[Congressional Record Volume 152, Number 125 (Friday, September 29, 2006)]
[Senate]
[Pages S10596-S10599]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          VETERANS HEALTHCARE

  Mrs. MURRAY. Mr. President, I rise to discuss how we are doing in 
caring for America's veterans. With our country at war, with 1.5 
million Americans who have served in the global war on terror, and with 
many of them coming home in need of care--it is a critical question.
  Last week, we got a shocking report from the Government 
Accountability Office, which found that the VA has misled Congress 
about its failure to plan for our veterans.
  Based on that report and other research, I came here to the Senate 
floor 2 days ago and shared my concerns with the full Senate. I said 
that the Bush administration has not been honest with us about its 
failures to plan for the needs of our veterans, and that we still have 
a lot of work to do to get back on track. And I warned that--3\1/2\ 
years into this war--the Bush administration still does not have a plan 
to meet the needs of all the veterans who will be coming home.
  In my speech on Tuesday, I said that Congress needs to provide real 
oversight of the Bush administration so that we can ensure our veterans 
get the care they have earned. For those who want to see my full 
remarks and all the evidence I cited, you can watch or read my speech 
on my Web site at http://murray.senate.gov.
 This morning, the Senator from Idaho came here to the Senate floor 
and spoke with great passion about our veterans. The distinguished 
chairman of the Senate Veterans Affairs Committee took issue with some 
of the things I said in my remarks here on Tuesday.
  I respect the Senator from Idaho. I appreciate his leadership of our 
committee, and I am pleased to provide more information before the full 
Senate. I want everyone to know that the Senator from Idaho and I have 
worked together on veterans issues.
  I want to point out that when the VA finally admitted that it was 
facing a $3 billion shortfall--the chairman was first to stand beside 
me and find the funding to fix the problem. And I thank him for that.
  I am proud to say that the Senator from Idaho and I agree on many 
points. We both agree that the VA provides excellent healthcare. When I 
was in college during the Vietnam War, I interned at the VA hospital in 
Seattle. I saw firsthand how dedicated and talented VA employees are.
  Today, that ethic of service and commitment to quality beats in the 
heart of every VA employee. I am proud of the progress we have made 
helping the VA become a model for effective, high quality healthcare.
  The Senator from Idaho and I also both agree that we have increased 
VA funding. It has been an uphill battle--and the facts tell me that we 
are not prepared for the many veterans coming home--but we both agree 
that we have increased veterans funding. I might point out that we in 
Congress provided those increases in spite of years of inadequate 
budget requests from the White House.
  We agree that the Senate Veterans' Affairs Committee works in a 
bipartisan fashion under the leadership of Senator Craig and Ranking 
Member Akaka. As I have said many times on this floor--taking care of 
our veterans is not a Democratic issue or a Republican issue. It is an 
American issue, and we all need to be part of the solution.
  And finally, I couldn't agree more with the Senator from Idaho that 
we should focus on the facts. Those facts should guide our budgets and 
our policy decisions. If the facts say everything is fine, that's 
great. But when the facts say there are problems, we need to hear those 
facts, and we need to respond based on the facts.

[[Page S10597]]

  That's why the GAO report is such a bombshell. Professional, 
independent government investigators found that the Bush administration 
has not told us the facts about its budget and planning problems.
  Think about that--if the people we rely on for the facts are not 
telling us the truth, we've got a real problem. If they're hiding the 
truth, we won't be able to provide veterans with the services they 
need. And one of the answers has to be more oversight and more 
accountability, so we can get to the truth.
  Let me turn to the three main points that are relevant here:
  First, the Bush administration does not have a real plan to meet the 
needs of our Iraqi War veterans--and that failure is impacting the care 
we provide all veterans.
  Second, the Bush administration misled this Congress and it is still 
not providing us with up-to-date, timely information.
  And third, we in Congress need to provide real oversight and demand 
real accountability--or our veterans are gonna fall behind.
  Mr. President, I am very concerned that the Bush administration still 
does not have a plan to meet the needs of our returning servicemembers. 
And to prove that I want to point to three sets of figures that come 
from the VA itself.
  The first piece of evidence concerns the number of veterans the VA 
expected to treat this year.
  For fiscal year 2006, the VA planned to take care of about 110,000 
veterans from Iraq and Afghanistan. 110,000. How many are they actually 
treating? 185,000. So in this fiscal year--that is just about to end--
the VA underestimated demand by 68 percent. And that is just for those 
veterans returning from Iraq and Afghanistan. If the VA had an accurate 
plan, they wouldn't have been so far off.

