[Senate Hearing 109-463]
[From the U.S. Government Publishing Office]
S. Hrg. 109-463
THE LEGISLATIVE PRESENTATION OF THE DISABLED AMERICAN VETERANS
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINTH CONGRESS
SECOND SESSION
__________
FEBRUARY 28, 2006
__________
Printed for the use of the Committee on Veterans' Affairs
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senate
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COMMITTEE ON VETERANS' AFFAIRS
Larry Craig, Idaho, Chairman
Arlen Specter, Pennsylvania Daniel K. Akaka, Ranking Member,
Kay Bailey Hutchison, Texas Hawaii
Lindsey O. Graham, South Carolina John D. Rockefeller IV, West
Richard Burr, North Carolina Virginia
John Ensign, Nevada James M. Jeffords, (I) Vermont
John Thune, South Dakota Patty Murray, Washington
Johnny Isakson, Georgia Barack Obama, Illinois
Ken Salazar, Colorado
Lupe Wissel, Majority Staff Director
D. Noelani Kalipi, Minority Staff Director
C O N T E N T S
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February 28, 2006
SENATORS
Page
Craig, Hon. Larry, Chairman, U.S. Senator from Idaho............. 1
Salazar, Hon. Ken, U.S. Senator from Colorado.................... 3
Akaka, Hon. Daniel K., Ranking Member, U.S. Senator from Hawaii.. 21
Murray, Hon. Patty, U.S. Senator from the State of Washington.... 23
WITNESSES
Jackson, Paul W., National Commander, Disabled American Veterans,
accompanied by: David W. Gorman, Executive Director, Washington
Headquarters; Arthur H. Wilson, National Adjutant; Joseph A.
Violante, National Legislative Director; Edward E. Hartman,
National Director of Voluntary Services; Edward R. Reese, Jr.,
National Service Director; and Judy M. Steinhouse, National
Commander, Disabled American Veterans Auxiliary................ 6
Prepared statement........................................... 10
APPENDIX
Thune, Hon. John, U.S. Senator from South Dakota................. 37
Reyes, Hon. Silvestre, U.S. Congressman from Texas............... 37
THE LEGISLATIVE PRESENTATION OF THE DISABLED AMERICAN VETERANS
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TUESDAY, FEBRUARY 28, 2006
U.S. Senate,
Committee on Veterans' Affairs,
Washington, D.C.
The committee met, pursuant to notice, at 2:10 p.m., in
room SH-216, Hart Senate Office Building, Hon. Larry E. Craig
(chairman of the committee) presiding.
Present: Senators Craig, Salazar, Akaka, and Murray.
OPENING STATEMENT OF HON. LARRY E. CRAIG,
U.S. SENATOR FROM IDAHO
Chairman Craig. Good afternoon, ladies and gentlemen. Thank
you all for being with us. I am proud to convene the Senate
Veterans' Affairs Committee, and I welcome all of you.
It is a pleasure to welcome you here today to receive
legislative presentations from the Disabled American Veterans.
Before we begin, I would like to extend a very special
welcome to the DAV members who have traveled from my home state
of Idaho. I understand that Edger and Sharon Dungess are in the
audience, our junior vice commander and DAV auxiliary
commander, along with Brian Alspach, a national service
supervisor, Francis Redding, a State commander for the
Department of Idaho, and Barbara Redding, past national DAV
officer. We welcome fellow Idahoans certainly to the committee.
I would also like to welcome Mr. Paul Jackson, the national
commander of the Disabled American Veterans. Congratulations on
your selection as national commander, and thank you for joining
us today.
I will also welcome Senator Ken Salazar, a Member of the
committee, who will be introducing Mr. Jackson, and welcome to
other DAV and DAV auxiliary members at the witness table who I
understand Mr. Jackson will introduce.
Today's hearing is the first of several hearings that the
committee will hold this year to receive legislative
presentations of various veterans organizations. Although these
Senate hearings are a departure from prior practice, I am
pleased that veterans organizations will continue to have an
opportunity to express their views to this committee, and I am
confident this hearing will provide us with valuable input to
consider as we tackle some of the important issues of this
session.
Before I turn it over to you, Mr. Jackson, I would like to
say a few words about this committee's activities this last
year and some important issues that we will confront this year.
By any measure, this committee has had a busy and
productive first session, convening 23 hearings here in
Washington, nine field hearings, and four markups. These
hearings led to the enactment of legislation to increase
disability compensation and survivor payments, to provide
traumatic injury insurance protection to seriously wounded
service members, to increase the maximum amount of veterans'
and service members' life insurance coverage, to provide
integrated online information to survivors about Federal
benefits, and to close the parole loophole that allowed certain
capital offenders to receive burial and funeral honors.
This committee also worked to fill a gap in VA's health
care funding and approved legislation to improve housing and
other benefits and to provide enhancement of health care
programs.
This session, we began by holding a hearing to examine
employment programs for veterans and why these programs have
not helped some groups of veterans find jobs. Exploring ways to
improve the high unemployment rate among some groups of
veterans, particularly young recently separated veterans and
veterans with disabilities, will continue to be a very clear
focus of this committee.
Of course, now the committee's primary focus must be the
President's fiscal year 2007 budget proposal for the Department
of Veterans Affairs. As I stated at a hearing earlier this
month, I believe this record budget request is extraordinary
and shows that the President has made veterans a top priority,
and I am pleased about that.
I am concerned, however, that at the present spending rate,
VA spending will double almost every 6 years and will soon
collide with spending demands in other areas of our Government.
Although we may wish that veterans funding exists in a vacuum,
it simply does not, and we, those of us on this committee, are
soon going to be faced with some very important decisions about
how to deal with these fiscal realities.
As I am sure you are all aware, the President has proposed
one way for us to respond to these fiscal challenges, by asking
7 and 8 priority veterans with no service-related disabilities
to contribute $21 per month to enroll in the VA health care
system and $15 for a 30-day supply of medicine.
Although I personally find these proposals to be
reasonable, I know DAV and other veterans organizations have
voiced strong opposition. So I will reiterate my hope that your
organization as well as other veterans organizations will
engage this committee in a serious and candid discussion, if
not about the President's proposals, then about other options.
Mr. Jackson, your organization played a key role in seeking
reform for the VA health care system 10 years ago, and we are
now reaping the benefits of that reform with one of the
highest-quality health care delivery systems in the Nation.
Today, we have that topnotch health care, and it is under
your leadership that DAV now has the opportunity to help us
find ways to sustain this incredible health care system into
the future.
If we address these issues now, we can help ensure that
future vets will not be faced with drastic or more difficult
changes needed to solve the problems. I personally do not want
to pass this issue on to the next guy. Instead, I want to pass
on to tomorrow's veterans a sustainable quality health care
system that provides quality care that is accessible to those
who need it, but affordable to those who want it.
I hope you agree with these goals, and are willing to work
together, no matter whatever it takes to make sure that we
resolve this issue and sustain the quality health care system
that I know all of us are tremendously proud of.
Again, thank you for all of you coming today to join with
us in providing this testimony and the kind of continuing
dialogue that your organization has had for so many years with
this committee.
Senator Akaka would like you to understand--let's see. He
is not here yet for his opening statement, but I believe that
he may be able to make it.
We also have a vote at 2:30. So we will recess for a moment
and step away, but with that in mind, let me turn to my
Democratic colleague who is here, a new Member of the committee
who I have enjoyed working with who, by his presence and his
dedication to this committee, has shown his dedication toward
America's veterans, Senator Ken Salazar of Colorado.
Ken, I turn to you for any opening comments you would like
to make and to the introduction of Mr. Jackson.
Thank you.
Senator Salazar. Thank you very much.
What I would like to do, if it is okay with you, Mr.
Chairman, is to make an opening statement and then have the
immense privilege and honor of introducing Commander Jackson.
Chairman Craig. Let me, before I do that, so we will move
right into Mr. Jackson's testimony, I see that we are being
joined by some of the House Veterans' Affairs Committee people,
and I welcome you. I understand there may be some others
coming.
I understand that the House Veterans' Affairs Committee had
an opportunity to hear DAV earlier this month. So I hope our
colleagues in the House will understand that I must ensure the
time be dedicated to the Senate Members. You are certainly
welcome, and we appreciate that, but for the sake of timing and
the sake of our colleagues, any question and answer and
response will be dedicated only to U.S. Senators, but you are
welcome. We appreciate you being here, and I recognize your
presence. Thank you.
Please.
OPENING STATEMENT OF HON. KEN SALAZAR, U.S. SENATOR FROM
COLORADO
Senator Salazar. Good afternoon. Thank you, Chairman Craig,
and I also want to thank Senator Akaka for holding this
important hearing today.
I want to thank the representatives of the DAV who are in
attendance here today, especially those who have traveled from
my State of Colorado, including Commander Jackson who just came
back from Iraq and had a trip around the Nation doing some
other things for the DAV.
Although the format of the hearing this year is a little
different from the past, I appreciate the opportunity that
Senator Craig and Senator Akaka are providing us, so that we
can hear from the DAV on your priorities. I am grateful for the
work that each of you do in connection with our service to our
Nation's disabled veterans.
I am very proud to have a fellow Coloradan who is a
commander, the national commander for the organization. I am
confident that he will exemplify the State's commitment to
these issues and that he will make Colorado and our Nation
proud as he has always in his past.
Today, I know is the first series of hearings on the
legislative proposals of the major veterans service
organizations that give us the Independent Budget. Every year,
27 VSO's work very hard to present this independent budget to
the Congress and to the executive branch. I appreciate the work
that goes into the creation of that Independent Budget.
These hearings for me were extremely valuable last year, my
first year in the Senate and my first year of service on the
Veterans' Affairs Committee, because they showed me your side
of the story from the veterans' perspective.
The hearings helped me understand the budget not from the
view of simply the VA or from other Members of Congress, but
from the people that the budget affects every day all across
our country, the veterans themselves. That is why I keep a copy
of the Independent Budget on my bookshelf. It lays out very
clearly the steps we need to take to reform our Nation's
veterans' services and to meet our obligation to provide for
the men and women who have sacrificed so much for our country
and for their families.
At the center of the Independent Budget's recommendations
for reform and at the forefront of priorities of disabled
veterans across America is a critical issue of how to fund VA
health care. As our Nation struggles with a growing health care
crisis, we can all agree that the VA health care system serves
as an example for how health care should be provided.
In addition, though, through its medical research programs,
the VA is frequently responsible for great strides in medical
science that contribute significantly to the quality of health
care across the country.
Given the significance of the Veterans Health
Administration to our Nation's health care system and the
paramount importance of providing our Nation's veterans with
the high-quality care that our Government and Nation has
promised them, we owe it to our service members, our veterans
and our Nation, to be honest about our needs and to provide
funding adequate to meet those needs.
While this year's budget request does a better job of
meeting those standards and the one we considered a year ago,
it does not take the steps that are necessary to ensure proper
continuity of care for our Nation's veterans. We cannot keep
responding to uncertain budget requests with appropriations we
hope are adequate, only to be faced with additional shortfalls.
This issue is especially important as our service members
return from Iraq and Afghanistan in growing numbers and with
severe service-connected disabilities. Instead of being forced
to ration care by uncertainty about funding, VA officials and
the veterans they serve deserve to know that the care they need
will be there today, tomorrow, and every day for the years to
come. The answer in my view is mandatory funding.
I am a cosponsor of Senator Johnson's bill to ensure that
funding for VA health care is guaranteed, and I will work hard
to see that we continue to fight to make it become law.
Unfortunately, VA health care funding is not our only
challenge. We need to do much more to eliminate the claims
processing backlog that exists with respect to veterans'
benefits. It is so disheartening to think that the only thing
standing between veterans in need and the benefits they have
earned is sometimes a needless bureaucratic delay.
We also must work down the disability tax and allow full
concurrent receipt now. You should not have to subtract what
you have suffered from what you have earned.
As we strive to overcome these and all the challenges we
face, I am proud to work with Senator Craig, my colleague and
friend from Idaho, and Senator Akaka, my colleague and friend
from Hawaii, as well as with our colleagues from the House of
Representatives. Our priorities are your priorities, and I am
proud to stand by you as we fight to achieve them.
Before I introduce Paul Jackson, I also want to introduce,
just very briefly, the most recent addition to the House
Veterans' Affairs Committee. He happens to be someone whom I
have known for the full 50 years of my life. He is a veteran
himself, and he is the Congressman from the 3rd Congressional
District of the State of Colorado which covers the Western
Slope and Pueblo and parts of southern Colorado. It is the
first time in our time together here in the U.S. Capitol that
we actually get to sit on a committee together and hold a
hearing together.
So, Representative Salazar, welcome to the Senate side of
things.
Chairman Craig. Ken, I am assuming there is a last name
similarity. Is there a relationship there, or are you just
distant neighbors?
Senator Salazar. You couldn't tell by the hair. Right?
Chairman Craig. Well, I was drawing some conclusions. Yes.
Welcome again.
Congressman Salazar. Thank you, Mr. Chairman.
Senator Salazar. He is my older brother. So he can pull
rank in that respect, but I am the Senator. So maybe I can pull
rank in that respect.
