[Senate Hearing 109-519]
[From the U.S. Government Publishing Office]
S. Hrg. 109-519
THE LEGISLATIVE PRESENTATION OF THE
VETERANS OF FOREIGN WARS OF THE
UNITED STATES
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINTH CONGRESS
SECOND SESSION
__________
MARCH 7, 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
----------
March 7, 2006
SENATORS
Page
Craig, Hon. Larry, Chairman, U.S. Senator from Idaho............. 1
Akaka, Hon. Daniel K., U.S. Senator from Hawaii.................. 3
Isakson, Hon. Johnny, U.S. Senator from Georgia.................. 5
Salazar, Hon. Ken, U.S. Senator from Colorado.................... 6
Murray, Hon. Patty, Ranking Member, U.S. Senator from the State
of Washington.................................................. 7
Jeffords, Hon. James M., U.S. Senator from Vermont............... 22
Thune, Hon. John, U.S. Senator from South Dakota................. 22
WITNESSES
Mueller, James R., Commander-in-Chief, Veterans of Foreign Wars
of the United States, accompanied by William Bradshaw,
Director, National Veterans Service; Robert E. Wallace,
Executive Director; Dennis Cullinan, Director, National
Legislative Service; and Dewey M. Riehn, Chairman, National
Legislative Service, Veterans of Foreign Wars of the United
States......................................................... 10
Prepared statement........................................... 10
THE LEGISLATIVE PRESENTATION OF THE VETERANS OF FOREIGN WARS OF THE
UNITED STATES
----------
TUESDAY, MARCH 7, 2006
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 10:00 a.m., in
room SR-216, Russell Senate Office Building, Hon. Larry E.
Craig (Chairman of the Committee) presiding.
Present: Senators Craig, Thune, Isakson, Akaka, Jeffords,
Murray, and Salazar.
OPENING STATEMENT OF HON. LARRY E. CRAIG,
U.S. SENATOR FROM IDAHO
Chairman Craig. Good morning, ladies and gentlemen, and
welcome to the Veterans' Affairs Committee of the United States
Senate. It is a pleasure to welcome all of you here, and
Commander Mueller, a very special welcome to you, sir. You and
your predecessors have been advocating for America's veterans
of foreign wars for over a century now. I am very pleased that
so many of you have traveled the distances you traveled to be
here today to carry on the tradition.
I would like to single out a few of your memberships from
my home State of Idaho who have made that special trek. I am a
weekend commuter and so there is a little sense in their body
now of what I go through on a weekly basis. It is the nature of
the job.
Let me ask my Idaho friends to stand, and I'd like to
introduce Pat Teague, our Idaho Department Commander. There you
are. Good to see you, sir. Gary Ellis, Senior Vice Commander;
John Crotinger, Junior Vice Commander; Bob Finney, an Adjutant;
and Daniel Johnson, Quartermaster. Thank you all so much for
being here.
[Applause.]
Chairman Craig. I would also like to recognize the National
President of the VFW Ladies Auxiliary, Sandy Germany. Sandy?
There you are. Thank you for being here.
[Applause.]
Chairman Craig. This past year has been an extremely
gratifying one for me. First, as Chairman of the Veterans'
Affairs Committee, I sincerely believe that this Committee and
its Members, while sometimes differing in approach, are all
united in a common mission, ensuring that the nations veterans,
particularly veterans wounded in the line of duty, receive the
highest quality of health care and benefits that they need.
By any measure, we have had a busy and a very productive
first year, convening 23 hearings here in Washington, 9 field
hearings, and 5 mark-ups. More importantly, committee-related
activity has led to several, I think very important,
accomplishments. I'm going to single out one accomplishment in
particular that deserves special attention because all of you
were instrumental in securing its enactment.
About a year ago I wandered into my office to meet with
three veterans of Iraqi Freedom. One was missing a leg, another
was missing two legs, and the third could no longer see. They
asked that I push legislation to create a new insurance benefit
for the traumatically injured such as themselves, although they
did not want it for their personal benefit. Before that meeting
was over, we had become good friends and they had convinced me
that this would be critical legislation, as a whole, in the
benefits structure that our country offers veterans from the
moment they are wounded. I went on to visit and continued to
visit with many of them rehabilitating at Walter Reed.
The good news is that that is law now and probably set some
kind of speed record. From the moment of idea through to its
completion and now to its implementation, Congress made it
retroactive for all service time from both Afghanistan and
Iraq. I am pleased and impressed at their selflessness, and I
and Senator Akaka on board, immediately took this proposal to
the floor. It became what is known as the Wounded Warrior
Legislation. With your support, it was signed into law
literally a few weeks later, and here is the result of
something we all can be proud of.
Almost 1,500 traumatically injured servicemen from OIF and
OEF are now being served. These are young men and women with
amputations, severe burns, total blindness, total deafness,
paralysis, and a host of other disabilities, all of them
sustained in defense of America. Going forward, Wounded Warrior
Insurance will meet the gap in the financial help that these
heroes are facing during their convalescence. On behalf of all
of them I want to salute all of you today for the support you
offered this Committee and those wounded warriors as we worked
to make that law.
Before I close, let me touch on what has consumed much of
our attention of late, and of course that is the Fiscal Year
2007 VA Budget. I believe this record budget requested is
extraordinary and shows that in this fiscally austere climate,
the President has chosen to make veterans once again a top
budget priority. That said, I am concerned that at present
spending rates, VA budgets will double nearly every 6 years and
will soon collide with the spending demands in all other areas
of Government, and I can see how the mainstream media and
others are now treating this proposed budget, it may be okay
for 2007, but it is surely going to mean cuts in 2008. To
prejudge any activity of the Congress is but a fool's game, I
think you all know that, especially when it comes to this
Congress' commitments to veterans. I want to, for just the next
few moments, deal with a bit of a reality check, and that is
something that we as veterans need to face along the way.
The Congress and this President have continued to plus-up
budgets progressively over the last 6 years. This President's
proposal, while the largest ever, has a new approach in it. Not
new in the sense that it is a new idea, but new in the sense
that calculated into the budget is some revenue enhancement,
and you know what I am talking about. He is asking Priority 7
and 8 veterans with no service-related disabilities to
contribute up to $21 a month to enroll in the VA Health Care
System and to pay $15 for a 30-day supply of medicine. Although
I personally find these proposals to be reasonable, I know your
organization has voiced opposition. So I will reiterate my hope
that the VFW and others will engage with this Committee in
serious and candid discussions, if not about the President's
proposal, then about other options. It is our collective
responsibility to sustain this incredible VA Health Care System
into the future. If we begin addressing these issues now, we
can help ensure that future veterans will not be faced with
even bigger challenges and more radical changes to meet these
challenges. Personally, I do not want to pass this issue on to
the next guy. It is not in my character. That is not the way I
like to operate. I want to pass on to tomorrow's veterans what
we have collectively created, a health care system that
provides quality care that is accessible to those who need it
and affordable to those who want it. I hope you will agree with
my goals and are willing to work with me and my colleagues in
this effort.
Before I introduce Commander Mueller to all of us and to
the Committee today, let me turn to my colleague Senator Akaka,
and I'm been joined by several of my colleagues for any opening
comments they would like to make.
Danny.
OPENING STATEMENT OF HON. DANIEL K. AKAKA,
U.S. SENATOR FROM HAWAII
Senator Akaka. Thank you very much, Mr. Chairman. It is
certainly a pleasure for me to be here with you and our
Committee to hear the legislative presentation of the Veterans
of Foreign Wars, and it is a pleasure, Mr. Chairman, to be
working with you to help the veterans of our country.
I wanted to thank Commander James Mueller, his senior
officials, as well as the veterans and their families who have
made the journey to the nation's capital to express their
concerns. This is truly democracy in action.
Your organization has a long and proud tradition of public
service. Your many charitable works and advocacy on behalf of
veterans is truly exemplary. This Committee relies heavily on
your concerns and your agendas for the coming year.
At this time, I would like to recognize some members that
traveled all the way from my home State of Hawaii to be here
today. I'd like for you to stand, Richard Wong, Roy Machado,
George Barlett, Vi Indie, Gerri Enos, Norbert Enos, John
Chapman, Sam Araki, the Department Commander, George Harada,
Ben Acohido and Mrs. Anita Acohido, and Nick Young. There you
are. Thank you very much. Aloha. Aloha.
[Applause.]
Senator Akaka. Thank you for being here today. You all do
fine work and the people of Hawaii owe you a great deal of
gratitude, and so do the veterans.
I would like to share some of my concerns and priorities.
During this time last year, many of us here in Congress were
sounding the alarm that the VA budget was facing a crisis
situation. Many months later, the Administration acknowledged
the fact and Congress took action to provide emergency funding.
Chairman Craig kept his promise and was the driving force
behind the emergency funding and, again, I applaud him for his
efforts.
When we started working together last year, we pledged to
work in a bipartisan manner and we have done so. There are
times, however, when we agree to disagree. We both agree that
veterans deserve to have the best health care services and
benefits, though we sometimes disagree on sometimes how to pay
for it. I want to be clear, however, that we have the same goal
and that is to ensure that the VA is provided with the
resources to provide quality care and services to our nation's
veterans. I remain dedicated to ensuring that the VA has the
resources it needs to care for all veterans.
We must learn a lesson from last year's budget crisis and
do everything we can to ensure that veterans and their family
members have access to the health care and benefits they have
earned. The VA's budget has increased over the past 6 years as
it should and has been mentioned by the Chairman. The cost of
caring for our veterans is, in my opinion, a cost of war. If
the Department of Defense's budget can grow exponentially and
be funded yearly out of supplementals, it only makes sense that
the VA's budget needs to grow exponentially as well. It is no
secret that each service member that we so readily fund out of
DOD will eventually be seeking services from the VA. It follows
then that if the DOD's budget grows steadily, the VA's budget
must grow steadily as well.
For me it is a matter of priorities. We must stand by our
veterans and ensure that they receive the care and services
that they have earned through their service to our country, and
we must ensure that we care for all veterans. We cannot fund
the VA system out of the pocket of middle-income veterans, as
many of these men and women make as little as $26,902 a year.
Higher co-payments and enrollment fees are not justified. To
date, over a quarter of a million veterans have been excluded
from VA health care. Over 700 veterans in Hawaii have knocked
on the doors of VA care only to be denied. We must work to
overturn this Administration's decision and open the VA system
up to those who need it.
I also am concerned about the VA Research Program being
slated for a cut under this budget. Since its inception, the VA
Research Program has made landmark contributions to the welfare
of not only veterans, but the entire nation, illustrating the
unique importance of keeping it adequately funded. With
thousands of military personnel engaged in conflict overseas,
it is vital that Congress invest in research that could have a
direct impact on their post-
deployment quality of 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. The VA must be ready to adjudicate
claims in a timely and accurate manner. All veterans and their
families deserve nothing less.
I will continue to oppose efforts to reduce veterans'
compensation as we saw with the ill-fated PTSD review. Now the
Institute of Medicine and the Veterans Disability Benefits
Commission are reviewing veterans' disability compensation. It
is my hope that these groups will recommend new ways for
Congress to improve benefits, not call for cuts in current
benefits.