  Let's go to the second piece of evidence that shows the VA has no 
plan. As I said, this year we are treating 185,000 veterans from Iraq 
and Afghanistan. How many will we treat next year? The VA estimates 
that it will only be 109,000 Iraq and Afghanistan veterans. We are 
treating 185,000 today, but the VA thinks that number is going to go 
down dramatically next year.
  Given what we know about our continued involvement in Iraq and 
Afghanistan, that simply defies logic. And you have to wonder how the 
VA ever came up with those figures in the first place. Its projection 
for next year is even lower than its projection for this year. Where 
are they getting these numbers? Why are they so wrong?
  Those are the questions we in Congress need to be asking. If the VA 
really thinks that next year we will have fewer veterans seeking care, 
it clearly has no plan to deal with those who will be coming home.
  Let me turn to the third piece of evidence that shows the VA has no 
plan to deal with Iraq war veterans. In July, the VA told us it will 
need $1 billion each year for the next 10 years to care for veterans 
from Iraq.
  But the fact is--for this year alone--we are already spending more 
than $1 billion. They have given us a 10-year estimate, and they are 
already wrong in the very first year. And the lion's share of veterans 
have not separated from the Pentagon yet, so it is a safe bet that 
demand for VA services will go up and that will require more funding.
  So the VA is already wrong in the figures it provided us just a few 
months ago. That's because they don't have a plan.
  The fact that they predicted 110,000 enrolled Iraq War veterans this 
year--and they are already serving 185,000 shows they don't have a 
plan.
  The fact that they think demand for care will drop next year shows 
that they don't have a plan.
  And the fact that we are already spending more than they said we 
would need for Iraq war vets shows they don't have a plan.
  This is unacceptable. If we tolerate it, then we are not doing our 
jobs here in Congress. They don't have a plan, and we better have some 
oversight and accountability before more veterans end up getting hurt.
  Next Mr. President, I want to turn to the facts of the GAO report 
that I requested. This report--prepared by independent, credible 
government investigators--tells us what is really happening. All of us 
care about the facts and we all care about getting this right, and 
that's why we should all take this report to heart. Unless we learn 
from our mistakes, we are never going to do any better for America's 
veterans.
  In that spirit, I want to focus on four findings. First, the GAO 
found that the VA knew it had serious problems with its budget, but 
failed to notify us in Congress. Even worse, it misled us.
  The report suggests that the VA could still be sending us inaccurate 
information in its quarterly reports.
  Second, the GAO found that the VA was basing its budgets on 
``unrealistic assumptions, errors in estimation, and insufficient 
data.''
  Third, the Pentagon failed to give the VA up-to-date information 
about how many servicemembers would be coming down the pipeline into 
the VA.
  Finally, the GAO found that the VA did not adequately plan for the 
impact of servicemembers from Iraq and Afghanistan.
  For me, I think one of the most disturbing findings is that the VA 
kept assuring us in Congress that everything was fine--while inside the 
VA it was clear that shortfalls were growing.
  The VA became aware it would have problems in October 2004--but 
didn't admit those problems until June of 2005. Veterans were telling 
me of long lines and delays in care.
  For months, I tried to give the VA more money, but the administration 
fought me every step of the way. And who paid the price for the VA's 
deceptions? America's veterans, and that's just wrong.
  Let me walk through some of the deceptions found in the report. It 
shows a very troubling gap between what the VA knew and what the VA 
told us.
  According to the GAO report, starting back in October 2004, the VA 
knew money was tight. It anticipated serious budget challenges, and 
created a ``Budget Challenges'' working group.
  Two months later, in December 2004, the budget group made internal 
recommendations to deal with the shortfall. It suggested delaying new 
initiatives and shifting around funding.
  Two months later, in February 2005, the Bush administration released 
its budget proposal for 2006.
  The GAO found that budget was based on ``unrealistic assumptions, 
errors in estimation and insufficient data.''
  A week later at a hearing--on February 15, 2005, I asked the VA 
Secretary if the President's budget was sufficient. He told me:

       I have many of the same concerns, and I end up being 
     satisfied that we can get the job done with this budget.

  Let's remember what was happening back at that time. I was hearing 
from veterans that they were facing delays in care and that the VA 
system was stretched to capacity. But the VA continued to say 
everything was fine.
  On March 8, Secretary Nicholson told a House committee that the 
president's fiscal year 2006 budget,

       gives VA what it needs.

  I was hearing a much different story as I spoke with veterans around 
the country. That is why on March 10, I offered an amendment in the 
Senate Budget Committee to increase veterans funding by 3 percent so we 
could hire more doctors and provide faster care to veterans. 
Unfortunately, Republicans said no.
  That same month, the VA's internal monthly reports showed that demand 
for healthcare was exceeding projections. That was another warning sign 
that the VA should have shared with us, but it didn't.
  On March 16, Senator Akaka and I offered an amendment here on the 
Senate floor to increase veterans funding by $2.85 billion. Once again, 
Republicans said no.
  The next month, on April 5, Secretary Nicholson wrote to Senator 
Hutchison saying:

       I can assure you that the VA does not need emergency 
     supplemental funds in FY 2005.

