U.S. GOVERNMENT PRINTING OFFICE

57–052 CC WASHINGTON : 1999

VIEWS OF VETERANS’ SERVICE ORGANIZATIONS

HEARING

BEFORE THE

SUBCOMMITTEE ON NATIONAL SECURITY,

VETERANS AFFAIRS, AND INTERNATIONAL

RELATIONS

OF THE

COMMITTEE ON

GOVERNMENT REFORM

HOUSE OF REPRESENTATIVES

ONE HUNDRED SIXTH CONGRESS

FIRST SESSION

MARCH 18, 1999

Serial No. 106–9

Printed for the use of the Committee on Government Reform

(

Available via the World Wide Web: http://www.house.gov/reform

(II)

COMMITTEE ON GOVERNMENT REFORM

DAN BURTON, Indiana, Chairman

BENJAMIN A. GILMAN, New York

CONSTANCE A. MORELLA, Maryland

CHRISTOPHER SHAYS, Connecticut

ILEANA ROS-LEHTINEN, Florida

JOHN M. MCHUGH, New York

STEPHEN HORN, California

JOHN L. MICA, Florida

THOMAS M. DAVIS, Virginia

DAVID M. MCINTOSH, Indiana

MARK E. SOUDER, Indiana

JOE SCARBOROUGH, Florida

STEVEN C. LATOURETTE, Ohio

MARSHALL ‘‘MARK’’ SANFORD, South

Carolina

BOB BARR, Georgia

DAN MILLER, Florida

ASA HUTCHINSON, Arkansas

LEE TERRY, Nebraska

JUDY BIGGERT, Illinois

GREG WALDEN, Oregon

DOUG OSE, California

PAUL RYAN, Wisconsin

JOHN T. DOOLITTLE, California

HELEN CHENOWETH, Idaho

HENRY A. WAXMAN, California

TOM LANTOS, California

ROBERT E. WISE, JR., West Virginia

MAJOR R. OWENS, New York

EDOLPHUS TOWNS, New York

PAUL E. KANJORSKI, Pennsylvania

PATSY T. MINK, Hawaii

CAROLYN B. MALONEY, New York

ELEANOR HOLMES NORTON, Washington,

DC

CHAKA FATTAH, Pennsylvania

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

ROD R. BLAGOJEVICH, Illinois

DANNY K. DAVIS, Illinois

JOHN F. TIERNEY, Massachusetts

JIM TURNER, Texas

THOMAS H. ALLEN, Maine

HAROLD E. FORD, JR., Tennessee

JANICE D. SCHAKOWSKY, Illinois

———

BERNARD SANDERS, Vermont

(Independent)

KEVIN BINGER, Staff Director

DANIEL R. MOLL, Deputy Staff Director

DAVID A. KASS, Deputy Counsel and Parliamentarian

CARLA J. MARTIN, Chief Clerk

PHIL SCHILIRO, Minority Staff Director

SUBCOMMITTEE ON NATIONAL SECURITY, VETERANS AFFAIRS, AND INTERNATIONAL

RELATIONS

CHRISTOPHER SHAYS, Connecticut, Chairman

MARK E. SOUDER, Indiana

ILEANA ROS-LEHTINEN, Florida

JOHN M. MCHUGH, New York

JOHN L. MICA, Florida

DAVID M. MCINTOSH, Indiana

MARSHALL ‘‘MARK’’ SANFORD, South

Carolina

LEE TERRY, Nebraska

JUDY BIGGERT, Illinois

HELEN CHENOWETH, Idaho

ROD R. BLAGOJEVICH, Illinois

TOM LANTOS, California

ROBERT E. WISE, JR., West Virginia

JOHN F. TIERNEY, Massachusetts

THOMAS H. ALLEN, Maine

EDOLPHUS TOWNS, New York

BERNARD SANDERS, Vermont

(Independent)

JANICE D. SCHAKOWSKY, Illinois

EX OFFICIO

DAN BURTON, Indiana HENRY A. WAXMAN, California

LAWRENCE J. HALLORAN, Staff Director and Counsel

ROBERT NEWMAN, Professional Staff Member

MARCIA SAYER, Professional Staff Member

JONATHAN WHARTON, Clerk

DAVID RAPALLO, Minority Counsel

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C O N T E N T S

Page

Hearing held on March 18, 1999 ............................................................................ 1

Statement of:

