May 1, 2002 

TO: Action E-List

FROM: Joseph A. Violante, National Legislative Director


DATE: May 1, 2002


Department of Veterans Affairs (VA) Secretary Anthony Principi has projected that, if he does not receive an additional $400 million in supplemental funding for VA health care programs this year, he may have to curtail enrollment of veterans seeking medical care.   However, the Administration has asked Congress for only $142 million additional for VA.  Senators Susan Collins, Tim Johnson, and Paul Wellstone have prepared a letter to be sent to the Senate Appropriations Committee urging the Committee to provide a minimum of $400 million for veterans' health care in the fiscal year (FY) 2002 supplemental appropriations bill. 

The DAV and the other three veterans' organizations coauthoring The Independent Budget sent a letter to all other senators urging them to join with Senators Collins, Johnson, and Wellstone as signatories on their letter to the Appropriations Committee.  These three senators have also invited their senate colleagues to sign the letter.  To persuade senators to join in this letter and effort to get this essential supplemental funding, we now need an immediate and strong grassroots campaign by DAV and Auxiliary members.  It is extremely important that you contact your Senators now to urge that they join in this letter to the Appropriations Committee.  For your convenience, you may use the prepared e-mail message at the DAV web site at www.dav.org to correspond with your senators.


As always, thank you for your support.


May 1, 2002

Health Subcommittee Backs Bills to Strengthen VA Health Infrastructure &Nation's Defenses Against Bio-Terrorism

(Washington, DC) -- The House Veterans' Affairs Subcommittee on Health this week approved three bills to strengthen the Department of Veterans Affairs' (VA's) health infrastructure (H.R. 4514), increase the VA's role in homeland security related to bio-terrorism (H.R. 3253), and name a VA medical center after former Senator Bob Dole of Kansas.

H.R. 4514, the Veterans' Major Medical Facilities Construction Act of 2002, sponsored by Subcommittee Chairman Jerry Moran (KS-1) will authorize $285 million for ten major medical facility construction projects. Six of the projects are designed to mitigate against potential seismic problems at VA facilities located in Palo Alto, San Francisco, West Los Angeles, Long Beach, and San Diego, California. Other projects authorized by H.R. 4514 are for VA facilities located in Cleveland, Ohio, Anchorage, Alaska, West Haven, Connecticut, and Tampa, Florida.

The Subcommittee also adopted an amendment to authorize a $2.6 million lease for an outpatient clinic in Charlotte, North Carolina.

"Over the past several years, the VA has requested very little funding for major medical construction, having delayed many projects while the so-called 'CARES' process goes forward," said Chairman Moran. "However, if we are to continue to maintain an infrastructure from which the VA can adequately provide health care to our nation's veterans, it is essential that we protect, preserve, repair and rehabilitate their medical facilities," he said.

"H.R. 4514 authorizes those projects identified by VA as its highest construction priorities; many involve seismic correction or protection, and all are concerned with patient safety," said Moran. "Each of these projects has been carefully scrutinized for cost, and the budget resolution adopted by the House in March supports this level of spending," he said.

In response to the new terrorist threat facing the United States, the Subcommittee also approved legislation to expand the VA's role in preventing and responding to biological, chemical and radiological terrorism threats. H.R. 3253, the Department of Veterans Affairs Emergency Preparedness Research, Education and Bio-Terrorism Prevention Act of 2002, is sponsored by Rep. Chris Smith (NJ-4), Chairman of the full Veterans' Affairs Committee.

"In the war on terrorism, it is absolutely essential that America maximize all of its existing resources, and that includes the VA's health care system," said Chairman Smith. "From providing top quality medical care, to now performing cutting edge medical research, the VA has become a unique national resource which must play an expanded role in homeland security," he said.

H.R. 3253 would authorize $100 million over five years to establish at least four National Medical Emergency Preparedness Centers at VA medical centers to conduct bio-medical research on, and develop health care responses for chemical, biological and radiological threats to the public health and safety. The centers would also provide education, training and advice to VA and community healthcare professionals, as well as provide rapid response laboratory assistance to local health care and law enforcement authorities in the event of a national emergency.