Chairman Craig. Of course, you can. You are on your turf
right now. Okay?
Senator Salazar. Thank you. Thank you, Chairman Craig.
Commander Jackson, it is my immense privilege to introduce
you here today. You are not only a distinguished member of
today's panel, but you also have distinguished yourself in the
service to our country.
As the national commander of one of the largest veterans
service organizations in the Nation, I am so proud of the fact
that you are also a fellow Coloradan.
Commander Jackson served honorably in our Nation's military
for 21 years, a career that included wartime service in both
Korea and two tours of duty in Vietnam.
He has served as a member of the U.S. Marine Corps, as a
member of the U.S. Army 1st Infantry in the 101st Airborne
Division, and 12 years after retiring from the military in
1973, Commander Jackson joined the Disabled American Veterans
where he has dedicated the last 20 years of his life to
advocating on behalf of disabled veterans and their families.
Commander Jackson, like the over 2 million veterans he
works tirelessly for every day, is a service-connected disabled
veteran. He does his job so well not only because he is a hard
worker and a dedicated professional, but because he is
intimately familiar with his constituents' priorities.
He has served with DAV in a number of capacities, ranging
from member of the DAV National Employment Committee to senior
vice commander to his current position as national commander. I
am especially proud of his service as a member of the DAV
Department of the Colorado Board of Directors.
Although he was born in Texas, Commander Jackson has been a
fellow Coloradan since his days as a student at Pike's Peak
Community College in Colorado Springs. He is a life member of
the Colorado DAV Chapter 7 where he has impressively held all
elected chapter offices. He has served our State in a number of
important roles, including as a fraud investigator in
Colorado's Department of Social Services.
I am deeply proud that Commander Jackson, his wife Jean,
and his four children call Colorado home, and a fellow
Coloradan is serving as a national commander for such a
distinguished organization. I am honored to have the
opportunity to introduce Commander Jackson at today's hearing.
Chairman Craig. Ken, thank you, and Commander Jackson,
welcome again before the committee.
As I did say, we have a vote at 2:30. We will allow you, of
course, to complete your opening statement. We may then recess
for a moment, run and vote. We will be back then for the
balance of the committee and for questions.
So please proceed, and welcome again.
STATEMENT OF PAUL W. JACKSON, NATIONAL COMMANDER, DISABLED
AMERICAN VETERANS, ACCOMPANIED BY: DAVID W. GORMAN, EXECUTIVE
DIRECTOR, WASHINGTON HEADQUARTERS; ARTHUR H. WILSON, NATIONAL
ADJUTANT; JOSEPH A. VIOLANTE, NATIONAL LEGISLATIVE DIRECTOR;
EDWARD E. HARTMAN, NATIONAL DIRECTOR OF VOLUNTARY SERVICES;
EDWARD R. REESE, JR., NATIONAL SERVICE DIRECTOR; AND JUDY M.
STEINHOUSE, NATIONAL COMMANDER, DISABLED AMERICAN VETERANS
AUXILIARY
Mr. Jackson. Thank you, Senator Salazar.
Chairman Craig, I want to personally thank you for this
opportunity to appear before you and your committee.
Mr. Chairman and Members of the Veterans' Affairs
Committee, please allow me to introduce those seated at the
table with me as well as some of our distinguished guests:
National Adjutant Art Wilson, Executive Directors Rick
Patterson and Dave Gorman, National Service Director Randy
Reese, Legislative Director Joe Violante, Volunteer Service
Director Ed Hartman, Auxiliary National Commander Judy
Steinhouse of North Dakota, Auxiliary National Adjutant Maria
Tedrow, DAV Senior Vice Commander Bradley Barton of Oregon;
Junior Vice Commanders Rob Reynolds of Virginia, Ray Dempsey of
Illinois, Bobby Barrera of Texas, and Wallace Tyson of North
Carolina; National Judge Advocate Mike Dobmeier of North
Dakota, Past National Commander James Sursely of Florida,
Chaplain Edward Bastille of California, and National Chief of
Staff Norbert Wenthold.
I would also like to introduce my wife Jean and my two
daughters, Ida and Jeanine, in the back of me.
Chairman Craig. Welcome to all of you.
Mr. Jackson. I will ask the DAV National Executive
Committee to please stand and be recognized.
May I ask the members of the National Legislative Interim
Committee to please stand.
I wish to recognize Department of Colorado Commander
Kenneth Camal, Adjutant Mike Terry, and the entire 17th
District which includes Colorado.
Mr. Chairman, in my remarks today, I will briefly touch on
a number of important topics that my written statement covers
in more detail.
Chairman Craig. Commander, your full statement will be a
part of the record. Please proceed.
Mr. Jackson. I welcome any questions or comments from
Members of the committee, and my staff will be available to
respond.
On behalf of the 1.5 million members of the Disabled
American Veterans and its Auxiliary, I am pleased to discuss
the agenda of our Nation's wartime disabled veterans and their
families.
Mr. Chairman, today, America's sons and daughters are
serving in our armed forces, protecting our freedoms here and
abroad.
Having returned from Iraq on February 22nd, I can tell you
that those brave men and women representing us over there makes
me very proud to be an American. They make us all very proud.
Sadly, though, all too many of them have come home bearing
the wounds and scars of war. Not since the Vietnam War has our
Nation had to deal with such a significant number of severely
disabled wartime casualties.
Although they do receive excellent military care from the
military, I am concerned about whether they will be able to
receive timely, quality health care from the VA well into the
future.
In March 2005, then-DAV National Commander Jim Sursely
expressed our concern about the VA's ability to care for our
Nation's veterans. In his testimony to the House and Senate
Veterans' Affairs Committee, he cited a number of news articles
about budget shortfalls at VA facilities across the country.
Unfortunately, at that time, his concerns fell mostly on deaf
ears.
Then last June, the VA finally admitted to a critical
shortfall, which Congress had to cover with supplemental
appropriations.
Mr. Chairman, I want to thank you, Ranking Member Daniel
Akaka, and Senator Kay Bailey Hutchison for your advocacy in
providing those much-needed funds. I also want to commend
Senator Patty Murray for bringing the funding crisis to light
very early on. Thank you all very much.
However, despite that welcome infusion of funds, we
continue to hear from the field that budget problems still
persist. The hiring freeze is still in place, and employee
levels in VA health care remain unchanged for the years 2005
and 2006. And what's worse, we understand that the VA medical
facilities are required to pay back the money they received to
cover last year's funding shortfalls. For some facilities, the
increase they receive will only help to pay for salary
increases. Others report continued deficits and backlogs. Some
are actually reducing health care, and some medical facilities
are wondering how they will make it through the year.
Mr. Chairman, veterans' health care remains underfunded,
and that threatens the quality and availability of care to
America's sick and disabled veterans, and just what kind of
message does that send to the brave men and women who are
fighting in the war on terrorism?
Under the President's budget, medical services would rise
from $22.5 billion to $24.7 billion, or a 9-percent increase.
The DAV and the Independent Budget organizations are calling on
Congress to provide almost $26 billion for medical services.
This is almost $1.3 billion more than the President has
requested, and we are united in opposing new fees and higher
co-payments on certain veterans who choose to get their care
from the VA.
Mr. Chairman, we believe the veterans health care system is
certainly worth the investment. The VA provides top-quality,
cost-
effective care to a most deserving group of veterans.
Today, the quality of VA care is recognized worldwide.
Improvements in VA care are a result of the Health Care
Eligibility Reform Act of 1996. In order to continue providing
this world-class quality health care, the VA needs a critical
mass of veterans, young and old, healthy and sick, to ensure it
can continue to provide a full range of care.
The long-term viability of the veterans health care system
also depends on an adequate reliable funding stream. The DAV
and other veterans service organizations are united in calling
for guaranteed mandatory funding. Only then will sick and
disabled veterans be able to receive this quality care in a
timely manner now and in the future.
We believe funding for veterans benefits and health care
should be a top priority for our Government. They are a
continuing cost of our national defense.
Mr. Chairman, I will now focus on the benefits side of the
VA.
A core mission of the VA is providing benefits to relieve
the economic effects of disability upon veterans and their
families. Disability benefits are critical, and they should
always be a top priority of the Government.
We are pleased the President's budget would add more
staffing in the education, vocational rehabilitation, and
employment programs, but we are perplexed by the recommendation
to reduce staffing for compensation claims processing.
Likewise, we are concerned about longstanding problems and
chronic understaffing in compensation and pension service. That
is compounded by an expected increase in disability claims.
While the President's budget calls for cutting 149 employees
from the current level, the Independent Budget has recommended
adding 1,300 claim workers. Because the already unacceptable
backlog would grow even larger in 2006 and 2007, we urge the
committee to recommend adequate staffing for C&P.
Mr. Chairman, DAV's legislative mandates have been made
available to your staff. So I will only comment on a few of
them at this time.
In addition to reforming the budget process for VA health
care and improving accuracy and timeliness of the claims
process, the members of the DAV call upon this committee to:
increase the face value of service-disabled veterans'
insurance, authorize VA to revise its premium schedule to
reflect current mortality tables, extend eligibility for
veterans' mortgage life insurance to service-
connected veterans rated permanently and totally disabled,
support additional increases in grants for automobiles and
specially adapted housing and provide an automatic annual
increase based on the cost of living, and support legislation
for full concurrent receipt of military longevity retirement
pay and VA disability compensation for all affected veterans.
We also ask support for S. 633 to authorize minting of
coins to help fund the American Veterans Disabled for Life
Memorial.
Mr. Chairman, since our inception, the DAV has sought to
protect the interests of all disabled veterans. The purpose our
founders set for themselves in 1920 remains the same today:
building better lives for America's disabled veterans and their
families.
I am extremely proud of what the DAV stands for and what we
have accomplished in our 86-year history.
In fulfilling our mandate of service, the DAV employs a
corps of 260 professional trained national service officers
located throughout the country and 24 transition service
officers at military separate centers. All of our NSO's and
TSO's are wartime service-
connected disabled veterans. About half of them are Gulf War
veterans.
Last year alone, our professional service officers
counseled, free of charge, a quarter-million veterans and their
family members in their claims for VA benefits.
The DAV's Mobile Service Office Program puts our NSO's on
the road to assist veterans where they live. Some of these
offices on wheels were deployed to the areas hardest hit by
Hurricanes Katrina and Rita, and the DAV provided nearly $1.8
million in direct funding to disabled veterans and their
families affected by the storms.
In addition to those professional services, the DAV and its
auxiliary together have more than 16,000 volunteers in VA
hospitals and clinics. Last year, they logged 2.4 million hours
of free service to the patients and VA.
Since we began our free transportation program, the DAV has
purchased and then donated to the VA nearly 1,700 vans at a
cost of $34 million. This year, we will be presenting the VA
with 129 more new vans.
Since the transportation program began in 1987, our vans
have provided nearly 9.5 million round trips to veterans,
traveling more than 360 million miles. This program served
disabled veterans in every State and every congressional
district in the country, and for all they do to serve our
veterans and their communities, these magnificent volunteers
are a source of pride and inspiration for us all. I want to
publicly acknowledge their commitment and compassion to our
Nation's veterans.
Thank you all very much. Mr. Chairman, this completes my
testimony.
[The prepared statement of Mr. W. Jackson follows:]
Prepared Statement of Paul W. Jackson, National Commander
of the Disabled American Veterans
Mr. Chairman and Members of the Veterans' Affairs Committee:
As National Commander of the more than 1.5 million members of the
Disabled American Veterans (DAV) and its Auxiliary, I am honored and
privileged to appear before you today to discuss the agenda and major
concerns of our nation's wartime disabled veterans and their families.
Chairman Craig and Ranking Member Akaka, I thank you for your
strong leadership of this Committee. During the first session of this
Congress, this Committee was very active on veterans' issues. I also
thank you for providing me with this opportunity to testify on the
legislative goals of the DAV following the unilateral cancellation of
joint hearings by the Chairman of the House Veterans' Affairs
Committee.
The opportunity to present testimony before joint hearings of the
House and Senate Veterans' Affairs Committee has been a long-standing
tradition enabling veterans service organizations (VSOs) the occasion
to provide the authorizers of veterans' programs with our legislative
agenda and concerns. These hearings also provided your members with the
chance to address the numerous constituents who are present from their
states, and it provided DAV members with the opportunity to see their
elected officials respond to issues critical to them and other disabled
veterans. Hundreds of DAV members make this annual pilgrimage to our
nation's capital to witness this event.
Again, however, let me thank you for fulfilling our request for
this hearing today. It is our sincere desire that next year we can
again provide our testimony before a joint hearing of the Veterans'
Affairs Committees.
In a speech on June 27, 1944, before the Republican National
Convention in Chicago, Illinois, former President Herbert Hoover
stated, ``Older men declare war. But it is the youth that must fight
and die. And it is the youth who must inherit the tribulation, the
sorrow, and the triumphs that are the aftermath of war.''
Mr. Chairman, before you today are the young men and women from
past generations who served this great nation in its time of need--its
time of war.