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
Mueller and all the VFW members here today. Your service and
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.
[Applause.]
Chairman Craig. Senator Akaka, thank you very much for
those opening comments. Now let me turn to Senator Johnny
Isakson, State of Georgia.
Senator.
OPENING STATEMENT OF HON. JOHNNY ISAKSON,
U.S. SENATOR FROM GEORGIA
Senator Isakson. Thank you, Mr. Chairman, and welcome
Commander Mueller. We're glad to have you and all the veterans
here today. I came to hear you and not to hear me, so I am not
going to make a speech which is probably a benefit to everybody
here.
However, I would like all the Georgia veterans that are
here to please stand.
[Applause.]
Senator Isakson. Mr. Chairman, I would like to remark about
two of those veterans who I know very well. One of them who had
to leave earlier I found out, Joe T. Wood. I served with Joe T.
Wood in the Georgia Legislature for some 15 years. He served
his country in Korea, he served his country nobly, and he has
been an advocate for the Veterans of Foreign Wars and veterans'
issues since I have known him. I am delighted that he made the
trip, although he had to go back early today.
Ted Daywalt at the back of the room is a resident of my
home County in Georgia and is a champion for employment
placement for veterans of the United States of America's armed
services. He has placed thousands of veterans in meaningful
employment in Georgia and works every day as an advocate for
them. It is not a surprise to me to see him today as we talk
about this important subject.
Lastly, Mr. Chairman, I thank you for taking the time to
bring the veterans before us one at a time through the various
service-related groups so that we can talk seriously and
constructively about veterans' affairs and the budget not only
for this year but in the years to come, and I thank you, Mr.
Chairman.
Chairman Craig. Senator, thank you.
[Applause.]
Chairman Craig. My staff says by order of entry or
attendance. Let me turn to Senator Ken Salazar of the State of
Colorado.
OPENING STATEMENT OF HON. KEN SALAZAR, U.S. SENATOR FROM
COLORADO
Senator Salazar. Thank you very much, Chairman Craig and
Ranking Member Akaka, and thank you to all of the members of
the VFW who are here joining us this morning.
I would like to also welcome the members of the Colorado
VFW delegation who are here today led by Dr. Rudy Aguerro who
is the Colorado State Commander of the VFW, and if I could see
the Colorado vets stand up.
[Applause.]
Senator Salazar. Thank you to all of you for the service to
our country. I have just a few comments to make.
First and foremost, out of the VFW national membership, I
know that in Colorado we have 135 posts and 21,000 members, and
I'm very proud of all of the contributions that they continue
to make to our State and the contributions that they make to
veterans' issues in Colorado.
Secondly, I want to make just a few comments about the work
of this Committee. First, one of the great hallmarks I think of
this Committee has been the work that we have been able to do
on a bipartisan basis. I think the leadership of Senator Patty
Murray and Senator Akaka and Senator Craig last year resulted
in the restoration of significant dollars to health care that
otherwise would have been cut under the miscalculations that
had been made by the Veterans Administration, and we need to
applaud their efforts and the efforts of the Congress in
restoring their efforts for that last fiscal year.
We, however, in looking at that significant issue that we
had to deal with last year must also be cognizant of looking
ahead and making sure that the budget process and the actuarial
process that is used at the Veterans Administration is in fact
working. Last year part of the explanation as to why we had
such a reality of missing the mark on what the health care
needs of veterans was had to do with a sense that they were
using 2002 statistics to set the budgets for last year. We have
asked, a number of us, GAO to take a look at how the VA sets
its budget so that we do not make the same mistake in future
years. We hope to have the report from the GAO out within
several weeks so that we can share with Members of this
Committee as well as with others.
Let me also say I share Senator Akaka's concerns with
respect to the proposed cuts that are set forth in the budget.
Commander Wallace, I know that you share some of those same
concerns with respect to funding for Priority 7 and 8 veterans
and the co-payment fees that are included, as well as the
enrollment fees. I think we ought not to move forward in that
direction at a time when we as Americans ought to be standing
up and saying that we are going to honor our nation's
commitment to our veterans. There will be, I'm sure, a healthy
debate about that issue and I can tell you that our presence
here today is noted and your position on these issues is very
much taken into account.
I also am concerned about the out-year budgets. When you
look at the upcoming fiscal year, the President's budget does
include in there significant increases for health care for the
VA. When you get beyond the next fiscal year, I do not want the
veterans of America to be falling off the cliff, and certainly
some of the projections that look out at the out years indicate
that while we might treat veterans well for 1 year, it does not
tell us where we are going to go in the following fiscal years,
and for Commander Mueller and others there are I think some
significant concerns that we ought to be looking at over the
long term. I think that's why the independent budget which the
veterans' organizations have come up with is something that we
all need to pay attention to.
The last point that I would make is that as a Member of
this Committee and given the place that I come from in Colorado
which is probably about as remote a place as anybody can think
about down in the San Luis Valley, I am very concerned about
what happens with veterans in rural communities. If you happen
to live in the Denver metropolitan area in my State, you can
get into the veteran's hospital maybe within 15 to 20 minutes.
But if you happen to live in Craig, Colorado, or down in the
San Luis Valley or other places, it can be an 8-hour journey
back and forth simply to get some veteran's health care. One of
the things that I want to make sure I am pushing with my
Democratic and Republican colleagues on this Committee is
additional attention to the particular need that veterans are
facing in the rural parts of America.
Mr. Chairman, thank you for the opportunity to make these
opening remarks.
Chairman Craig. Senator Salazar, thank you.
[Applause.]
Chairman Craig. Now from a neighboring State, the State of
Washington, Senator Patty Murray.
Senator.
OPENING STATEMENT OF HON. PATTY MURRAY, U.S. SENATOR FROM THE
STATE OF WASHINGTON
Senator Murray. Thank you very much, Mr. Chairman and
Senator Akaka for holding this hearing, and I wanted to join my
colleagues in welcoming Commander-in-Chief Mueller and all of
our VFW members, and I want to thank them for their sacrifices
and work on behalf of veterans all across this country.
I want to thank the veteran leaders who have traveled here
from Washington State. If they could stand, John Beem, Doug
Reed, Mike and Valerie Peterson, and John Rust are here with us
today I believe in the room. Some of them might be out in the
outer room.
Chairman Craig. There's an anteroom.
Senator Murray. I am delighted that they are here with us.
[Applause.]
Senator Murray. Not long ago, Doug Reed who is here today
and I were at a Veterans' Round Table in Longview, Washington,
a small, remote community in my State. We were meeting with
veterans who had just come back from Iraq and Afghanistan, and
Doug introduced me to a guardsman whose name was William who
had just gotten back a few months earlier from Iraq. He had
lost his job, he could not get unemployment benefits, and he
was lost somewhere between DOD and the VA health care system.
His doctors could not figure out what was wrong with him, and
he had to feed his family on food stamps. It was an appalling
story. I asked Doug a few weeks ago how William is doing, and
he is still struggling.
I know that William is not alone. Doug just like everybody
in this room today could tell us a story about veterans who are
falling through the cracks, whether they are struggling with
employment, or mental-health issues, or drug and alcohol, or
simply transitioning from Haifa Street to Main Street, there
are many of our veterans who are struggling. As we begin this
new budget year, I hope we can all join together to make sure
that veterans like that Guard member in Longview that I met are
getting the care and the benefits and the help that they need.
I also recently heard from Court Fraley. He is a VFW
service rep in Seattle and he outlined concerns with veterans
trying to get their benefits from the VA. He told me about
veterans going in to get their compensation and pension exam
from QTC doctors and that veterans say it is kind of hit or
miss right now depending on the doctor they see. That is not
right.
Court Fraley also shared that he is seeing increased rates
of benefits that are being denied by the VA, only to have that
decision reversed upon looking at the case a second time that
wastes time of our staff and money. Mr. Chairman, I am
concerned about the VA benefits backlog and I am concerned we
do not have enough staff to take care of the needs that are out
there, and I hope that Commander-in-Chief Mueller will talk
about this today.
As I have said many times, we have some big problems, we
have some serious delays in veterans receiving care and
benefits and this budget does not fix the funding problem. It
is built around denying care instead of meeting real needs.
There is no question that the VA provides the best medical care
in the country, but now the VA is being asked to do more and
more with less and less. We owe it to everyone in this room
today to make this right, to make the system work for them,
just as we owe it to veterans of every generation.
[Applause.]
Senator Murray. Perhaps most of all, we owe it to our men
and women in the armed forces today, many of whom are deployed
even as we sit here. Time and again the Department of Defense
shares that VA health care and benefits is one of their best
recruiting tools and we need to keep it that way. I have heard
the Chairman's concerns about the budget about why we should
consider increased enrollment fees and co-pays and about budget
decisions have been made and that we need to find some new
solutions for veterans' health care. I believe that we need to
make it clear that we owe our veterans more than a budget line
we are willing to sacrifice for other choices. I am tired of
hearing that the choice is within the budget tax cuts for the
wealthy rather than veterans' health care and benefits, and I
am tired of hearing that because we have a multitrillion-dollar
deficit that now when we have Vietnam veterans aging, Iraq and
Afghanistan veterans coming back home and a health care crisis
that is spiraling out of control, and that now we cannot find a
way to take care of those who have served us. I think we can do
a lot better than that.
[Applause.]
Senator Murray. I encourage all of you who are here today
to not accept false choices. You are entitled to the thanks of
a grateful nation and a commitment from this Government that
was equal to your commitment. I look forward to hearing from
you today, Commander. Thank you very much.
[Applause.]
Chairman Craig. Senator Murray, thank you very much. Before
I introduce the Commander, you all are probably getting tired
of us, but there needs to be a record reality so that we
understand where we are.
During the years of the Clinton administration, the Federal
Government collected $1.789 trillion worth of revenue. In 2005,
the Government collected $2.154 trillion worth of revenue. That
is a revenue increase during a time of tax cuts of 20 percent.
That is one side of the story.
The other side of the story that is important to know is in
that 5-year timeframe, Government programs have gone up 38
percent, but veterans' increases have been 46 percent, and
every Member of this Committee has defended that and fought for
it right along with all of you. That is something to be proud
of, not to be critical of.
What I am suggesting today is that we look at this budget
with a discerning eye, and future budgets with a discerning
eye, but it is important that we set the record straight
because those are the facts.
With that, let me do something that is the privilege of
this Chairman, and that is to introduce you, Commander. We
thank you so much, Jim, for your life of service and sacrifice.
Commander Mueller served in the U.S. Army from 1966 to 1968 and
is a veteran of the Vietnam War for which he earned the
Veterans Service Medal, excuse me, the Vietnam Service Medal,
the Vietnam Campaign Medal, and the National Defense Service
Medal.
