Summary: GAO discussed the Department of Veterans Affairs' (VA) plans for establishing a medical center on the grounds of the Tripler Army Medical Center. GAO noted that: (1) VA included adequate acute care capacity in the Tripler Center renovation to meet the current and future needs of Hawaii's veterans; (2) construction of 105 additional VA acute care beds will increase costs and decrease access to VA-sponsored care for many of the state's veterans; (3) a state mandate requiring employers to provide health insurance to employees working over 20 hours per week could reduce the demand for VA services; (4) according to a 1987 VA survey, nationally less than 1 percent of all insured veterans had used a VA hospital in the past year compared to about 8 percent of uninsured veterans; and (5) access and options for VA-sponsored care will be reduced once the additional acute care beds are constructed, especially for veterans living on the outer islands, who will be required to use the new hospital rather than municipal hospitals closer to home.