"There is ample precedent and experience within the VA for undertaking this expanded mission. Through their extensive medical research programs, the VA has documented expertise in diagnosing and treating viral diseases with devastating health consequences, such as their groundbreaking work on HIV and hepatitis C," said Smith. "And just last month, Dr. Karl Hostetler and his VA colleagues in San Diego developed a new oral treatment for smallpox, one of the most deadly bio-terror threats confronting the world today," he said.

The VA has the world's largest integrated health care network with over 200,000 health care professionals, 163 medical centers, 115 medical research programs, affiliations with over 100 schools of medicine, and a $25 billion annual budget. Dedicated to providing health care to America's military veterans, the VA is now the federal government's leading provider of direct medical services, with over 4.5 million patients treated last year.

"The VA already operates two War-Related Illness Centers tasked with developing specialized treatments for illnesses and injuries related to combat, one in Washington, DC and the other in East Orange, NJ," said Smith. "In essence, these new National Medical Preparedness Centers would similarly study illnesses and injuries most likely to come from a terrorist attack, and develop new treatments and protocols to mitigate their dangers," he said.

"It is both necessary and appropriate for the VA to play a larger role in homeland security and the legislation I have proposed is one way to take advantage of the VA's expertise without reducing its primary commitment of providing health care to our nation's veterans," said Smith. "Importantly my legislation calls for funding of these new centers to come from additional monies provided to combat terrorism, and not from the already hard-pressed VA health care system," he said.

The Subcommittee amended H.R. 3253 to include provisions from H.R. 3254, sponsored by Rep. Steve Buyer (IN-5), which would require the VA and Department of Defense to jointly develop training programs for health care professionals to detect and respond to chemical and biological terrorism. In addition, H.R. 3253 was amended to authorize a new assistant secretary in the Department of Veterans Affairs. This assistant secretary would coordinate Department-wide operations, preparedness, security and law enforcement functions.

The Subcommittee also approved another bill sponsored by Chairman Moran, H.R. 4608, which would name the VA Medical Center in Wichita, Kansas, the Robert J. Dole Department of Veterans Affairs Medical Center.' Former Senator Dole, who was wounded in combat during World War II, has been a tireless advocate for veterans his entire adult life.

All three bills were reported favorably to the full Committee, which is expected to take further action on them at next week's scheduled Committee markup session on Thursday, May 9, 2002.

Please visit http://veterans.house.gov, the House Committee on Veterans' Affairs web site, named 'One of the Best Web Sites in Congress' by the Congressional Management Foundation, May 3, 1999.

May 2, 2002

Benefits Subcommittee OKs Two Bills to Strengthen Job Programs & Increase Pensions and Benefits for Veterans

(Washington, DC) -- The House Veterans' Affairs Subcommittee on Benefits approved legislation (H.R. 4015) to reform and strengthen federal job training and placement programs for veterans. The Subcommittee also backed legislation (H.R. 4085) to increase disability compensation payments, and expand several other benefit programs for veterans, their dependents and survivors.

H.R. 4015, the Jobs for Veterans Act, sponsored by Benefits Subcommittee Chairman Mike Simpson (ID-2) and Silvestre Reyes (TX-16), would reform the Veterans Employment and Training Service (VETS) in the Labor Department which has responsibility for helping military veterans transition to the civilian job market.

"H.R. 4015 takes a very direct approach: those programs that produce favorable results for veterans will be rewarded; those that don't will not," said Simpson. "Furthermore, our legislation will establish a new performance accountability system that will continually measure whether veterans are being helped. Whether the service member is stationed at the 38th parallel in Korea, on a nuclear sub in the South Pacific, or at a base right here in the United States, this initiative will put job opportunities or job training right at their finger tips," he said.

H.R. 4015 authorizes $260 million over five years for performance incentive awards to states that provide the highest quality of services or that have made significant improvements in service for veterans job placement. The bill would provide states with $200 million in staffing grants, and establish a new comprehensive performance accountability system to measure  the performance of veterans' employment and training programs. H.R. 4015 would also establish an Internet-based one-stop job training and placement service for military personnel and veterans, and would create a new presidential 'National Hire Veterans Committee' to encourage employers to hire veterans and disabled veterans.

