[Congressional Record Volume 150, Number 30 (Wednesday, March 10, 2004)]
[House]
[Pages H994-H995]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                       RURAL VETERANS HEALTH CARE

  The SPEAKER pro tempore (Mr. Burgess). Under a previous order of the 
House, the gentleman from Nebraska (Mr. Bereuter) is recognized for 5 
minutes.
  Mr. BEREUTER. Mr. Speaker, this Member rises today to join the 
distinguished gentleman from Nebraska (Mr. Osborne) in his Special 
Order to highlight the health care challenges that rural veterans face 
when attempting to access care through the Department of Veterans 
Affairs.
  For many years, this Member has been far from satisfied with various 
actions of the U.S. Department of Veterans Affairs, such as, one, the 
use of the health care allocation formula instituted by the Clinton 
administration and continuing to this day, which in effect penalizes 
veterans in sparsely settled States like Nebraska; number two, the 
reorganization of the Nebraska-Iowa region into a larger region 
headquartered in the Twin Cities of Minnesota; three, the end of 
inpatient hospitalization in the Lincoln and Grand Island, VA 
hospitals; and, four, the current procedural difficulties for veterans 
to have prescriptions filled.
  In total, these faulty decisions have amounted to discrimination 
against

[[Page H995]]

veterans in rural areas. First, due to the closure and consolidation of 
veterans health care facilities in Nebraska, veterans in rural areas 
frequently travel several hours simply to receive the basic services 
for which they are entitled and are eligible. As a result of this 
travel, they must incur transportation costs such as overnight 
accommodations which other veterans are not expected to incur for the 
same services. Furthermore, requiring elderly and frequently sick or 
incapacitated veterans to travel on Interstate 80 or other very busy 
roads and highways is not only unfair to them, but also places them and 
other citizens at risk.
  The severity of this problem was brought to this Member's attention 
by a January 2002 Lincoln Journal Star article featuring one Nebraska 
veteran who served in the Navy during World War II. Three years after 
he was diagnosed with several diseases, his wife of 49 years could no 
longer care for her husband. She said that putting her husband in a 
nursing home was the hardest thing she had ever had to do in her entire 
life. Medicare and a private insurance supplement cover doctors' 
expenses, and the couple uses their retirement savings to pay for the 
$4,000 monthly nursing home cost.
  However, additional expenses include $1,000 a month to cover the cost 
of seven prescription drugs that this veteran must take to stay alive. 
Although he qualifies for a prescription drug benefit through the VA, 
in order to obtain this benefit, the drugs must be prescribed by a VA 
doctor at VA-approved facilities. As a result, this veteran must travel 
50 miles every 6 months in order to have prescriptions reauthorized.
  Now, because that veteran is 74 years old, confined to a wheelchair, 
suffers serious blood clots which prohibit him from traveling, this 50-
mile trip often proves to be impossible.
  With the struggles of this veteran and many others in mind, this 
Member expresses his strongest support for H.R. 2379, the Rural 
Veterans Access to Health Care Act for 2003. Indeed, this Member is a 
proud cosponsor of this measure, which was introduced by my colleague, 
the distinguished gentleman from Nebraska (Mr. Osborne). He is to be 
commended for crafting this legislation, which addresses a critical 
problem about which our constituents in Nebraska are increasingly 
expressing their concerns.
  Through H.R. 2379, no less than 5 percent of the total appropriated 
funds for health care would be dedicated to address veterans health 
care access problems in highly rural or geographically remote areas. As 
amended by this bill, highly rural or geographically remote would apply 
to areas in which the veterans have to drive at least 60 minutes or 
more to a VA health care facility. Each Veterans Integrated Service 
Network, that is called VISN, director would receive an equal level of 
funding from this account and then have the discretion to address rural 
access issues as best fit each VISN. If a VISN would be unable to use 
all of these funds from this account, the VISN would not be allowed to 
retain unused funds. Instead, the Secretary of Veterans Affairs would 
then have the opportunity to reallocate those funds to other VISNs 
closely nearby or anywhere that is rural and geographically remote.
  All Members of Congress should agree that the VA must provide 
adequate services and facilities for veterans all across the country 
regardless of where they live, in sparsely settled areas with resultant 
low-usage numbers for VA hospitals. There must be at least a basic 
level of acceptable national infrastructure of facilities, medical 
personnel and services for meeting the very real medical needs faced by 
our veterans wherever they live. There must be a threshold funding 
level for VA medical services in each State and region before any per 
capital funding level is applied.
  Furthermore, I support H.R. 3777, the Healthy Vets Act of 2004. This 
Member is also a cosponsor of this legislation, introduced by our 
colleague, the distinguished gentleman from Colorado (Mr. McInnis).
  This measure would allow those veterans in rural areas which are 
geographically inaccessible to the nearest VA medical facility to enter 
into contracts with community health care providers on a fee basis to 
receive primary health care in their own communities. This authority 
would allow rural veterans to receive preventive regular medical 
attention without being forced to travel what is too often a 
prohibitive distance to seek such care.
  In spite of the fact that each Congress sets a new record on the 
amount of appropriation for veterans health care, there have been 
cutbacks in the access veterans in rural areas have to adequate health 
care, while there have been advances in other geographic areas. The 
health care needs of our military veterans must be met to the fullest 
extent possible. Veterans served in our armed services to protect our 
freedom and our way of life. As they served our Nation at a time of 
need, the Federal Government must remember them in their time of need. 
The debt of gratitude the people the U.S. owe to our veterans surely 
means we should assist the veterans wherever that need exists.
  Finally, Mr. Speaker, this Member remains committed, I would say, to 
ensuring that Nebraska veterans receive the benefits they deserve, 
benefits they had expected and which the American people said they want 
to deliver. I urge support of H.R. 2379 and H.R. 3777.

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