Dr. MUSSER. $1 million of it was used for acceleration of our dialysis program but again in a number of special medical programs, the committee will recall, there was a delay in availability. Mr. GIAIMO. Are you moving to get those services implemented as quickly as possible? Dr. MUSSER. Yes, sir. Mr. GIAIMO. There is a strong feeling, nationwide, not to change those programs. DISTRIBUTION OF ADDITIONAL FUNDS Mr. RHODES. Mr. Wilson reminds me and I think Mr. Shytle alluded to the fact that in our presentation before your committee in the justification of the 1972 budget, we did list the utilization. Perhaps we should submit a statement for the record. Mr. GIAIMO. Insert the table at this point in the record. (The information follows:) VETERANS' ADMINISTRATION Medical care distribution of $105 million appropriation increase in fiscal year 1971 1. Fee dental backlog. 2. Payroll adjustment to support budgeted fiscal year 1971 FTEE_ 3. Increased costs of contract and fee dialysis___ 4. Increased fuel costs___ 5. Public law 91-418 (increased Government contributions for employee health benefits) 6. Preactivation costs at new hospitals__ 7. M. & R. backlog reduction___. 8. Equipment replacement backlog reduction : (a) Object 31. (b) Object 32-. 9. Contract hospitalization program_ 10. Pay raise absorption__. $31,000 9, 400 1,000 500 4,300 700 5,000 17, 500 2,700 600 32, 300 Total COMPENSATION AND PENSIONS 105, 000 Mr. GIAIMO. We will place in the record the portion of House Document 92-73 that pertains to compensation and pensions and the justification material for compensation and pensions. (The material follows:) COMPENSATION AND PENSIONS For an additional amount for "Compensation and pensions," $433,779,000, to remain available until expended. VETERANS' ADMINISTRATION-COMPENSATION AND PENSIONS Additional requirements of $433,779,000 are needed to make payments authorized by law. Nearly 80 percent or $344,964,000 of this total, is due to legislation enacted subsequent to the initial budget submission. The balance, or $88,815,000, is required to cover unforeseen increases in caseloads, particularly in the Vietnam era category, and higher than planned average payments, especially veterans pension, which manifested themselves in 1970 after the 1971 budget request was submitted to Congress. Obligations incurred against these funds arise by operation of law and are not administratively controllable. Requirements by major category are as follows: 1. Compensation: (a) Veterans: Public Law 91-376, approved August 12, 1970 Total veterans compensation. (b) Survivors: Public Law 91-262, approved May 21, 1970, Total survivors compensation___ 2. Pensions : (a) Veterans: Public Law 91-588, approved December 24, Total veterans pension___. (b) Survivors: Public Law 91-376, as it did for survivors Subsistence allowance: Public Law 91-219, approved March Total other__ Summary of requirements: (a) New legislation_ (b) Reprograming Total supplemental requirements for 1971. REASONS FOR SUPPLEMENTAL $269, 187, 000 6, 161, 000 100, 186, 000 45, 705, 000 12, 540, 000 344, 964, 000 88,815, 000 433, 779, 000 Mr. GIAIMO. Most of the supplemental requested for compensation and pensions is mandatory. Of the $433,779,000 requested, $344,964,000 is due to legislation enacted subsequent to the initial budget submission, isn't that right? Mr. RHODES. That is correct. Mr. GIAIMO. The $88,815,000 is due to increases in caseloads and average unit costs. Is most of the request pertaining to caseloads due to underestimation? Mr. RHODES. Yes, sir. For example, in readjustment benefits, our outreach program has caused an increase of veterans into the program. Also the unit cost is going up which accounts for a part of it. We feel that a part of the increase, indeed, may be due to the fact that people are turning now, because of unemployment, to the utilization of veterans benefits. Also cranked into this, was a rate increase. Mr. OWEN. The significant case increase in the compensation program is due to the full impact of the Vietnam war on the compensation rolls. CHANGES IN CASELOADS Mr. TALCOTT. What are the principal changes in caseload? Mr. OWEN. Mr. Talcott, it is in the Vietnam veterans compensation. That has increased about 48,000 more than we had anticipated and then there has been a lesser decline in the survivors pension caseload than we had anticipated. Mr. TALCOTT. How accurate are your estimates now? Are you estimating the war will wind down quicker? Mr. OWEN. Mr. Talcott, this is not a factor in determining our needs for 1971. It could be for future estimates but this is, we think, extremely accurate at this time because our estimate only goes to June 30. Mr. TALCOTT. The supplementals, I suppose, are always more accurate, but the more you can avoid a supplemental, the better. We hope your estimates will be better in the future. Mr. OWEN. We certainly plan that they will be. Mr. TALCOTT. Your supplemental is about one-tenth of your total budget. ACCELERATION OF SEPARATIONS Mr. WILSON. There is another element causing this change. The Defense Department has been discharging about 100,000 more a year than we had anticipated. This has an effect on us. We get our compensation cases about 18 months after an injury. Mr. SILBERMAN. Most of the $88 million relates to Vietnam. They are coming on the rolls at the rate of about 7,000 per month. We had anticipated around 4,000 or 4,500. There was the acceleration of separations from the Armed Forces, and we think a better relationship between DOD and the Veterans' Administration in reporting these cases quickly, getting them out of the hospital and then on the compensation rolls, that accounts for the difference. This also accounts for our belief that the estimates for 1972 are very solid. Mr. GIAIMO. Were the estimates in the 1972 budget calculated at the increased rate? Mr. SILBERMAN. Yes, sir. We projected in 1972 the similar growth that has occurred in the last half of 1971, for example, the number of cases in 1972 will