Today, it is our sons and daughters, grandchildren and, in some
cases, great-grandchildren who are serving our nation in our armed
services, protecting our freedoms here and abroad. Many are fighting
and dying in our War on Terror in Operations Enduring Freedom and Iraqi
Freedom. These brave men and women are attempting to bring peace and
democracy to an area of the world that has known neither for centuries.
These brave soldiers, sailors, airmen, Marines, and coast guardsmen,
whether active duty, reservists, or national guardsmen, are also
serving to ensure our safety and preserve our cherished way of life.
It is because of our nation's ongoing War on Terror and the
aftermath of that war on our youth that the DAV's focus on veterans'
programs has been with an eye towards the future. Each day, new combat-
injured and other casualties of our War on Terror return to America for
medical care and rehabilitation of their injuries. For many,
rehabilitation of their physical wounds will require years of sustained
medical and rehabilitative care services.
Not since the Vietnam War has our nation had to deal with such a
significant number of severely disabled wartime casualties. As of
January 3, 2006, there were 381 amputees from Operations Iraqi Freedom
and Enduring Freedom. These individuals have sustained the loss of an
arm(s), leg(s), hand(s), and/or foot (feet). This number includes 276
soldiers, 45 of whom have multiple amputations; 87 Marines, 14 of whom
have multiple amputations; 7 sailors, one of whom has multiple
amputations; 6 airmen, one of whom has multiple amputations. Of the 381
amputees, 104, or 27 percent of these individuals have upper extremity
amputations.
Although the medical care and services they are receiving from the
military today is excellent, I am concerned about their ability to
receive quality health care in a timely manner from the VA in the
future, if our government continues to fund VA programs at inadequate
levels or undermines the ``critical mass'' of patients needed to
provide a full continuum of quality health care to disabled veterans
currently enrolled in the VA health care system and those who will
enroll in the future.
It has been stated: ``To prepare for the future, examine the
present. To understand the present, study the past.'' The DAV has
undertaken such a study.
In a recently published history of the DAV, Wars & Scars, DAV's
Adjutant and Chief Executive Officer, Arthur H. Wilson, noted:
This great organization was formed as our country struggled
to deal with the painful effects of World War I. At this
moment, our Nation is struggling once again with the impact of
war--as American men and women face combat in Iraq,
Afghanistan, and other nations.
A great deal has changed in the 85 years since the DAV was
founded, but this much has remained the same: those who come
home from war wounded and sick need the care and attention of a
grateful nation. . . .
But the story on the pages that follow--the history of the Disabled
American Veterans--is not a story of able-bodied people taking care of
handicapped veterans. While it is certainly true that the American
people have been invaluable partners in the DAV's mission, the work of
our organization has been a self-help proposition since the beginning.
The DAV--disabled veterans helping disabled veterans--continues working
cohesively to build better lives for all disabled veterans and their
families!
Since its inception, the DAV, then known as Disabled American
Veterans of the World War (DAVWW), looked to protect the interests not
only of current veterans, but for those who would follow them.
The DAV's first National Commander, Judge Robert S. Marx, of
Cincinnati, Ohio, an Army infantry officer, who had the distinction of
capturing the furthest point taken by the American Army prior to the
armistice, and who was wounded by an enemy shell exploding over his
battalion headquarters, convincingly pointed out that, as an organized
national group, the voices of disabled veterans would be stronger in
the halls of Congress and the White House. Judge Marx earned the
honored title, ``Father of the DAV.''
The purpose those disabled veterans set for themselves in 1921
remains the same today: building better lives for all of our nation's
disabled veterans and their families. The first goal the DAVWW wanted
Congress to establish was one Federal agency that would have the
authority to handle all programs for veterans. The DAVWW called upon
Congress to consolidate veterans' programs that fell within the
jurisdiction of three agencies: the Bureau of War Risk Insurance, the
Public Health Service, and the Federal Board of Vocational Training.
Working with other veterans' groups, the DAVWW eventually secured
legislation establishing the Veterans' Bureau, later renamed the
Veterans Administration, which was the forerunner of today's Department
of Veterans Affairs.
By 1926, the DAVWW had fielded a nationwide claim-filing assistance
effort that eventually evolved into today's DAV National Service
Program. I will discuss DAV's Service Program in more detail later. In
1931, the Disabled American Veterans Service Foundation was created,
the forerunner of the organization known today as the DAV National
Service Foundation. At the time, the Foundation was the fundraising arm
of the national organization and its chapters. It no longer fulfills
such a comprehensive role, but its official mission remains ``to
develop financial resources in support of the goals and purpose of the
DAV, including providing support to DAV's National Service Program and
other service initiatives.''
In the dark days of the Great Depression, during 1932, high
unemployment in America created a tax revenue problem for our
government, and a crisis developed regarding the $2.4 billion bonus
bill for our nation's World War I veterans. A ``Bonus Army'' of some
20,000 unemployed American veterans came to Washington and set up camp,
vowing to stay until Congress passed a bill providing full and
immediate payment of their bonus certificates. However, after the
Senate voted down the bill, known as the Patman Resolution, most of the
veterans returned home. On July 28, 1932, on one of the saddest and
most memorable days in the veterans' movement, General Douglas
MacArthur led Federal troops and used tear gas to forcibly evict the
Bonus Army from their huts along the Anacostia River. It was at the
height of this crisis, that the National Economy League was formed.
With many prominent citizens in its leadership, the league received
substantial press attention as it fought against instances of what it
saw as ``excess spending.''
In an effort to cut Federal expenses, President Roosevelt imposed
the Economy Act of 1933, which cut veterans' disability allowances by
25 percent, approximately $400 million. Unfortunately, Roosevelt was
quoted as saying:
``No one, because he wore a uniform must therefore be placed in
a special class of beneficiaries over and above all other
citizens. The fact of wearing a uniform does not mean that he
can demand and receive from his government a benefit which no
other citizen receives.''
I believe President Roosevelt was wrong on that score, and so did
Congress.
Pressure from veterans' groups continued until a lump-sum bonus law
was passed over Roosevelt's veto in 1936. Congress restored the cuts in
veterans' benefits, but it took until 1948 to win back what the economy
bill had taken away.
On June 17, 1932, Congress recognized the DAV'S unique and
outstanding service and issued a Federal charter to the organization.
This document recognized the organization as the official voice of our
nation's wartime disabled veterans.
A decade later, the 1943 delegates to the DAVWW convention were
treated to one of the best collections of speakers up until that time.
VA Administrator Frank Hines, Kaiser Shipbuilding Corporation President
Henry J. Kaiser, U.S. Civil Service Commissioner Arthur J. Flemming,
and New York City Mayor Fiorello LaGuardia, all echoed a similar theme:
``Thank God for the DAVWW in times like these when we need them the
most!''
With this country once again embroiled in war, the National
Executive Committee felt it was time to update the name of the
organization, and the DAVWW became the Disabled American Veterans--the
DAV.
With many returning disabled World War II veterans, the DAV
initiated a new National Service Officer training program in October
1944 at American University in Washington, DC., and 354 people were
trained and employed as DAV National Service Officers. This training
provided an exceptional base of service officers with the knowledge and
expertise to ensure that disabled veterans receive their earned
benefits under VA law.
These 354 men and women who graduated from the 10 classes between
1944 and 1948, formed the core of the DAV National Service Program, and
provided a management team that led this organization for several
decades.
In 1994, 50 years after DAV's first training academy, DAV began a
new 16-week training course at the DAV National Service Officer
Training Academy at the University of Colorado at Denver. One of the
first classes at the academy was greeted by a Member of the President's
cabinet, Secretary Jesse Brown, instructing them on information they
would need to know to help them serve disabled veterans. Secretary
Brown stated, ``America has a solemn obligation to assure that the men
and women who have served and sacrificed for this country and the cause
of freedom will never be forgotten or neglected.''
Like the founders of this great organization, we must be farsighted
to ensure that VA remains a viable provider of veterans' benefits and
health care services for our newest generation of disabled veterans.
These young brave men and women will need the full continuum of care
and services VA provides today, well into the latter part of this
century.
Last year, in March 2005, my predecessor, then National Commander
James E. Sursely, expressed his concerns about the VA's ability to care
for our nation's sick and disabled veterans and he reported the
following to this Committee and the House Veterans' Affairs Committee:
On December 20, 2004, I was briefed by the [VA] . . . on VA's
fiscal year (FY) 2005 budget outlook. While I was acutely aware
of the fact that the fiscal year 2005 budget approved by
Congress for VA was totally inadequate. . . . I was shocked and
dismayed to learn that the $1.2 billion increase for VA health
care provided by Congress above the Administration's request,
resulted in a zero net gain for the VA health care system. . .
.
Within a month of the passage of the fiscal year 2005
appropriations bill, stories began to appear around the country about
the shortfalls in VA health care funding and its adverse impact on VA's
ability to care for our nation's sick and disabled veterans.
In a December 20, 2004 story in a Mississippi newspaper, it was
noted that although the VA medical center in Jackson, Mississippi, will
receive a 6 percent increase in its budget, it is ``not enough to fully
fund everything. . . .''
``Colorado's veterans health care system is straining under
unprecedented demand and a budget shortfall'' as reported in a December
23, 2004 article in the Denver Post. . . . The system will get $3
million less this year than expected. This 2 percent shortfall will
mean a hiring freeze and a likely return of waiting lists for medical
care, according to the VA director. . . . Actually, according to the
article, the fiscal year 2005 budget is $700,000 less than the fiscal
year 2002 funding levels--that's correct, $700,000 less than the fiscal
year 2002 spending level.
In Pennsylvania, the Van Zandt VA Medical Center faces a projected
$5 million shortfall this fiscal year as reported by the Altoona
Mirror. . . .
In a news story out of Augusta, Maine, it was reported that there
is an initial $14.2 million shortfall projected for the annual
allocations at the VA Medical Center at Togus. . . . It was also noted
that the annual deficit for the VISN . . . was pegged at $65 million;
however, approximately $30 million had been found to reduce that
shortfall.
We have been told that the VA facility in Boise, Idaho, has an
approximate $2 million deficit in fiscal year 2005. As a result of this
deficit, no new programs will be started, there is a hiring freeze, and
there will be no new growth in primary care patients.
In New Mexico, there is a $4 million budget shortfall. As a result
of this budget deficit, the hospital will lose 60 employees who will
not be replaced.
The Administration has proposed a fiscal year 2006 budget
recommendation that is one of the most tight-fisted, miserly budgets
for veterans programs in recent memory. Instead of providing adequate
funds for the VA medical system, the budget proposes to shift the cost
burden onto the backs of veterans, making health care more expensive
and even less accessible for millions of America's defenders.
The VA medical system has been strained to the breaking point over
the years because its appropriation has failed to keep pace with the
skyrocketing costs of health care and increased patient loads. As a
result, VA facilities across the country are cutting staff and limiting
services even as the number of veterans seeking care is on the rise.
Mr. Chairman, that was a year ago. Between then and now, Congress
stepped up and provided supplemental funding for VA for fiscal year
2005, and designated $1.2 billion as emergency funding for fiscal year
2006. The DAV was pleased when the President signed off on that
emergency designation on January 28, 2006, and that money became
available to VA. However, we are hearing from the field nationwide that
budget woes are still present in 2006. The hiring freeze is still in
place. A review of the recently submitted Administration's budget
proposal demonstrates unchanged employee levels for fiscal years 2005
and 2006.
It is our understanding that VA medical facilities are required to
``pay back'' a substantial portion of the money they received from VA
Central Office for the shortfalls in funding for fiscal year 2005. Some
facilities are reporting that the increase they received in the fiscal
year 2006 budget will help to pay for salary increases only. Others
report continued deficits and backlogs. Some are actually reducing non-
VA health care. And some medical facilities are questioning how they
will make it through the year.
Mr. Chairman, it is our sincere desire that Congress will not allow
VA to get into another shortfall situation like the fiscal year 2005
fiasco. The DAV was grateful that Congress enacted the requirement that
VA report to Congress quarterly on its state of affairs. We look
forward to reviewing that first report.
Mr. Chairman, I can assure you that the DAV, along with the other
members of the Independent Budget, AMVETS, Paralyzed Veterans of
America, and Veterans of Foreign Wars of the United States, does not
ask for more money for VA just to help VA build a large fiefdom. Our
monetary and program recommendations are based on not only discussions
with the ``bean counters'' and program directors at VA Central Office,
but also on conversations with VA employees who are on the front line
of providing care and services to our nation's sick and disabled
veterans. We also receive information from our members and employees
about the state of affairs at VA facilities nationwide.
The time is now for all of us--Congress, the Administration, and
the veterans' community--to come together to resolve the inherent
problems involved in funding VA health care. It is shameful that
veterans are forced each year to come to Congress to beg for necessary
additional funding for VA programs.
As called for in the President's fiscal year 2007 budget
submission, total VA funding for the next fiscal year would increase
about 12 percent, from the current $71.8 billion to $80.6 billion. More
than half of the budget would go for mandatory programs such as
disability compensation and pensions. Medical care for veterans would
rise from $30.8 billion to $34.3 billion, or an 11 percent increase. As
called for in the President's budget submission, medical services for
veterans would rise from $22.5 billion to $24.7 billion, or a 9 percent
increase. In testimony, VA is on record as stating that it needs an
annual 13 percent to 14 percent increase in medical care funding to
provide current services. Fortunately, this year's budget proposal
comes much closer to meeting the needs of our nation's sick and
disabled veterans than the past several years. Although there is still
a significant gap between what has been proposed and what is needed to
ensure timely access to health care services and benefit decisions.
