When it comes to planning hospitals, the VA marches to its own beat.

If you want to build a hospital, you have to convince state and local health planners that the facility is needed and won't add to any oversupply of hospital beds in the area. You have to, that is, unless you're the Veterans Administration. The VA is exempt from the federal health planning law, even on a voluntary basis, and that's caused some problems recently. In Baltimore, for example, the VA intends to erect a 400-bed hospital even though local planners say the area already has more beds than patients to fill them. And in Minneapolis and Portland, Ore., there are similar conflicts between health planners and the VA.