How Much Does It Cost to Fix the VA?

With the August recess looming, lawmakers sparred across the Hill over proposals to fix the embattled Veterans Affairs Department.

Sen. Bernie Sanders (I-VT)
National Journal
Jordain Carney
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Jordain Carney
July 24, 2014, 7:42 a.m.

The Vet­er­ans Af­fairs De­part­ment wants to hire 10,000 new clini­cians — in­clud­ing 1,500 phys­i­cians — to help fill gaps and meet what it calls a rising de­mand.

Just one small prob­lem: Law­makers have to ap­prove the pro­pos­al first, and the on­go­ing scan­dal has made them skep­tic­al.

“If they don’t have the abil­ity to ac­cur­ately pre­dict staff­ing needs, then how do we know that 10,000 more bod­ies is needed to solve the prob­lem?” House Vet­er­ans’ Af­fairs Com­mit­tee Chair­man Jeff Miller asked at a com­mit­tee hear­ing Thursday.

Philip Matkovsky, the Vet­er­ans Af­fairs as­sist­ant deputy un­der­sec­ret­ary for health for ad­min­is­trat­ive op­er­a­tions, told law­makers that the de­part­ment reached the fig­ure by try­ing to pre­dict fu­ture vet­er­ans’ needs and the num­ber of vet­er­ans.

The ad­di­tion­al staffers are part of a lar­ger $17.6 bil­lion re­quest that act­ing Sec­ret­ary Sloan Gib­son un­veiled while testi­fy­ing be­fore the Sen­ate Vet­er­ans’ Af­fairs Com­mit­tee last week. Law­makers — par­tic­u­larly Re­pub­lic­ans — have ques­tioned if giv­ing the VA more money, and par­tic­u­larly a lot more money, is really the cure to what ails the VA.

“You asked for the whole en­chil­ada at one time, and that’s caused a lot of us to struggle,” said Rep. Jeff Den­ham, sug­gest­ing in­stead that the de­part­ment should have re­ques­ted a smal­ler amount and proved they could use it re­spons­ibly.

That struggle has spilled in­to the con­fer­ence com­mit­tee, the Cali­for­nia Re­pub­lic­an said, where law­makers are still try­ing to hash out le­gis­la­tion that would in­crease fund­ing for the VA and make it easi­er for vet­er­ans to get care out­side of the VA.

Mov­ing for­ward, Gib­son out­lined six pri­or­it­ies for the VA: Get vet­er­ans off wait lists and in­to clin­ics, fix schedul­ing prob­lems, change cul­ture, quanti­fy what re­sources the VA needs, hold per­son­nel ac­count­able for mis­man­age­ment, and es­tab­lish a routine for dis­clos­ing in­form­a­tion.

But Miller warned that the days when the VA’s budget was in­creased without ques­tion are over. “The VA can no longer con­sider it­self a sac­red cow,” he warned.

The VA’s budget has grown from $100 bil­lion in 2009 to $154 bil­lion in 2014. But vet­er­ans ad­voc­ates have long cri­ti­cized what they view as an en­trenched prac­tice with­in VA lead­er­ship of hes­it­at­ing to ask for ad­di­tion­al re­sources.

“Where I am from, that’s a lot of money,” said Rep. Phil Roe, R-Tenn. ” “¦ How is it go­ing to be spent? And how do I know it is go­ing to be spent wisely?”

On the side­lines of the hear­ing, the Sen­ate and House Vet­er­ans’ Af­fairs com­mit­tees sparred through press re­leases.

The House com­mit­tee sent out a re­lease say­ing House and Sen­ate mem­bers of the con­fer­ence com­mit­tee will hold a meet­ing Thursday to dis­cuss po­ten­tial amend­ments to the le­gis­la­tion it is hash­ing out.

But Sen­ate Vet­er­ans’ Af­fairs Com­mit­tee Chair­man Bernie Sanders said in a state­ment that the “uni­lat­er­al” push by Miller to call a con­fer­ence com­mit­tee “is a sad in­dic­a­tion that the House lead­er­ship is not ser­i­ous about ne­go­ti­ations.”

“We don’t need more speeches and pos­tur­ing. We need ser­i­ous ne­go­ti­ations,” he said, cast­ing fur­ther doubt on wheth­er law­makers will be able to reach a com­prom­ise be­fore they leave for the Au­gust re­cess.

The Ver­mont in­de­pend­ent out­lined his pro­pos­al on Thursday from the Sen­ate floor, which he said will cost less than $25 bil­lion. In­cluded in the pro­pos­al is fund­ing for staff­ing, in­fra­struc­ture, in­form­a­tion tech­no­logy, and a two-year pro­gram that would in­crease vet­er­ans’ ac­cess to non-VA care.

And Sanders voiced frus­tra­tion with his House coun­ter­parts, say­ing: “We have put good-faith of­fers on the table time and time again…. I am very saddened to say … at this point, I can only con­clude with great re­luct­ance that the great faith we have shown is simply not be­ing re­cip­roc­ated by the oth­er side.”

Sen. John Mc­Cain ap­peared on the floor with Sanders, ur­ging every­one to “cool down some.”

The Ari­zona Re­pub­lic­an said it would be a “gross dis­ser­vice to those who de­serve our con­sid­er­a­tion most” if law­makers left for the Au­gust break without an agree­ment.

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