[Congressional Record Volume 140, Number 35 (Thursday, March 24, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: March 24, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
  LEGISLATION TO AUTHORIZE VA PILOT PROGRAMS TO PARTICIPATE IN STATE 
                      HEALTH CARE REFORM PROGRAMS

 Mr. MURKOWSKI. Mr. President, I rise today to join with my 
colleague from West Virginia in introducing legislation which would 
authorize VA to participate in health care reform plans enacted by 
individual States and provide VA with the tools and flexibility 
necessary for that participation.
  One of the strengths of our Federal system of government is found in 
the constellation of our 50 States, each one a proving ground where the 
ideas of government and public policy can be germinated, developed, 
tried and tested. Each of our States has the responsibility to craft 
solutions to the problems facing its citizens. With each of the States 
constituting itself as a laboratory of ideas, the Founders created an 
environment where the process of natural selection of ideas can lead to 
the evolution of policies. The Congress can select the best of these 
ideas when we write national policy.
  Mr. President, as the Congress begins the debate on national health 
care reform, we do so in a Union where many of our States have already 
grasped that nettle. Hawaii, Washington, Oregon, Minnesota, Vermont, 
Tennessee, Florida and others either have already, or are now in the 
process of, enacting or implementing programs of health care reform.
  Congress would do well to observe their efforts and to learn from the 
lessons of their experience. One of the most important lessons which we 
must learn is the lesson taught by, and taught to, the Department of 
Veterans Affairs [VA] as VA adapts its health care system to the 
changing health care environment of the reforming States.
  The VA health care system is too important of a national asset to be 
placed at risk by a reform which does not take its unique capabilities 
and its imperative obligations into account. Each year, VA treats over 
2\1/2\ million veterans. Mr. President, today as we speak, over 84,000 
veterans are receiving inpatient care from VA. Today, as the Congress 
proceeds with its business, over 63,000 veterans will seek and receive 
outpatient treatment from VA.
  These veterans, and the health care system created by the Congress to 
care for them, depend upon us to get it right when we enact legislation 
which will govern one-seventh of the national economy and which will 
set the stage within which the VA health care system must either thrive 
or whither.
  That is why I am pleased to join with my friend, and chairman of the 
Committee on Veterans' Affairs, the Senator from West Virginia in 
introducing legislation which will authorize VA to implement pilot 
programs of eligibility reform in up to five States which are reforming 
their health care system. By authorizing waiver of regulations and 
procedures which constrict local decisionmaking, the legislation would 
give local VA leaders the tools they will need to adapt to a rapidly 
changing local environment. By authorizing VA to participate in local 
health care plans, and the funding streams that support them, VA will 
have access to both the patients and resources needed to provide the 
complete continuum of care that defines quality medical practice today.
  Mr. President, in embracing the call for health care reform, the 
Congress has launched veterans and the Department of Veterans Affairs 
on a jounrey whose outcome cannot be confidently predicted without more 
information. This legislation is the first step in preparing for that 
journey and will help provide veterans and the Congress with the 
information we will need to set the stage for VA's role in the century 
to come.

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