Robertson, Steve, director, National Legislative Commission, the American Legion; Dennis Cullinan, director, Legislative Services, Veterans

of Foreign Wars; David Woodbury, national service director, AMVETS;

Richard Wannemacher, Jr., associate national legislative director, Disabled American Veterans; Rick Weidman, director of Government Relations, Vietnam Veterans of America; and Paul Sullivan, executive director, National Gulf War Resource Center ..................................................... 11

Letters, statements, etc., submitted for the record by:

Cullinan, Dennis, director, Legislative Services, Veterans of Foreign

Wars, prepared statement of ........................................................................ 26

Filner, Hon. Bob, a Representative in Congress from the State of California, prepared statement of ...................................................................... 4

Robertson, Steve, director, National Legislative Commission, the American Legion, prepared statement of ............................................................. 14

Sullivan, Paul, executive director, National Gulf War Resource Center,

prepared statement of ................................................................................... 77

Wannemacher, Richard, Jr., associate national legislative director, Disabled American Veterans, prepared statement of ...................................... 44

Weidman, Rick, director of Government Relations, Vietnam Veterans of

America, prepared statement of .................................................................. 61

Woodbury, David, national service director, AMVETS, prepared statement of ........................................................................................................... 36

(1)

VIEWS OF VETERANS’ SERVICE

ORGANIZATIONS

THURSDAY, MARCH 18, 1999

HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON NATIONAL SECURITY, VETERANS

AFFAIRS, AND INTERNATIONAL RELATIONS, COMMITTEE ON GOVERNMENT REFORM, Washington, DC.

The subcommittee met, pursuant to notice, at 8:32 a.m., in room

2154, Rayburn House Office Building, Hon. Christopher Shays

(chairman of the subcommittee) presiding.

Present: Representatives Shays, Souder, Mica, Terry,

Blagojevich, and Sanders.

Staff present: Lawrence J. Halloran, staff director and counsel;

Robert Newman and Marcia Sayer, professional staff members;

Jonathan Wharton, clerk; David Rapallo, minority counsel; and

Earley Green, minority staff assistant.

Mr. SHAYS. We are going to call this hearing to order.

Good morning. Our early start today is one measure of the importance the subcommittee places on the views of national veterans’ service organizations. Before the crush of meetings and votes

overtakes the day, and before our agenda fills for the year, we feel

it is essential to hear from those who served in our country’s armed

forces and whose daily mission is to help others who did the same.

In previous hearings, the General Accounting Office, the Inspector General, and representatives from the Department of Veterans

Affairs described the many challenges confronting a department

managing a $43 billion in health, compensation, and other benefit

programs for more than 25 million veterans and their families.

They mentioned chronic claim processing delays, uncertain healthcare quality protections, inaccurate data systems, and budget inequities within and between regions.

Our witnesses today bring a unique perspective to these issues.

They risked their lives and helped make the United States of

America the great Nation it is today. It is a perspective which provided invaluable to our work and the Gulf war veterans’ illnesses,

and one I know will inform and improve our continuing VA in Defense Department oversight.

Welcome to all of you, and we look forward to your testimony.

What I would like to do is to invite my colleague, Robert Filner,

from California—he serves on the Veterans Affairs Committee and

is, I believe, the ranking member—the Benefits Subcommittee, an

important subcommittee for the issues we are dealing with, so I

would like to invite him to make a statement.

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Then I am going to swear you in, and then we are going to hear

from you all.

Mr. FILNER. Thank you, Mr. Chairman, and I do appreciate your

courtesy to allow a Member of the minority to have a quick statement. I would like to submit my full statement for the record. Second, I want to thank you for all your work in the last Congress,

and in the coming Congress, on the Persian Gulf war illness. You

have brought us, more than anyone, closer to the truth on this

issue. We still have a ways to go, but I appreciate your courage and

your leadership on this issue. Last, your oversight on this issue is

very important. You will hear from organizations who have put together, not only a budget guideline for us to go by, but, of course,

their lifelong commitment and their organizations’ commitment to

veterans is unquestioned, so when they speak, it is good for us to

listen. I thank you for providing the forum for them.