Jim began his service with the Veterans of Foreign Wars in
1970 when he joined Post 5077 in O'Fallon, Missouri. It did not
take long for him to ascend the leadership positions of his
Local, State and National levels in the VFW. The list of
National Committees Commander Mueller has served on attest to
the breadth of his knowledge on issues of importance to
veterans and service members. Those committees include Voice of
Democracy, Homeless Veterans, National Security and Foreign
Affairs for the POW/MIA. Recognizing Jim Mueller's knowledge,
leadership and dedication and service to the country, his peers
elected him Commander-in-Chief of the Veterans of Foreign Wars
in August 2005. Jim and his wife Patricia have been married for
40 years and have two children. They reside in O'Fallon,
Missouri.
Let me tell you, Commander, it is very much an honor for
this Committee to have you and your colleagues here today, and
I would ask you to introduce those who are with you at the head
table. Thank you very much, Jim. Welcome.
STATEMENT OF JAMES R. MUELLER, COMMANDER-IN-CHIEF, VETERANS OF
FOREIGN WARS OF THE UNITED STATES, ACCOMPANIED BY WILLIAM
BRADSHAW, DIRECTOR, NATIONAL VETERANS SERVICE; ROBERT E.
WALLACE, EXECUTIVE DIRECTOR; DENNIS CULLINAN, DIRECTOR,
NATIONAL LEGISLATIVE SERVICE; AND DEWEY M. RIEHN, CHAIRMAN,
NATIONAL LEGISLATIVE SERVICE, VETERANS OF FOREIGN WARS OF THE
UNITED STATES
Commander Mueller. I would like to introduce our Executive
Director, Mr. Bob Wallace; our Veterans Service Director, Mr.
Bill Bradshaw; and Legislative Director Mr. Dennis Cullinan.
Chairman Craig. Thank you very much, Commander, and the
floor is yours.
Commander Mueller. Thank you, sir. Chairman Craig, Ranking
Member Akaka, distinguished Members of this Committee, honored
guests and friends, before I begin I would like to express my
sincere and deep appreciation of the invitation to appear here
today. We are delighted that you recognize the importance of
this tradition and that you continue to recognize the
importance of veterans' voices. No other Committee in this
Congress has such a clear constituency, a constituency you see
before you. We thank you and your hard-working staff for their
efforts.
I would request that my full written statement be entered
into the record.
Chairman Craig. Commander, your full statement and any
accompanying material will become a part of the record. Thank
you.
Commander Mueller. Thank you, sir.
[The prepared statement of James R. Mueller follows:]
Prepared Statement of James R. Mueller, Commander-in-Chief, Veterans of
Foreign Wars of the United States
Mr. Chairman and Members of the Committee: It is a great honor to
be before you representing the 2.4 million men and women of the
Veterans of Foreign Wars of the U.S. and our Auxiliaries. Founded in
1899, the VFW is this nation's largest organization of combat veterans.
Our members come from across the country, and even the world.
We thank you for the opportunity to testify today. With war
dominating the news on a daily basis, it is right that this country's
focus is on those who serve this nation in uniform, both past and
present. We have long said that what this nation provides to its
veterans is part of the ongoing costs of war, and is the price of
peace. These costs do not end when the last shot is fired. They extend
long into the future, as we strive to make those who have worn a
uniform in defense of this great nation whole, to compensate them for
the sweat and the blood they have lost.
As you proceed throughout the year, an election year for some of
you, I would ask that you keep these priorities in mind. In prior
years, we have done what these brave men and women are doing in Iraq
and Afghanistan. We understand the stresses and strains they must feel.
We understand, too, the needs they will have as they return,
transitioning back into productive society.
VA MEDICAL PROGRAMS
The Veterans Health Administration (VHA) is the nation's largest
integrated hospital system with over 160 medical centers and over 860
outpatient clinics. In fiscal year (FY) 2005, VHA took care of more
than 5.5 million veterans.
The administration's request for medical programs in fiscal year
2007 is a good first step. We were pleased to see that it appropriates
a total of $35.7 billion in discretionary funding. This is a $2.7
billion increase over fiscal year 2006, an 8 percent increase. While we
are grateful for the extra funding, we must keep in mind that we will
have many thousands of returning servicemembers, an aging veterans'
population, and the ever-eroding pace of medical inflation chipping
away at this amount.
Given the difficulties that VA faced with respect to their budget
modeling and projections for the future, we must be vigilant to ensure
that proper funding is authorized and appropriated. You met the
challenge last year when VA was on the verge of running out of funding.
We are confident that you will be there in the future, but I certainly
hope that it does not have to come to that in the coming fiscal years.
We would urge this Committee and its counterpart in the House to use
its oversight authority, and we applaud the steps you have taken thus
far.
COPAYMENTS AND FEES
Once again, the administration's request balances the budget on the
backs of veterans. Instead of authorizing a complete level of funding,
it forces veterans to subsidize further their healthcare, and fails to
acknowledge that veterans have already paid for it with their service
to this country.
The request would increase the pharmaceutical co-payment from $8 to
$15 for each 30-day supply. Category 7 and 8 veterans who pay these
fees would have their medical bills nearly double, a completely
unreasonable request. Pharmaceuticals are part of VA's standard
benefits package, and this dramatic increase would, in effect, make
them inaccessible to many veterans. Although you or I could probably
afford the increase, those who scrimp for food and can barely pay their
rent would have great difficulty paying these extra charges.
The same can be said for the administration's proposed enrollment
fee. This proposal would charge veterans in categories 7 and 8 $250
each year. This is not a deductible, but a yearly fee. If a veteran
goes just once a year, even for a preventive health exam, such as a
physical, he would be charged. Like the co-payment, this would affect
veterans making as little as $26,000.
Together, they would place an unhealthy financial burden on a large
number of veterans. For example, a veteran who receives just three
prescriptions would face $502 in extra fees each year. VA has admitted
that one of the intents of these fees is to drive veterans from the
system, even though many of them might not have other forms of health
insurance. This is unacceptable.
We urge Congress to reject these fees, and to provide sufficient
appropriations to cover for VA's projected collections for these
proposals.
COLLECTIONS
We remain concerned that the President's request relies on an
assumption of $2.8 billion in collections. These collections directly
offset appropriated funding.
We feel that this amount is unreasonably high. Even if we take out
the projected $544 million for the proposed co-payment and enrollment
fee, that means that VA will need to take in nearly $2.3 billion.
Numerous GAO reports have detailed the substantial problems with VA's
billing process and the institutional problems, which prevent VA from
recapturing these monies. While VA has made great strides, an over
reliance on an unreachable goal could mean that VA will need to make do
without proper funding once those goals aren't met. As it stands, VA
would need to increase its collections by 11.4 percent over fiscal year
2006's projected total. If that large increase isn't met, care for
veterans could suffer.
MEDICARE SUBVENTION
Although veterans pay into the Medicare system, they cannot use
their Medicare benefits at VA. VA is not allowed to collect money from
Medicare for services rendered. This, in effect, is a multi-billion
dollar subsidy of Medicare. If even a portion of this money were
allocated to the VA health care system, many of its funding problems
would disappear. Studies have even shown that VA provides care at a
per-patient rate below that of Medicare. We understand that there are
institutional and bureaucratic difficulties with allowing Medicare
subvention, but we would hope that they could be overcome.
ASSURED HEALTH CARE FUNDING
The President's request is the exception to the rule. The last
several years have seen administration requests far below what is
needed, and while Congress has seen fit to increase them each year, VA
funding has failed to keep pace with medical inflation and increased
demand, as evidenced by the need for repeated emergency supplementals.
Further, VA has made do with these inadequate budgets by rationing
health care. The Secretary has prevented new category 8 veterans from
enrolling in the health care system. Those that remain are forced to
wait lengthy periods of time--in some cases, months--for needed
services. Recent GAO reports have shown that past budgets were built on
faulty methodology, including the assumption of savings through
management efficiencies, which were never adequately explained, leading
us to believe that there weren't really any savings, just cuts.
Even when VA receives its budget, it never receives it on time. For
the better part of a decade, VA's appropriation has been months late.
How can VA properly plan for the future, let alone budget for the
current year, when it is receiving its funding 6 months late? Even the
best business minds in the country would be hard pressed to adequately
manage and operate as large a system as VA with a late budget.
Temporary measures, such as the supplemental appropriations, are
certainly welcomed, but they do not fix the underlying problem. The
discretionary process is broken.
We must look to alternative means of funding VA health care. An
assured funding system could make VA health care more dependable and
stable, eliminating year-to-year uncertainty and allow for proper
planning, best business practices, and assurances that VA will be able
to adequately care for this nation's veterans.
SEAMLESS TRANSITION
When our servicemen and women return from their battles around the
globe, DOD, VA, and DOL should be adequately prepared to help these men
and women transition to veteran status. Unnecessary delays force
veterans to wait months for benefits and health care that they have
earned by virtue of their service.
To help smooth this process, VA and DOD must develop electronic
medical records that are compatible with each other. As it is, the two
departments are unable to synch up in any meaningful way, which delays
how quickly VA is able to receive vital health care and deployment
histories from DOD's records. Were VA to have this information, it
could provide timely and accurate decisions on claims, as well as
enhancing delivery and access to health care, while minimizing the time
veterans must wait.
We also believe that there should be an increased emphasis on
separation physicals for active duty and the reserves. These physical
exams conducted jointly with DOD and VA could highlight any potential
health problems, but also serve as a future baseline for any symptoms
or ailments that may pop up in later years. Additionally, the increased
information would allow them to better handle new illnesses and have
better data for conditions such as Gulf War syndrome and other
undiagnosed illnesses.
VFW seeks to enhance DOD's pre-separation counseling process and
VA's and DOL's Transition Assistance Programs. We suggest that the
programs ensure that counseling services are available during regular
working hours and allow the inclusion of National Accredited Service
Organizations to assist veterans preparing their claims for benefits
prior to their discharge. We further seek that additional information
be added to the scope and content of the programs pertaining to access
to VA health care and benefits, and federal and private sector
employment.
These have been problems for several years. Despite progress, they
still remain. We need strong, effective leadership to fix these
problems. We have heard excuses. It is time for results.
MENTAL HEALTH SERVICES
VA has a difficult balancing act with respect to mental health
services for veterans. They must maintain and even improve services for
current veterans, while adjusting to cope with the changing nature of
conflict current servicemembers face and the new needs they have.
Conflict for today's servicemembers is different than it was for
those in past wars. Urban combat, suicide bombers, and roadside bombs
create a situation with constant stress and constant tension. For those
in the combat zone, there is frequently little relief.
VA already is treating over 10,000 veterans of the current war for
post-traumatic stress disorder (PTSD). As the number of returning
veterans climbs, and as veterans come to terms with the depression and
anxiety they may feel, many more will turn to VA and the excellent
services it provides. We must be ready for them.
We believe that VA must continue on its path to a system, which
treats conditions, rather than just managing symptoms. This is the only
way that veterans can be made whole, and will help them to become
productive members of society. To that end, we believe that VA must
continue to support its full continuum of care, which would include
intensive case management, rehabilitation, integrated treatment, work
therapy, and other support services to allow for a veteran's complete
recovery.
To accomplish this, we must be mindful of the impact of the CARES
process. As it stands, mental health services were not a part of the
original CARES model. VA's plans must adapt as needs change.
