Chairman Michaud, Ranking Member Miller, thank you for holding this important hearing today. AMVETS is pleased to provide our views on pending health care legislation.

AMVETS opposes amending Section 7422 by removing subsections (b), (c) and (d) that is outlined in H.R. 4089. Allowing VA employees who are directly involved in patient care to have collective bargaining rights could have direct negative impact on the care our veterans receive. Patient care managers need to have the authority to make decisions on clinical competence and the flexibility to arrange his/her staff in a way that will benefit the veterans who are receiving care the most.

Allowing collective bargaining will undoubtedly remove the authority of those who are tasked with managing the highest level of care of our veterans. Clinical care issues are often very fluid and decisions on staffing needs or the quality of care that is provided to the patient cannot be tied up in protracted collective bargaining hearings. Even if the bargaining process is only two months long the quality of care our veterans receive could be impeded.

H.R. 4463 provides provisions that will enhance recruitment for hard-to fill positions within VA, as well as ensure that during the recruitment process that only the best qualified doctors are hired. AMVETS supports this legislation. When veterans welfare is at stake, verifying work history and understanding the career history of a potential employee is vital. Practicing medicine is a high-risk profession and VA needs to have every tool necessary to ensure they hire the best qualified so the care our veterans receive will continue to be the highest quality.

H.R. 5888 expands veteran eligibility for reimbursement for emergency treatment furnished in a non-Department facility. Under Section 1725 of title 38, veterans are not compensated if emergency care is paid for in whole by a third party. Veterans receiving emergency care in a non-Department facility are not being reimbursed fully if services are paid for in part by another entity, as is the case with Medicare and other insurance companies. H.R. 5888 removes the provision “or in part” to allow the Department to reimburse veterans who have unpaid medical bills after partial coverage by their insurance companies. This helps improve the lives of veterans who are unable to pay medical bills without help from the VA and for this reason, AMVETS wholly supports this legislation.

AMVETS wholly supports 6114 the “Simplifying and Updating National Standards to Encourage Testing of the Human Immunodeficiency Virus of 2008” or “SUNSET Act o 2008”. Current Veterans Affairs healthcare standards, which have been in place since 1988, are outdated and inconsistent with the new CDC guidelines issued in September 2006. A recent study conducted by the Public Health Strategic Health Care Group at the Veterans Health Administration showed that 55% of HIV positive veterans had already suffered significant damage to their immune system and developed full blown AIDS. In addition, 40% of these veterans had accessed the VA system an average of 6 times before being diagnosed. The VA system is the largest in the United States, also making it the largest provider of HIV care. Conversely, compared to the general population, veterans are disproportionately affected by the lack of routine HIV testing. Increasing the frequency of testing will facilitate early detection, treatment, reduce HIV and AIDS related death while improving the health of veterans living with these diseases.

AMVETS wholly supports H.R. 6122 “Veterans Pain Care Act of 2008”. This bill seeks to implement department-wide standards of the management of pain experienced by veterans through the assurance of prompt and appropriate pain care treatment, education and training on veteran pain care, and the creation of an annual report by the Secretary to the Committee on Veterans’ Affairs. Acute and chronic pain is experienced disproportionately to the general public by military personnel and veterans. Serious, but survivable injuries acquired in modern warfare can lead to long term problems associated with chronic pain and left untreated, can have life long consequences. It is important for the Department of Veterans Affairs to have a comprehensive policy on the management of pain experienced by veterans enrolled in health care services provided by the Department. Helping veterans manage pain can lead to an improved quality of life for them and their families.

Chairman Michaud, this concludes my testimony. I am happy to respond to any questions the Subcommittee may have.