Most of the organizations—I think all the organizations before

you—have endorsed what is called the Independent Budget for the

Year 2000, and several played a role in putting that budget together. What their budget provided in a very succinct, professional,

and convincing manner, what do we need to make sure that we fulfill our contract with our Nation’s veterans?’’ They concluded that

the President’s budget was woefully inadequate, that approximately $3 billion more was needed just to keep even with the

present budget. Many of us on the Veterans Affairs’ Committee

agreed with them. The budget, as submitted by the President, left

the VA healthcare system drastically underfunded, in danger of actual collapse. The budget for the GI bill is far short of realistic

needs and failing as a readjustment benefit and as a recruitment

incentive. Desperately needed staffing increases included in the

budget appear to be phony, little more than ‘‘shell games.’’ The National Cemetery system has been underfunded for years, and the

money needed for the most basic repairs and upkeep is unavailable.

These are drastic problems. This is no way to treat those who

have made sure that we have a country that is worthy of defense.

Veterans have been wronged by this budget, and now it is time for

Congress to right that wrong.

We need, Mr. Chairman, to unite as a Congress, to unite as both

parties, to unite with these organizations, to make sure an adequate budget is passed by this Congress.

I think I use a dirty word here, but the ‘‘caps,’’ with respect to

Veterans Affairs, have to be broken. There is no way that we can

do justice if we are going to stay within the caps that were given

to us. There is an urgency and frustration in the budget and in the

testimony of these gentlemen in front of you that I have not heard

before.

They are telling us that they have done more than their fair

share to balance our budget, and now they expect us to be their

advocates. They are reminding us that America is safe and free

only because of the hardships and sacrifices that they have suffered.

Let me just read you one statement, Mr. Chairman, from the

independent budget.

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As the administration and Congress develop budgets and policies for the new millennium, we urge them to look up from their balance sheets and into the faces of

the men and women who risked their lives to defend our country. We ask them to

consider the human consequences of inadequate budgets and benefits denials for

those who answered the call to military service.

I take that to heart.

They have outlined what is needed for healthcare, the GI bill, the

benefits package, for Persian Gulf war veterans, Mr. Chairman.

The funding, for example, in the budget that was both presented

by the President and most likely will come out of Congress as it

exists now, does not adequately fund the legislation for Persian

Gulf war veterans that you put forward and was passed by the

House and the Senate last year. Without that money, the VA system will not be able to absorb the additional Persian Gulf war veterans who will be eligible for healthcare under the new law that

you led the fight for.

So we have a lot of work to do. I appreciate your kindness and

courtesy, your courage, your leadership, Mr. Chairman. We have to

do right by these veterans.

[The prepared statement of Hon. Bob Filner follows:]

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Mr. SHAYS. Thank you, Congressman Filner. Let me just say,

this is—I never think of this as a majority or minority. You are an

equal partner in this process and have been very helpful, and I

really thank you for being here.

Mr. Blagojevich is on his way and just wants to make sure that

we get started.

So I am going to introduce our witnesses. Mr. Steve Robertson,

director, National Legislative Commission, the American Legion;

Mr. Dennis Cullinan, director, Legislative Services, Veterans of

Foreign Wars; Mr. David Woodbury, national service director,

AMVETS; Mr. Rich Wannemacher, Jr., associate national legislative director, Disabled American Veterans; Mr. Rick Weidman, director of Government Relations, Vietnam Veterans of America; and

Mr. Paul Sullivan, executive director, National Gulf War Resource

Center.

I would invite our witnesses to stand and we will administer the

oath in this committee, and then we will hear your testimony.

Thank you.

[Witnesses sworn.]

Mr. SHAYS. For the record, all of our witnesses responded in the

affirmative.

It is very nice to have Congressman Terry from the great State

of Nebraska. I always love watching them play football among

other things.

Mr. TERRY. So do I—[laughter.]

Mr. SHAYS. If we could just start in the manner I called you. And

we are going to hear all your testimony. We don’t have a light up

there. We have a timer here. Let me just tell you our restraints.

Our restraint is that technically we are supposed to adjourn by

9:30. We can go on a little beyond, but we are going to be having

a top-secret briefing on our defense system and one that they have

requested that we not have hearings during that time, but we can

run over a little bit.

STATEMENTS OF STEVE ROBERTSON, DIRECTOR, NATIONAL

LEGISLATIVE COMMISSION, THE AMERICAN LEGION; DENNIS CULLINAN, DIRECTOR, LEGISLATIVE SERVICES, VETERANS OF FOREIGN WARS; DAVID WOODBURY, NATIONAL

SERVICE DIRECTOR, AMVETS; RICHARD WANNEMACHER,

JR., ASSOCIATE NATIONAL LEGISLATIVE DIRECTOR, DISABLED AMERICAN VETERANS; RICK WEIDMAN, DIRECTOR

OF GOVERNMENT RELATIONS, VIETNAM VETERANS OF

AMERICA; AND PAUL SULLIVAN, EXECUTIVE DIRECTOR, NATIONAL GULF WAR RESOURCE CENTER

Mr. ROBERTSON. Thank you, Mr. Chairman.