We take great interest in VA's planned PTSD study with the
Institute of Medicine. This study will impact both the treatment of
PTSD in returning servicemembers and their eligibility for compensation
to support themselves and their families. VA must meet the needs of
these returning heroes.
We hope that outreach programs will ensure that those returning
service-members, as well as their families receive the treatment
options they need to cope with a sometimes-difficult transition. To
that end, we support pre- and post-deployment mental health screening
process to serve as a baseline. The more information we have, the
better will we be able to treat these conditions.
CARES PROCESS
Over the last few years, VA's construction budget has been
overshadowed by the Capital Assets Realignment for Enhanced Services
(CARES) process. CARES, which aims to reorganize the VA health care
system to properly plan for the future, and, in turn, realize improved
health care service for veterans, has been a long and difficult
process.
We will continue to support CARES as long as VA returns to its
primary emphasis and intent: the ``Enhanced Services'' portion of
CARES. We accept that locations and missions of some VA facilities may
need to change to improve veterans' access, to allow more resources to
be devoted to medical care rather than to the maintenance of old
buildings, and to accommodate more modern methods of health care
delivery.
Over the last few years, the funding for major construction has
ebbed. This moratorium was caused by the planning of the CARES process.
There was much political resistance to funding any projects before the
planning process took place. Now that it has occurred, it is time to
move forward, and advance this important plan.
VA CONSTRUCTION
We call for a total investment of $1.447 billion for major
construction, which includes funding for CARES. The President's request
comes far below that, providing just $399 million for major
construction
Of particular importance is the funding for seismic corrections.
Currently, 890 of VA's 5,300 buildings have been deemed at
``significant'' seismic risk, and 73 VHA buildings are at
``exceptionally high risk'' of catastrophic collapse or major damage.
Accordingly, this will increase VA's need for construction funding.
This is a chance to be proactive and fix a problem before the health
and safety of VA's patients and workers is further compromised.
We also call for funding for an architectural master plan. Without
this plan, the benefits of CARES will be jeopardized by hasty and
shortsighted construction planning. Currently, VA plans construction in
a reactive manner--i.e., first funding the project then fitting it on
the site. Furthermore, there is no planning process that addresses
multiple projects; each project is planned individually. ``Big
picture'' design is critical so that a succession of small projects
don't ``paint'' the facility into the proverbial corner. As the cost of
construction rises with inflation, the importance of optimal planning
becomes paramount.
We believe that architectural master planning will also provide a
mechanism to address the three critical programs that the CARES study
omitted. Specifically, these are long-term care, severe mental illness,
and domiciliary care. These programs must be factored into any long-
term plans.
With the reticence over the last few years to provide construction
funding, the amount appropriated for maintenance has lagged far behind
what has been needed. Price-Waterhouse, following standard industry
practices, has recommended that VA spend at least 2 to 4 percent of the
value of its buildings for nonrecurring maintenance. These small
projects, such as replacing a roof or improving the fire alarm system,
are necessary for the safety of patients, but also to maintain the
integrity of the building so that it is viable for its entire lifespan.
Accordingly, VA should spend no less than $1.6 billion for nonrecurring
maintenance in fiscal year 2007. Unfortunately, the Administration has
only allocated $514 million, which will only make the already
backlogged maintenance lists grow.
Further, because maintenance comes out of the medical care account,
not the construction budget, much of the funding for the last few years
has been used to provide medical care. Now, VA needs to cover deferred
maintenance. In fact, according to VA's own assessment, which is
conducted on three-year cycles, the investment necessary to bring all
facilities currently rated ``D'' or ``F'' up to an acceptable level is
$4.9 billion. There should not be a choice between fixing a roof and
buying medical supplies. It is Congress' job to allocate properly
funding for both.
VETERANS BENEFITS ADMINISTRATION
VBA's primary mission is to deliver efficiently the compensation
and benefits to which veterans, their survivors and dependents are
entitled. These programs help make the veteran whole, allowing him or
her to transition back into productive society. In the case of someone
who is wounded in conflict, it helps provide income to overcome the
loss of working productivity. In the case of a young man or woman fresh
out of service, it helps them fulfill the American dream of home
ownership. They are all worthy programs, and they recognize the
disadvantages that service to this nation creates when our men and
women in uniform interrupt their lives as civilians to defend our
freedoms.
CLAIMS BACKLOG
As of 2/24/2006, VA is sitting on 828,653 compensation, pension,
and education claims and appeals. This massive backlog of unprocessed
claims means that the average claim takes over 6 months for a decision.
This is unacceptable.
Nearly 600,000 of these claims are for disability compensation,
which are intended to alleviate the economic hardships placed on
veterans and their families. Delay in providing benefits forces these
veterans to scramble to provide basic necessities for their families.
Despite the effort and intention of VA management, this backlog has
grown. As the number of pending claims increases, the difficulties with
managing the backlog and finding acceptable solutions to the problems
are compounded.
VA claims that an increase in the complexities of these claims is
the chief reason for the increase in the backlog. While we would agree
that some claims have grown more complex, that explanation is just a
symptom of the larger problem: a lack of resources.
Despite the increased complexity of these claims, VA has proposed a
149 FTE cut in compensation direct labor. How can VA be expected to
make meaningful improvements in this backlog with a reduction in staff?
The answer, we fear, is that they do not expect an improvement. VA
predicts that backlogs and delays will continue to grow. We cannot
accept this.
VA leaders have been quick to explain that there is an offsetting
increase in FTE for processing pension claims, which results in a net
gain of 14 FTE for both programs. Even if VA's leaders are correct and
no barriers exist to assigning these new employees wherever they are
needed, the fact remains that a miniscule 14 FTEs will have almost no
meaningful impact on a backlog that is 66,000 cases higher than it was
last year.
VBA's staffing requests must match the real-world demands placed on
their system. The only way the department can make a meaningful dent in
the number of claims is to devote adequate resources. The size of the
backlog is proof positive that this has not been done.
ACCURACY
The accuracy of the claims process is a significant problem that
must be overcome. VA's own quality measurement system showed that VA
made a significant error in 15 percent of all cases. Not only must a
veteran wait 6 months for a decision, he or she has a pretty good
chance of receiving an incorrect decision, too. That is unacceptable.
As is the case with the claims backlog, this accuracy problem is a
function of inadequate resources, but is also a result of management
inaction. VBA has an aging workforce, many of whom are eligible or
nearing eligibility for retirement. Claims adjudication is a difficult
process, which improves greatly with experience. VBA is facing a crisis
with inexperienced replacements for this aging workforce. This is a
problem that will only grow worse in the coming decade.
Poor quality decisions create several problems. In some cases, it
forces the veteran to file an appeal, which further aggravates the
backlog. If VA had decided the case correctly the first time, many of
these appeals could have been prevented. More important to us, however,
is the number of veterans who may just give up out of frustration.
Although our network of national service officers helps many veterans,
we can only assist those that seek us out. For a veteran without a
service officer, navigating the highly complex bureaucracy that the VA
claims process has become is a nightmare. Many of them receive an
incorrect rating, unbeknownst to them, and then give up. Is this how we
should treat our nation's heroes?
VA must not only provide the right level of staffing, they must do
more to train claims processors and develop measures to hold them
accountable for their job performance.
GULF WAR ILLNESSES
As thousands of men and women return from the Middle East, we must
pay careful attention to their health needs, especially in light of
what we learned in the aftermath of the Gulf War. A recent VHA study
noted that around 29 percent of the veterans of Iraq and Afghanistan
who sought care at VA were suffering from ``ill-defined conditions.''
There has rightly been much concern about the mental effects of the
recent conflict, but this alarming statistic indicates that we cannot
let this focus detract us from physical conditions, too. VA and DOD
underestimated the effects of the first war. We must take what we know
from the ailments these veterans suffer, and ensure that those who have
unexplained illnesses are aware of and receive treatment and benefits
they are eligible for through VA.
GI BILL EDUCATION BENEFITS
The Montgomery GI Bill (MGIB) has been one of this nation's most
effective programs, allowing veterans to better themselves through
education. Giving these men and women financial assistance helps them
to better themselves, which allows them to assume their rightful place
as the leaders of the private and public sector.
GI BILL FOR THE 21ST CENTURY
VFW's long-time goal has been a return to a WWII-like GI Bill. We
envision a bill, which would pay for the full costs of attendance, to
include tuition, books, fees, and living expenses, to any school at
which a veteran is admitted. The Senate's own Education Committee did a
study several years ago which noted that the original WWII GI Bill paid
for itself many times over because of the additional tax revenue
generated by the program. Further, many historians have noted that the
GI Bill created the middle class as we know it.
TOTAL FORCE GI BILL
As a step on the path, we support the idea of the Total Force GI
Bill, which would acknowledge the changing contributions that our men
and women in uniform make to the defense of this country. Our goal,
which is shared with the Partnership for Veterans Education, would
consolidate the current GI Bill program, and would improve its
effectiveness.
We envision a three-tiered approach. The first tier would be
similar to the current active duty benefit. The second would be similar
to the current Reserve, with the largest difference being that we would
re-benchmark it with the historical rate of 47 percent of the active-
duty benefit. The third tier would be similar to the current Chapter
1607 benefits, but would simplify them, and make them more commensurate
with the contributions that our Guard and Reserve are making as part of
the Total Force concept. After 90 days served on active status, we
would give these men and women 1 month of education benefits at the
active duty rate for each month they serve on active duty status.
To foster retention, we envision allowing Reservists to control
this enhanced benefit for as long as they remain active members of the
selected reserve. Otherwise, all the other tiers would retain 10 years
of eligibility.
PAY REDUCTION FOR GI BILL ELIGIBILITY
The VFW strongly opposes the $1,200 buy-in that is required for GI
Bill eligibility. No other form of federal student aid requires a
recipient to pay into the program, and it is not fair that those who
have given so much to this country be required to give up their pay for
it.
Currently, a service member has only one chance to declare
eligibility. Upon joining the military, he or she is given the option
to sign up. If they do, they have $100 taken out of their paycheck for
each of the first 12 months. $1,200 is a significant burden on someone
just starting out in the military, where an E-1, who has just joined,
only makes $1,178 a month.
Forcing a young man or woman to make that kind of decision at that
point in their lives is not very productive either. Circumstances
change, and people change. Perhaps the person that walks out of the
military down the road isn't the same person who entered. The narrow
rules for eligibility restrict these choices, and do not allow for
veterans who, for example, mature and decide that an education is
something that he or she will need to better themselves in the future.
Just as we want a GI Bill that adapts with the changing nature of
combat and service, we need a GI Bill that adapts with changing
lifestyles.
VA HOME LOAN PROGRAM
VA currently requires servicemen and women to pay fees to VA for
the use of the home loan guarantee. These fees, which are a percentage
of the total cost of the loan, can be an unnecessary burden. What is
particularly distressing to us, however, is that recent years have seen
fee increases used to subsidize other veterans' programs. Veterans, in
effect, are forced to pay for other veterans benefits. This is not
right. We would urge Congress to repeal these fee increases, and to
ensure that no veteran subsidizes another.
