The Official Voice of Vietnam Veterans of America, Inc. ®
An organization chartered by the U.S. Congress
March/April 2003
GOVERNMENT RELATIONSA Tough VA Budget Battle
BY H. AVERY TAYLOR, CHAIR, VVA GOVERNMENT AFFAIRS COMMITTEE,
WITH VVA GOVERNMENT RELATIONS STAFFFThe struggle over the Budget approved by Congress this year has been a tough one. In order to fund the President's proposal for very large tax cuts, the Republican-controlled House and Senate have cut funds vitally needed for veterans health care. In the Senate Budget Committee, an amendment offered by Sen. Tim Johnson (D-S.D.) was rejected during mark up, apparently because the offset would reduce the tax cut. (Sen. Johnson is the only current Senator with a son or daughter serving in the active-duty military. SFC Johnson is an Army Ranger in Iraq.) Several hours later, in that same session, Sen. John Ensign (R-Colo.) offered virtually the same amendment, to add $1.795 billion to medical care at VA, with an offset of across-the-board cuts when the budget is finally done. VVA is grateful to Sen. Johnson, Sen. Ensign, and all the Senators who supported them in this effort. VVA had representatives in the Senate mark up to provide information and be a presence on behalf of veterans.
MORAL COURAGE
On the House side, the Budget Committee in mark up cut approximately $15 billion in both discretionary and mandatory spending for the VA over the next ten years. Since VA health care is already grossly underfunded, this would have had terrible effects on both access to and the quality of VA health care. The cut for next year in discretionary funding was slated to be about $463 million. Additional cuts on the mandatory side would not have left enough to pay legitimate benefits and compensation.The argument advanced was that these cuts could be absorbed by eliminating "waste, fraud, and abuse." While VVA has long been a proponent of measures to exact greater cost accountability from VA senior managers, the simple fact is that VA does not have nearly enough money to meet its obligations to veterans. There simply is not that amount of waste, fraud, and abuse at VA.
As there were no other amendments to restore the cuts to veterans health care offered by members on the Budget Committee, VVA supported the Democrat's alternative budget offered by Rep. John Spratt (D-S.C.), the Ranking Democrat on the Budget Committee.
House Veterans' Affairs Committee chair Chris Smith (R-N.J.) stood up to the leadership of his own party on the evening of March 20 (the same day as VVA's annual testimony). He was joined by Rep. Rob Simmons (R-Conn.--a decorated combat Vietnam veteran and VVA life member--and several other colleagues. They refused to vote for the leadership's proposed budget until veterans were held harmless and the cuts restored. Although the cuts remain in the bill that passed, Chairman Smith has written assurance from House Budget Chairman Jim Nussle (R-Iowa) that they would recede to the Senate in conference.
In a message to Chairman Smith, National President Thomas H. Corey noted that "moral courage is every bit as rare and as precious as physical courage. You exhibited real moral courage in essentially placing your job on the line for what is right. VVA commends you."
ANNUAL TESTIMONY
VVA National President Tom Corey presented the 2003 Legislative and Policy Priorities to a Joint Hearing of both the House and Senate Veterans' Affairs Committees on March 20. Corey made a strong case for increased funding for veterans health care (written testimony is available on the VVA web site.). VVA compared proposed budget figures to those that would have been in place had the VA budget just kept up with increased demand and inflation.The dynamic this year echoes those of the last eight years: The administration (no matter who is President) submits a request that is not enough to operate the VA medical system properly, and the veterans service organizations and our allies spend enormous time trying to increase this figure to something less unacceptable. Current discussions are over a figure for the VA's medical operations. The administration requested $25.3 billion for FY 04, while VVA believes that a minimum of $28 billion is needed (the Independent Budget of the Veterans Service Organizations figure was $27.2 billion).
VVA holds that the fundamental purpose of the VA medical system is best expressed in the motto: "To care for he [or she] who hath borne the battle, his widow and his orphan." While we appreciate the administration's proposal to increase the $23.9 billion appropriated for FY 2003 for medical operations, the $25.3 billion proposed for FY 04 is inadequate to keep the system from deteriorating further.
VVA contends that the funding for medical operations at the Veterans Health
Administration needs to be at least $28 billion in hard appropriated taxpayer dollars for FY 2004.
VVA took the stand that the Secretary of Veterans Affairs chose the only responsible
action he could when confronted by dire fiscal realities: He created a new Category 8 for prioritizing medical care in the VA system and temporarily suspended new enrollments of veterans in that category. While VVA applauds the Secretary's short-term triage action, we strongly oppose making this exclusion permanent, or even to extend it beyond FY 2003. We ask that Congress direct the VA to use figures that include providing services to Category 8 veterans for planning and projection purposes. VVA notes that the Secretary has the authority to do this because the Congress gave it to him.
The question that we need to ask now is: Why did Secretary Principi have to take so
drastic an action as suspending registration and access for Category 8 veterans? No
Secretary should be forced to triage American veterans in this way at home. This should not be a fiscal battlefield. The system should be assured adequate funding that complies with the law, which mandates that funding for VA healthcare meet the level of effort that existed in 1996. This law was undermined by years of flat-line budgeting and medical inflation, straining the VA system beyond capacity, and rendering the VA unable to meet the needs of veterans it serves. This is their right as veterans, and that right is being abrogated.
While enrollees in the VHA system have increased by almost 120 percent since 1996--from some 3.4 million to a projected more than 7.0 million in FY 2004--VHA per capita expenditures have decreased over the same period by 30 percent. Had the level of funding indicated by law and common sense been met, funding for the VA's medical operations would now be hovering at $36 billion, and triage would never have had to become an option for Secretary Principi.
Funding shortfalls are putting veteran safety and the quality of their care at ever greater risk. An April 2001 study sponsored by four Health and Human Services agencies confirmed that inadequate direct-care nurse staffing increases risks of urinary tract infections, pneumonia, shock, intestinal bleeding, and lengthy hospital stays. Doctors and nurses under greater stress risk injury, too, as their increased workloads cause slower mental processing, diminished memory, and improper responses to patients. This kind of hospital environment forces veterans into harm's way.
The recommendation of the House Budget Committee to drastically reduce funding for veterans health care is simply unacceptable, especially now when our servicemembers are on the front lines. This Budget Committee's level of funding must be raised on the floor of the House to at least the level recommended by the Senate Budget Committee. Please send an e-mail to Sharon Hodge at shodge@vva.org or go to the web site www.vva.org and click on Government Relations to access legislative updates and to access CapWiz to assist you in communicating with your Members of Congress.
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