  A week later, on April 12, I offered two amendments on the Senate 
floor to boost veterans funding. First, I asked the Senate to agree 
that the lack of veterans funding was an emergency and that we had to 
fix. Republicans said no.
  Then I asked the Senate to agree that supporting our veterans was a 
priority. Again, Republican said no. As a

[[Page S10598]]

result, veterans didn't get the funding they needed, and the deception 
continued.
  On June 9, I asked Secretary Nicholson at a hearing if he had enough 
funding to deal with the mental health challenges of veterans returning 
from Iraq and Afghanistan. He assured me the VA was fine.
  So for 6 months we had happy talk that everything was fine with the 
VA. Then, in June--just two weeks after the Secretary's latest 
assurance--the truth finally came out. On June 23, the VA revealed a 
massive shortfall of $3 billion.
  I went to work my colleagues, and we came up with the funding. But we 
could have solved that problem much earlier and saved veterans the 
delays they experienced.
  By misleading us, the Bush administration hurt America's veterans. We 
could have provided the money when it was needed. We could have been 
hiring the doctors and nurses we needed. We could have been buying the 
medical equipment that was needed. And we could have helped keep 
thousands of veterans off waiting lists for care.
  Here's the bottom line: The Bush administration knew about a problem 
back in October 2004.
  They saw it getting worse, but they kept assuring us everything was 
fine. They worked to defeat my amendments to provide funding, and they 
didn't come clean until June 2005. That is unacceptable.
  I think America's veterans deserve real answers. This report shows 
that the VA was not telling Congress the truth and was fighting those 
of us who were trying to help. We need to bring Secretary Nicholson 
before the Veterans' Affairs Committee so we can get some real answers. 
We need to ensure the VA does not repeat the same mistakes of the past 
2 years. We owe that to our current and future veterans who sacrifice 
so much for us.
  We need an explanation of why the VA misled us about so-called 
management efficiencies. The GAO found those alleged savings were 
nothing but hot air. This report clearly shows the Bush administration 
misrepresented the truth to us for 4 fiscal years, through 4 budgets, 
and 4 appropriations cycles about these bogus savings. And when they 
could not make these efficiencies a reality, they took the funds from 
veterans' healthcare. That is unacceptable.
  The report also suggests that even in its latest quarterly reports to 
us--the VA is slow to report and does not provide key information we 
required--such as the time required for veterans to get their first 
appointment.
  The GAO report also says that the Department of Defense failed to 
provide the VA up-to-date information on how many servicemembers would 
be separating from service and seeking care at the VA. That is really 
frustrating to me because I have been asking every general who comes up 
here if they're doing enough to ensure a smooth transition from the 
Pentagon to the VA.
  In fact, on February 16 of last year, I questioned Secretary Rumsfeld 
directly. I got him to agree that caring for veterans is part of the 
cost of war but he had no real answer when I asked why his request for 
the war did not include funding for veterans.
  Finally, the GAO report verifies that the VA failed to plan for the 
impact of the veterans coming back from Iraq and Afghanistan.
  Mr. President, I would like to take a moment to respond in detail to 
some of the points my colleague from Idaho raised. He is a very 
dedicated and hard-working advocate for America's veterans.
  At times, we may disagree on policy, but it is never personal. And it 
is my highest hope that whatever policy disagreements we may have will 
result in better service for America's veterans.
  The Senator from Idaho said that VA healthcare is the best care in 
the world. And I certainly agree as I said earlier. But too often, 
veterans are barred from that receiving that care and are put on 
waiting lists.
  For example in the VA Service Network that covers Alaska, Oregon, my 
home State of Washington and Senator Craig's home State of Idaho, the 
VA states that there are over 10,000 veterans on waiting lists for 
their initial appointments. There are thousands more waiting for 
specialty care. Veterans in need are told to wait months before they 
can see a doctor.
  In fact--of the 21 regional Service Networks--the region that covers 
both Washington and Idaho is the worst at getting veterans primary and 
specialty care appointments within 30 days of the date requested. That 
data comes straight out of the VA's own quarterly budget reports. It is 
not my interpretation.
  So great care is important, but making sure veterans can actually get 
timely access to that care is equally important. And that's an area 
where the VA is falling short.
  The Senator from Idaho pointed out that we required the VA to submit 
quarterly reports on budget execution. He says we have received three 
such reports this year. That is accurate. But what the chairman did not 
say is what the GAO found. From page 5:

       However VA's reports have not included some of the measures 
     that would assist Congress in its oversight, such as measures 
     of patient workload that would capture the costlines of 
     patient care, and the time required for new patients to be 
     scheduled for their first healthcare appointment. Moreover, 
     while VA has 12 months to execute its budget, it did not 
     submit its first two quarterly reports to Congress until 
     nearly 2 months after the end of each quarter, using patient 
     workload data that were as much as 3 months old at the time 
     of submission.