I am going to try to summarize my statement. I would request

that my full statement be submitted for the record.

Mr. Chairman.

Mr. SHAYS. Yes?

Mr. ROBERTSON. My full statement be submitted——

Mr. SHAYS. Yes——

Mr. ROBERTSON [continuing]. For the record, and I will try to

summarize——

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Mr. SHAYS. Yes. I am going to wait until my colleague gets here

to make sure that we make it official that it will be in the record,

but it—[laughter]—will be.

Mr. ROBERTSON. OK, sir.

Mr. SHAYS. Thank you.

Mr. ROBERTSON. I am going to summarize my remarks so that

we can open up the discussion for dialog.

The last time I took an oath like that, it wound up 20 years of

military service, so I get a little edgy when I have to raise my

hand.

Mr. Chairman, the American Legion appreciates this opportunity

to present testimony on critical issues facing agencies and programs within your jurisdiction.

It is important to remember that the costs of war and peace go

on long after the guns are silenced, the treaties are signed, the

dead are buried, and the parades are over. It is our service members that take an oath of allegiance to support and defend the Constitution at the risk of personal safety. They endure many hardships and sacrifices to fulfill that promise. What awards and benefits this Nation provides them should reflect its gratitude for dedicated service. Medals and ribbons are appropriate, but do not heal

the mental and physical scars of war or make a broken body whole.

Turning to issues of national security, the first area deals with

Tricare, DOD’s newest version of military healthcare delivery. Mr.

Chairman, this single issue represents one of the biggest lies ever

told to service members. If you retire from the armed forces, you

and your dependents will receive medical care from the military, at

no cost, for the rest of your lives.

In 1973, I was commissioned in the U.S. Air Force. This promise

was made to me and, in fact, was a practiced policy. Now, military

retirees are allowed to participate in a federally subsidized

healthcare program called Tricare. The degree of healthcare coverage military retirees and their dependents receive is based on

how much money they are willing to—or in many cases, able to—

pay.

As radical as paying for an entitlement seems, they are only allowed to participate in this program until they become Medicareeligible. Once they become Medicare-eligible, they are ineligible for

Tricare. At a point in their lives when demands for quality

healthcare are the greatest, they lose the very healthcare system

that they have depended on for the vast majority of their adult

lives.

The American Legion is not surprised to hear about the recruiting and retention problems of the Armed Forces. After all, your

best recruiters are your alumni. Should you decide to hold hearings

on Tricare. The American Legion is prepared to participate and

offer some workable solutions.

Mr. Chairman, the next issue is concurrent receipt. The American Legion sees this issue as among the greatest inequities in the

Federal Government. Under current law, if a military retiree has

a VA service-connected disability, the veteran loses $1 of military

longevity retirement pay for every VA compensated dollar received.

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Military retirees are the only Federal retirees penalized in this

manner. Concurrent receipt represents a bean-counter’s compensation concept, not the thanks of a grateful Nation.

Turning now to the area of veterans’ affairs, I must express the

disappointment in the President’s budget request for fiscal year

2000 for the VA. The entire veterans’ community agrees that it is

inadequate. The American Legion supports the Veterans Affairs

Committee’s views and estimates to add $1.9 billion and hope that

Members will demand the budget resolution reflects such an increase.

Although VA funding is not directly under your jurisdiction,

there are three funding mechanisms that need your attention: the

Medical Care Collection Fund [MCCF], the Veterans Equitable Resource Allocation [VERA], and Medicare Subvention. All three of

these programs directly impact veterans’ healthcare funding systems. Again, the American Legion would welcome the opportunity

to participate in any hearings you hold.

Another issue deals with legislation enacted last Congress to

amend title 38 of the United States Code and now denies due process to a small percentage of veterans. Without the benefit of congressional hearings, Congress chose to deny some veterans their

right to receive a service-connected disability rating for a medical

condition related to their service in the Armed Forces. I can’t help

but notice the picture of Representative former-Chairman Brooks

up there with his cigar in his hand.

