, some of which were terminated when only half finished. Patients with heart trouble have been deprived of the opportunity to have frequent important adjustments of their medications. Other patients have been deprived of periodic examinations for signs of reactivity of tuberculosis. Supervision following brain operations, so important during convalescence, has been curtailed. Finally, the mandatory curtailment of 40 percent of the visits by consultants and attendant physicians means that a patient who formerly was seen each weekday by one or more senior physicians will receive less care from older and more experienced members of the staff. The senior medical consultants in New York have thus concluded that the effect of dismissing the 105 full-time employees from that hospital has, and I quote, inevitably diluted the quality of medical care,” “prolonged hospitalization," "delayed treatment,and “increased cost of patient care."
In consideration of this question, we would like to point out that, of 107,000 patients in all VÀ hospitals, 35 percent, or approximately 37,000 patients, are service connected. Another 10,000 are non-serviceconnected tuberculosis patients. Another 27,000 have non-serviceconnected mental or neurological disabilities; another 32,000 have non-service-connected general medical and surgical conditions, and of this number it should be assumed that at least 10,000 have chronic diseases such as cancer, heart trouble, and so forth. We believe it to be self-evident that very few, if any, of these individuals who are on the non-service-connected rolls would be financially able to pay for their own long-term hospitalization.
While AMVETS favor hospitalization benefits for all needy war veterans, we believe the controversy of service-connected versus nonservice-connected hospitalization to be dwarfed by an overriding necessity to eliminate inferior medical care to any veteran. When this basic principle is endangered and affects men disabled in war, AMVETS feel that this committee, which is charged with the protection of veterans' benefits, should lead the way to a solution of the problem.
To this end we earnestly request that the Congress immediately restore $15,000,000 into the appropriation for the Department of Medicine and Surgery of the Veterans Administration. To do less will permit the continued deterioration of the Veterans' Administration medical program.
In addition to this action we further request this committee to undertake an immediate detailed investigation of the status of VA medicine. We urge you to call public hearings and to go into the overall subject of VĂ medical care, requirements for admission to VA hospitals, need clauses, non-service-connected hospitalization, and in fact every possible avenue of approach.
AMVETS stand ready to offer testimony if such hearings are held, Upon the conclusion of an investigation of this nature, we are certain
that the Committee on Veterans Affairs will arrive at the conclusion that has been arrived at by every major veterans' organization; namely, that the VA medical program is a needed service that has been provided by a grateful nation to care for its war disabled, that nonservice-connected disabled needy veterans must have medical care, that the people of the Nation demand the maintenance of this program, and that this program can be operated within the Nation's economy.
For our part, AMVETS feel that the Congress should declare a public policy that the VA medical program must be strengthened, maintained, expanded, and perfected. A clear-cut policy statement in this vein would do much to repair the deplorable damage already made manifest. We are extremely hopeful that you will see fit to take this action as a priority course of business.
I think that concludes my report at this time.
The CHAIRMAN. Thank you for a very interesting statement. I am particularly interested in your findings regarding the hospitals.
I think it is very unfortunate that the Appropriations Committee finds it necessary to cut the authorizations, and I think in the last appropriation bills certain Members of the House voted for cuts without realizing it would hurt the hospital program.
Mr. MILLER. I think that is true.
The CHAIRMAN. I am very sure Members voted in error. I think you will agree with me that some of the people previously in the Veterans Administration seemed to take great delight in hurting Veterans' Administration programs now that they are out of the VA.
Mr. MILLER. We have noticed that.
The CHAIRMAN. That is right; it is a great disservice to veterans. Instead of building up, they are trying to tear down services to the veterans in every way possible, and I am very sure you do not want to turn over the hospitalization of veterans to the department of public health or to civilian hospitals. Is that right?
Mr. MILLER. That is right.
The CHAIRMAN. And you are fighting against this program of turning VA hospitals over to other agencies that are glad to take them
I think other committees are anxious to take over many of our prerogatives and duties.
Mr. MILLER. We oppose it, as do other veterans' organizations. The CHAIRMAN. I think, if we fight together, we will win.
Mr. MILLER. I would like to introduce to the committee Dave Schlothauer, our executive director, and Rufus Wilson, who is in charge of our service department.
The CHAIRMAN. We bother them a lot. They are very fine, we know.
Mr. ADAIR. Madam Chairman.
Mr. Adair. I might simply say, having an eye on the clock that I wanted to point out that earlier in your statement you came out for a one year guarantee on homes built under the GI loan program.
Mr. MILLER. Yes, sir.
Mr. ADAIR. As you are aware, that has been a matter under discussion in this committee. A major problem in that connection is the
question of enforcement. How are you going to protect the rights not only of the veterans but of the builders and the financial institutions?
Mr. MILLER. I thought the most expedient way would be to have the Administrattor of the Veterans Administration enpowered to pass on contracts. If there were any breach of contract, you would have the facilities of the civil courts in actions for breach of contract or declaratory judgement.
Mr. ADAIR. Then, if a veteran considered himself aggrieved, he would go into a court of his community and say, "Here is a contract”?
Mr. MILLER. Yes, "Here is a contract that has been violated.” And he would ask the jury for damages, and I believe he would get a verdict.
Mr. ADAIR. He would employ his own counsel at his own expense?
Mr. MILLER. Yes; on a contingent-fee basis, I hope. I think counsel in most parts of the country are considerate of the needs of veterans.
Mr. Adair. A man could consider himself aggrieved, but counsel might entertain some doubt on the question and might not feel enough assurance as to the result to take the case on a contingent-fee basis. You might ask your staff to let us have your thinking on that.
The CHAIRMAN. Judge Mack.
Mr. MacK. You are not asking for medical care in the supplemental appropriation ?
Mr. MILLER. The budget has asked for $5,000,000 to finish the construction of new hospitals and to staff them.
The CHAIRMAN. My understanding was the Veterans' Administration was going to ask for a supplemental appropriation but perhaps was stopped by the budget.
Mr. MILLER. We think an independent bill will be necessary for restoration of the cut last year.
The CHAIRMAN. I put in a bill, H. R. 28, for additional money for hospitals, and I have appointed a Hospitals Subcommittee with General Kearney as chairman of it.
Perhaps you would like to know the chairmen of our various subcommittees?
Mr. MILLER. Yes.
The CHAIRMAN. Mr. Adair is chairman of our Subcommittee on Administration and Finance in the Veterans Administration.
Mr. Radwan, of New York, is chairman of the Subcommittee on Compensation and Pension.
Mr. Springer, of Illinois, is chairman of the Subcommittee on Education and Training:
General Kearney is chairman of the Subcommittee on Hospitals. Mr. Ayres, of Ohio, is chairman of the Subcommittee on Housing.
Mr. Prouty, of Vermont, is chairman of the Subcommittee on Insurance.
And Judge Mack, of Washington, is chairman of the Subcommittee on Spanish War.
Mr. FRELINGHUYSEN. Madam Chairman.
Mr. FRELINGHUYSEN. I would like to ask a few questions on the importance of eliminating inferior medical care to veterans.