November 15, 2007 - A Senate committee’s vote on Wednesday to approve four veterans’ health care bills was just as important for what did not pass.

The Veterans’ Affairs Committee passed a mental health care improvement bill and proposals to improve pain care management, strengthen research into epilepsy and expand reimbursement for veterans receiving emergency care from non-VA hospitals and clinics.

In addition, the committee talked about — but did not pass — proposals that would make fundamental changes in veterans’ benefits.

Sen. Richard Burr, R-N.C., is pushing a novel idea to pay veterans a monthly stipend to receive rehabilitative training for service-connected injuries if they agree to delay filing a formal veterans’ disability compensation for at least a year.

Burr said his proposal — which would be optional, not mandatory — seeks a new way of helping veterans.

“The system we currently have just doesn’t work,” Burr said. “The system today is not designed to make somebody well again. We have to find an incentive to make these veterans actually come for treatment.”

Burr’s proposal is an offshoot of a recommendation made by the Veterans’ Disability Benefits Commission in a report earlier this year. The independent commission recommended paying veterans to continue rehabilitation, including boosting payments over the course of treatment to encourage a patient to continue treatment.

Burr was going to offer his idea as an amendment to the mental health bill but withdrew it after Democrats asked for more time to study the idea. Sen. Patty Murray, D-Wash., said she is worried about the idea of using rehabilitation as an incentive not to file a disability claim, and she wondered if the proposal would hurt veterans who cannot access rehabilitation because of waiting lists.

A second proposal, introduced but withdrawn for more study, came from Sen. Jon Tester, D-Mont., who wanted all demobilizing National Guard and reserve members automatically enrolled in the VA health care system so it would be easier for them to get treatment.

Tester said only about 45 percent of reservists enroll in the VA care system during demobilization. Those who wait until they get home can face extended delays, including having to travel to a VA regional office to enroll and to a major veterans care facility for an initial physical before getting the treatment they need.

Burr said he shared Tester’s concern but was not sure about the solution. Automatic enrollment of all Guard and reserve members in VA health care could make it impossible to accurately estimate how many people will seek treatment and could overwhelm the system.

“If automatic enrollment is right for the Guard, it could be right for everyone else to do, too,” he said.

The fourth measure becomes part of a growing pile of veterans- related legislation waiting to be taken up by the full Senate. Sen. Daniel Akaka, D-Hawaii, the Veterans’ Affairs Committee chairman, complained Tuesday about a hold that Sen. Larry Craig, R-Idaho, the former committee chairman, placed on a comprehensive veterans benefits bill and on a bill to improve treatment for veterans with traumatic brain injuries.

Placing a hold on a bill, which any senator is allowed to do, prevents that legislation from moving to a final vote in the Senate. The two veterans bills have been waiting since July for a final vote.

“I do not expect all members to support or agree with these bills, only to allow for their consideration,” Akaka said.