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Mr. COBURN. I thank the chairman of the Veterans' Affairs Committee for working with Senator McCain to get a bill.
I support Senator Sessions and the budget points of order on this bill. I take exception to some of the statements by my colleague from Vermont.
As reported yesterday, if you look at the patient list for many of the primary care doctors in the VA, they are half of what the average practicing physician outside the VA is. When you drill down on those, many of them have patients that have been deceased for years. About 10 to 15 percent of their patient list has never been to the VA, or they came once from a different State or were transferred from somewhere else. What you actually see is the patient load in the private sector is about 2 1/2 times what the patient load is in the VA.
I have no doubt we need to increase the number of physicians in the VA, but we also need to increase markedly the amount of output that those physicians perform.
The other thing that is important in this bill is the transparency--which I don't believe has been mentioned--that will actually allow veterans to know the quality outcomes of where they are being treated and the credentials of those who are treating them. Those are important factors for care.
Our veterans deserve the best care. I agree with the chairman of the Veterans' Affairs Committee that the vast majority of our VA employees are hard-working employees, but there are some who aren't.
Our lack of oversight and the lack of management expertise at the VA has now exploded into issues that are going to continue to be exploded. We hear every day new whistleblowers coming forward on the problems in the VA.
It is not only scheduling; it is a lack of truthfulness in a lot of other areas. It is a lot of inaccuracy in terms of outcome.
I agree with the chairman. This is just the beginning. But if, in fact, somebody puts their life on the line for us, we certainly, at a minimum, ought to make sure that we don't just have words that say we are going to give you the health care if you are an injured returning war veteran, but that we actually give that care, and that it meets the standard of care we want for anybody in our family. This is just the start.
The other thing that I would say, in agreement with Senator Sessions, there are ways to pay for this bill.
On the clinics, we drill down on one clinic--and I am going to go spend just a minute talking about it. It is a clinic that will triple in size, but with an average expected increase in veteran population of 5 percent and visits of less than 7 percent over the next 20 years. So it is going to go from 50,000 to 190,000 square feet.
We are going to spend $188 million for that facility and pay $40 a square foot per year for it on a rate of increase of 4 percent in part of the lease. We can rent the same space in Tulsa at $15 a foot and spend less money than we pay for the engineering cost for this to have a clinic just as good or better.
So the planning and the management of the VA on these clinics is suspect, and I plan on drilling down on every one of those before this bill comes to conference and give our conferees the information based on that. Because we are going to spend emergency money, as the chairman would like to do on this, we ought to make sure there isn't a penny that is wasted.
So we can do it. We can do it better, we can do it for less money, and we can do it in the confines of what we are actually going to see.
The final thing is I would say again to my colleague from Vermont, I appreciate his willingness to compromise on the issues. His heart is dedicated to veterans, and I understand that. Our philosophies are different on how we get there, but his commitment is nonetheless real and felt, and I thank him.
I yield the floor.
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