| Good morning, Chairman Simmons, Ranking | | | | and illnesses that a veteran may have that are in |
| Member Rodriguez, and other distinguished | | | | some way related to his military service. Currently |
| members of the House Subcommittee on Health | | | | the VA largely has no idea of "who hath borne |
| of the Committee on Veterans Affairs. On behalf | | | | the battle" among the users of the VA system, |
| of National President Thomas H. Corey, we thank | | | | even if they are service-connected disabled |
| you for the opportunity for Vietnam Veterans of | | | | veterans. For example, VA can only tell at a |
| America (VVA) to appear here today to share | | | | glance if an individual is a Vietnam-era veteran, |
| our views on the issue of "Transitional Pharmacy | | | | and not whether or not they served in the |
| Benefits" at the Veterans Health Administration | | | | Vietnam theater of operations. |
| facilities of the U.S. Department of Veterans | | | | In the five years since the announcement of the |
| Affairs (VA). I ask that you enter our full | | | | "Veterans Health Initiative," the VA has yet to |
| statement in the record, and I will briefly | | | | implement a training program for all employees, or |
| summarize the most important points of our | | | | even just the new employees and clinicians that |
| statement. | | | | defines these special people whom we serve, and |
| The "Transitional Pharmacy Benefit" would never | | | | what makes veterans different from the general |
| have been necessary if the veterans health care | | | | population that one might see in a general hospital. |
| system were fully and properly funded to take | | | | The taking of a complete military history (what |
| care of the veterans who are statutorily eligible to | | | | branch, when, what duty stations, what military |
| use the VHA system. If there were anything | | | | job M.O.S., and what actually happened to them) |
| approaching adequate funding, there would have | | | | and utilizing this vital information in the diagnosis |
| been no need to promulgate the regulation issued | | | | and treatment process, is central to the |
| to accomplish the filling of prescriptions written by | | | | raison-detre of the VA, i.e., that it be a Veterans |
| non-VA physicians as there would never have | | | | Health Care System, and not just general health |
| been waiting periods of longer than thirty days. | | | | care that happens to be for veterans. |
| This would have rendered the premise of VHA | | | | While we are assured that the new Information |
| Directive 2003-047 (issued August 14, 2003, and | | | | Technology is being designed to find out complete |
| affecting veterans enrolled in VA health care by | | | | military histories, and correlate this information |
| July 25, 2003) and other various legislative | | | | with diseases, exposures, and the like which may |
| proposals moot. This is but one more good | | | | have affected the veteran, this architecture is not |
| reason why we need mandatory funding for | | | | due for realization until FY 2008 at the earliest. |
| health care for America's veterans. | | | | VVA commends Undersecretary Robert Roswell |
| When VVA received notice of this hearing late | | | | for including this in the "20/20 Vision Statement" |
| last week, we sent out messages soliciting | | | | for the VHA. VVA believes that much more can |
| thoughts and data from our Service | | | | be done today even without all processes being |
| Representatives and from the VVA National and | | | | automated. VVA also commends Secretary |
| State leadership who are geographically dispersed | | | | Principi for including the taking and using of military |
| across the nation. The reports were that it was | | | | history for each veteran in the above-described |
| not utilized because there was no waiting list | | | | manner, for the very first time in the "2003-2008 |
| longer than 30 days at the local VA Medical | | | | Strategic Plan for VA." |
| Center, or that the "Transitional Pharmacy | | | | If the VA were taking a complete military history |
| Benefit" was working well, and in the manner | | | | and using it in the diagnosis and treatment |
| intended by the Secretary of Veterans Affairs. | | | | processes, then it would become doubly |
| The reports are consistently favorable. The VA | | | | important for those who potentially served at a |
| pharmacy service is doing a very good to | | | | time and place where they were exposed to |
| excellent job with this program, and that veterans | | | | toxic substances or diseases that should be |
| and veteran's advocates at the local level are | | | | evaluated by VA physicians who (at some time in |
| pleased with this benefit, if not the reasons that | | | | the future) would be trained to spot and to test |
| made it necessary. | | | | as appropriate for these potential service related |
| It is worth noting that the pharmacy operation | | | | conditions. Attached please find a copy of the |
| has so improved in the last two decades that it is | | | | web site for the "Pocket Card" that is supposed |
| now one of the best-run VA programs. It is | | | | to be used to train interns, residents, and other |
| generally effective, efficient, and is constantly | | | | new VA professionals. These cards are also |
| improving based on clinician and veteran reactions | | | | supposed to be available to, and used by, all VA |
| and suggestions. Of all the VA operations, it is the | | | | clinicians, although that is rarely the case. |
| one that appears to be truly operating on the | | | | If the VHA were working as a true Veterans |
| "Demming" method, devised by the late W. | | | | Health Care system, and when it is again |
| Edwards Demming, of constant improvements, | | | | adequately funded to properly care for all |
| with many of these modifications being small but | | | | veterans who are statutorily eligible, VVA would |
| some large, that result in an increasingly more | | | | not favor any program that moves case |
| effective operation at the least possible cost. It is | | | | management outside of the VA. |
| indeed ironic that the pharmacy operation should | | | | Since we are where we are with funding and |
| apparently be one of the areas targeted for | | | | overcrowding today, VVA again congratulates |
| eventual outsourcing by the Office of | | | | Secretary Anthony J. Principi for moving ahead |
| Management & Budget (OMB). One could say that | | | | with this program to provide a short-term fix for |
| this is yet another case of "if it's working, let's | | | | those who needed medications but had to endure |
| break it" by the OMB bureaucracy. | | | | long waits to secure these already privately |
| There has been discussion of making the concept | | | | prescribed medicines, and to reduce the backlog |
| of VA filling prescriptions written by non-VA | | | | of veterans waiting to be seen at many facilities, |
| physicians a more far-reaching and permanent | | | | especially in VISN 8 and other areas where |
| program. VVA in the past has not favored such | | | | particularly long waiting times had become a really |
| efforts, for a variety of reasons, and not just | | | | sever problem. |
| cost to the medical operations fund at the current | | | | Mr. Chairman, that concludes our brief remarks on |
| inadequate level under discretionary spending. | | | | this issue. I would be pleased to answer any |
| The most important function of the VA medical | | | | questions you or your distinguished colleagues |
| system is "to care for he who hath borne the | | | | may have. |
| battle" In other words, it should deal with the | | | | Again, thank you for allowing VVA the |
| "veteran-ness" of an eligible person by properly | | | | opportunity to offer our views here today. |
| testing and diagnosing all of the maladies, injuries, | | | | |