The DAV and other major veterans service organizations are united
in calling on Congress to provide $25.99 billion for veterans medical
services, almost $1.3 billion more than the President has requested,
and we are united in opposition to imposing new fees and higher co-
payments on certain veterans who choose to get their care from the VA.
Again, in light of last year's admonishment to not include such a
proposal, the Administration wants to impose a new $250 annual user fee
on certain veterans who also would see their prescription drug co-
payments almost doubled, from $8 to $15. Those veterans, some of whom
are DAV members, already pay for the health care they receive from the
VA. Adding to their out-of-pocket costs would force them out of the
system and put even greater strain on resources needed to treat their
fellow veterans. The cost of medical care for these veterans is the
least costly care of any group of veterans treated by VA, and these
groups bring in the highest level of collections.
A medical system that only treats the sickest of the sick and the
poorest of the poor is not sustainable and would be undesirable. In the
end, it would seriously erode the quality of care for today's veterans
and tomorrow's.
Mr. Chairman, let us not forget that benefits and services for
disabled veterans, in fact all veterans, remain primarily the
responsibility of our government. The citizens and government of a
country that sends its young sons and daughters to defend its homeland
and fight its wars have a strong moral obligation to repay them for
bearing such a heavy burden. While all citizens of this great nation
enjoy our cherished freedoms and our way of life, less than 10 percent
of our population have served, sacrificed, and paid a price for those
freedoms and our life style. Our indebtedness to veterans is more
important than any other part of our national debt because, without
their sacrifices, we would not exist as a nation, nor would the
citizens of many foreign nations enjoy the freedoms many Americans take
for granted.
While we can never fully repay those who have stood in harm's way
protecting freedom, a grateful nation has established a system to
provide benefits and health care services to veterans as a measure of
restitution for their personal sacrifices and as a way for all citizens
to share the costs of war and national defense.
Because of their extraordinary sacrifices and contributions in
preserving our cherished freedoms and way of life, veterans have earned
the right to VA health care as a continuing cost of national defense
and security. The Health Care Eligibility Reform Act of 1996 authorized
eligible veterans access to VA health care and brought us closer to
meeting our moral obligation as a nation to care for veterans and
generously provide them the benefits and health care they rightfully
deserve. It also authorized VA to provide a full continuum of care to
veterans, thereby greatly improving the quality of care VA provides.
Today, the quality of VA health care is recognized worldwide.
In the mid-1990s, DAV partnered with nine other organizations to
form the Partnership for Veterans Health Care Reform. At that time, the
10 organizations, representing more than nine million veterans,
petitioned Congress to reinvent veterans' health care.
This Partnership also discussed another problem, chronic under
funding of the VA health care system. We noted that discretionary
funding for VA health care failed to keep pace with medical inflation
and the changing needs of the veteran population. Further, as a result
of the chronic under funding of the system, VA was forced to ration
care, deny services to eligible veterans, restrict needed medical
treatment, and forego the modernization of facilities and the purchase
of necessary state-of-the-art medical equipment.
Then and now, the solution seems rather obvious: ``guaranteed
funding.'' We recommended that VA health care funding must be
guaranteed for the provision of a comprehensive benefit package to all
eligible veterans who choose VA. The Partnership asked Congress to make
VA health care accounts non-discretionary.
Congress passed the Health Care Eligibility Reform Act of 1996;
however, Congress did not change the funding stream for VA health care.
Therefore, because the level of funding to cover the costs of treating
veterans is not guaranteed, and is repeatedly insufficient, VA is
forced to ration medical care.
Ten years after eligibility reform, DAV and other veterans
organizations continue to petition Congress for meaningful action to
ensure that VA has sufficient funding to care for those veterans who
come to VA for their medical care needs. Guaranteed funding for VA
health care is a viable solution to the current crisis in VA health
care and is supported by all the major veterans service organizations.
To guarantee the viability of the VA health care system for current
and future service-connected disabled veterans, it is imperative that
our government provide an adequate health care budget to enable VA to
serve the needs of disabled and sick veterans nationwide. To meet those
needs, it is imperative that the funding for the VA health care system
be guaranteed and that all service-connected disabled veterans and
other enrolled veterans be able to access the system in a timely manner
to receive the quality health care they have earned. By including all
veterans currently eligible and enrolled for care in a guaranteed
funding proposal, the system and the specialized programs VA developed
to improve the health and well-being of our nation's service-connected
disabled veterans will be protected, now and into the future. To
exclude a large segment of currently eligible and enrolled veterans
from the VA health care system, however, could undermine VA's ability
to provide a full continuum of care and specialty care to disabled
veterans in the future.
Mr. Chairman, DAV supports and endorses the efforts of the Senators
from South Dakota to call for hearings by this Committee to examine the
budget process to determine how best to serve the health care needs of
our nation's sick and disabled veterans. Both Senators have also
introduced legislation on changing VA health care funding from a
discretionary funding stream to a mandatory funding process. Senator
Johnson introduced S. 331, the Assured Funding for Veterans Health Care
Act, and Senator Thune introduced S. 963, the Veterans Health Care and
Equitable Access Act. DAV encourages all the Members of this Committee
to support and co-sponsor this important legislation.
When properly funded, the VA is able to provide cost-effective,
quality health care services to millions of sick and disabled veterans
each year. Additionally, treating veterans at VA rather than state-
sponsored programs helps to relieve the stress on states, which
routinely pick up the cost of caring for the poor. For example, an
analysis conducted by Missouri's state auditor in 2004 found the state
could have saved at least $5.5 million if veterans who received
benefits through Medicaid had instead received care from the VA. The
specialized services provided by VA, such as acute and long-term care,
actually subsidize Medicare and Medicaid programs at great savings to
the Medicare Trust Fund and to taxpayers, since VA health care is less
costly than the services provided by either Medicare or Medicaid. It
makes fiscal sense to treat veterans in the VA health care system,
instead of more costly care elsewhere.
Missouri is not the only state to see a benefit in getting veterans
off state rolls and into the VA. The State of Washington Department of
Social and Health Services has recently used software to identify
veterans enrolled in public assistance programs, and ``introduced''
more than 2,000 veterans to VA health care benefits. The state project
manager claimed that the state has saved more than $4 million in fiscal
year 2005 moving people from Medicaid to VA. Reportedly, of the nearly
46,000 Medicaid enrollees who receive long-term care in the state of
Washington, about five percent are veterans.
VA is the largest integrated health care system in the United
States with 7.5 million enrollees, 1,300 sites of care, including 156
medical centers or hospitals, 720 outpatient clinics, 206 readjustment
counseling centers, 43 residential rehabilitation treatment programs,
and 134 nursing homes. VA has about 197,000 health care employees and
affiliations with 107 academic health systems. The veterans health care
system offers an array of specialized services to meet the complex
health care needs of veterans who tend to be older, sicker, and poorer
than the population as a whole. Many of these specialized services in
areas such as prosthetics, spinal cord injury, blind rehabilitation,
post traumatic stress disorder, serious mental illness, and traumatic
brain injury are not readily available in the private sector.
As the debate over national health care continues, this country
cannot afford to ignore the hundreds of hospitals, clinics, nursing
homes, and other facilities that care for America's veterans. In purely
material terms, the nation can ill afford to lose the nearly 200,000
dedicated health care professionals and support staff who provide this
high-quality care and contribute to the economic stability of
communities across the country. We cannot sit silently on the sidelines
as the debate moves forward. The virtues and benefits of the VA health
care system must be part of the debate. If we don't make our voices
heard, we could be in jeopardy of losing the system designed to meet
the unique health care needs of sick and disabled veterans.
The change in the VA health care system due to eligibility reform
has created a more cost-effective and efficient health care system.
Progress made as a result of these changes has made VA a world leader
in the health care industry. VA consistently sets the benchmark for
patients' satisfaction in inpatient and outpatient services, according
to the American Customer Satisfaction Index developed by the University
of Michigan Business School. The Institute of Medicine has recognized
the VA as one of the best in the nation for its integrated health
information system. The top-notch research done at VA facilities
benefits all Americans, not just veterans. VA medical, prosthetic, and
health services researchers have received Nobel Prizes and other
distinguished awards for their work at VA. Major breakthroughs
pioneered by the VA are invaluable to the entire health care
profession. The VA also leads the nation in geriatric research,
education, and training and provides long-term care for thousands of
veterans each year.
In addition to these notable accomplishments, VA medical facilities
are a strategically located national resource. By statute, the VA
serves as a backup to the Department of Defense and the National
Disaster Medical Systems in time of national emergency. This so-called
fourth mission for the VA is especially important while the nation is
at war and remains at risk for terrorist attacks that could injure or
sicken thousands. However, this fourth mission has never been properly
funded.
Even though VA is unquestionably a success story, Congress
typically provides an annual discretionary appropriation for veterans
health care that falls far short of actual needs. Over the years,
funding needed to ensure health care programs and services are readily
accessible for veterans has not kept pace with inflation, let alone the
increased demand for services.
When resources are inadequate to meet demand, VA hospital directors
are forced to ration care, and Veterans Health Administration (VHA)
policymakers must make difficult decisions and set priorities for care
delivery. The current discretionary funding method used to appropriate
resources for VA, coupled with continued inadequate and frequently late
budgets, have created a funding crisis in the system and jeopardize
quality of care to America's sick and disabled veterans.
We believe funding for veterans benefits and health care services
should be a top priority for Congress and the Administration as a
continuing cost of our national defense. Once the guns fall silent,
veterans should not have to beg for benefits they have earned and
rightfully deserve for their service and sacrifice. A promise of
benefits and services alone is not good enough. Approved programs must
be sufficiently funded. As a nation, we must be willing to bear the
costs of providing special benefits to such a unique group--those men
and women who were willing, on behalf of all Americans, to serve in
peace time and fight our wars to preserve our cherished freedoms and
democratic values. To assure the veterans medical care system is
maintained as a top government priority, its funding should be
mandatory to remove it from competition with politically popular but
less meritorious projects and programs.
An American servicemember injured today in Afghanistan or Iraq will
need the VA health care system beyond the middle of this century.
However, if the VA health care system is allowed to be significantly
reduced, these brave men and women would not likely be able to
replicate the special care they receive from VA in the private sector,
which is currently undergoing a crisis of its own.
During this period of war, emphasis has been placed on ensuring
that newly returning war wounded veterans have top priority for
treatment at VA facilities. Although no one would question that this
new generation of veterans deserves ready access to VA's specialized
health care services, we must not forget there are previous generations
of veterans who continue to rely on the VA health care system for
service-related injuries incurred decades ago. As veterans age, those
with catastrophic spinal cord injury, limb loss, blindness, post
traumatic stress disorder, and traumatic brain injury often require
more medical attention than in the past for their service-connected
conditions. Likewise, other veterans dependent on VA health care
services deserve timely access to care as well. Funding must be
sufficient to provide timely quality health care to all enrolled
veterans.
We recognize that providing full funding for VA health care will
not solve all of VA's problems. However, VA, as the largest integrated
health care system in the United States, must have a sufficient budget
to effectively manage its health care programs and services and to hire
the appropriate number of clinicians, nurses, and support staff to meet
the demand for high-quality medical care. VA must also have the ability
to adequately prepare for the coming year well in advance. With
guaranteed funding, VA can strategically plan for the future to
optimize its assets, achieve greater efficiency, and realize long-term
savings. The current discretionary funding mechanism for VA medical
care benefits neither VA nor taxpayers, and it certainly is having a
negative impact on veterans.
One thing is clear--the shortfall in the fiscal year 2005 budget
for VA medical care has had a sobering effect on local medical centers,
as I noted earlier. The Administration's initial budget recommendation
for VA health care in fiscal year 2006 was a recipe for disaster.
Backfilling these shortfalls does not have the same effect as providing
VA with the proper funding levels at the beginning of each fiscal year.
While we applaud the Members of this Committee for their action to
correct the past shortfall in VA's health care funding, the need for
after-the-fact corrections of funding shortfalls for VA health care
places the VA health care system and those sick and disabled veterans
who rely on that medical care at risk. Forcing VA to ration health care
to veterans and then trying to play ``catch-up'' when much-needed funds
are belatedly infused into the system is at cross purposes with
providing quality health care in a timely manner. It also prohibits VA
officials from adequately planning for future health care needs, such
as hiring doctors, nurses, and other health care providers.
As an organization dedicated to building better lives for disabled
veterans and their families, we have an awesome responsibility
regarding these important health care issues that impact our veterans
and generations of veterans to come. Now, with our fighting men and
women in battle and our veterans from past eras battling for needed
care, our message is more important than it ever has been. Make the
commitment now that you will stand up to be counted by supporting a
change in the current VA health care budget process. By doing so we
ensure the sacrifices of those who have served are recognized and
honored.