CONCURRENT RECEIPT
We thank Congress for their efforts in starting the process of
ending the prohibition on a military retiree from receiving their full
VA disability compensation and their full DOD retirement pension. While
the programs in place to eliminate the offset do positively affect many
thousands of military retirees, there are many thousands who still are
drastically affected by the law's required offset. No military retiree,
no matter how small their disability, should be forced to subsidize
payment of that disability out of their earned retirement paycheck. We
would urge an immediate end to the prohibition for all disabled
military retirees, which would include those who were declared
medically retired because of their service-connected disabilities, as
well as for those who are deemed disabled and ``unemployable'' by VA.
TRICARE FEES
We strongly oppose the administration's recent request to
dramatically increase fees paid by retired service members. In some
cases, TRICARE Prime premiums will double or triple, and in other
cases, TRICARE standard users will face a quadrupling of the amount
they pay for eligibility. While we can understand that health care
costs are on the rise, there is no way that the increase in these fees
could be considered reasonable.
Further, we are distressed at attempts by some in the Pentagon to
paint these increases as necessary because military readiness and
weapons systems need the funding. These budget-driven tradeoffs are
misguided political stunts, which we will not tolerate. These health
care programs are part of the on-going costs of war, an acknowledgement
of our gratitude for those who served this country for many years. If
the Defense Department feels that there is not enough money for
bullets, then let them request more money for bullets. They cannot take
it from the wallets of those who have already dedicated their lives to
this country. Also, at a time when recruitment and retention are an
increased priority and goals are not being met, what kind of message
does this send to those currently serving or those who are considering
service? Certainly, it is not a good message.
ACTIVE DUTY ISSUES
Pay Comparability
Over the last few years, Congress has made great strides to reduce
the pay gap between what the military pay rates are and what is
available in the private sector. In 1999, this gap was over 13 percent,
and today it is just over 4 percent. We thank you for that. We must,
however, remain vigilant and resist temptation to tie military pay to
inflation, when what matters, in terms of recruitment and retention,
are comparisons to the private sector.
Family Life
Today's military is different than the one from years ago. Many
servicemen and women have families, and their needs are quite
different. When combined with frequent deployments, we must maintain
family readiness and support structures. These include childcare,
spousal employment, education, and community structures.
One of the largest concerns is housing. We have supported Congress'
efforts to eliminate the average out-of-pocket housing expense, but we
must ensure that fair-priced, quality housing actually exists. As
efforts to privatize housing ramp up, we would hope for oversight to
ensure that the needs of those in uniform are adequately protected.
Guard and Reserve Issues
Since September 11, 2001, over 500,000 members of the Guard and
Reserve have been mobilized, and many thousands are currently fighting
in Iraq. They were intended to supplement our Active Duty forces, not
supplant them. As their role changes, we must be mindful of the
particular needs that they and their families have.
We support recent efforts to expand TRICARE coverage to them, but
feel that the fees charged are prohibitive for many in uniform. For
those without access to other forms of health insurance, these high
charges are particularly unfair.
With the changing nature of the reserve components, it is time that
the retirement system adapts as well. Frequent call-ups can and do
disrupt their careers, and can affect their own private-sector
retirements because of lessened contributions to private retirement
plans, fewer chances for promotions, or even time needed for civilian
pension programs. We strongly support allowing members of the Guard and
Reserve to begin drawing retirement pay at age 55.
SURVIVOR BENEFITS PLAN OFFSET
Current law prevents a surviving spouse of a military retiree who
dies from a service-connected illness from receiving the full amount of
their Dependency Indemnity Compensation (DIC) and the full amount of
their Survivor Benefit Plan (SBP). SBP is reduced dollar for dollar
with respect to DIC. This is patently unfair, as each program is paid
for different reasons. In the case of SBP, it is a program purchased by
military retirees to continue a portion of their military pension for
their spouse should they die. For DIC, it is a special disability
compensation program, which is paid to a survivor, should the veteran
die from a service-connected condition. This inequity must be fixed.
NATIONAL CEMETERY ADMINISTRATION
The NCA is charged with meeting the burial needs of this nation's
veterans and their dependents. They have a stated goal of having a
national or state veteran's cemetery within 75 miles of 90 percent of
all veterans. We have supported VA's cemetery expansion plans, and we
would hope that Congress would be mindful of future funding needs of
VA's plans. Additionally, we would urge increased funding for the
National Shrine Commitment, which aims to restore older cemeteries and,
by extension, honor those brave men and women interred therein.
BURIAL BENEFITS
Unfortunately, too little attention has been paid to the burial
needs of our veterans. Funeral expenses, even for a small service, can
run many thousands of dollars. Benefits today have not kept pace with
these rising costs, and they only pay a fraction of what they did in
1973, when these payments were first made.
Accordingly, we recommend that the plot allowance be increased to
$745, and extend its eligibility to all veterans. Despite a recent
increase in the allowance for service-connected deaths, for which we
are thankful, we would still like to see an increase to $4,100. The
non-service connected benefit has not been adjusted since 1978, and we
would like to see it increased to $1,270. All three-dollar amounts
would be commensurate with what was provided in 1973. We would also
support adjusting these amounts automatically with inflation to prevent
these benefits from eroding in the future.
POW/MIA ISSUES
The VFW remains strongly supportive of the Joint POW/MIA Accounting
Command (JPAC). Their goal, which is to provide the fullest possible
accounting for all those still missing, is one of this nation's most
sacred missions. None of our members will rest until we know the
whereabouts of every one of our men and women who have served in
uniform, even for those who have paid the ultimate price.
This is why we are distressed to inform you that due to budgetary
concerns, JPAC has been forced to scale back a number of missions and
recovery operations. This is unacceptable. Currently, JPAC receives its
funding through the U.S. Pacific Command. With a war going on, their
priorities are different than JPAC's. We propose that a separate line
item in the budget be used so that those in charge of the military do
not have to make a choice between accounting for those who are missing
and defending this country. They should not be competing priorities.
HOMELESSNESS
VA estimates that there are over 200,000 homeless veterans in this
country. If you add to that the number of veterans and their families
who were made homeless by the Gulf Coast hurricanes, it is truly a
national tragedy. We must do everything in our power to help these
former warriors, and to offer them health care, education, training,
and skills to become productive members of society. To accomplish this,
we need more outreach. VA, in partnership with many state and local
organizations, has excellent programs. They just do not reach enough
people. With increased effort, and focused attention, we can make a
meaningful impact in these veterans' lives.
VOCATIONAL REHABILITATION
Advances in technology are creating a generation of wounded
warriors who, in previous eras, would have died from their wounds.
While we are thankful that they were spared, the influx in service-
disabled veterans creates new challenges, especially when it comes to
vocational rehabilitation and employment.
We applaud the efforts to focus this program on its end goal of
employment for these veterans, but we need a program that looks to the
future. We need to train these men and women, and help them receive the
education and care they need to overcome and lessen the effects of
disability, so that they will be employable for employment beyond the
entry level. These skills and tools must look for the future and not
just for the quick fix today.
A truly effective program will be focused on a goal of avoiding
disability-related unemployability later in life, and that will allow
the disabled veteran to build a career to provide for him or her as
well as the veterans' family. We envision a comprehensive program that
truly meets our disabled veterans' needs, and we welcome the
opportunity to work with you to make this a program that truly works.
Mr. Chairman, I thank you again for the opportunity to testify, and
I would be happy to answer any questions that you or the Committee may
have.
Commander Mueller. Today is a very special day for me both
professionally and personally. Professionally, it is a true
honor to be here before you today representing the 2.4 million
men and women that make up this great organization, and our
Ladies Auxiliary. Our members are from all over the country,
and range from the oldest World War I veteran, to the youngest
service member fighting in Iraq and Afghanistan. Today we share
a bond as combat veterans. The honor I feel right now
representing their combined voices is tremendous.
Personally, this is a very meaningful day for me as well.
When I took my office last August, I challenged all of our
members to dedicate this year to a veteran who is no longer
with us. I dedicated my year to Alan Gruber, an extraordinary
young man with whom I had the honor of serving with in Vietnam.
He was a great man, but he died way before his time, 38 years
ago. Alan is someone I think of every day, but especially
today. Today is the anniversary of the attack which took his
life. The memory of Alan has guided me throughout the year, and
that memory is with me today.
Just as I have dedicated my life in my year as Commander-
in-Chief to Alan's memory, I would urge you all to do the same.
Although the ranks of veterans serving in Congress is
dwindling, I have no doubt that each of you have been touched
as well, whether that's a friend from your younger days or a
fine man or woman from your State who has paid the ultimate
price for this great nation.
These people are the reason that we do what we do.
As I did with my fellow members, I challenge you to think
about that one person who is no longer with us. Think of their
face and think of what they would have wanted. Think of this
face as you make these sometimes very difficult decisions. I
have memories of Alan who is guiding me today.
Chairman Craig, if I may be so bold, I suspect I can think
of face or two that runs through your mind although they are
thankful they are still with us, Heath Calhoun, Ryan Kelly,
Jeremy Feldbusch, the wounded service members who came to you
urging your support for the Traumatic Injury Insurance Program
and your inspiration for that program which we were so pleased
to support. With them in mind, you spearheaded that legislation
through in near record time and we thank you, as well as the
Members of this Committee who supported this worthwhile
program.
[Applause.]
Commander Mueller. You proved that Congress cares deeply
about those who go in harm's way to protect America and that
Congress can act quickly and decisively in their interests.
That is what we are asking, dedicate yourself to a personal
memory. Put a face on the problems we are confronting.
Turning to the issues, I would like to start with the VA
budget. We were pleased to see the President's request. It is
an excellent start. When the VA came to us last spring and said
they were running out of money, you did not hesitate. You
simply did the right thing. You knew that your actions were
affecting actual veterans, it was not just an empty and
meaningless number. We hope, however, that as you consider the
budget that you will remove the prescription drug co-payment
increase and the enrollment fee. A Category 7 veteran who makes
$26,000 could be forced, for example, to pay many hundreds of
dollars out of his or her own pocket. You and I could probably
afford that, but many of our veterans cannot. As a result, the
VA says that many thousands of veterans will be driven from the
VA health care system. These are not just the registered
veterans. Many of those lower-income veterans will be forced
out, too, some who would likely have no other insurance to turn
to. This is unacceptable. Keep these veterans in your mind as
you shape policy.
While we are appreciative of this initial budget request,
we are also mindful that this is the exception to the rule. We
would like to work with you to ensure that there is an assured
funding source to provide the VA with a sufficient and timely
budget. We cannot allow what happened in last year's funding
problems to occur this year or any in the future, for the VA
must have an on-time budget, something they have not had in
nearly a decade.
We would also like to work with you on two issues that we
feel are underserved, mental-health care and long-term care. As
the number of our older veterans grows, we need to place
increased emphasis on the VA's ability to meet the growing
demand for long-term care. The VA must simply live up to its
obligation to our older veterans.
With respect to mental health, it is obvious that veterans'
needs are changing. We can see that every night on the TV
screen as we watch the war unfold before our eyes. We strive to
see that the VA adequately cares for returning service members.