The Subcommittee also approved H.R. 4085, the Veterans and Survivors' Benefits Expansion Act of 2002, sponsored by Chairman Chris Smith (NJ-4), that would increase compensation payments to service-connected disabled veterans and their dependents through a cost-of-living adjustment (COLA) equal to the Social Security COLA effective December 1, 2002. The Congressional Budget Office projects that this increase will be 2.3%. H.R. 4085 was amended to include provisions from another Smith bill, H.R. 3731, to increase funding for State Approving Agencies, which certify the eligibility of schools and training programs for GI Bill recipients.

"The performance of our nation's all-volunteer armed forces remind us of the imporant role these brave men and women play in defense of our nation and our freedom. When they return home we have an obligation to make them whole and assist them when they transition into civilian life," said Smith. "With approval of H.R. 4015 today, we have taken another step forward for our veterans and for all of our fighting men and women in the future," he said.

H.R. 4085 was also amended by the Subcommittee to allow surviving spouses of veterans who remarry after age 65 to continue receiving their dependency and indemnity compensation, eligibility for CHAMPVA medical care, education, and housing loan benefits. Those surviving spouses who remarried after age 65 prior to enactment of the bill would have one year from date of enactment to reapply for benefits. This provision was modified from legislation originally introduced by Veterans' Affairs Committee Vice Chairman Michael Bilirakis (FL-9).

"Today's action for these long suffering surviving spouses should be seen as a down payment being made under budgetary constraints. It is a starting point, not an ending point, and the Committee will revisit this issue early in the next Congress in order to more fully address this inequity," said Smith. "For these resilient women - so many of whom have made sacrifice after sacrifice, both while their husbands served, and then after they died - deserve the right to remarry later in life without suffering severe financial penalties," he said.

Several other provisions were added to H.R. 4085 in the substitute amendment offered by Smith and adopted by the Subcommittee, including requirements that the home loan fees charged to qualifying members of the Selected Reserve be the same as fees charged active duty veterans; an increase in Veterans' Mortgage Life Insurance coverage from $90,000 to $150,000; and a change in law to allow veterans over the age of 70 to continue coverage under Veterans' Mortgage Life Insurance.

Both H.R. 4015 and H.R. 4085 were reported favorably to the full Committee, which is expected to take further action on them at next week's scheduled Committee markup session on Thursday, May 9, 2002.

Please visit http://veterans.house.gov, the House Committee on Veterans' Affairs web site, named 'One of the Best Web Sites in Congress' by the Congressional Management Foundation, May 3, 1999.


USAA quitting add-on policies
By Aïssatou Sidimé
Express-News Business Writer

Web Posted : 05/04/2002 12:00 AM

Facing the military's beefed-up health-care plan, USAA has decided to discontinue selling supplemental healthcare coverage to active-duty military, retirees and their families.

In March, USAA stopped selling new, supplemental coverage to the government's Tricare program, formerly called CHAMPUS. Now, company officials are notifying existing customers that USAA will cease renewing Tricare supplemental coverage on Dec. 1.

The Department of Defense revamped its 40-year health- care program and launched the Tricare managed-care program in the mid-1990s to slow medical expenses that were growing at a rate 36 percent faster than national health-care expenditures, according to one General Accounting Office Report.

The new program offered three insurance choices that range from a restrictive HMO to a traditional, high-deductible plan.

Private insurance companies and military associations successfully sold supplemental policies because Tricare required up to $7,500 in out-of-pocket expenses on one policy and didn't subsidize drug coverage for the retirees who didn't live near military clinics.

USAA had been offering supplemental health-care coverage to military families since 1986 and sold most of its Tricare supplements to retirees and their family members under the age of 65, according to the company.

But last year, the Department of Defense discontinued co-payments for most active-duty personnel and their families; cut the out-of-pocket expense cap to $3,000; began paying for any services not covered by Medicare and introduced a drug benefit that charges less than $10 per refill for the average prescription.

The changes dramatically affected about three-fourths of the estimated 8.7 million participants, based on Tricare figures.

So, USAA decided that, "There would be little left for the supplement to insure, creating a 'dollar-swapping' situation where the cost of the supplemental policy is about the same as members' claims," according to USAA spokeswoman Lesli Hicks.

However, few other competitors have dropped the coverage, according to the Military Benefit Association, which sells a competing product to about 5,000 customers.

Tricare officials say the supplemental market is still strong among retirees who don't yet qualify for Medicare.

