Closing V.A. Hospitals Has Congress Squirming

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> Closing V.A. Hospitals Has Congress Squirming

>

> By CARL HULSE

>

> WASHINGTON, Aug. 15 The Department of Veterans Affairs is relearning a

> truism about Congress the hard way: Nothing gets a lawmaker riled up

faster

> than a plan to shut something down.

>

> Always available for a ribbon cutting, members of Congress have a

> pathological fear of seeing the doors shut to any federal facility back

> home, whether it be a military base, Social Security office, or in the

> relevant example, a veterans hospital.

>

> So it is no surprise that the department's new proposal to close seven

> hospitals and change the services available at dozens of others landed

with

> a thud on Capitol Hill this month, even though the plan called for

spending

> billions of dollars to build new centers and open scores of outpatient

> clinics in areas where veterans have migrated.

>

> Senators and representatives fired off angry letters, vowing to fight any

> closings. Emergency community meetings were convened. Advocacy groups were

> mobilized.

>

> " There is a lot of unhappiness, " said Senator Ron Wyden, Democrat of

> Oregon, who noted that a potential cutback at three sites in his state

> ranked right up there with the economy as he held town meetings in the

past

> week. " You are talking about a huge veterans population, and they

basically

> have no place to turn. "

>

> In New York, the Congressional delegation is fuming about the department's

> plan to close or eliminate inpatient care at three hospitals Canandaigua,

> Montrose and Manhattan. Lawmakers are also upset in California, Kentucky,

> Mississippi, Ohio, Pennsylvania, Texas and other states with hospitals on

> the block.

>

> Peter Gaytan, a deputy director at the American Legion headquarters, said,

> " We don't see how closing a hospital can solve any problem when we have

> 100,000 veterans standing in line waiting for appointments. "

>

> Given the hopeful acronym of Cares (Capital Asset Realignment for Enhanced

> Services), the plan is the department's most ambitious effort to date in

> its struggle to put its services where the veterans are and catch up to

the

> shift of medicine to outpatient care.

>

> It is also an effort to get a grip on what has been an embarrassing

problem

> vacant and underutilized veterans centers built in the Northeast and

> Midwest decades ago when veterans were clustered there before they retired

> to the Sunbelt. The object of the plan is to save $45 million a year over

> the next 20 years by reducing the department's vacant and little used

space

> by more than 40 percent to 4.9 million by 2022 from 8.5 million square

feet

> in 2001.

>

> " Bottom line the draft plan will allow us to avoid imbalances between the

> size and location of health care facilities and veterans' demand for care

> tomorrow, " said Dr. Robert H. Roswell, the department's undersecretary for

> health.

>

> The agency's report concedes that closing hospitals is touchy in the

> extreme. " Disposition of capital assets traditionally has been a difficult

> process in the federal sector in general, and in the V.A. in particular, "

> it says with bureaucratic understatement.

>

> Many lawmakers would acknowledge that some veterans facilities should have

> been mothballed long ago or transformed into something other than

> 1950's-style hospitals. But they also know their communities expect them

to

> put up a fight. More is at stake than providing care. In some towns, the

> veterans center is the major employer. Losing jobs is as painful as losing

> health care.

>

> In a letter to the department secretary, Anthony J. Principi, Mr. Wyden

the

> economic consequences of closing a rehabilitation center in White City,

> Ore. " In all of White City, there are 2,152 residents with jobs, " he

wrote.

> " The domiciliary alone employs 400 people. "

>

> Congress has conceded in the past that it is almost incapable of closing

> down anything. To cut the number of military bases, lawmakers established

a

> special commission to recommend the targets. Then in their best " stop us

> before we spend again " mode they limited themselves to a straight up or

> down vote, knowing that was the only way they would get anywhere.

>

> But some lawmakers are now summoning the nerve to shut down one thing

there

> is a move afoot to eliminate the next round of base closings in 2005.

> http://www.nytimes.com/2003/08/16/politics/16TALK.html?th

>