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Bush Proposals To Revise Health Care, Disability System For Veterans

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Health Care, Disability System For Veterans

President Bush on Tuesday announced a proposal to revamp the healthcare and disability system for wounded veterans of the wars in Iraq andAfghanistan, the Washington Post reports. His proposal is based on the recommendations of a presidential commission co-chaired by former Sen. Bob Dole (R-Kan.) and University of Miami President and former HHS Secretary Donna Shalala.

Bush'splan includes eliminating bureaucracy and providing more assistance tofamilies of soldiers with long-term care needs. According to the Post, the "bulk of the legislation is aimed at eliminating the parallel disability evaluation systems" run by the departments of Defense and Veterans Affairs.

Underthe proposal, DOD would decide whether servicemembers are fit for duty.Those who are deemed unfit would receive a lifetime annuity paymentdetermined by rank and length of service. After their fitness for dutyis assessed by DOD, disabled veterans then would be transferred to theVA, which would evaluate the extent of their disability and determine apayment based on loss of earnings and quality of life.

Ifapproved by Congress, the new system would apply to all soldiers,sailors, airmen and Marines who are newly injured in the wars in Iraqand Afghanistan. Any servicemembers injured since October 2001 wouldhave the option of remaining in the current system or transferring tothe new system.

Veterans of past wars would not be eligible toparticipate in the new disability system. In addition, Bush's proposalwould permit post-traumatic stress disorder care for soldiers withoutrequiring them to prove the connection between the condition and theirservice (Baker, Washington Post, 10/17).

Alsounder the proposal, the VA would establish "recovery coordinators," whowould serve as patient advocates to help returning veterans navigatethe bureaucracy and transition back to civilian life. Severely injuredservicemembers also would qualify for 40 hours of in-home assistanceweekly (Gerstenzang, Los Angeles Times,10/17). The parents or spouses of seriously wounded veterans would beeligible for up to six months of unpaid leave to help provide care (Washington Post, 10/17).

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Cost, Future Steps

According to Karl Zinsmeister, assistant to the president for domesticpolicy, the current disability system costs the government about $30billion annually to cover the three million wounded veterans, and thenew system would probably "cost a little more than the old system."

According to Shalala, implementing the commission's recommendations would cost $1 billion over 10 years (Los Angeles Times, 10/17).

Congress is working to reconcile wounded veterans' legislation (HR 1538) that passed in the House and Senate. The defense authorization bill (HR 1585) also includes provisions for wounded servicemembers.

Senate Armed Services CommitteeChair Carl Levin (D-Mich.) said that conferees "will examine theprovisions contained in the White House proposal to see if they couldbe incorporated" into the conference report. However, House Veterans' Affairs Committee Chair Bob Filner (D-Calif.) said he plans to address the commission's recommendations in separate legislation (CQ Today, 10/16).


Bush said, "Our system for managing this care has fallen behind. It'san old system; it's an antiquated system; it's an outdated system thatneeds to be changed." He added, "By taking these steps, we'll honor ashared commitment to care for those who defend our freedom."

DuringBush's announcement, Shalala said, "Let me compliment youradministration on the implementation of 90% of our recommendations" (Washington Post, 10/17).

Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America,said although he is pleased the commission's recommendations have beenimplemented, two urgent issues still need to be addressed: the VAappropriations budget must be approved by Congress and Bush must pick asuccessor to former VA Secretary Jim Nicholson, who stepped down onOct. 1 (Riechmann, AP/Houston Chronicle, 10/17).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, afree service of The Henry J. Kaiser Family Foundation.