"They are still in a situation of having some out-of-pocket costs," said Steve Lillie, director of program development with the Tricare Management Activity division of the Department of Defense. "And only half of the retirees under the age of 65 have employer-based insurance."


May 10, 2002

A proposed plan published in the Federal Register would establish a uniform formulary for beneficiaries using military pharmacy services, which would include a co-pay of $22 per prescription for non-formulary drugs. Under the proposed plan, active duty members would continue to get all medicines free. In addition, prescriptions filled on bases would be free. But the retail drug network and the National Mail Order Pharmacy would add a third level of co-payment to the current co-payments of $3 for generic drugs and $9 for brand names. The new level of $22 for non-formulary brands would cover a 30-day supply from network retailers and a 90-day supply from NMOP. For prescriptions filled at non-network pharmacies, the co-pay for a 30-day supply would be 20 percent or $9, whichever is greater, for a formulary drug, and 20 percent or $22 for a non-formulary drug. Until June 11, comments can be mailed to Medical Benefits and Reimbursement System, TRICARE Management Activity, 16401 East Centretech Parkway, Aurora, CO 80011-9066.

Vets still have no answer
By Matt Crenson
Associated Press

Web Posted : 05/12/2002 12:00 AM

To veterans, it's a cruel mystery: Which of the countless pesticides, pollutants, microbes and poisons they encountered during the Persian Gulf War has left one in seven of them sick with a debilitating and persistent illness?

On Capitol Hill, it's an outrage: Why, after spending more than $200 million on hundreds of studies, can't the Pentagon and the Veterans Affairs Department determine what pollutant or microbe is causing the panoply of symptoms known as Gulf War illness?

Most scientists who've studied the chronic health problems of Gulf War veterans say they have answers to both questions: There is no environmental toxin or infectious agent to blame. A decade of research overwhelmingly points to another cause — stress.

Yet many veterans don't believe it.

"I know a lot of people who are sick, and stress is not what's killing them," said Stephen Robinson, who served in special forces during the Gulf War and now heads the National Gulf War Resource Center, an advocacy group for ill veterans.

Part of the problem, many Gulf War illness experts say, is that many veterans have the wrong idea about stress. They think experts are telling them their illness is all in their heads.

Actually, scientists say, stress causes real, physical problems. Hormones released into the bloodstream when a person is under stress can cause harm to both nervous and immune systems that lasts long after life returns to normal.

Unpersuaded, Robinson has joined many veterans and their advocates, including a handful of scientists, in insisting more studies be done. Congress has responded by continuing to authorize millions of dollars for research into alternative causes of Gulf War illness — money many scientists say is wasted.

That veterans deserve to know what's making them sick isn't disputed. But what should the government do now that scientific research has produced evidence that leaves many veterans resolutely dissatisfied?

Data show that Gulf War veterans are no more likely to die or be hospitalized than their peers who never served in the region. Their rates of cancer and other serious diseases are no higher than expected in 700,000 people of their age and background.

The VA did announce in December that Gulf War veterans are twice as likely to suffer from Lou Gehrig's disease as their peers, but many experts question the finding because no scientific paper has been published to back it up.

Even if it's borne out, says University of Iowa epidemiologist Gregory Gray, the Lou Gehrig's disease finding doesn't topple stress as the most likely cause of Gulf War illness because it applies to only a few dozen people.

Still, no one disputes that Gulf War illness is real.

Researchers have verified veterans of the Persian Gulf War are more likely to suffer from a range of chronic symptoms including memory and thinking problems, fatigue, joint pain, depression, anxiety, insomnia, headaches and rashes.

But why? In the 11 years since the Gulf War, myriad possibilities have been advanced, investigated and found wanting.

Government, university and independent investigators have looked at pesticides, parasites, insect repellents and pills the troops took to protect themselves from chemical attack. Also examined: Contaminated vaccines, infectious bacteria, depleted uranium ammunition and smoke billowing from oil wells that were set alight by retreating Iraqi troops.

Those who've proposed such agents as the cause of Gulf War illness have run up against a major obstacle: the estimated 100,000 victims have no single thing in common except that they all became ill after serving in the same war. Symptoms have been reported by veterans who were stationed thousands of miles apart and who performed widely differing duties.

