Out Of The Line Of Fire

Read the plaque outside the department of Veterans Affairs' Washington office, and you'd think the agency's mission one of the more ennobling in government: it's ""to care for him who shall have borne the battle.'' But walk into room 433A at the VA Medical Center in Beckley, W.Va., and you meet Gregory Walker, 29, who's never been anywhere near battle. A self-described alcoholic and prescription-drug addict, Walker calls his problems ""service-related'': he first got hooked on booze at Fort Knox. Sharing Walker's room is Kermit Fox, a wizened 55-year-old vet who has spent much of the last decade living in a VA psychiatric ward -- the result, he says, of a traumatic gunshot wound he suffered in Chicago long after he left the army. The total cost to the government for Fox's treatment? More than $1 million. Does Fox believe he's entitled to free lifetime care at taxpayer expense? Hell, yes: ""There wouldn't be no U.S.A. if it weren't for the veterans.''

Paying benefits to America's former servicemen and -women -- including to people like Walker and Fox whose ailments aren't war-related -- now costs $38 billion a year. That's a big-ticket item, even for the Feds. But at a time when Washington is desperately seeking spending cuts, the mere suggestion that taxpayers can't afford such a high veterans' tab summons one of the country's most effective lobbies into action.

Just ask the House Appropriations Committee. After it voted recently to cut a slight $200 million from the VA, the vets descended on the capital to demagogue the modest reduction. ""Who are these people attacking veterans' programs?'' VA Secretary Jesse Brown asked bitterly at last week's Veterans of Foreign Wars midwinter conference. ""Have they served in the military? Have they been to the river of death?'' President Clinton -- whose own lack of military service makes him especially eager to please the veterans -- then promised a $1.3 billion increase in the VA's budget. Grouses Ed Derwinski,a VA secretary in the Bush administration who clashed with the veterans: ""They're the ultimate sacred cow.''

While the number of veterans has been declining (from 28 million in 1980 to 23 million this year), the VA has spent nearly $2.8 billion since 1990 on new hospitals, clinics and nursing homes to expand a system that's actually underused. Two groups of vets are entitled to free care: those who get sick or injured while in the service (even if not inthe line of fire) and vets who are poor. A Newsweek review of VA and congressional audits identified billions in questionable expenditures and waste in veterans' spending:

This year, the VA plans to erect a $211 million hospital in northern California although three other centers in the region are operating below capacity. It's also spending $104 million in Honolulu for a new 105-bed medical wing. But in recent years, the VA has eliminated 68 beds at the same Hawaii hospital because so few veterans were using them.

At one facility in southern California, auditors discovered that 13 surgeons -- each paid an average of $135,000 annually -- had performed no surgery in a three-month period under review. Nationally, the VA has an oversupply of 500 surgeons, costing the department $67 million a year.

The VA spends $1.1 billion to run its own nursing homes despite the fact that the General Accounting Office says it would cost less than half that to pay for a veteran to live ina community facility. And the VA proposes spending $32.4 million this year to build and restore more nursing homes.

The VA spends hundreds of thousands of dollars for 19 golf courses -- including two 18-holers -- and other recreational facilities. A spokesman for a Lyons, N.J., center defends its $70,000-a-year links, saying, ""We'd still have to mow the grass and cut the trees.''

Jesse Brown defends the agency's overall expenditures, saying that veterans' benefits are ""a continuation of the costs of war.'' And he argues to Newsweek that the VA is ""restructuring'' to emphasize cheaper outpatient care instead of higher hospital costs. But new construction goes ahead, and old facilities aren't being closed.

The VA hospital in Beckley illustrates what's wrong with the system. A 173-bed facility in a remote corner of Appalachia, Beckley is a $29 million-a-year, full-service medical center. But from 1990 to 1994, admissions dropped by nearly a third, and last year only 54 percent of the hospital's beds were occupied. Why not close it? There are, after all, three other VA hospitals in the state. Politically, however, VA facilities are among the government goodies hardest to take away -- Congress hasn't shut one down since the Johnson administration.

Empty beds are just one of the VA's problems. The agency will also ladle out $11.4 billion this year for generous ""disability'' pensions. Nobody begrudges money for survivors of the Bataan Death March or draftees who lost their legs in Vietnam. But more than 80 percent of disability payments flow to those whose problems can't be traced back to the battlefield. Three years ago, a federal court ruled that a fair-skinned navy deckhand could collect disability for skin cancer contracted because of prolonged exposure to the sun. The VA later concluded that veterans with lung cancer may be entitled to disability if they were heavy smokers.

Congress has also approved more than 90 diseases that qualify veterans for compensation. The result: nearly $2 billion a year is paid out to those who suffer from heart disease, hemorrhoids and other ""diseases of life'' that began while a vet was in the military but weren't necessarily caused by military service. And more than half of the 2.2 million vets on disability have minor conditions that in most cases allow them to work other jobs, earning money on the one hand while receiving government checks on the other. One disabled vet, Michael Everett Martin, was diagnosed with diabetes during his 24-year navy career but makes his living as a house painter. Martin checked into a Jackson, Miss., VA hospital last Valentine's Day and received a $5,800 penile implant to cure his impotence -- an operation that embarrassed the VA when a local newspaper disclosed that Martin also was a convicted child molester.

Is there hope for reform? Not much, and it's a bipartisan problem. In 1992 Derwinski, a GOP appointee, proposed opening up three rural and underused VA hospitals to nonveterans. But, as Derwinski recalls, ""all hell broke loose . . . I'd get these letters from veterans saying, "I'm not going to go in the hospital and have a draft dodger next to me'.'' The proposal died and Derwinski lost his job. When Al Gore mandated ""downsizing'' every department in 1993, Congress rushed to protect the VA health services. And now it appears they'll be protected once again.