Programs and services must be in place and properly funded that
will allow them and their families to resume their roles in
productive society despite the strains being placed on them
today. This is what the heart of the VA is all about.
The VA's mission extends not only to health care, but to
the delivery of its benefits. The Veterans Benefits
Administration is charged with making a veteran whole,
especially through the Disability Compensation Program.
Disability compensation is essential. This compensation makes
up for the economic loss that veterans face because of their
service-related disabilities. On a very basic level, it helps
veterans to lead productive lives. It allows them to care for
their families, to provide shelter, and to put food on the
table. It is a modest benefit, but one that has been accepted
by many generations of veterans as fair.
Unfortunately, the administration of the program needs
improvement. We want accountability for the problems that it
faces, and these problems are twofold. First, the length of
time it takes for a veteran to wait for a claim decision is
unacceptable. On average, it takes the VA 6 months to process a
claim. That's 6 months without their earned compensation, and
while assuming a proper decision that the veteran eventually
receives the money he or she is due, it is awfully hard to put
food on the table with money you're going to receive in the
future. It creates a real hardship and unnecessary strain on
veterans and their families.
This is why we were upset to see a serious cut in the
number of VBA employees who decide compensation claims. The
budget calls for a decrease of 149 employees, with a backlog of
claims that currently exceeds 800,000, and waiting time that
the VA predicts will grow. With the number of men and women
fighting around the globe, it makes no sense to cut back the
number of these claim decision makers. The VA explains that
part of the delay in these decisions is due to the increased
complexity of these claims, yet the VA does not request the
resources necessary to provide adequate service. This is most
certainly not the way to welcome home our courageous warriors.
Another issue that we are concerned with is the VBA's
accuracy. When they decide a claim, they're wrong 15 percent of
the time. Not only does the veteran have to wait 6 months, they
stand a chance of being unjustly denied compensation. How many
of them give up in frustration at this point? These men and
women fought to protect our freedom. They should not have to
fight a bureaucracy. We, through our service officers, do our
best to ensure that veterans' claims are fully developed and
ready to rate. Even then, the VA makes mistakes. While we file
appeals when appropriate, we can only help those veterans who
seek us out. What about those veterans who file claims without
our assistance? What chance to they have? Is this error rate
acceptable? The answer is clearly no.
We need accountability. VBA must strive for more accuracy
and better timeliness. We look to you to hold them accountable
for these shortcomings. VBA is not adequately preparing for the
future. What is their plan for dealing with the increase in
combat-wounded veterans? How about the Administration's
proposed cut in compensation staffing to help these brave men
and women? How is VBA going to process these additional claims
when there are already hundreds of thousands of cases in their
piles? We want to work with you to improve the VBA and to help
them develop a strategy and a plan. No veteran should be forced
to wait months for an incorrect decision. Together we must fix
this.
Despite these problems with the VBA, we acknowledge that
some improvement is being made under the leadership of Under
Secretary Daniel Cooper. We hope to work with him to find
positive solutions to these many issues. We look forward to
working with you to address veterans' policies. Many brave men
and women bravely served America and fell while in the service
of this great nation. They now need our help. We will work with
you to improve VBA programs so that these men and women can be
successful and productive leaders for the future. We want the
system to work. We want the programs to be in place that will
enable all veterans who are unable to work to resume their
places in productive society and make them whole. We welcome
reasoned approaches to this and all other issues, but we must
be part of this dialogue.
Another important issue that we would like to see improved
is the GI Bill. Our long-term goal is the creation of a World
War II-like GI Bill which would pay for the full cost of
attendance at any school. In the short-term, however, we would
like to see some improvements made to the GI Bill benefit for
Reservists and the Guard. They are taking an increased role
fighting as active-duty forces but not qualifying for education
benefits equal to their service. This must be improved, and we
must acknowledge the burden we are placing upon them.
Along the same lines, we welcome the opportunity to work
with you on a seamless transition. Even after years of trying,
VA and DOD are unable to adequately communicate with or work
together at this pivotal time in service members' lives.
We have all heard horror stories about how some veterans
have fallen through the cracks. It is inexcusable. A service
member should be able to go right to the VA without months of
delay and endless bureaucracy full of paperwork. While I am not
an IT expert, I do know that this is an issue that can only be
solved with top-down leadership. This must be made a priority
and the two departments must get the job done. We are passed
the point of excuses. We need to see results. You are the
Congress and you can make it happen. All of these problems have
solutions even if they are not easy, and we want to work
together having an honest and frank discussion, putting it all
on the table to solve the problems for America's current and
future veterans. When we have worked together in the past such
as on Traumatic Disability Insurance Program, we have done
amazing things.
Before I conclude, I would be remiss if I did not say
something about our POW/MIAs. This nation and everyone who has
worn the uniform of this great country has a sacred mission to
ensure the fullest possible accounting of all of those who are
missing. Funding for the Joint POW/MIA Accounting Command is
now competing for funding with the war, leading to the
cancellation of some of the missions and investigations. It
should not be this way. This mission is far too important, and
I am sure you would agree. Please do what you can to ensure
that these are properly funded.
Mr. Chairman, in all of these issues I have spoken of
today, it is important that we keep that individual veteran in
mind. Our actions have real benefits to them and to the
millions of men and women who have worn this uniform, all
individuals, all with homes and dreams and futures, we owe them
and we owe it to them. We must be mindful of this. It is a
special and sacred role. We must make those veterans whole and
help them and their families. As you hold your hearings and
make critical votes and decisions throughout this year, please
do as I have asked our members to do, think of that veteran,
think of his or her family and loved ones. Ask yourself what he
or she would want. Ask yourself how he or she would be
impacted. Let them be your guide just as Alan Gruber is mine.
Their memory can show you the way.
Mr. Chairman, this concludes my testimony. I would be happy
to answer any questions that you or the Members of this
Committee may have.
[Applause.]
Chairman Craig. Commander, thank you very much for that
marvelous statement, and your admonition that we think of a
veteran is a good one and really one of the very best because
we oftentimes look at large programs and numbers and dollars
and cents. I think that you are right that when it comes to an
individual veteran and his or her problems, it allows us to
focus in a way that you normally do not focus when you deal
with these kinds of issues. Let me thank you for that.
We have had a couple of our colleagues join us. We also
have a vote, we believe, starting around 10:45. We will work
our timing accordingly. Senator Jim Jeffords of Vermont has
joined us. Jim, welcome. Do you have any opening comment?
Senator Jeffords. Just a little one.
Chairman Craig. Please proceed.
OPENING STATEMENT OF HON. JAMES M. JEFFORDS,
U.S. SENATOR FROM VERMONT
Senator Jeffords. Thank you, Mr. Chairman. I appreciate
hearing your testimony today, all of you, and thank you for
being here.
I was pleased to meet with the Vermont representatives of
the Veterans of Foreign Wars and so I am familiar with some of
your agenda items and goals. I have enjoyed working with you in
the past to serve our nation's veterans and I look forward to
working with you again. You can count on me. Thank you.
[Applause.]
Chairman Craig. Jim, thank you. Senator John Thune lives in
an area where spring has not yet sprung, in the Dakotas, South
Dakota.
Senator Thune. You and me both, Mr. Chairman.
Chairman Craig. Right.
OPENING STATEMENT OF HON. JOHN THUNE, U.S. SENATOR FROM SOUTH
DAKOTA
Senator Thune. I also want to thank you, Mr. Chairman, for
holding this hearing to give our veteran organizations the
opportunity to testify about their legislative priorities and
want to extend our welcome to the national leadership of the
VFW who are here today testifying, as well as the many in the
audience here today. We want to thank you all very much for
your distinguished service to our country.
I would simply add, Mr. Chairman, that as I have noted
before, budgets are an indication of a nation's priorities and
I think it is awfully important, as we go through the budgeting
process here in Washington, that we bear in mind the comments
of the Commander that were just made about the importance of
keeping in mind the individual veteran out there and the
responsibility that this nation has to our veterans. Clearly
this year the increase in funding that has been proposed
already in the President's budget is significant and I think a
reflection of the importance that we need to be placing on
funding for veterans programs. The biggest room in the house is
the room for improvement, and we are always looking for ways
that we can do a better job of serving our veteran population.
I look forward to working with you as well as with members
of the service organization, the VFW that is represented here
today and the members across the country and certainly in my
State of South Dakota as we grapple with our best to serve the
needs of our veteran community and try and accomplish that
within the budgetary constraints that we face here in
Washington every day, giving the appropriate and high priority
that we need to veterans' programs.
Thank you, Mr. Chairman. Thank all of you for your service
and for your representation here today. It means a lot to us to
see all of you here engage in this process and obviously
lending your voice to what is a very important priority for our
nation, and that is meeting the needs of America's veterans.
Thank you.
[Applause.]
Chairman Craig. Tom, thank you. We will start our
questioning from the Committee, and then if the bell rings and
we have to vote, Commander, we will do that. We will all let
you stand down for a bit and then we will be right back to you.
Commander Mueller. Thank you, sir.
Chairman Craig. One of the responsibilities I have is no
different than yours in the sense that it is important that we
not only look at today's needs, but we look at future
responsibilities as it relates to funding a system that is so
critical to veterans' care, not only for those who are now
there, but for those who will be there in the future.
Certainly, one thing that I think all of us can be proud of
and certainly you can with your advocacy is that because of
that advocacy, we have created a system that is now by most
veterans' estimation a health care delivery system of first
choice, not second choice or third choice or simply an
alternative if you do not have any other place to go. As a
result of our funding and your advocacy, it is now by most
medical journals' analysis one of the best health care systems
in the country, and I think that is something we can all be
proud of.
It is interesting that that whole effort started some years
ago and it is a product of investment that has brought us to
where we are today. In that commitment of money, I have
mentioned that during these times, the VA budget while you have
all been critical of it, has still grown at a rate faster than
nearly any other budget in the Federal Government. As an
example, as I mentioned that over that 5-year period, about a
38 percent government-wide growth, yet the VA was at 46
percent. That is not something to be critical of. That is
something to be proud of. It shows where Congress and where you
were and are today as it relates to priorities.
Last year, Patty Murray, I and others became frustrated
with where the budget was, so we marked it up dramatically
because we knew it was the right thing to do. We also said to
the VA we are not going to go through this again. You are going
to start reporting to us on a quarterly basis your expenditures
so that we can map it and track it, and, more importantly, so
they can in a way that they had not done before. The Secretary,
Secretary Nicholson, has honored that. We have had our first
quarterly estimate of expenditures and revenues, and we are on
track in relation to where we were with the budget, and we will
continue that process and attempt to refine it.
Commander, our priorities are our priorities from medical
health care to long-term care, disability, the GI Bill. I want
to tackle the GI Bill this year. I think we have a reality
check there as it relates with Guardsmen and Reservists who now
have served actively but may not be eligible under the current
program and I think probably deserve that eligibility.
Seamless transition should not be simply a flight of
rhetoric. It needs to be a reality of the kind that we have not
seen in the past, that we will stay with DOD and with VA until
they get it right.
[Applause.]
Chairman Craig. I cannot imagine that a thorough
examination by a doctor at DOD isn't good enough for VA.