Experts say it would have been virtually impossible for such a wide cross-section of troops to have been exposed to the same thing.

The multitude of symptoms veterans report also makes it extremely unlikely a toxin or microbe is involved, most experts say. A microbe or toxin would produce one well-defined illness.

Yet stress is known to produce nearly all the symptoms reported by Gulf War veterans.

It has been implicated in cardiovascular disease, immune system disorders, chronic headaches, memory and cognitive problems. Some researchers believe it's the cause of chronic fatigue syndrome and fibromyalgia, two so-called "mystery diseases" that are similar to Gulf War illness.

Studies show symptoms of Gulf War illness are most frequently reported by those who had particularly stressful war experiences. A British study of war pension files going back to 1872 found evidence for ailments similar to Gulf War illness among veterans of every major conflict since the Boer War.

Unconvinced, members of Congress continue to approve funds for research into various theories. For example, Rep. Robert Livingston, R-La., now retired, attached $3.4 million to the 1996 defense budget to investigate the theory that Gulf War illness is caused by infectious bacteria.

Sen. Kay Bailey Hutchison, R-Texas, has earmarked a total of $10 million in the past two defense budgets to establish an independent research institute at the University of Texas Southwestern Medical Center so the theory on toxic chemicals can continue to be studied.


Battle rages over vets' ailments
By Matt Crenson
Associated Press

Web Posted : 05/12/2002 12:00 AM

Ross Perot convinced Dr. Robert Haley to start studying Gulf War illness in the early 1990s.

The Dallas tycoon and former presidential candidate had approached the University of Texas Southwestern Medical Center at Dallas, where Haley is head of epidemiology, wanting to fund research into the cause of Gulf War illness.

An ardent veterans' advocate, Perot steadfastly has disputed scientists' contention that stress is responsible for Gulf War illness.

In January 1997, Haley published three papers in the Journal of the American Medical Association describing the results of the Perot-funded research.

Haley had done questionnaire surveys in which he asked the 249 members of a naval reserve construction battalion about their health and what toxic chemicals they had come into contact with during the Gulf War.

He identified six syndromes. The most significant: one that impaired attention, memory and reasoning; another that caused problems with thinking, balance and orientation; and a third that inflicted joint and muscle pain and fatigue.

Other Gulf War researchers found Haley's research intriguing, but not convincing.

The study involved a comparatively small number of people and relied on the soldiers' own reports of their exposures to pesticides, insect repellent and nerve gas, a far cry from quantifying the actual amounts of chemicals to which they may have been exposed.

In fact, most experts say there's very little evidence American troops were exposed to significant amounts of nerve gas during the Gulf War.

Haley's studies also failed to compare ill veterans to a suitable control group that hadn't served in the gulf area.

"To verify the findings of these studies, further investigation is required and larger numbers of representative veterans need to be evaluated with objective tests," Dr. Kenneth Hyams of the Naval Research Institute in Bethesda, Md., and a colleague wrote in a letter responding to Haley's articles.

Haley then wrote a research proposal for a larger, better designed study and submitted it to the Defense Department.

His bid twice was rejected by an independent panel that rated the merits of research proposals for the department.

Haley appealed, and eventually, Bernard Rostker, the Pentagon official responsible for funding Gulf War research, agreed to give Haley $3 million to repeat his experiments in a larger population with proper control groups.

Rostker says Haley never did that. Haley says he did by showing that 350 mostly Army veterans being treated at the Dallas Veterans Affairs Medical Center fell into one of his three major syndrome groups.

In any event, Haley spent much of the money doing additional research on the 23 sickest members of his original study group, using cutting-edge technology to document subtle nerve damage to their brain stems and doing tests that suggested their genes might make them more susceptible to nerve gas and pesticides.

Government officials complained repeatedly that Haley wasn't living up to the terms of his grant.

"Dr. Haley has failed to deliver on his cooperative agreement with the government," Rostker complained at an October 2000 Senate hearing.

Many epidemiologists say Haley's research, while scientifically valid, only applies to the small number of people in his study group — not the larger population of ill Gulf War veterans.

Haley dismisses the criticism as politically motivated.

"We think we're getting to the exact neurophysiologic mechanism of it now ... although much more slowly than we would like to," Haley said.