Mr. Chairman, mandatory health care funding would not create an
individual entitlement to health care, nor change the VA's current
mission. Making veterans health care funding mandatory would eliminate
the year-to-year uncertainty about funding levels that have prevented
the VA from being able to adequately plan for and meet the growing
needs of veterans seeking treatment. Rationed health care is no way to
honor America's obligation to the brave men and women who have so
honorably served our nation and continue to carry the physical and
mental scars of that service.
Your support of guaranteed funding for veterans health care would
further demonstrate your commitment to the men and women appearing
before you today and the more than seven million veterans who have
enrolled for VA health care. Again, I ask your active support of this
critical legislation. At the very least, we should be afforded an
opportunity to provide testimony on alternative methods to funding VA
health care and openly discuss this issue with Members of this
Committee and the VA present.
Mr. Chairman, I will now focus on the benefits side of VA.
A core mission of the VA is the provision of benefits to relieve
the economic effects of disability upon veterans and their families.
For those benefits to effectively fulfill their intended purpose, VA
must promptly deliver them to veterans. The ability of disabled
veterans to care for themselves and their families often depends on
these benefits. The need for benefits among disabled veterans is
usually urgent. While awaiting action by VA, they and their families
suffer hardships; protracted delays can lead to deprivation,
bankruptcies, and homelessness. Disability benefits are critical, and
providing for disabled veterans should always be a top priority of the
government.
VA can promptly deliver benefits to entitled veterans only if it
can process and adjudicate claims in a timely and accurate fashion.
However, VA has neither maintained the necessary capacity to match and
meet its claims workload nor corrected systemic deficiencies that
compound the problem of inadequate capacity.
Rather than making headway and overcoming the chronic claims
backlog and consequent protracted delays in claims disposition, VA has
lost ground to the problem, with the backlog of pending claims growing
substantially larger. The claims backlog has swollen, and the appellate
workload is growing at an alarming rate, suggesting further degradation
of quality or at least continuation of quality problems.
Insufficient resources are the result of misplaced priorities, in
which the agenda is to reduce spending on veterans programs despite a
need for greater resources to meet a growing workload in a time of war
and a need for added resources to overcome the deficiencies and
failures of the past. Instead of requesting the additional resources
needed, the President has sought and Congress has provided fewer
resources. Recent budgets have sought reductions in fulltime employees
for the Veterans Benefits Administration (VBA) in fiscal years 2003
through 2006. Since fiscal year 2003, VBA has lost about 500 employees.
Such reductions in staffing are clearly at odds with the realities of
VA's workload and its failure to improve quality and make gains against
the claims backlog.
The fiscal year 2007 budget submission again fails to provide
sufficient resources to VBA to handle the claims workload. Let me now
turn to the President's budget request for the VBA under the General
Operating Expenses account. We are pleased to see that the President
finally recognizes a need to add more staffing to meet the workloads in
the education benefits program and the vocational rehabilitation and
employment program, though these requests still fall short of what is
necessary. At the same time, we are perplexed by the budget
recommendation to reduce direct program staffing for compensation
claims processing, an area with the most critical and widely
acknowledged need for additional adjudicators.
The President's budget requests 930 fulltime employees (FTE), an
increase of 46 above the fiscal year 2006 authorization, for VBA's
Education Service. As a partner in The Independent Budget (IB), the DAV
recommends 1,033 FTE for Education Service. This increased staffing is
needed to make up for improvident reductions in staffing in FYs 2004
and 2005 and to meet the increased workload.
For the Vocational Rehabilitation and Employment business line, the
President's budget requests 1,255 FTE, an increase of 130 FTE over the
fiscal year 2006 level. The IB recommends 1,375 FTE. This represents an
additional 200 FTE as recommended by the VA Vocational Rehabilitation
and Employment Task Force to improve the program, along with another 50
additional FTE for management and oversight of contract counselors and
rehabilitation and employment service providers.
Based on the adverse and long-standing problems from chronic
understaffing in VBA's Compensation and Pension Service (C&P),
compounded by anticipated increased claims volumes, the IB recommended
10,820 FTE for C&P Service. The President's budget requests 9,445 FTE,
which would reduce direct program FTE for handling compensation claims
by 149 in 2007. Even with ambitious assumptions of increased production
during fiscal year 2006 and fiscal year 2007 despite this reduction in
staffing and even with unsupported projections of slowed growth in the
volume of new claims in both years, the budget concedes that the
already unacceptable claims backlog would grow even larger in 2006 and
2007. To knowingly request resource levels that will only make an
intolerable situation worse, is indefensible, and we urge the Committee
to recommend adequate staffing for C&P.
VA must have a long-term strategy focused principally on attaining
quality and not merely achieving production numbers. It must have
adequate resources, and it must invest them in that long-term strategy
rather than reactively targeting them to short-term, temporary, and
superficial gains. Only then can the claims backlog really be overcome.
Only then will the system serve disabled veterans in a satisfactory
fashion, in which their needs are addressed timely with the effects of
disability alleviated by prompt delivery of benefits. Veterans who
suffer disability from military service should not also have to
needlessly suffer economic deprivation because of the inefficiency and
indifference of their government.
Once again, this year's budget recommendations fail to provide the
necessary resources and, therefore, the timely adjudication of claims
continues to remain at risk.
Mr. Chairman, major policy positions of the DAV are derived from
resolutions adopted by the delegates to our annual National
Conventions. Since our first National Convention in 1921, the DAV's
annual legislative program has served to guide our advocacy for
disabled veterans in accordance with the will of our members. Our 2006
mandates cover a broad spectrum of VA programs and services and have
been made available to your Committees and to the members of your
staffs. Since DAV was founded in 1920, promoting meaningful,
reasonable, and responsible public policy for disabled veterans has
been at the heart of who we are and what we do. Our will and commitment
come from the grassroots, nurtured in the fruitful soil of veterans'
sacrifices and strengthened by the vitality of our membership.
With the realization that we shall have the opportunity to more
fully address those resolutions during hearings before your Committees
and personally with your staffs, I shall only briefly comment upon a
few of them at this time.
What I communicate to you here today echoes the hopes and desires
and, in some cases, the despair of disabled veterans, who appeal to the
conscience of the nation to do what is right and just. Accordingly, in
addition to correcting the budget process for VA health care and the
problems at VBA prohibiting the timely and accurate production of
claims decisions, the members of the DAV call upon the Members of this
Committee to:
Increase the face value of Service Disabled Veterans'
Insurance (SDVI). The current $10,000 maximum for life insurance for
veterans was first established in 1917, when most annual salaries were
considerably less than $10,000. The maximum protection available under
SDVI should be increased to at least $50,000 to provide adequately for
the needs of our survivors.
Authorize VA to revise its premium schedule for SDVI to
reflect current mortality tables. Premium rates are still based on
mortality tables from 1941, thereby costing disabled veterans more for
government life insurance than is available on the commercial market.
Extend eligibility for Veterans Mortgage Life Insurance to
service-connected veterans rated permanently and totally disabled.
Support additional increases in grants for automobiles or
other conveyances available to certain disabled veterans and provide
for automatic annual adjustments based on increases in the cost of
living.
Provide additional increases in the specially adapted
housing grant and automatic annual adjustments based on increases in
the cost of living.
Support legislation to remove the prohibition against
concurrent receipt of military longevity retirement pay and VA
disability compensation for all affected veterans.
Support equal medical services and benefits for women
veterans.
Extend commissary and exchange privileges to service-
connected disabled veterans.
Extend space-available air travel aboard military aircraft
to 100 percent service-connected disabled veterans.
Support legislation to allow all veterans to recover
amounts withheld as tax on disability severance pay. Currently, a 3-
year statute of limitations bars many veterans from recovering the non-
taxable money withheld by the Internal Revenue Service.
Restore protections against unwarranted awards of
veterans' benefits to third parties in divorce actions by prohibiting
courts from directly ordering payment of such benefits to third
parties, other than dependent children.
Support the fullest possible accounting of our POW/MIAs
from all wars and conflicts.
Support an expansion of POW presumptions.
Provide educational benefits for dependents of service-
connected veterans rated 80 percent or more disabled.
In honor of the brave men and women--our heroes who have sacrificed
so much and who have contributed greatly to protect and defend our
cherished freedoms--who were disabled as a result of their military
service, the DAV is providing major support to the Disabled Veterans'
LIFE Memorial Foundation in its work to construct a memorial to
disabled veterans in Washington, D.C. Congress has enacted legislation
that authorizes construction of the memorial on select lands in the
shadow of the U.S. Capitol. There are companion bills in both
chambers--H.R. 1951 in the House and S. 633 in the Senate--to provide
for the minting of coins by the Treasury to commemorate disabled
veterans and to contribute the surcharges on the coins to the fund for
construction of the American Veterans Disabled for Life Memorial. I
want to especially urge the Members of this Committee to give their
full support to this legislation. During the 108th Congress, the Senate
passed S. 1379, the forerunner to S. 633.
Mr. Chairman, as you can see, our work for disabled veterans and
their families continues to involve many issues and many challenges.
Although we can be proud of the accomplishments made on behalf of
disabled veterans in the past, much remains to be done. When it comes
to justice for disabled veterans, we cannot be timid in our advocacy.
This Committee and the DAV, working together with mutual cooperation,
must battle for what is best for our nation's disabled veterans.
Veterans have every right to expect their government to treat them
fairly. We call upon you, the Members of this Committee, as our
advocates in Congress, to educate your colleagues about the priorities
of disabled veterans.
Our nation's history of meeting our obligations to veterans has
fallen short not only of its highest ideals but also of its
capabilities. We simply have not always kept veterans at the top of the
list of national priorities. Our government can no longer excuse its
failure to provide veterans the benefits and services they rightfully
deserve by saying it cannot afford to fully honor its promises. We have
the means to meet those obligations. Now our nation, a nation once
again at war, must demonstrate it has the will to do so.
Mr. Chairman, previously, I talked about DAV's proud past. I will
now discuss where the DAV is currently.
For 86 years, the DAV has been dedicated to one, single purpose:
building better lives for disabled veterans and their families.
In fulfilling our mandate of service to America's service-connected
disabled veterans and their families and in keeping faith with the
principle on which this organization was founded, which is that this
nation's first duty is to care for its wartime disabled veterans, their
dependents and survivors, the DAV employs a corps of 260 National
Service Officers (NSOs), located throughout the country, about half of
whom are Gulf War veterans, and a number are veterans of Operations
Iraqi Freedom and Enduring Freedom. Last year alone, these men and
women, all wartime service-connected disabled veterans themselves,
represented--free of charge--over 158,790 veterans and their families
in their claims for VA benefits, obtaining for them more than $2.7
billion in new and retroactive benefits. Our NSOs also participated in
199,302 Rating Board appearances.
Mr. Chairman, the DAV continues to strive to more effectively meet
veterans' needs and ensure they receive the benefits our grateful
nation has authorized for them. Several years ago, DAV undertook two
additional initiatives to enhance and expand benefits counseling and
claims representation services to the veterans' community. The first of
the two programs involves outreach to members of the Armed Forces at
the location and time of their separation from active duty. The second
involves services to veterans in the communities where they live.
For benefits counseling and assistance to separating servicemembers
in filing initial claims, the DAV has hired and specially trained 24
Transition Service Officers (TSOs), who provide these services at
military separation centers, under the direct supervision of DAV NSO
Supervisors. This enhancement in assistance to those seeking veterans'
benefits will contribute to the DAV's goal of maintaining its
preeminent position as a provider of professional services to veterans.
In 2005, our TSOs conducted 2,068 briefing presentations to groups of
separating service-
members, with 103,963 total participants. TSOs counseled 55,070 persons
in individual interviews, reviewed the service medical records of
43,500 and filed benefit applications for 28,137, again, at no charge
to the separating servicemembers.
The DAV's Mobile Service Office (MSO) program is a part of the same
goal. By putting our NSOs on the road to rural America, inner cities,
and disaster areas, the DAV assists veterans where they live, which
increases accessibility to the benefits our nation provides for
veterans. The DAV has 10 of these specially equipped mobile offices on
tour to make stops in the communities across this country. During 2005,
our Mobile Service Offices interviewed 13,347 persons filed 9,938
claims.
These specially equipped MSOs and disaster relief teams were
deployed by DAV to the Gulf Coast regions hardest hit by Hurricanes
Katrina and Rita. These mobile offices allow the DAV to provide much-
needed assistance to displaced disabled veterans and their families. As
many residents of the stricken areas were evacuated to other
communities, the DAV NSOs nationwide assisted qualified veterans at the
various evacuation sites and elsewhere. To date, in support of DAV's
disaster relief efforts, nearly $1.8 million in direct assistance was
provided to disabled veterans and their families.
In addition to the dedicated services performed by DAV's NSOs and
TSOs, equally vital are the activities of the more than 16,420 DAV and
Auxiliary members who selflessly volunteer their valuable time to
assist America's sick and disabled veterans. Last year alone, these men
and women continued to serve this nation by providing over 2.4 million
hours of critical services to hospitalized veterans, saving taxpayers
nearly $42.6 million in employee costs.
