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Decentralize VA

Lawmakers should pass a bill now in Congress that would eliminate waste and offer veterans more health-care options that meet the needs of outpatient, long-term and community-based care.

America's military veterans are getting older, and becoming more dispersed across the country, than ever before. Yet the government agency responsible for their care, the Department of Veterans Affairs, still operates as a centralized behemoth. A new report by the General Accounting Office, the investigative arm of Congress, says the agency wastes $1-million daily on facilities it doesn't need _ money that would be better spent providing veterans with a network of outpatient clinics, home health services and long-term care. Lawmakers should pass a bill working through Congress that would streamline the VA, improve access to medical care for veterans and cut waste.

The legislation is needed to position the VA for changes in the delivery of modern medicine. As veterans age and shrink in number, the government needs to change the VA's mission, close its underutilized hospitals and redirect the agency's limited budget to cover more pressing needs for outpatient, long-term and community-based care.

The VA has already begun to move in that direction, and some veterans' groups and members of Congress view the shift as a threat. But quality medicine is no longer concentrated in large urban hospitals. With admissions to VA hospitals dropping and veterans looking for more convenient options for care, the agency needs to consolidate where it can and contract more with private providers.

The bill would expand nursing home and home-based care, pay emergency room costs at non-VA medical centers and require the VA to sell or lease millions of square feet of vacant office space. It also would dilute the VA's pool of high-risk patients by expanding elective services to veterans and their dependent children. Adding families to the mix is a good way to bring healthier patients into the system. Expanding coverage for extended-care services, from eyeglasses and hearing aids to prescription drugs, will help the VA remain competitive by bringing in new revenue.

Congress needs to prod the VA down this responsible path. Rep. Cliff Stearns, a Florida Republican who chairs the health subcommittee of the Committee on Veterans Affairs, is right: "We should be taking care of veterans, not buildings." Closing any of the VA's 172 hospitals or hundreds of other medical facilities won't be easy. It shouldn't be. But playing politics with the VA only robs veterans of the health benefits they deserve.