be 295,000 Vietnam cases which is about an 85,000 increase. About 7,000 cases per month for 12 months which would be approximately 85,000 cases. INCREASE IN AVERAGE COST PER CASE Mr. TALCOTT. May I ask what is the principal cause for the increase in the average unit price? Mr. OWEN. There are two factors, Mr. Talcott. One, the increase in the rate of compensation payable which was an increase effective July 1 at 11 percent and the other is the average rate of disability for the Vietnam veteran. Mr. TALCOTT. Is the average rate of disability higher for the Vietnam veteran? Mr. Owen. We are experiencing higher disability for the Vietnam veteran than for World War II and Korea. It is averaging about 35 percent. Mr. TALCOTT. Is this the early Vietnam dischargee? Mr. WILSON. We are talking about a man injured about 18 months ago. Mr. OWEN. In the latter part of 1969, probably. COMPARISON OF SUPPLEMENTAL REQUESTS Mr. CLAWSON. How does this supplemental request compare with prior year supplemental requests on a percentage basis? Mr. SHYTLE. This supplemental estimate of $835 million is larger than any we have had since 1950. Last year we had supplementals totaling $768,121,917. Mr. CLAWSON. My question was on a percentage basis. Your budget is larger, too. Mr. SILBERMAN. It is about the same on a percentage basis. We had $273 million in our compensation and pension appropriation last year for supplemental and around $327 million for readjustment benefits. TWO PAY INCREASES Mr. TALCOTT. Very seldom do you have two wage increases in one supplemental. Mr. WILSON. This is quite unusual. Mr. SHYTLE. I don't remember two in 1 year in one supplemental. Mr. WILSON. There is something else that affects us. If the military men get this pay increase, an increase in survivor benefits will also be felt. Mr. TALCOTT. The Congress hasn't been as bad to the veteran as many people would portray. Mr. GIAIMO. When I came on this committee 6 or 7 years ago, the Veterans' Administration budget was about $5 billion and has grown each year since. LETTER PRAISING VA SERVICES Mr. TALCOTT. Mr. Chairman, may I have permission to put a letter in the record at this point? It is from a constituent who happened to end up in a veterans hospital. She has terminal cancer. She tells me that she is the only woman there. She is quite pleased-in fact laudatory-about the treatment she was getting from Veterans' Administration officials, doctors, aides, the Red Cross people who help there and everyone connected with the hospital. She is very pleased and proud of the Veterans' Administration services. Mr. GIAIMO. Without objection, we will insert the letter in the record at this point. (The letter referred to follows:) WARD NO. 6, HINES VA HOSPITAL, DEAR FRIEND BURT: While sitting around here all day, I decided to write you a letter. At the present time I am a patient at the VA hospital in Hines, Ill. Have been here 3 weeks and it looks like 3 or 4 weeks or longer. Jimmy came to the Montgomery plant of Western Electric about a year ago and I came to see him, and was not too well so hence my being a patient. They have diagnosed terminal cancer of the breast, so here I am. The treatment is very rugged but they sure are giving me fine care. I would return to Los Angeles to the VA there; but the doctors believe it wiser for me to stay here. This is a large complex and at the present time they about have 1,500 men and I am the only woman here. So you can see I get more than 100 percent cooperation. I will say that it is run very efficiently and everything is spotless. The food is excellent and plenty of it. They have some of the finest doctors and surgeons I have met. I am grateful indeed that I came here. I am not bedridden, but up and down and their recreation rooms are fine, and the Red Cross girls are wonderful. When they discovered a lady in the place they have showered me with so much it sort of makes me embarrassed. It is a fine organization and they are doing fine work. Several of the Legion posts close by have workers, also the VFW. They have nightly bingo games and you get a $2.50 certificate for the PX. They have a number of Vietnam amputees here. Young lads, and they are so happy for the care and attention they are receiving. If you get a chance tell Senator Percy he should take time out and check this place. It's a wonderful place, but my heart really belongs in California. I have heard from the Post, flowers and cards. It was so nice. I hope to return to California and may try to get into Napa-Yountville home; but until the doctors decide, I will remain here. They had two specialists here from Washington, D.C. and they suggested I be sent there, but at least I know they are willing to help. There are so many nice men coming here for outpatient care and it is all run so efficiently. It is a very hard job to run a place like this, but from all I see it is wonderful and gratefully thank all for their help. This is about all for now and I surely wish you much more success, and we are so happy to have such a fine man in the Congress. With kindest regards. Sincerely, READJUSTMENT BENEFITS MARIE G. BROWNE. Mr. GIAIMO. We will turn to readjustment benefits and place in the record the portion of House Document 92-73 that pertains to readjustment benefits and the justification material. (The material follows:) READJUSTMENT BENEFITS For an additional amount for readjustment benefits, $302,200,000, to remain available until expended. VETERANS' ADMINISTRATION-READJUSTMENT BENEFITS Additional funds in the amount of $302,200,000 will be required to supplement the initial appropriation for 1971. The continued wide publicity given to VA's educational programs, together with recent increases in educational allowances, have increased 1971 requirements beyond original estimates. In addition, new legislation has generated $19,200,000 of the total $302,200,000 supplemental requirement. Obligations incurred against these funds arise by operation of law and are not administratively controllable. |