Somehow it just does not make sense that you run a veteran
through these constant myriads to qualify because if you are
not wearing the VA pin on your lapel it does not count. To me
it does not count, it does not make sense in that regard. As a
result of that and cost savings, and we will look for cost
savings, that is a part of that analysis and seamless
transition that is all I think going to be extremely important.
Let me address the tough one, the tough one that most
Members of this Committee reject and that I have had to look
straight at that your organization rejects, and that is where
we are today with revenues and services and programs, and not
with some concept of simply going out and raising more taxes
across America, because when you look at the reality of
budgets, it is very difficult to say that VA has done badly
under any of these scenarios or, in fact, that the Government
is not raising more money. It is simply in what is now a very
strong growth economy by most estimations.
Ten years ago Congress enacted Eligibility Reform
Legislation to expand access to VA health care for veterans
according to a value-based priority system. At the time, major
veterans' organizations including yours argued that eligibility
reform would be budget-
neutral. We were in a deficit at that time. We corrected that
deficit, we tightened our belts, the economy took off and we
found ourselves in the late 1990s in a surplus. We went on to
say that low-priority veterans would access VA care at their
own expense. That is what most major veterans' organizations
agreed to during this time of reform. Some would argue it was
during a time of deficit and that was then, this is now. It is
also true that Congress during the time of surpluses simply
chose to walk away from that as did most veterans'
organizations. Why? Because there was money out there, and a
lot of it and we were funding at a higher level ever and so we
didn't push the point of the reform.
Fast-forward to 2006. We know that eligibility reform was
not budget-neutral. In fact, the VA health care budget has
doubled in 10 years since its enactment and many believe VA's
budget is under funded still, and that is clearly what we are
hearing from most of you and many of our colleagues.
Given this set of circumstances, and I try to approach this
as neutrally as I can, but recognizing that I have a job to do
and it is a job not of falling to the rhetoric, but looking at
all the numbers and working with all of you to try to resolve
some of these critical problems and keep these levels of care
where we want them to be.
Is it unreasonable to ask that those with no service-
related disability and the means to afford it, and while it is
arguable that some may not be able to, 90-plus percent of those
7s and 8s have health care or access to health care today by
their own admission, is it wrong to ask for $21 a month or just
69 cents a day to gain access to the No. 1 health care system
in the country? That is a phenomenal asset by any estimation. I
could say less than the cost of a carton of cigarettes a month,
but then again the argument is what can we do and what should
we do, and where should our priorities lie.
I sent a budget letter last week to the Chairman of the
Budget Committee. It is part of the process we do here. Now the
Chairman of the Budget Committee has all of the letters from
the authorizing Committees as to levels of expenditure and what
we are recommending. We took the President's budget, we looked
it over a little bit. We changed some of it because we thought
some of the priorities in research and mental health were not
as good as they ought to be and we moved the numbers. But in
that, I did move the issue of the co-pay as it relates to 7s
and 8s, and drugs from 7 to 15.
Here is why I did it. If we do not do that, then to keep
this President's budget at this level or above, we have got to
go find $795 million out of the General Fund. My colleagues on
this side of the aisle have recommended substantially more than
that. I think it was $1.6 billion more than the President's
budget, and so on and so forth.
The reason I walk you through this is that we really are
focused and have to be and should be on your behalf. Instead of
just simply saying, ``no,'' we are going to ignore it this year
and move on, because within a year and a half or two if I am
still Chairman of this Committee and you are back, we are going
to be presiding over a $100 billion VA budget and it will be
competing with every other budget of our Federal Government. I
am not sure at that point we can sustain it because I do not
agree with the rhetoric which is flowing out there now which is
purely politics, that, ``oh well, 2007 is what it is, the
President deserves a little credit, but gee look, in 2008 we
are going to cut like heck.'' This Congress is not going to do
that, period, end of statement. What we are going to have to
do, I believe, and that is why I am approaching you as boldly
as I can today, is to look at some alternatives for resources
as it relates to those who are not disabled or service-
connected, who are less than needy, but who can gain access to
the best health care system in the world, and to make sure that
our funding gives us the sustainability of that quality health
care system.
For those of you who are members today of the VFW and those
incoming who will be members tomorrow and 20 years from today,
Commander, that is our challenge. Your organization and many
organizations were once there at a different time, a different
place, but we recognized the need to prioritize then. Today the
arguments are different. The budgets are not much different as
it relates to deficits and demands. We are at war. We were not
10 years ago. Priorities have shaped a different kind of
budget.
Those are my concerns and I have spoken too long. There is
a question within that. Possibly you, Commander or maybe Mr.
Wallace, would like to respond, but it is a concern that I do
not believe I can just pass go anymore for the sake of the
politics of the issue. I think there is a responsibility I have
to bear up under.
Commander Mueller. Mr. Chairman, I would ask that Mr.
Wallace answer this.
Mr. Wallace. Mr. Chairman, to go back 10 years when
eligibility reform became a reality, Dr. Ken Kaiser was the
Under Secretary for Health, and there were two things that he
said would happen. No. 1, the VA would collect insurance from
those veterans for nonservice-connected aliments. The VA has
been doing a better job of it. I think it is around $2 billion
they got this year, but they are estimating $2.8, I believe, in
the budget and I do not think they are going to get that. That
is one thing, the VA has not been fast enough in beefing up
insurance collections.
The other thing that Dr. Kaiser emphasized was Medicare
reimbursement, that the VA would be able to charge Medicare
eligible veterans for their Medicare money. Congress has never
moved on that, so that's hurt the problem. Someone who makes
$26,000 a year is not a rich veteran, and $21 may affect them.
Someone who makes a lot more money, that we can talk about, I
would think. A lot of people in VA say there are 800,000
veterans that are Category 8. Only 200,000 of those 800,000
actually use the system from what VA reports, and they use it
for prescription drugs only. If that is the case, why doesn't
Congress look at a prescription drug plan for those people
where they charge them a fee for admission, and charge them
more money for their drugs if they make over X amount of
dollars? The VFW has pushed that legislation for 2 years and we
got absolutely nowhere, but I think that it is something you
could look at. The two things that eligibility reform were
predicated on was Medicare reimbursement and the third-party
collections, and that has not come through.
[Applause.]
Chairman Craig. Thank you for that response. We are pushing
VA to accelerate third-party reimbursement, and by our own
admission, $2 billion is a lot better than where it was, and we
hope it will become much better. You are right, it was Congress
that chose not to go to the Medicare route. Why? Because some
VSOs saw a conflict there and were very fearful that if money
began to be replaced within the system by Medicare
reimbursement, that the overall budget priorities of VA within
the system would lessen because Congress would see an
alternative form of revenue flowing in that they would not have
to compensate. Those are very legitimate concerns, but in all
fairness, Mr. Wallace, it is pleasing for me to hear that maybe
there are some things that we can look at.
Frankly, right now what I am hearing is, ``no, no,'' and I
must tell you that the day that a fellow taps me on the
shoulder in Boise, Idaho, who is a very successful retired
doctor with by any estimation a fair amount of money in his
pocket is frustrated because he cannot gain access to the
system because he wants just exactly what you have said some
show they want, they want access to the pharmaceutical program.
He was eligible because he had served and he believed he was
eligible and needed it. I will not go any further than that.
There are savings to be made and realities here to deal with
and that is why I am challenging all of us today not just to
say, ``no, no, we will just pull it out of the budget.'' That
will be even a more difficult task than last year. It is not an
impossible, but it is a difficult task, and what I am looking
at, I am trying to get out in front of the headlights just a
little bit as it relates to the future.
Mr. Wallace. I think the Commander's testimony was very
clear, we want to work with you and we are not saying no to
anything. We want to sit down and we want to have a real
dialogue where everybody clears their brain of their
preconceived notions and sits down and has a dialogue that is
honest and open and frank to try to solve the problems. You
cannot get $100 million of new money last year from the
President's budget, and this year you get $2.675 billion in new
money and anticipate the VA or any business to work in an
efficient manner when they never get the money on time for the
last 10 years. It cannot happen and so veterans are being
affected by that also. We want to work with you in an open and
frank dialogue.
Chairman Craig. Thank you. Thank you very much. We will
count this as a dialogue begun, all right?
Mr. Wallace. Thank you, sir.
[Applause.]
Chairman Craig. Now let me turn to Senator Patty Murray.
Senator.
Senator Murray. Thank you, Mr. Chairman, and thank you so
much for your testimony. I hear about the increased dollars for
the VA and I say, ``yes, it is about time,'' and we also have
to have part of the reality of why we have had to increase
dollars and why we still are not there yet. We know that
Vietnam veterans are now accessing the VA system. We have heard
of a 46 percent increase in the budget of the last 5 years, but
in some areas we have seen a 70 to 80 percent increase in the
number of veterans accessing the VA system. No surprise here, a
lot of companies are now not providing health care, so veterans
who have a right to access the VA are now accessing their VA
system there. It is part of the health care crisis here, and
veterans have a right to do that.
The overall cost of health care has increased dramatically
in the last 5 years. That has affected the VA. We have to
budget for that increased cost just like every business is
having to do. We know that over 140,000 Iraq and Afghan
veterans are now accessing the VA system. When we send our men
and women to war we have to budget here in Congress for the
cost of that war, and part of that cost of war and an important
part of it is caring for those veterans when they return.
We know that over 500,000 men and women have already served
in Iraq and they now all are entitled to VA care, and it is our
responsibility to budget for them. There are a number of
increasing pressures on the VA system. That is why we saw the
problem last year of being under funded by $1.5 billion. I am
concerned we still do not have a real model to track the needs
of veterans. I, for one, just am deeply concerned about a
budget that relies on veterans themselves to now have out-of-
pocket expenses paid for when I know that none of them--when
they signed the dotted line to serve our country, so no
asterisk there--said if you make a lot of money you do not get
care.
[Applause.]
Senator Murray. What I know is that they signed up to serve
our country and our country signed up to serve them. I am just
one of those who does not believe that that is what we need to
do in order to balance our budget. We have a lot of things we
need to do within our budget to balance it. We also need to
call on all of our American citizens to help pay for the cost
of war, and veterans are a part of that.
Let me ask you, Commander, we have gone through all of this
about the VA not having adequate funding. We are delighted that
the President's budget has more funding. I am still very
concerned. I hear about those long lines. I hear about our vets
not getting the services they need. I hear about instead of
producing a budget that has the dollars looking for ways to
have veterans pay for it. That concerns me. I would like to
find out from you how you think the VA should change its budget
model so that we can better track the real needs of our
veterans.
Commander Mueller. Ms. Murray, I will call upon Mr.
Cullinan to answer that.
Mr. Cullinan. Thank you very much for the question, Senator
Murray. One of the things that we have been looking at and
promoting through the years is an assured funding method to
make sure that VA not only gets enough money, but VA gets it in
a timely basis, and that is also known as mandatory funding.
The reason that we have supported mandatory funding through the
years is because, as Mr. Wallace mentioned earlier, the budget
has been late the last 10 years in a row and there has been
terrific uncertainty as to not only when it is going to arrive,
but how much it is going to be. This puts an awful strain on
those who manage this nation's largest and best health care
system.
