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WASHINGTON -- A half dozen key lawmakers were struggling Wednesday to quickly craft a compromise bill to help veterans facing long appointment waits at veterans hospitals and make it easier to fire administrators who covered up the delays.
The goal is to address an uproar over veterans' health care following allegations that veterans have died while waiting to see a Veterans Affairs doctor. Senators hope to pass the bill before Friday's 70th anniversary of the Allied invasion of Europe in World War II.
Leading the negotiations were Sen. John McCain of Arizona, the Republican presidential candidate in 2008, and independent Sen. Bernie Sanders of Vermont, chairman of the Senate Veterans Affairs Committee and the only self-described socialist in Congress.
They met face to face early Wednesday and again later in the day.
Also involved were Senate Majority Leader Harry Reid, D-Nev.; North Carolina Sen. Richard Burr, the senior Republican on the Veterans Affairs Committee; and Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee.
Sanders acknowledged that he and McCain make an unlikely pair, but he was upbeat about the prospects of quickly reaching a deal. "I'm cautiously optimistic," he said in an interview. "McCain is serious, I'm serious and Reid is serious."
McCain was less optimistic about a bill being passed this week. "I am not predicting anything," he told reporters.
The main stumbling block appeared to be over when and under what circumstances veterans could turn to doctors and other providers outside the 1,700-facility VA system for what is largely free care for them.
The two lead negotiators couldn't agree on how to define it. Sanders said the primary issue was waiting times, while McCain said it was giving veterans a choice beyond VA for getting care.
"The issue is how do we make sure every veteran in this country can get into a VA facility in a reasonable period of time. And if they can't, what do they do?" Sanders said, answering his own question: "They go to private doctors, they go to other medical providers. And we've got to work out the details."
McCain would rather let veterans who can't get a VA appointment within 30 days or who live more than 40 miles from a VA hospital or clinic go to any doctor who participates in Medicare or the military's TRICARE program. He complained that Sanders' approach "has the VA bureaucrat decide whether that veteran should get the health care of their choice."
A federal investigation into the troubled Phoenix VA Health Care System found that about 1,700 veterans in need of care were "at risk of being lost or forgotten" after being kept off an electronic waiting list. The investigation also found broad and deep-seated problems throughout the sprawling health care system, which provides medical care to about 6.5 million veterans annually.
An interim report by the VA's inspector general said veterans in Phoenix wait an average of 115 days for a first appointment -- five times longer than the 24-day average the hospital had reported. The inspector general said at least 42 VA facilities were under investigation, including the Phoenix VA hospital, where a former clinic director said as many as 40 veterans may have died while awaiting treatment.
Sanders has complained that the VA does not have enough doctors or nurses, particularly for primary care. He is sponsoring a bill that would authorize the VA to lease 27 new health facilities in 18 states. The VA system now has 150 hospitals and 820 clinics nationwide.
Miller, the House VA chairman, said Sanders' bill was "too broad for the current discussion" and did not do enough to hold senior officials at the VA accountable for falsified waiting lists and other problems.
The House last month passed a bill by Miller that would allow the VA to immediately fire as many as 450 regional executives and hospital administrators for poor performance. Sanders has a similar bill but would give those managers more avenues to challenge their terminations. The differences didn't appear to be a major hurdle.
"The House bill is not terrible. It doesn't have the due process I would like but, you know, we can probably live with that. I can at least," Reid told reporters this week.
Meanwhile Republican governors of six states, including Rick Perry of Texas and Rick Scott of Florida, asked President Barack Obama to give states authority to conduct reviews of all veterans health facilities within their borders. The governors said the state investigations would offer an independent review by officials "who have not been part of the current systemic crisis."
Besides Scott and Perry, the letter was signed by Pennsylvania Gov. Tom Corbett, Kansas Gov. Sam Brownback, Maine Gov. Paul LePage and Louisiana Gov. Bobby Jindal.
Associated Press writers Alan Fram and Erica Werner contributed to this report.
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