It is too soon to know whether recent funding changes will reduce the unacceptable delays for care in the Veteran Affairs Medical Center at Togus. But the increased dollars and, more importantly, the higher reimbursement rates and more specific method for assessing the need for funding demonstrate that federal officials understand this region’s longstanding complaints about the rationing of care.

With helpful prodding from New England congressional delegations, VA Secretary Anthony Principi has added an immediate infusion of $25 million to the VISN 1 budget, which will continue through the total increase of $70 million in the ’03 regional budget of approximately $1 billion. The hospitals won’t see this second increase, however, until Congress completes work on its budget bills, which are badly overdue.

The added money was gained in part by changes in the reimbursement formula from three classifications for care to 10, including areas such as basic medical are, heart and lung, oncology, supportive care, chronic mental illness and care for the critically ill. A system that more accurately recognizes different demands for care and reimburses critical care at a higher level benefits this region especially because the region tends to have older veterans who need more intense services.

Maine veterans are now waiting between one and two years for certain types of service at Togus, delays that would cause outrage in other health systems and certainly worsen veterans’ health in this one. It is one more ill-fitting piece of a health care puzzle that Congress refuses to consider in its entirety and therefore cannot wholly solve and it will get worse in Maine for veterans because of the increased number expected to need health care in the next decade. Togus and its state clinics are preparing for an increased patient count from 40,000 now to 60,000 in just a few years.

The added funding is unlikely to be enough to eliminate the current delays entirely. But it is a significant move in the right direction; it gives hospitals money to hire more doctors and replace equipment. It will help. The new reimbursement rates and classifications, over time, will help even more. They are small fixes for a national health-care system that requires major reform, but they are essential. And veterans, who already have been waiting too long, cannot be expected to wait until Congress makes major changes to health care.