  That is the GAO telling us that the VA's information was late and 
outdated. We need to demand better.
  Let me comment on another statement by the Senator from Idaho. He 
said that we've had great success in delivering service to veterans. 
Then he said this:

       it doesn't mean that every veteran got exactly what they 
     wanted the moment they asked for it.

  That has never been the standard. The question is this: Can veterans 
who need help get it when they need it?
  The evidence I have seen suggests we have got a long way to go. On 
Tuesday, I shared with the Senate the story of a soldier in Virginia 
who is back from serving our country in Iraq. He can't sleep at night 
so he called the VA for an appointment. They told him he would have to 
wait 75 days to see a doctor. That is unacceptable. Ensuring that 
veterans get timely care--especially for mental health services--is a 
dire need.
  Again, don't take my word for it. Remember what a VA undersecretary 
said in medical journal recently--that mental health care services are 
``virtually inaccessible'' because of long waiting lines. So when we 
use a reasonable standard, it is clear we are falling far short of what 
our veterans deserve.
  Senator Craig said that during the last 6 years, the administration 
and Congress has increased VA funding by 70 percent. But let me remind 
him that every step of way Congress had to fight the administration for 
those increases.
  I know that we are putting more funding into the VA than we have 
historically. I have worked with my colleagues to fight for that 
funding. But let me remind my colleague from Idaho that we still have 
thousands of veterans waiting for primary and secondary care--or not 
being allowed to access care at all.
  The funding that this Congress has provided for the VA still does not 
provide enough to ensure that every veteran who is eligible can access 
care. The VA takes what Congress appropriates and then limits which 
veterans can access care to make the care the VA provides fit within 
the budget box Congress provides.
  Time and again, proposals for increased fees and copays are presented 
to discourage veterans from accessing VA care. I am happy to say we 
have fought off this administration's efforts to put those increased 
fees and copays in place. But--at the same time--the administration has 
limited access to the VA for Priority 7 and 8 veterans.
  The VA admitted that fees and copays within its fiscal year 2007 
budget would discourage 200,000 enrolled veterans from accessing care, 
and another 1.1 million from enrolling at all. This is wrong. We need a 
real budget based on the real needs. Not one based on limited access 
and discouraging veterans from seeking the care they were promised.
  The Senator from Idaho wanted to be very clear that he had called 
hearings and exercised oversight. I agree. He did. I was one of the 
people who pushed for those hearings. I was at those hearing. I 
demanded answers at those hearings.

[[Page S10599]]

  And one thing is clear--those efforts were not enough. We are still 
not getting straight answers from the VA. We are still getting out-of-
date information. We still do not have a plan from the VA to care for 
the veterans from Iraq and Afghanistan.
  So yes, there were hearings--I think we'd all agree that after a $3 
billion error that hurt our veterans there better be hearings--but they 
were not enough. And we need more oversight and more accountability if 
we're going to make sure veterans do not get hurt again.
  The Senator from Idaho asked--why now? Why am I calling for more 
oversight now? Because the GAO just released its report. I didn't tell 
the GAO how long to take in its investigation. When it had the facts, 
it released them, and I spoke up immediately. In fact, I think the 
Senator from Idaho will remember the morning the GAO released its 
report I shared the results with our Veterans Affairs Committee at a 
public hearing.
  I thought everyone on the committee needed to know immediately that 
government investigators found the VA had not told us about the 
problems it knew about and that the VA is providing quarterly reports 
that are late and based on old information. Simply put, I spoke out 
when we got the facts.
  I would add that if anyone believes that my remarks on Tuesday are 
the first time I have stood up and spoke out for our veterans--they 
just have not had their eyes open over the past few years. And I would 
remind my colleagues that there is no moratorium on speaking out for 
our veterans. Whenever we learn facts that affect America's veterans, 
I'm going to share them, and I'm not going to stop speaking out until 
we in Congress do the right thing.
  Furthermore, unless we change the path we are on, we will be talking 
about this issue next September, the September after that, and every 
month in between. This is not going away.
  So we in the Senate debate a lot of issues--none more significant 
than the issue of going to war. We are at war, and this body has a 
responsibility to meet our obligations in prosecuting that war--that 
includes taking care of our veterans. Today, we are not meeting that 
obligation. That is not just my opinion. It is the only conclusion a 
reasonable person could draw from the GAO report. And however 
inconvenient that may be--that is a fact.
  Mr. President, I repeat my conclusion from my remarks here on 
Tuesday. Veterans deserve better, and this Senate and America can do 
better.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Georgia is recognized.

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