The pace of Haley's research should pick up soon. One of the senators at the October 2000 hearing, Republican Kay Bailey Hutchison of Texas, has provided $10.5 million for Haley in defense spending bills.

Haley says that when he gets the money, he intends to set up a Gulf War illness research institute that will be independent of government oversight.

"The veterans can be assured that we're going to go and do the studies that our scientists and our reviewers here think are best," Haley said.

Dr. Edward Hyman, a physician in New Orleans, is another critic of the stress theory who received money through direct congressional action rather than the more traditional grant proposal process.

Not long after the first reports of Gulf War illness, Hyman reported the disease was caused by infectious bacteria and could be cured with high doses of intravenous antibiotics. Several of Hyman's patients testified on Capitol Hill about their miraculous recoveries.

Because there wasn't enough scientific evidence to support these anecdotal reports, Hyman couldn't get federal funding through normal channels to perform a clinical test of his treatment.

Then-Rep. Robert Livingston, R-La., responded by attaching a $3.4 million grant for the doctor to the 1996 defense budget.

By his own account, Hyman spent most of the money on airline tickets to New Orleans for patients participating in his study. The trial was a success, he says; but every scientific journal he has approached has declined to publish it. Hyman says he expects his research will come out soon.

"Meanwhile," Hyman says, "the VA would rather spend millions or billions calling people psychologically ill rather than get to the cause."


January 6, 2006

The Joint Chiefs are joining the Defense Department in seeking to more than triple annual enrollment fees for officers in Tricare Prime and double the fees for enlisted retirees by 2008. DoD wants Congress to jack up fees for those under-65 officer retirees from $240 a year for individual coverage to $750, and from $450 annually for family coverage to $1,500. The department wants to raise fees for enlisted retirees under age 65 to $450 for individuals and $900 for families. The deductible for Tricare Standard also would be raised, and an annual enrollment fee would be imposed. Medicare-eligible retirees also would take a hit, with copayments for retail generic drugs jumping from $3 to $5 and for brand name drugs from $9 to $15 retail and $10 by mail order. DoD claims it needs the money from the retirees to balance the defense budget.

MAY 24, 2002

To reduce a backlog of 412,000 claims to 250,000 by 2003, a goal set by VA secretary Anthony Principi, the Department of Veterans Affairs must process 78,000 claims a month. It reached 73,000 in March, but a report from the General Accounting Office says that letters of notification have left veterans shaking their heads. Although the letters generally show the decisions clearly enough, the reasons for the decisions or the explanations of the benefits to expect are often incomprehensible or even flat wrong. A contractor specializing in clear writing has been hired to help the VA improve the letters, said Principi.

MAY 24, 2002

One of the administration's objections to the defense authorization bill is a provision strongly supported by the House and Senate that would overturn the century-old requirement that military retirees must forfeit one dollar of retired pay for each dollar of VA disability compensation. This has enraged the Disabled American Veterans leadership. "It is unconscionable that President Bush appears to care so little about retired members of the armed forces who were disabled as a result of their service to our nation," said DAV commander George H. Steese, Jr. "We must put an end to this long-standing injustice against some of America's most deserving disabled veterans." The House version of the defense bill would authorize $5.8 billion over five years for some disabled military retirees to receive both disability and retirement benefits. The Senate version is expected to authorize full concurrent receipt benefits for all disabled military retirees.

Metro and State 
VA readies for terror response role
By Suzanne Gamboa
Associated Press

Web Posted : 05/24/2002 12:00 AM

WASHINGTON — The government is installing biological decontamination centers at some veterans hospitals as part of a homeland preparedness plan that could cost up to $200 million, Veterans Affairs Secretary Anthony Principi said Thursday.

Principi also said he would consider suspending the VA's policy of open enrollment for all veterans to reduce a backlog of treatment requests and maintain the quality of care provided at agency facilities.

Principi said the VA should play a key role in homeland defense. The duties will be determined by Congress and the Bush administration, but Principi said he envisions VA hospitals being used to treat victims, store and disseminate medicines and offer other health care assistance.

Some VA hospitals already are being outfitted with decontamination units, he said.

"We are looking at the large urban areas that may be subject to attack and trying to establish those units in those locations," Principi said.

The House passed legislation Monday authorizing $100 million for four new VA research centers aimed at combating bioterrorism.