The DAV also employs 181 Hospital Service Coordinators at VA
facilities across the country. The DAV's transportation program
provides essential transportation to and from VA health care facilities
to those veterans who could not otherwise access needed medical care.
Last year, DAV's National Transportation Network logged in more than 22
million miles and transported more than 613,000 veterans to VA health
care facilities. More than 9,000 volunteer drivers spent 1.3 million
hours transporting veterans during 2005. Since our national
transportation program began in 1987, more than 9.5 million veterans
have been transported about 360 million miles.
In 2005, DAV presented the VA with 119 Ford vans. This year, we
will be presenting VA with 127 vans. Since 1987, the DAV has donated
1,668 vans, at a cost of $34 million. Our commitment to this program is
as strong as ever. We have vans in every state and nearly every
Congressional district serving our veterans--your constituents. DAV not
only advocates on behalf of our nation's veterans, but we also continue
to give back to our nation and our fellow veterans.
As you can see, the DAV devotes its resources to the most needed
and meaningful services for our disabled veterans. These services aid
veterans directly and support and augment VA programs. We are able to
do so only with the continuing support of an American public that is
grateful for all that our veterans have done.
I hope I have demonstrated that America's disabled veterans, rather
than being satisfied to rest on their laurels, continue to stand ready
to actively and unselfishly be involved in their communities and across
the nation to assist our government in meeting the needs of other
service-connected disabled veterans, their dependents and survivors.
Mr. Chairman, this completes my testimony. Thank you for allowing
me the opportunity to appear before you on behalf of the Disabled
American Veterans to share our proud record of service to veterans and
our country and to discuss our agenda and our concerns for the second
session of the 109th Congress. Thank you also for all that your
Committee has done and for all that you will do for veterans in the
future.
May God bless America. And, may God bless America's brave young men
and women who have been placed in harm's way in our fight against
terrorism.
Chairman Craig. Commander, thank you very much.
Sitting and listening to your testimony and especially
those last comments expressed so very clearly, the dedication
you and your organization have had and continue to have for its
members and for other veterans, that is a tremendous record,
and you are to be congratulated for it.
The vote that I had mentioned earlier has just started. I
am going to recess the committee for a few moments, and Ken
Salazar, being younger than I, might get there sooner to vote,
but as soon as we can get there and get back, we will be here.
My guess is we will stand down for upwards of about 10 minutes.
Thank you. The committee will stand in recess.
[Recess taken from 2:35 p.m. to 2:50 p.m.]
Chairman Craig. Thank you all very much for your patience.
The vote is still underway. Some of our colleagues will be
joining us, but most importantly, we have been joined by
Senator Akaka, the Ranking Democrat on this committee, and
Senator Patty Murray of Washington. So we will turn to them
first, Commander, for any opening comments they would wish to
make, and as our other colleagues arrive, we will allow that,
and then we will turn to you once again for questions of all of
our colleagues.
With that, let me turn to the gentleman I enjoy working
with on this committee. We have shared good times, and most
importantly, I love holding field hearings in his State in
February. He just could not understand, when he asked me last
summer to go to Hawaii for field hearings, why I would want to
do it, and I said, ``Of course, I will come, but not in the
summertime.'' So this past month, we had some excellent field
hearings over there, and I enjoy working with Senator Akaka.
Senator Akaka, the floor is yours.
OPENING STATEMENT OF HON. DANIEL K. AKAKA,
U.S. SENATOR FROM HAWAII
Senator Akaka. Thank you. Thank you very much, Mr.
Chairman.
Now you know how gracious he is and how I enjoy working
with him in a bipartisan manner. We all do this all for the
sake of helping our veterans, and we will continue to do this
together here on the committee. Again, I want to say I really
enjoy working with Chairman Larry Craig.
It is a pleasure for me to be here today. When they
mentioned this room, I said, ``Well, I guess this room will be
bigger than we need,'' but you see what has happened. We have
people outside the door trying to get inside, but I am
delighted to see all of you here today. That tells us how
important these hearings are for our country.
I want to thank and welcome the national commander of the
Disabled American Veterans, Mr. Paul Jackson and also all
members of DAV who have made the journey to the Nation's
Capital to express their concerns about veterans health care
and benefits. This is truly democracy in action.
DAV has long been a leader in advocating on behalf of
disabled veterans, and I see that your proud tradition is
continued today.
I would like to acknowledge some of our Members here from
the House who are seated here on this side. I am also glad to
say hello to them. There is Congressman Michaud, also
Congresswoman Hooley, Congressman Tom Udall, and Congressman
John Salazar brother of Senator Ken Salazar. Good to have you
folks here with us.
At this time, I would like to be the first person to say
``aloha'' to Brenda Reed. She is moving to Hawaii, and I am
sure she will soon fall in love with the rich culture and
generous people of my home state and will continue to help
veterans.
Also, if there are any other Members here today from
Hawaii, I thank them for their presence here.
After reviewing your testimony, I share many of the
concerns that you present to the committee today. During this
time last year, many of us here in Congress were sounding the
alarm that the VA budget was facing a crisis situation, as you
will recall.
Many months later, the administration acknowledged this
fact, and Congress took action to provide emergency funding.
This year, I will remain dedicated to ensuring that VA has the
resources it needs to care for all veterans.
Questions still remain as to whether or not the
administration's proposed budget for the next year adequately
takes returning service members into account.
I also am concerned about the VA research program being
slated for a cut under this budget. I want you to know that I
will continue to oppose efforts to reduce veterans
compensation, as we saw with the ill-fated PTSD review. Now the
Institute of Medicine is currently conducting a review of PTSD
diagnosis and compensation. It is my hope that the Institute of
Medicine suggests improvements to diagnosis, but not reductions
to how we now compensate our veterans for their invisible
wounds. In this time of conflict abroad, reduction in benefits
would send a wrong message to veterans and service members who
are transitioning from military to civilian life.
With regard to the VBA budget, I am concerned whether or
not this budget provides an adequate level of staffing for
compensation claims rating. Whatever the reason for the
increase in compensation claims, VA must be ready to adjudicate
claims in a timely and accurate manner.
I will continue to monitor VA's workload and rating output
because our veterans deserve nothing less than their claims
rated accurately and in a reasonable amount of time.
I am also proud to be a cosponsor of Senator Johnson's
American Veterans Disabled for Life Memorial. DAV is the
leading advocate for this legislation, and I applaud your
efforts.
My last priority is near and dear to my heart. As a veteran
of World War II, I owe a great deal of where I am today due to
the GI bill educational benefits I used as a young man. With
this in mind, I will continue to look for ways to enhance and
modernize educational benefits to more adequately prepare
veterans for the new challenges of our economy.
In closing, I would like once again to thank Commander
Jackson and the membership of DAV. Your service and your
dedication to this Nation and its veterans is unquestionable.
I look forward to your presentation and working with you in
the future.
Thank you very much, Mr. Chairman.
Chairman Craig. Senator Akaka, thank you very much.
Now let me turn to Senator Patty Murray of the State of
Washington, and, of course, Patty, in your absence, the
commander spoke well of you and your diligence this past year
as we worked our way through this budget difficulty with the
Veterans Administration.
Please proceed.
OPENING STATEMENT OF HON. PATTY MURRAY, U.S. SENATOR FROM THE
STATE OF WASHINGTON
Senator Murray. Thank you very much, Mr. Chairman, and
thank you and Senator Akaka for holding this important hearing.
I want to welcome our colleagues on this side from the House as
well and thank you for your tremendous work in advocacy on
behalf of veterans as well. We are pleased to have you join us.
Commander Jackson, thank you for coming today and your
testimony, and really, this is a true unbelieving statement to
see so many people here today behind you who are here to remind
us that, when we send men and women to war, we have a
responsibility to keep the promises we gave them and, when they
return home, be there to support them, and I want to thank each
and every one of you on behalf of a very grateful Nation for
your service and to let you know this is one Senator that will
not forget the sacrifices you made.
Commander, I want to thank you for your statement. I
apologize for not being here before, but I heard reference to
it as I was coming into the room, and I share your concerns
about--first of all, we like the number, but this is a budget
that doesn't fix the funding problems that we have, and it is
really built around denying care instead of meeting real needs.
For me, that is just something that I cannot support. So I am
going to continue to do everything I can here to make sure we
meet the needs of those who served us, without asking them more
than they have already given.
I was back home this last week, like many of my colleagues,
and held hearings around my State on the issues facing
veterans. I was in Spokane, Seattle, and Shelton, and I
actually even went to Fort Lewis and talked to current members
who are serving about some of the responsibilities we have and
what they were seeing out there.
I heard firsthand about veterans who are still struggling
to get care. I heard about recently separated service members
who couldn't get a job. They had been home from Iraq for 6
months and couldn't get a job. I heard about Iraq War veterans
who were waiting months to get in to a doctor.
I heard about long delays in the process for getting
disability veterans benefits, and I held a hearing in Seattle
on the issue of M.S. and veterans who have returned home and
there is a 7-year deadline on being able to get veterans
disability benefits if you are diagnosed with M.S., Gulf War
veterans who are returning, and M.S. is a very hard disease to
diagnose. I know because my father, who was a World War II
disabled veteran, had multiple sclerosis. I know the disease
well, and there should not be an arbitrary deadline of 7 years
because many of our Gulf War veterans are coming home, and it
is 10 to 12 years later before they are diagnosed, and they
shouldn't be denied service.
So I will continue to do that, but, Mr. Chairman, you need
to know I was in Spokane, Washington, and held a hearing, and I
hold hearings for veterans all the time. It was a jammed
hearing, and I was just impressed with how many people turned
out. The No. 1 thing that they came to tell me was that they
did not want to see proposed enrollment fees and copays because
it would hurt low-income veterans and all veterans, and it is
something that they really felt strongly about. So I came away
from that very impressed.
They were not there to ask for a handout or a favor or to
be seen as trying to take anything from their Government. They
were there saying:
``I served my country. I went there on a promise that was
made to me, and I am fighting not for myself, but for those who
follow me, that their benefits are not taken away or they sign
up and, depending on how well you do later in life, you get
benefits. I am fighting for the veterans following me.''
I really came away impressed with that.
I think our veterans deserve better. I think they deserve
fair treatment. Their policies should not be limited by copays
and fees that are arbitrary. I think that when veterans signed
up to serve us, they were promised care equal to their
sacrifice, no asterisks, no pauses, and we should follow
through on that.
Finally, Mr. Chairman, I think we need a real budget based
on real numbers and reality, and I fear that we are going down
the same road if we don't do that today.
So, Commander, thank you for your testimony. Thank you to
everyone for being here. We have a lot of work ahead of us, but
you all shouldn't have to come to a meeting like this to remind
us of the promises we made. We should do it on our own, and I
will continue to fight for that.
Thank you very much.
Chairman Craig. Patty, thank you very much.
Now we will move to questions by those of us who are here.
Commander and to your panel and team assembled, let me ask
a couple of questions that I think put into context part of the
struggle we are dealing with.
Last year, I worked with my colleagues, as you mentioned,
and the administration to plug a gap in the funding of the VA's
budget. A total of $2.7 billion in supplemental funding was
provided to make up for not only an unexpected surge in demand,
but also the inaccurate way in which VA, in my opinion, had
projected their budget. It was an error, it was found, and we
corrected it, and we did so in a joint and bipartisan effort. I
mentioned, as did you, that Senator Kay Bailey Hutchison who
chairs the Subcommittee of Appropriations that I serve on for
MILCON and veterans helped lead that fight along with Senator
Feinstein. Senator Murray was involved, certainly Senator
Akaka, and myself. We accomplished that.
We also said at that time to our Secretary and to VA that
no longer would we tolerate guesstimates or unrealistic
projections; that they were to go to work and bring us a
process that delivered numbers that we and they--while we might
differ on approaches, but at least the numbers would be
accurate, and they were to report on a quarterly basis.
We have had that first report, and they will now report on
a quarterly basis to Congress as to the spend-downs in the
programs and to see whether they are accurate and reasonable
projections, and I think that is a major step forward.
With that accomplishment, this year the President, the
administration, has proposed an 11.3-percent increase in VA
medical care. In a medical care dynamic which is relatively
flat, that seems like a tremendous increase, and yet we know
that it is probably necessary, and we will certainly work to
get it.
If that request is enacted, VA medical care funding will
grow by about 69 percent over 2001. Now, in reality and the
reason I am saying that is for all of you to understand how we
have to deal with this in placing it in context not alone, not
separate from all other budgets, but in context with our
national Federal budget.
At the present rate of growth, 11.3 percent, if we were to
sustain that, that means that VA health care in the broad sense
will double every 6 years. This is a phenomenal challenge.
Please understand that, and everyone who is here who speaks
about programs and importance and quality and access speaks
about money in reality and how we deal with making sure that
there is access and that it is all well funded.
I have not at this moment, out of hand, said no to the
President's concept of fees. Here is why I have not. Because I
am struggling with how to replace them if the Congress says no,
and I would not be surprised if the Congress says no. To
replace them will cost the budget, if we sustain this level of
spending, not higher levels that some are advocating including
your organization, we will have to find about $800 million,
close to a billion dollars, give or take. That is if we deny
some other level of resource and revenue coming in, and that is
why I said wait a moment.