The group that I am talking about, the American Legion adamantly opposes the decision to deny a select group of veterans with

tobacco-related illnesses their right to receive service-connected disability, should they be able to prove that it is connected with their

military service. This needs to be repealed. It was wrong; it was

unethical. It was immoral; it was flat wrong to do that.

Another area of great concern is the long-term healthcare for

both military retirees, their dependents, and veterans. The longterm care for military retirees, their dependents, and veterans is

basically nonexistent. And it is very ironic that today, one of your

other subcommittees is holding a hearing on long-term care for

Federal employees, and there is nobody from the military there to

represent them.

In the area of international relations, the American Legion has

two areas of concern—the administration’s certification of Vietnam

and the Orderly Departure Program.

Thank you, Mr. Chairman, for the opportunity to testify today.

I hope that this is just the first of many appearances before your

committee.

[The prepared statement of Mr. Robertson follows:]

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Mr. SHAYS. Thank you very much. You covered a lot in 6 minutes. [Laughter.]

Mr. Dennis Cullinan.

Mr. CULLINAN. Thank you very much, Mr. Chairman, and members of the subcommittee and concerned Members of Congress.

On behalf of the men and women of the Veterans of Foreign

Wars, I would express our deep appreciation for inviting us to participate in today’s important hearing.

Mr. Chairman, in preparation for this hearing, in discussions

with your staff, I asked what it was that I should address here

today. And it was suggested to me that I should talk about those

things that truly trouble us, as an organization, an organization of

veterans’ advocates—the things that wake us up at 3 a.m.—and

those are some of the things that I intend to discuss here today.

Securing sufficient funding for the VA medical care system has

now taken on such a note of urgency that if we fail in this regard,

its continuing existence as a viable healthcare provider for veterans

is very much in doubt. Similarly, inadequate funding continues to

undermine the effectiveness of the Veterans Benefits Administration, and veterans are suffering as a consequence.

The administration’s proposed fiscal year 2000 budget for the Department of Veterans Affairs would be devastating to our Nation’s

veterans. If the Congress does not step forward and increase the

funding provided for this purpose, VA’s ability to provide quality,

timely, accessible healthcare for veterans will do irreparable harm.

The VFW hears daily complaints of increasing waiting times for

veterans to see a specialty provider, such as an orthopedic doctor

or a dermatologist. This is happening throughout the country. More

egregious in the specific, however, is the 1-year wait for hip replacement surgery in Ann Arbor, and the 1-year wait for dentures

in Maine, and the 1-year wait for dermatology appointments in

New Orleans.

Then there is the veteran in Louisiana who is 50 percent serviceconnected, has a significant skin condition, and cannot get a dermatology appointment for 7 months. A 100 percent service-connected disabled veteran in a private nursing home under VA contract in Rhode Island since Korea for his service-connected condition, was told that VA could no longer afford the cost of keeping

him there, and that he could afford to pay for his own care, himself. His removal from the home was only halted through VFW

intervention.

A New Jersey veteran in a VA nursing home for 15 years was

threatened with expulsion. This was due to cost-driven mission

change to eliminate all long-term care. Once again, it was only

VFW intervention that prevented him from being thrown out.

These are only a few of the examples of the tragic, nationwide

epidemic, an epidemic of increased waiting times and delays in getting appointments which, in these examples, can only be interpreted as a denial of care. And it will get worse, this year and next,

because of this proposed budget, if the Congress doesn’t act.

Mr. Chairman, you are, of course, familiar with the numbers, the

statistics, but this is a situation—this is a human tragedy in the

making, a human tragedy that needs to be addressed before more

veterans suffer, wrongly and for no good reason.

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There are other issues to be addressed—the aging veteran population. As you know, Mr. Chairman, at this point in time, long-term

care is not mandated under law and because of cost-driven mission

changes like the one I cited just earlier, long-term care capability

is being steadily eroded, eliminated from the Department of Veterans Affairs. This, in the face of a rapidly aging population, just

at a time when our World War II veterans need such care, the VA’s

already limited capability is being diminished. This is wrong.

Another area of concern—waiting times to receive treatments in

specialty clinics continues to get worse. Calls from veterans have

indicated, for instance, more than a 1-year delay to receive dentures in Network 1 and more than a 1-year delay to receive orthopedic surgery in Network 11. We have also seen an increase in the

number of calls received about obtaining timely appointments in

clinics such as cardiology, dermatology, podiatry, ophthalmology,

and a variety of other specialty clinics. Pharmacy waiting times

have worsened over the past year. Calls about 1- and 2-hours’ waiting times to receiving medications are commonplace. Waiting times

are increasing because staff has been reduced, and the outpatient

workload has increased. With staffing reductions to take place in

the near future, this problem will surely get worse.