The centers would focus on research and response to potential chemical, biological and radiological terror attacks.

The VA is taking on the additional homeland defense duties at a time when Principi said the agency is struggling under a "burgeoning, staggering workload," with veterans sometimes waiting months for care.

The nation has about 25 million veterans. Although not all use the VA, all are eligible under the open enrollment policy Congress mandated.

"In the past, the easy decision has been to let everyone come in whether you can treat them or not, just put them on waiting lists," he said. "I have a problem with that. I don't think it's fair to people to say we have open enrollment and put them on a waiting list."

Principi had proposed charging veterans with higher incomes co-payments totaling up to $1,500 for services, but Congress balked at the idea.

Without such a co-pay, the VA will need about $1 billion more to maintain its current level of service, he said.

President Bush wants $1.5 billion more for the VA in 2003, which would be a record increase for the agency.

The House has included about $417 million in a supplemental spending bill for VA health care this year. The Senate version includes an equal amount, plus $1.1 billion for pensions and compensation, the VA said.

That combination may be enough for the VA to continue providing services at the current level, Principi said.

But if it doesn't, "we will suspend enrollment for a period of time until we get it under control, then we'll reopen enrollment."


Hero gets medal earned in 1942
By Sig Christenson
Express-News Military Writer

Web Posted : 05/26/2002 12:00 AM

It came 59 years late, but famed Flying Tiger David Lee "Tex" Hill received his Distinguished Flying Cross like a long lost friend Saturday night.



Hill, 86, saluted after retired Gen. Henry "Butch" Viccellio Jr., a former chief of the Air Education and Training Command at Randolph AFB, pinned the medal on Hill's jacket.
Hill, 86, saluted after retired Gen. Henry "Butch" Viccellio Jr., a former chief of the Air Education and Training Command at Randolph AFB, pinned the medal on Hill's jacket.

Already standing, 286 well-wishers that included Texas oilman Oscar Wyatt Jr. and retired test pilot A. Scott Crossfield erupted into loud applause.

"What can I say? My God, I mean, I can't believe what I'm seeing," a visibly moved Hill said. "All these wonderful people here that came out. It's a very emotional thing for me."

The night was the climax of a career made famous by Hill's service with the American Volunteer Group, better known as the feared Flying Tigers that flew over China.

A three-member Air Force board that awarded the medal last year said Hill had been denied it because of a conflict between two Army generals and his boss, Brig. Gen. Claire Lee Chennault.

The story opens on Oct. 25, 1942. Fighting battle fatigue and malaria, Hill led his U.S. 23rd Fighter Group on a daylight bomber escort mission. High above enemy-occupied territory in China, 24 Japanese fighters jumped his formation.

Seeing six enemy planes climbing steeply from the left of his bombers and others closing to attack from the right flank, Hill turned his P-40 Warhawk on its back for a speed dive and put his plane between the Japanese fighters and the bombers.

"He repeatedly attacked the large number of Japanese fighters and by sheer force carried the fight to the enemy," an Air Force board said in a report issued on the 60th anniversary of Japan's attack on Pearl Harbor. "Furthermore, during the attack, he so relentlessly held his fire that had his plane not gone into a spin he would have rammed the Japanese fighters."

Outnumbered 24 to eight, Hill and his men fought on. He shot down one Japanese plane and damaged three others while forcing an enemy retreat. Only one bomber was damaged.

Chennault recommended that Hill receive the Distinguished Service Cross, a medal the Army gives to soldiers who display extraordinary heroism not justifying the Medal of Honor. Two months later, though, he received the Silver Star instead.

An Air Force Decorations Board at the time found that Hill 's actions did not rise to the level of extraordinary heroism, but there was more to the tale.

The three-member panel that awarded the Distinguished Service Cross found that Army Lt. Gen. Joseph W. "Vinegar Joe" Stilwell, commander of the China-Burma-India Theater, and Brig. Gen. Clayton L. Bissell downgraded Hill 's honor because of a personality conflict with Chennault.

Stilwell and Bissell, a World War I ace who commanded the 10th Air Force at the time, are dead. Hill and retired Air Force Col. J. Ward Boyce, former director of the American Fighter Aces Association, said the dispute centered on Stilwell's prejudice against air power.

