Principi also said the government is installing biological decontamination centers at some veterans hospitals as part of a homeland preparedness plan that could cost up to $200 million.
In an interview with The Associated Press, Principi said the VA is struggling under a "burgeoning, staggering workload" and veterans sometimes are waiting months for care.
"In the past, the easy decision has been to let everyone come in whether you can treat them or not, just put them on waiting lists," he said. "I have a problem with that. I don't think it's fair to people to say we have open enrollment and put them on a waiting list."
Principi had earlier proposed charging veterans with higher incomes co-payments totaling up to $1,500 for services, but Congress balked at the idea. Without such a co-pay, the VA will need about $1 billion more to maintain its current level of service, he said.
President Bush wants $1.5 billion more for the VA in 2003, which would be a record increase for the agency.
The House has included about $417 million in a supplemental spending bill for VA health care this year. The Senate version includes an equal amount, plus $1.1 billion for pensions and compensation, the VA said.
That combination may be enough for VA to continue providing services at the current level, Principi said. But if it doesn't, "we will suspend enrollment for a period of time until we get it under control, then we'll reopen enrollment."
The government in March appealed a court ruling that retired veterans who signed up with a promise of lifetime free medical care in return for a 20-year hitch are entitled to receive it.
Principi said the VA should play a key role in homeland defense. The duties will be determined by Congress and the Bush administration, but Principi said he envisions VA hospitals being used to treat victims, store and disseminate medicines, and offer other health care assistance.
Some VA hospitals already are being outfitted with decontamination units, he said, noting Washington is among them.
"We are looking at the large urban areas that may be subject to attack and trying to establish those units in those locations," Principi said.
The House on Monday passed legislation authorizing $100 million for four new VA research centers aimed at combating bioterrorism.
The centers would focus on research and response to potential chemical, biological and radiological terrorist attacks. They also would provide related education and training to health professionals and assist local authorities with laboratory work in time of emergency.
Among other issues Principi discussed:
- The VA is following up on a study that found Gulf War veterans were twice as likely to be diagnosed with amyotrophic lateral sclerosis, a fatal nerve disorder also known as Lou Gehrig's disease. Principi said the agency is looking at where veterans with ALS served and what they did during the war to try to find a cause for the disease.
- Principi said the lack of answers for Gulf War veterans suffering mysterious illnesses is not because of "a lack of effort or lack of trying or cover-up or any of the conspiracy theories you hear about." He said he hopes an advisory committee he appointed will help find answers.
By Suzanne Gamboa