WASHINGTON – The Togus veterans hospital took center stage at a congressional hearing on Tuesday as lawmakers discussed ways to repair the increasingly strained health services system provided by the Department of Veterans Affairs across the country.

Many witnesses and members of the House government reform subcommittee on veterans affairs agreed that the VA system faces explosive growth because of aging patient populations at the same time that funding remains tight. They also said that the money available could be better allocated to serve the communities of greatest need.

As with many veterans clinics in the country, Togus and other New England facilities have found themselves regularly strapped for resources to meet rising patient demands in recent years.

The constant shortfall has driven Maine’s congressional delegation to repeatedly press for greater funding, while complaining that the government formula used to distribute operating cash could use a major overhaul.

Testifying before the committee, John Bachman, chairman of the Committee to Save Togus, agreed that the funding formula first adopted in 1995, known as the Veterans Equitable Resource Allocation, needs rethinking.

“The system has failed,” said Bachman, a decorated Vietnam veteran who now works as a physician assistant at the Maine hospital. “And Togus has become a casualty.”

Bachman said that while the Veterans Administration and Congress intended VERA to help distribute funding equitably around the country by considering local costs, the opposite has occurred and was made worse by the creation of regional divisions called Veterans Integrated Service Networks.

“The VISNs fund themselves first,” Bachman claimed. “Then whatever is left over is divided among the other medical facilities within the VISN.”

Another problem for Togus is the rising number of patients. Some 500 more veterans visit Togus each month than did two years ago. This year’s patient roster could top 30,000, according to hospital officials.

The story is the same throughout New England where the number of patients has grown from 180,000 in 1999 to 279,000 in 2001.

Dr. Jeanette Chirico-Post, VISN director for New England and New York, credited the growth to a souring economy and “the fact that many HMOs have failed in the region.”

The growth in patients in New England and elsewhere is also attributed to larger numbers of higher-income veterans with illnesses unrelated to their time of service who are now turning to VA clinics for health care services. Classified as “Category 7” veterans, this group of patients grew from 35,000 in New England in 1999 to almost 90,000 last year.

The low-cost VA program for prescription drugs also has been a popular draw at VA centers, including Togus. Veterans who are 65 or older are turning to veterans hospitals to fill their prescriptions – “no matter what the drug is” – because of the small $7 co-payment, according to Robert Boswell, the Veterans Administration undersecretary for health.

Government costs for the drug benefit may soon climb even higher, Boswell noted, because while only 1 million veterans now take advantage of the program, an estimated 9 million are eligible to apply.

That valued prescription service, said Bachman, is one reason for a funding shortfall at Togus, which spent $16.6 million on pharmaceutical drugs during the year 2000, but now is seeing projected costs during the first six months of this year reaching $25 million.

Democratic Rep. Tom Allen of Maine, a member of the committee, agreed with Bachman’s assessment on many counts.

“Togus,” Allen said, “is understaffed, underfunded and sometimes overly micromanaged by VISN.”

Allen, along with Maine’s entire congressional delegation recently met with Veterans Affairs Secretary Anthony Principi to discuss funding issues at Togus. All the lawmakers share the same observations.

“Togus delivers high quality care but is consistently underfunded and a great source of frustration for the entire delegation,” Sen. Susan Collins said on Tuesday. “New England is consistently slighted due to the formula in allocating resources.”