Last year, I would not in any way accept the proposal. I
ruled it out, out of hand, and yet this year, in the context of
where we want to take the quality of our health care and the
access to the system--and all of us want that--there remains a
reality check that I have got to force myself through and that
the Appropriations Committee, based on their allocation as it
relates to resource, is going to have to put itself through.
So, having said that, this is not to put you on the spot.
This is to put us into a reality check of where we go from here
because, if you don't accept a $21-a-month fee for 7's and 8's
to gain access to the system and you don't accept going to $15
for a 30-day prescription drug fill, my guess is some on our
committee and some in the appropriating committee will want to
look for alternative revenue sources, other than just
borrowing.
According to a 10-year-old testimony that I have been
looking at, that was introduced in the record at our budget
hearing earlier this month, your organization, the DAV, did not
previously oppose asking for some higher-income veterans to
contribute to the cost of receiving care from VA.
Can you give us an idea of what circumstances led your
organization to change its views on the issue, which it is
obvious by your testimony you have, and have you thought about
alternative revenue sources for maybe this category of veteran
who might have other kinds of insurance, other kinds of health
care access, but because of the quality of health care in the
veterans system today is choosing to come to the VA?
Mr. Jackson. Mr. Chairman, before someone answers that, we
use the term ``for the good of the order.''
Would you allow me to introduce some young men that have
come in, please?
Chairman Craig. Absolutely. Please do.
Mr. Jackson. These are some brave Americans that are seated
behind us here who have been wounded and disabled in the war on
terrorism, and if you would, please, allow me to introduce
them.
Army Sergeant Tyler Hall of Alaska.
Chairman Craig. Welcome.
Mr. Jackson. Army Sergeant First Class Chris Baine of
Pennsylvania.
Army Sergeant Wasem Khan, originally from Pakistan, now a
U.S. citizen.
Chairman Craig. Gentlemen, thank you for your service.
Welcome to the committee.
Mr. Gorman. Mr. Chairman.
Chairman Craig. David.
Mr. Gorman. If I may try to respond to your question. If it
were 10 years ago that we gave testimony, it might well have
been myself that delivered the testimony.
Chairman Craig. David, it was.
Mr. Gorman. It was?
Chairman Craig. I won't quote your testimony at that time,
but it was you. Yes.
Mr. Gorman. I wasn't sure, but I knew you were.
Back then, I believe we said something for the record that
went that service-connected veterans, service-connected
disabled veterans, medically indigent veterans or poor veterans
should be allowed to get the spectrum of VA health care that
they need and that they should be eligible for.
Others who come into the system should come in with either
copayments, deductibles, or third-party private insurance
reimbursements.
I think the key to your question is the ``or.'' We have the
copayments. We have the private insurance from third parties.
So that has already taken place. We agreed back at that point
in time that one of those or, as we have it now in law, a
combination of at least two of those have come into play.
We still don't think it's--let me back up a minute. The
whole concept back then when these copayments were made into
law, they were temporary, and they were temporary for the
purpose of deficit reduction.
I can well remember meetings where I sat in personally that
those discussions held true. They were to be on a temporary
basis and end when the budget was no longer in deficit. We have
come out of that. We came out of that situation under another
administration, and those copayments and insurances continued,
much to our dismay.
It has been all along, we didn't like the idea. We went
with it because we thought out of necessity at the time. At
that point in time, we came out in opposition to the
deductibles. We don't think they are needed.
I think the VA--and I am not sure of the numbers, but it is
hundreds of thousands of veterans who were in the system now
getting care and VA billing their private insurance companies,
collecting $2 billion, I think, in third-party insurers. VA
estimates hundreds of thousands of those veterans would be
knocked out of the system or would opt out of the system if
deductibles were to be required.
So you are taking, on the one hand, veterans who were in
the Category 7's and 8's, requiring deductibles to be paid,
while they are getting third-party reimbursement from them.
Those veterans would go away from the system, which means a
good portion of the third-party reimbursements that the VA
collects would likewise out of necessity go away.
So, in likelihood, you could be costing the VA scarce
dollars by imposing deductibles.
Chairman Craig. Well, certainly, I have heard that
argument, and I am not denying that there may well be some fact
to it.
If you were to shift that kind of payment, you would
obviously shift the pattern of use. People respond to dollars
and cents.
Mr. Gorman. And the one further point I would make, Mr.
Chairman, is all along we have maintained that any additional
revenue stream that comes into the VA should be supplemental to
appropriations and should not supplant the Federal Government's
obligation to adequately appropriate dollars for veterans
health care.
Chairman Craig. Thank you.
Senator Akaka, questions?
Senator Akaka. Thank you very much, Mr. Chairman.
You are in constant contact with veterans throughout the
country. Are you concerned with the message that veterans with
PTSD may be getting as a result of the now-defunct PTSD review,
the Disability Benefits Commission's evaluation and assessment
of benefits provided under current law and the Institute of
Medicine study on treatment, diagnosis, and compensation to
veterans with PTSD?
What is your membership telling you about this?
Mr. Violante. Senator Akaka, we are hearing from our
membership. They are concerned. We think that it was ill-
advised early on when the VA came out with that original
review. It put a lot of veterans who didn't have to be at risk,
at risk, thinking about it.
We are also somewhat concerned, although we heard from the
Deputy Secretary on Sunday, that the IOM review was put in
place to assist VA to determine whether or not they are
providing the proper care to veterans who are suffering from
post-traumatic stress disorder.
We hope that IOM will look at it from that aspect. I know a
lot of veterans out there are concerned about that study, and
unfortunately, there are a lot of veterans now who are
returning from our war on terror who have been identified as
suffering from post-
traumatic stress disorder.
So we just hope that this IOM study and the VA moves
forward in ensuring that these veterans not only receive proper
level of benefits for their disabilities, but also the proper
care.
Senator Akaka. The President is clear on who should be
eligible for VA health care, those with service-connected
health needs.
Do you think the system as we know it today can survive if
eligibility is severely narrowed? Can we continue to train
nearly half of all physicians in the United States, maintain
specialty programs unparalleled in the community, and teach the
rest of the health care system about quality management if
eligibility is limited only to service-connected health needs?
Mr. Gorman. We don't believe so, Senator Akaka.
You need, as the commander pointed out in both his written
and oral remarks today, old and young, healthy and unhealthy
veterans in this system. You need a critical mass of patients
for the VA to be able to take care of, to recruit the
professionals, to be trained, competent quality health care
providers. I think pretty soon if you only concentrated on the
service-connected disabled veteran in the VA health care
system, you would have a system that would simply shrivel up on
the vine, and then it would be one that could be easily
contracted out to the private sector that I don't believe is
good for the disabled veteran, the VA, or, in that case, for
that matter, the American taxpayer, which it has been clearly
shown by data the VA is clearly the cheaper provider of care
than anybody else out there and the more quality provider of
care than anybody else out there.
Senator Akaka. On National Guard and Reserve participation
and the MGIB program, as some of you may know, VA assisted me
in attending college, as I mentioned, and after I left military
service. I am thankful for my education and opportunities in
life that have been afforded me because of that education.
I am concerned that some in military service may not
receive benefits that mirror their service commitment. Can you
make recommendations to the Reserve and Guard components of the
MGIB program?
Mr. Violante. Senator, the GI bill is not really a DAV
issue, although we are involved in it to the extent we are a
member of the Independent Budget, and we certainly do support,
with the added emphasis on the use of the National Guard and
the Reserve in our current war on terror, their ability to
receive the same benefits as our active-duty military, but to
be more specific than that, again, it is not an issue that DAV
plays a major role in.
Senator Akaka. Thank you very much, Mr. Chairman. My time
has expired.
Chairman Craig. Senator Akaka, thank you very much.
Senator Murray.
Senator Murray. Thank you very much, Mr. Chairman.
You know, there are two ways to put a veterans' health care
budget together. One is to determine how much money you want to
spend on it, and then write the rules, so everybody fits within
that spending package. The other is to determine how many
veterans need access to health care and put the money in to
cover that.
I kind of go with the latter one, but I am concerned
because, as we all remember the fiasco we went through on
funding last year, we know why there were increased costs and
why we were short. We were not accounting for the increased
rate of health care costs, as the chairman referred to a few
minutes ago, that we have to take into account. We have an
increased number of Iraq and Afghani soldiers returning who are
accessing our VA health care system. We have a number of
veterans who served in Korea and Vietnam and even World War II
who didn't access VA health care until they reached an older
age or their employer said ``I'm no longer providing health
care'' and then they went into the VA system. So we know that
we have increased numbers of veterans who are accessing VA
health care. It is an excellent system, and they deserve the
care, and we should have it there for them. So we have to
budget for it.
One of the things that I think we are not taking into
account today, Commander--and I would like to ask you about
this--is that as the new Medicare Part D prescription drug plan
goes into effect, I am hearing from many seniors who are
calling up Medicare to ask about signing up for the new
prescription drug plan and are asking if they are a veteran,
and if they are, they are told don't sign up for this, go into
the VA health care system.
I am worrying we are not budgeting for that, for those now
coming into the VA health care system as a direct result of
another agency telling them to go that way in services they
need.
Are you hearing, Commander, of any stories that you are
aware of, of more and more veterans accessing VA health care
today who are being driven there by the new prescription drug
plan itself?
Mr. Gorman. I am not sure, Senator Murray, we are hearing
an awful lot of that, but even before Medicare Part D came into
effect, veterans were coming to the VA simply for their
medications, and as a result, the VA was treating them as a
whole patient, enrolling them in the system, and giving them
their VA health care.
There is no question that it is advantageous to many to get
their medications through the VA, but they also are seeing the
benefits of getting their health care through VA at the same
time. So it is sort of a dual-edged sword that is costing the
VA because these veterans are entitled to care. It is costing
both for the provision-of-care aspect as well as the
prescription aspect, too.
Senator Murray. How do you think that the VA should change
its budget model, so it can better track the needs of our
veterans?
Mr. Gorman. Well, we believe--we are a proponent of some--
the system today, we believe is broken. We have been a
proponent and a strong advocate of guaranteed or mandatory
funding.
We think that is the way to go, and I think that fits the
latter category of what you are talking about, but I simply
believe--and I welcomed the Chairman's remarks about working
together, sitting down, and trying to come to some kind of an
agreement on what the VA should be and who it should be for. I
think that is essential if we are going to tackle this problem.
I think clearly the mistakes of last year are going to be
repeating themselves. Whether it be this year to that
magnitude, I don't know yet, but it is not going to be fixed
adequately to take care of the number of veterans that need to
come into the system.
And we are worried about the generation, like these three
young men behind us, who in all probability, 60 years from now,
are going to continue to need the benefits of the VA health
care system. They are going to need their treatment. We worry
that it may not be there for them, and that would be a national
travesty, let alone a travesty for those individual veterans.
So there is a model out there somewhere that is going to
fit. It is going to be better than what we have now. It may not
be a full model of what we all would like to see, but it has to
be better than what we have today, and we very much welcome the
opportunity to sit down with, out of necessity again, not only
this committee, but your counterpart in the House and the
Administration to come to some kind of a rationalization of how
we are going to do this and how we are going to tackle it.
Senator Murray. Well, it is really important we do that, so
that we can set that as a priority when we do our budget. The
Budget Committee is going to be making up the budget next week,
and if we set a parameter that is too low, it will impact our
ability later in the year to be able to fund VA at what we need
to do.
So I think we need a much better budget model, so we can
accurately portray what we need, and we would be happy to work
with you on any suggestions that you might have.
Let me ask another question, if I still have time, Mr.
Chairman. Last fall, this committee had a hearing on trying to
get more VA individual unemployment recipients back to work.
Would you share with us your thoughts on trying to push more of
our disabled veterans off of IU and into the workforce?
Mr. Violante. I am not sure it is a good idea to force them
off. Certainly, I think we believe that if an individual is
able to work and gets the proper vocational rehabilitation
training and can move into the workforce, that that is great.
To just identify scaling down on individual unemployability and
trying to force veterans out into the workforce by reducing
their rating is another story that we wouldn't support, but I
think that any time that you can get individuals back into the
workforce and making their own living, it benefits not only the
individual, but the society. But it just depends on how it is
done.
Senator Murray, if I could go back to your first question,
we are seeing that there are several States, including the
State of Washington and Missouri, that have now undertaken
identifying veterans on State rolls. As you all know, State
dollars for Medicare and Medicaid are being tightened up, and
they are looking at ways to get individuals off of their rolls
and are identifying veterans and encouraging them and
introducing them to the VA health care system. So that is
another thing that we need to be----
Senator Murray. That will impact our budget. You are
absolutely right.
Mr. Violante. Definitely.
Senator Murray. Thank you for your comments.
I know my father, as I told you, who had multiple sclerosis
would have loved to work, but his disease prevented him from
doing that and making him feel even worse because he was
collecting--any kind of disability, because he wasn't working,
I think is sort of the wrong message to be sending to people.