I think anyone who has run a business knows that if you do
not know how much money you have to work with nor when you are
going to get it, you simply cannot operate in an efficient
manner. We assert that something along that line would not only
provide the proper funding for VA, but it would increase
efficiency as well. That is another advantage. The managers
know when they are going to get the money and how much it is
going to be, and that in itself increases efficiency and it
allows them to bring on board the health care professionals
that the system needs in a timely fashion. Thank you.
Senator Murray. Thank you. Commander, you are a member of
the Independent Budget Committee. I wanted to ask you what your
impression is of the $1.1 billion in funding that the VA is
supposed to find through management efficiencies.
Commander Mueller. I think we would have a lot of work to
do in that area to find that money in that.
Senator Murray. Do you think there are management
efficiencies?
Commander Mueller. I believe in efficiency. Yes, I do.
Senator Murray. Do you think there is $1.1 billion that we
can find there?
Commander Mueller. I do not.
Senator Murray. How do we do that?
Commander Mueller. I would ask Bob or anybody else who
might want to comment on that.
Mr. Wallace. Figures do not lie, but liars figure and
management efficiencies so many times is just a plug figure to
make it look good.
Senator Murray. I think that really concerns me.
Mr. Wallace. The reality of it is there are some
efficiencies that can be made, but I think it is a little bit
overoptimistic on the part of the Administration.
Senator Murray. I have to agree. I go out to my veterans'
hospitals and these are hard-working doctors. They are doing
the best they can. They are really struggling. It is always so
easy to say find a management efficiency and too often that
means somebody has to wait in line longer, and I am just not
going to support any kind of management efficiency that means
that. I would like to hear more from you on that in the future
if you could.
I know our time is running out and I know we have a vote. I
just wanted to ask you, in your testimony you outlined a need
for over a billion dollars in construction funding to even meet
the Enhanced Services Threshold that is promised as CARES
Review that we have been through. What message does this lack
of construction funding send to your members?
Commander Mueller. I think if they do not have the interest
to go ahead and do new building and construction for hospitals
and make them available especially to the veterans who are in
rural areas, as was addressed, where veterans can get to them
without a lot of travel and inconvenience, it is the wrong
priority in some ways.
Senator Murray. I agree with that because many of our
veterans are in very rural communities and have to travel 8 to
10 to 12 hours. We are talking about World War II veterans, an
aging Vietnam veteran population, often veterans with severe
health care problems. We promised them these clinics through
the CARES process but we have not budgeted for them. I am very
concerned that this is a huge hole that we need to address.
Commander Mueller. I will agree wholeheartedly.
Senator Murray. Thank you. I know, Mr. Chairman, we have a
vote so I will submit the rest of my questions if that is all
right.
Chairman Craig. Patty, thank you very much. We do have a
vote underway. I am going to ask that the Committee stand in
recess for a few moments. I will hustle over and vote and be
back in probably about 10 minutes. I have a couple of more
questions to ask, and some other of my colleagues may join us
at that time. Again, thank you all very much, and the Committee
will stand in recess for approximately 10 minutes.
[Recess.]
Commander Mueller. Mr. Chairman, we must always make our
veterans a top priority. I do not know who the author of this
is, but it was said that once a nation forgets about its
warriors, that nation will soon fall from greatness, and I
think we owe it to our veterans coming back to put them as one
of our top priorities in this country.
Chairman Craig. Thank you for that.
Mr. Wallace. Mr. Chairman, I think we all agree the system
is not working today. It can be called Craig Funding, Wallace
Funding, Mueller Funding, VFW Funding, Akaka Funding, whatever,
we have to fix it, I think that is where we have to have some
serious dialogue, on how to fix it. Maybe some mandatory, maybe
some assured, whatever you want to call it, for certain
veterans, maybe for others, I do not know what the answer is,
but we have to get in a room and start throwing things against
the wall to see what can stick. We want this system to stay in
place and we want it to be improved, and today's system is not
working when we have to worry about whether we are going to
make the payroll tomorrow or when they are going to get the
money and how many staff they are going to be able to hire and
so forth and so on.
We welcome the opportunity, again, to sit down and talk
about it in a very serious nature. We realize we are not going
to win everything, and you realize you are not going to win
everything. Politics is the art of the possible, and I think we
can make the possible become a reality if we have a serious
discussion.
Chairman Craig. That is a marvelous challenge. We are in
the process of taking you all up on it because I think the
process itself, the budget process we are now in, offers us
that challenge. Thank you.
Let me turn to our Ranking Member, Senator Akaka.
Danny.
Senator Akaka. Thank you very much, Mr. Chairman. I thank
you for this opportunity. As I said early in my statement, we
have the same goals--the Chairman and I. We differ on how we
pay for it. For me it is a matter of priorities. We must make
some hard decisions and ensure that our veterans be our
priority, as much as a priority as our national defense. Many
of us feel that veterans deserve all they need, having served
our country as you have.
As we do this, I remain committed to ensuring that all
veterans receive access to the VA's health care and services.
You do understand that this Committee, the Chairman and I, have
been looking for the funds needed to help veterans and will
continue to do that. As I mentioned also in my statement, that
I have been looking for justification for whatever our needs
are and the costs of that and have been pinning it on what I
call the cost of war, to put it on another level.
I have been with this Committee now for 16 years and during
that period of time this Committee has had difficulties and
challenges in trying continually to get the kind of funding
that is required for veterans' benefits. As I just mentioned
this is a cost of war.
I mentioned also in my opening statement the GI Bill and
how it really helped me. Senator Inouye, Senator Matsunaga, and
I, as well as many other leaders of the communities in Hawaii
and in government, really got to these positions because of the
GI Bill. I remember receiving $113 a month to help with my
finances, and all of my tuition was paid. It was such a huge
help. When I look back I will tell you that without the GI Bill
I would not be here. That is how important it was for me, and
it is important for our veterans today.
I note, Commander, in your testimony that you believe it is
unfair for young men and women to declare participation in what
we call MGIB which is the Montgomery GI Bill Program so early
in their careers. What do you think would be a better
alternative to what we have now?
Commander Mueller. I know how important education is to
everybody if they are going to succeed in life, and I think a
lot of our young men and women have joined the military to also
further their education. I think we need to afford that chance
to take up that education. I am not sure if I understand what
you mean, and I will ask Dennis to help me on this.
Mr. Cullinan. Thank you very much, Commander-in-Chief, and
thank you for the question, Senator Akaka. One of the things
that we are looking toward is the elimination of the $1,200
contribution. That is right at the point when a service member
is making the least amount of money. It is also the stage of
their career in their youth where their priorities may not be
such where they would opt to pay that kind of money.
What we would most prefer is to see the $1,200 eliminated,
and most certainly lacking that, that they should be able to
make the election at some later point. They are first starting
their military service, it is the lowest amount of money they
make, and they may not then really understand how important an
education is. I know myself when I went in the military, it
took me a while to figure it out.
I would add one other thing. We also think it is very
important to look to our Guard and Reserve, and that was
mentioned earlier on. There is the issue of proportionality.
Right now the Guard and Reserve benefit simply has not kept
pace with the regular active-duty force. Another issue is the
fact that when they leave military service, they cannot use the
benefit anymore. We think the benefit has to go up proportional
with their service, and they have to be able to take it with
them as well. They have to be able to use it when they leave
the Guard or Reserve, similar to the way it is with the active-
duty MGI Bill.
Senator Akaka. Thank you for your responses. Given that
Congress rejected the enrollment fee and drug co-payment
increase for the past 3 years consecutively, why do you think
that the Administration has proposed that again? What options
does your organization see as viable for ensuring that adequate
capacity and resources remain available?
Commander Mueller. I would think we would go back to the
Medicare issue, accepting Medicare, to let them come in and use
their Medicare and co-payments and that.
Senator Akaka. As I mentioned, the Congress has rejected
the enrollment fee and drug co-payment for the past 3 years
consecutively, and we're proposing to do that again. It is
something that maybe we need to continue to look at. I know my
time has expired.
Chairman Craig. Go ahead. If you have some more questions,
I am through. Please proceed.
Senator Akaka. Let me ask another one, and I'll have other
ones that I will enter into the record.
This question continues the dialogue we have begun to have
with other veterans' groups. As we talk about narrowing
eligibility, we must understand what the consequences will be
to the entire VA health care system. The President is clear on
who should be eligible for VA health care, only those with
service-connected health needs. Do you think the system as we
know it today can survive if eligibility is severely narrowed,
could our teaching and research missions be continued, and
would specialty programs survive?
Mr. Cullinan. Thank you, Senator Akaka. Senator, we
strongly believe as an organization for the world's best health
care system to survive as a system, it would be absolute folly
to limit the eligibility to that degree. Just to have a system
this large operate efficiently, you need something along the
lines of a critical mass of patient load, you need a diversity
of patients with a diversity of health care problems. That has
to do with the treatment modalities themselves, it has to do
with what you yourself just mentioned, attracting the proper
research mix into the system, drawing some of this nation's
very best doctors and research scientists into the VA, because
not only are they dealing with things associated with combat
trauma, but aging and any number of other health care issues.
Absolutely not, we think it would be disastrous if the
eligibility were to be narrowed to that regard for that reason.
Senator Akaka. Another mention I made in my opening
statement was about research and its mission. What do you think
about continuing these research missions?
Mr. Cullinan. Research is incredibly valuable in and of
itself. If it were not for the Department of Veterans Affairs
with respect to such things as prosthetics, cardiology, hearing
impairments, blindness, vision impairments, we would be in
medical terms 100 years behind where we are today, so
absolutely. These are essential things that the VA handles. A
lot of these things are not commercially viable which is the
reason that the VA had to take the lead. It was so important
that they did it a number of years ago because they are money
losers, but if the Department did not take a lead in this area,
veterans would suffer as a consequence and the nation would
suffer because it is this technology and the medical treatments
that the VA has developed through the years that help not only
veterans, but all of us, and the world as a whole.
Senator Akaka. Thank you, Mr. Chairman. I know my time has
expired. I want to tell you that we would like to continue to
hear from you. You are very important to the veterans of our
country and your thoughts are very important to us.
Commander Mueller. It's good to work with you.
Chairman Craig. Senator Akaka, thank you very much. The
Committee record will remain open for any additional questions
that Members may have for the appropriate period of time.
Commander, again on behalf of the Committee we thank you
and your colleagues at the table and certainly all assembled
and those well beyond you that you represent for the kind of
work that you do on behalf of America's veterans. I hope that
the dialogue of today has been appropriate and enlightening and
I hope challenging to all of us as we work our way through
these difficulties and opportunities. I really am one who
believes that sometimes problems can become opportunities if we
are willing to look beyond the box a bit and try to resolve
some of these questions because there is one goal that we all
hold very common, and that of course is to sustain a system to
continue to serve America's veterans and that is a challenge
that we will meet.
Again thank you all very much for your time here today, and
with that the Committee will stand adjourned.
Commander Mueller. Thank you, Mr. Chairman.
[Applause.]
[Whereupon, at 11:18 the Committee was adjourned.]