A retired Air National Guard brigadier general, Hill is a triple ace with 181/4 kills. He emerged from the war a national hero. John Wayne portrayed him in the 1942 film, "The Flying Tigers," and Hill earned numerous medals, among them the Silver Star, Legion of Merit, four Distinguished Flying Crosses, the British Flying Cross and six Chinese combat decorations.

Hill's time with the Flying Tigers was retraced in a video clip that showed him and other P-40 pilots taking off from grass airfields, flying in formation, strafing Japanese airfields and shooting down enemy bombers and fighters. Big Band tunes accompanied parts of the film.

A longtime San Antonian, Hill logged 3,500 hours, flew 150 combat sorties and later tested the first U.S. jets before joining the Air National Guard, where he became its youngest brigadier general.

Viccellio, who praised Hill's leadership and contributions to national defense during the Cold War, said a 60-year wrong at last had been redressed.

"You usually have to go out to the movies these days to see the good guys win in the end," he said. "But not tonight. Tonight we're going to sweep all the forces of evil aside. We're going to overcome bureaucracy — 60 years of it. The good guys are going to win in the end."

VA is taking steps to reduce backlog
By Laurie Kellman
Associated Press

Web Posted : 05/27/2002 12:00 AM

WASHINGTON — The Department of Veterans Affairs has doubled the number of claims it decides each month and slashed a mountainous backlog of benefit requests dating back years, Secretary Anthony Principi said.

That backlog, which generated widespread concern on Capitol Hill and among veterans groups as it ballooned during the 1990s, has been cut from 600,000 to 394,000 claims in recent months.

"We decided to really declare war on that backlog and took some rather bold steps to address it," Principi said "We're really getting this backlog under control and we did it through sheer focus and discipline, performance measurements and production goals."

VA claims managers now resolve some 70,000 claims a month, more than double last year's monthly rate of 29,000, he said.

In addition, the department has established a "tiger team" of managers in Cleveland that ruled on claims for about 28,000 veterans over the age of 70 who had waited more than a year for an answer, he said.

Veterans hailed Principi's commitment to the issue, but say it remains to be seen whether the agency is properly deciding claims.

"We have seen the figures where VA has been increasing their production. I believe Secretary Principi is seriously concerned about the state of the VA backlog and the adjudication process," said Joe Violante, national legislative director for Disabled American Veterans.

"Our concern, however, is that while they are increasing their production, if they are not getting them right the first time they are no better off than if they weren't processing those cases," he said.

Principi said he didn't have exact figures but that the majority of the processed claims approve benefits for the veterans requesting them.

"It's a case study that things can, in fact, turn around — not only in private sector corporations but in government bureaucracy as well," said Principi, a U.S. Naval Academy graduate and Vietnam War veteran.

The VA, the second-largest government agency with 220,000 people, has been besieged with caseload problems. Last year, Congress blasted the department for training problems that resulted in inaccurate decisions on four of every 10 claims for veterans disability payments.

Newly confirmed by the Senate last year, Principi told Congress and the General Accounting Office, its investigative branch, that fixing those problems would be one of his top priorities.

He implemented GAO recommendations to set up a system to track the outcome of video conferencing and other state-of-the-art training methods.

Looking forward, Principi said he has set up "triage" teams in various regions— Texas, Florida, Washington, for example — to handle massive amounts of claims and prevent future backlogs.

He said the department is not favoring speed over accuracy.

May 31

The Department of Veterans Affairs is contacting participants in military tests involving biological and chemical warfare materials during the 1960s about medical care and benefits to which they may be entitled. Initial notifications went to 622 of some 4,300 veterans identified so far as participants in Project SHAD (Shipboard Hazard and Defense). The SHAD tests were conducted to determine the effectiveness of shipboard detection and protective measures against chemical and biological threats and to determine the potential risk to American forces. Medically significant information from twelve tests has been declassified and released to the VA: Autumn Gold, Copper Head, Shady Grove, Eager Belle (phases I and II), and Scarlet Sage, Fearless Johnny, Flower Drum (phases I and II), DTC Test 68-50, DTC Test 69-32, and Purple Sage. Additional letters will be sent as more test reports are declassified. Veterans concerned should call 1-800-749-8387 or e-mail shad.