One other quick question. As I was doing the M.S. hearing
that I had last week, I heard about the difficulty that many
people--well, veterans were not getting the information they
needed about what they qualified for in terms of disability or
any other benefits. What is your impression of the VA in doing
outreach today to try and find men and women who served to make
sure they are getting their benefits, whether it is Agent
Orange or Gulf War syndrome or other impacts?
Mr. Gorman. From what we know and what we understand about
VA and what we have seen, they are not doing enough.
I think when you do outreach out of necessity, it creates
work, an additional workload, an additional volume of veterans
coming into the system for whatever benefit, and I simply don't
think they are prepared to do that, from either the health care
system or the compensation delivery system. So I think they are
holding back on some outreach that could be very, very valuable
to veterans across the country.
Senator Murray. I appreciate that very much.
Thank you, Mr. Chairman.
Chairman Craig. Patty, thank you very much for those
questions.
A couple of more questions, David. I want to go back to
your earlier statement because I am not in disagreement with
what you said on what you said back in 1996, I believe, but if
I understand your answer to the previous question, suggesting
that lower-
priority veterans pay their own way through a combination of
copays, deductibles, and billable insurance, and since that
time, Congress has come through on copays and billable
insurance--we agree on that. But copayments were already a part
of the law in 1996. Isn't that correct?
Mr. Gorman. I believe so.
Chairman Craig. So wasn't your statement an amplification
of what was already existing law?
Mr. Gorman. I think at the time, although there may have
been a provision of law, they were still in effect temporary,
and that was the understanding we entered into with the
Congress, that they would be and remain temporary until a
certain point in time.
Chairman Craig. Until such time.
Mr. Gorman. But I don't think--without looking at the
context of my full testimony at that time, which I----
Chairman Craig. That is fair.
Mr. Gorman [continuing]. Am at some disadvantage, I don't
believe we said that all three of those should be a part of law
and should be imposed upon veterans. I think it was a
combination or the ``or'' as far as--private insurance, I think
was the key.
Chairman Craig. In your testimony, Commander, you used the
word ``guaranteed funding,'' and in response I think either to
Senator Akaka or Senator Murray, the word ``mandatory'' and/or
``guaranteed'' was used.
I would like to pursue that just a little bit because any
of us who sit here in Congress today, although we are yet
unwilling to do it, in a very short time have got to recognize
that that light at the end of the tunnel coming at us is a very
big fast freight train, and it is called Social Security and
Medicare. There isn't an economist in this country who would
argue against the statement I am about to make, that if you
leave things exactly where they are today, that in a reasonably
short time, possibly 2030, with our baby-boomers hitting the
Social Security market and therefore eligibility for Medicare,
that those two programs along with Medicaid will consume the
entire Federal budget, including veterans, Interior,
Agriculture, Defense gone unless we make significant hard
political choices in whatever form they will be, and I can't
even predict that yet because Congress is very resistant.
Those are tough decisions. They impact human lives. They
impact constituents--and constituents, every 6 years here in
the Senate, go to the polls to vote. We are really squirming
right now on a way to figure it out. We don't want to face
those hard tough issues in whatever form we face them, but they
are there. We know they are there, and the sooner we fix them,
the easier they will be on not only the recipient of the
benefit, but the economy at large and those who pay into the
budget for the purpose of keeping those programs going.
So, in view of these challenges we are facing, I am
struggling, in all seriousness, with adding another major $100-
billion program to mandatory spending with the growth rates
that are obvious within this. Using the word ``mandatory'' or
``guaranteed,'' could you explain to me what you mean?
You have just heard Senator Murray talk about shifting how
you budget. That kind of gets to the point of being mandatory
because obviously you determine numbers and needs and fund
accordingly. How do we deal with that in your own mind?
Mr. Gorman. Well, first of all, it is a matter of
priorities.
You say people's lives that were impacted. The young men
and women who have put on the uniform, gone off to foreign
shores to do our battles for us to preserve the life and the
ideals we have, have put themselves in harm's way. Many, most,
have come back unscathed, but those who have not, the
individuals who we believe should be ratcheted up to a level
that have nothing but the highest priority for Government
services in this country, it is the Federal Government foreign
policy decisions that create disabled veterans. They are not
created by people's own whims or IBM or Ford Motor Company.
They are created by the Federal Government's foreign policy.
So, having said that, I would agree with Senator Murray to
the point that instead of drawing a circle and filling it with
money and saying within this circle are the number of veterans
we can treat, we must, out of necessity, especially now as we
are at war, and it appears we are going to be at war for some
period of time in the future, which means many thousands of
more young men and women are going to put themselves in harm's
way and many more are going to come back in need of VA
services.
You need to take, in our view, the number of veterans who
require VA medical care services and have an adequate budget to
treat those veterans. It is a simplistic statement to make, I
know and I realize that. To try to formulate it into a way that
is workable is very, very difficult, and I think that is where
we have been--I say ``we''--the whole veterans community have
been at sort of a loggerhead with each other for some time. How
do we accomplish that?
There has not been, in my opinion, an honest debate on that
issue, and I think that is what has been sorely lacking.
Although we talk about it and we go across the other side of
the Capitol and talk about it over there, the Administration is
always on the outside of that discussion. There aren't those
discussions going on with all interested parties.
When Secretary Principi was in office, one of the last
things we talked to him about--and he agreed to--was to create
what we called a Veterans Health Care Summit, trying to get the
administration, VA officials, people who know the system, know
how the system works, to sit down together at a table and throw
everything out there and talk about it. That, out of necessity,
would include you, your staff, the House Veterans' Affairs
Committee staff, hopefully the appropriators.
It is going to take everybody to sit down and say this is
an issue we have to face, it is a priority, how are we going to
reasonably do it, and I believe somewhere in the middle of all
of what we have today and the call for mandatory funding,
somewhere in there, there is a solution to this problem that is
going to save the VA health care system, and it is going to
allow them to continue to treat the veterans it needs to treat.
Chairman Craig. Well, David, I disagree with nothing of
what you said.
Now, I don't know whether this administration's--at this
time--numbers are right. Time will tell. If they are accurate
and justify the 11.3-percent increase, most of that is spent
and directed at disabled and service-connected, and those
numbers, even including the incoming, if you will, these young
men and others serving in Iraq and Afghanistan, the number is
relatively flat, not a dramatic increase.
So this is a substantial budget increase, but to address
those that are almost--now I say almost--I don't want to put
words in your mouth--almost outside your comment, 7's and 8's,
not disabled, not by definition poor, not rich, but not poor,
not service-connected, and yet many VSO's say all are entitled.
I agree with the broad statement, but I will tell you where
I come down. I come down for the disabled and the service-
connected and the truly needy, and I have a little trouble. And
I will tell you this. You have probably heard me tell this
story before, but maybe the audience hasn't. When a retired
medical doctor living in a lovely home by a golf course who
happens to be a veteran is very angry at me because he can't
get access to the pharmaceutical program, tells me I am not
doing my job, something is wrong with that picture. He can
afford not to be there, but he is led to believe that he is
entitled.
I do not believe this system will sustain itself under any
scenario if we don't recognize some of those problems.
To say that the President is wrong in what he proposed is
to argue that the President isn't attempting to challenge us
into the debate and into the discussion you have just proposed,
to recognize what is glaringly obvious, or more importantly,
ultimately to get the Congress to finally back off because the
revenue simply doesn't exist and for us to have to start moving
around numbers as it relates to the truly needy, the disabled,
and the service-connected.
That is what I am going to struggle with. Senator Murray is
going to do the same. We come at it a little differently. Both
of us have the same goal, and we are very proud of the system
that we have an opportunity to impact in our service here in
the Senate.
I say to all of you, these gentlemen sitting at your front
table here serve you very well. We have candid and open
dialogue, and we will continue to do that as we wrestle through
this issue, and I have already explained to you the
difficulties we will go through in the coming months to bring
about a budget at this level or above or somewhere near in
relation to how this budget has been put together or how we
will put it together.
Let me tell you, Commander, I thank you sincerely today for
your comments, for bringing your organization to the Senate. We
are pleased and proud to have you here.
With that, Senator Murray, do you have any other questions
you would like to ask?
Senator Murray. I just have a quick final comment. First of
all, let me preface it by saying last year when the VA finally
did come forward and say that they had a huge budget deficit
problem, Senator Craig is to be commended for coming forward
immediately and working with us to resolve that, and he was
there every step of the way for the veterans, and we all owe
him a debt of gratitude for that.
He is right in that we have a little different philosophy
on veterans and veterans health care funding, and I just have
to say that when someone signs up for service, there is no
asterisk on the form saying if you have a swimming pool or you
go to Mexico in the summer, you don't qualify. And I don't
think any of us are ready to go out today to where we are
trying to recruit men and women to go to Iraq or Afghanistan to
fight the war on terror, that we are going to put an asterisk
in there, and I think we have an obligation as a country to set
our priorities within our budget to make sure we have the
funding for the VA. If it comes up and costs more because that
is what it costs, then we have an obligation to figure out how
to do that within the budget, and I am going to keep advocating
for that.
Thank you, Mr. Chairman.
Chairman Craig. Thank you very much.
Mr. Gorman. Mr. Chairman, may I just have one more moment--
--
Chairman Craig. Please, David, go right ahead.
Mr. Gorman [continuing]. Based on something you just said?
Whereas the service-connected and the medically indigent
are, in fact, the most important people we want to try to take
care of, one other scenario--and I am not proposing that this
is the solution, but it might be something to think about--is
that you have a mandatory or guaranteed funding stream for
those two categories of veterans and you make a discretionary
funding stream for others that are found eligible to come into
the VA health care system.
Chairman Craig. Thank you.
Mr. Gorman. Thank you, sir.
Chairman Craig. I mean that most sincerely. That is the
kind of creative thinking we have all got to get to here.
A lot of people criticized our President this past year for
proposing reform in Social Security. He started a very
important national debate. We will have to pick it up someday
in the future to resolve it, and as we will other issues. So I
am not going to suggest to any of you I am going to create a
national debate when it comes to the veterans system, but I am
going to make awfully darn sure that during my tenure, those
who we feel are most eligible receive the quality of care that
I believe is addressed to them.
Well, I understand other Senators may be en route. We have
gone on and held you here long enough, and we will add their
opening statements to the record. The committee record will
remain open for a week. There may be some additional questions
to be asked of you.
Senator Murray, thank you for attending, some of our House
Members who attended, and most important to you, Commander, to
you and all of those who are behind you and the 1.3 million, I
believe you said, you represent. Thank you so much for your
presence here today and your commitment to veterans.
The committee will stand adjourned.
[Whereupon, at 3:42 p.m., the committee was adjourned.]
A P P E N D I X
----------
Prepared Statement of Hon. John Thune, U.S. Senator from South Dakota
Mr. Chairman, thank you for holding this hearing to give our
veterans' service organizations an opportunity to present their
legislative priorities before the Senate. I'd also like to welcome Paul
Jackson, National Commander of the DAV.
As I have noted before, budgets are an indication of where we, as a
government, place our priorities. Clearly, veterans funding is a very
high priority in this budget request, as it is one of the few areas of
the budget that has been proposed to receive generous increases in
funding. In fact, the President's 2007 budget would represent a 75
percent increase since 2001 in funding for veterans programs.
I look forward to today's testimony, and thank you again, Mr.
Chairman, for holding this important hearing.
__________
Prepared Statement of Hon. Silvestre Reyes, U.S. Congressman from Texas
Mr. Chairman, as a life member of the Disabled American Veterans
(DAV), I would like to thank you and Ranking Member Akaka for allowing
Members of the House to participate in today's hearing and for allowing
the DAV to present their legislative priorities. Their knowledge of the
needs of their membership is vital to the budget process as we consider
fiscal year 2007 funding for veterans programs.
As in previous years, the Administration's budget request includes
legislative proposals that would impose enrollment and pharmaceutical
co-pay fees on our nation's veterans. I find this absolutely
unacceptable and assure you that I will work with the House Veterans'
Affairs Committee to remove this language in a bipartisan fashion as we
have done in the past.
I am also concerned that not enough progress has been made to
increase the number of healthcare professionals working for the
Department of Veterans Affairs (VA) so that we can substantially
decrease the wait period for medical services. Unfortunately, these
issues are not new and, as the VA witnessed last year, the number of
Iraqi Freedom and Operation Enduring Freedom veterans is only
increasing.
To this end, I recently joined my colleagues in the House Committee
on Veterans' Affairs in submitting our ``Minority, Additional, and
Dissenting'' views and estimates for the fiscal year 2007 Department of
Veterans Affairs budget. Our recommendation would eliminate the
President's legislative proposals for enrollment and pharmaceutical co-
pay fees and lift the Administration's enrollment ban on new Priority 8
veterans. In addition, our estimates provide the needed funding for
Post Traumatic Stress Disorder outpatient and inpatient programs while
ensuring the Department of Veterans Affairs maintains an adequate
number of health care professionals to meet the demand for services.
Again, I would like to thank the representatives of the DAV for
taking the time to be here today. Their dedication to our nation's
veterans is commendable and I look forward to working with my
colleagues to provide the VA a budget that will meet all the needs of
our nation's veterans.