And then there are other upcoming challenges; you referenced it

briefly earlier. The VA is about to undertake treating veterans suffering from hepatitis C, and they have to do this. This is the only

correct and right thing to do, but the money to pay for it isn’t

there. This can only result in tragedy, if not remedied.

Emergency room care is another issue. Right now, there are veterans who would go for emergency room care—service-connected

veterans—who would seek emergency room care outside of VA, and

VA won’t cover the costs, even if it is for their service-connected

problem.

And a newer horizon—you discussed Persian Gulf briefly earlier.

Persian Gulf is an issue which has yet to be resolved, although

much progress has been made in the right direction. But this augers for future challenges. In this day and age, there are going to

be more and more small conflicts. And with these small conflicts,

they will have their own particular problems. A tough thing to

meet, and the last thing we need is a reduction of funding.

I would also say here, addressing the issue of the caps, the VFW,

of course, salutes the action in the Senate Budget Committee the

day before yesterday, in providing an additional $1.1 billion in discretionary money for VA. Of course, VA hardly has that money at

this point in time, and we only urge that the House follow suit.

In fact——

Mr. SHAYS. Could I ask, is that—you said $1.1 million?

Mr. CULLINAN. Billion.

Mr. SHAYS. Billion; I am sorry—$1.1 billion. But is that above

the President’s budget or above——

Mr. CULLINAN. That is above the——

Mr. SHAYS. Or above the baseline——

Mr. CULLINAN. Yes, that is above——

Mr. SHAYS [continuing]. That we had last year, or we are in this

year?

Mr. CULLINAN. It is above the baseline. It is above the baseline.

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Mr. SHAYS. So it is significantly more than——

Mr. CULLINAN. Although——

Mr. SHAYS. Yes.

Mr. CULLINAN [continuing]. In spending authority.

The point I would make here, though, is even more is required. The independent budget has identified the need for about $3.2 billion. Nonetheless, we salute the fact that they took the initiative

to go that far, and we ask that the House, now, even go further.

The Veterans Benefit Administration continues to encounter serious problems in its ability to render quality, timely decisions in the

adjudication of veterans’ claims for benefits, especially those for

compensation. Contributing to these problems is the escalating

amount of appeals—now slightly over 100,000—to be processed in

those offices, primarily in response to the number of remands from

the Board of Veterans Appeals.

We are absolutely convinced that inadequate staffing is now the

root cause of the Veterans Benefit Administration quality problems. Statistics confirm this supposition. The VBA has gone from

13,856 employees in fiscal year 1992 to approximately 11,200 presently, a 20 percent reduction in less than 6 years.

What is immediately required is an infusion of additional employees to replace normal attrition. And I would add to that that

they need to be carefully trained employees who have the inclination and the intellectual wherewithal to undertake that highly rigorous calling.

The ‘‘Fiscal Year 1999 Veterans’ Independent Budget and Policy’’

document provides justification for an increase of 500 employees in

the compensation and pension service. Congress must now immediately act and provide the necessary appropriated funding to reverse the deleterious employee reduction in VBA, if we hope to

have any further success toward achieving the goal of timely and

proper claims adjudication for veterans.

Once again, this is not simply a matter of statistics, but it is a

human tragedy that needs to be addressed.

Mr. Chairman, and members of the subcommittee, this concludes

my written statement. Once again, I will thank you for having included us in this important forum, and I will, of course, be happy

to respond to any questions you have.

[The prepared statement of Mr. Cullinan follows:]

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Mr. SHAYS. Thank you very much.

Mr. Woodbury.

Mr. WOODBURY. Mr. Chairman, AMVETS——

Mr. SHAYS. Could you move the mic closer to you, and I think

push it down a little bit.

Mr. WOODBURY. OK.

Mr. SHAYS. And it won’t stay down. [Laughter.]

Mr. WOODBURY. Can you hear me all right?

Mr. SHAYS. It worked fine.

Mr. WOODBURY. We appreciate the opportunity to join you this

morning and provide testimony in support of your oversight responsibilities concerning National Security, Veterans Affairs, and International Relations issues.

Now, Mr. Chairman, at a time in our history when unemployment is approaching record lows, the economy is strong, and, for

the first time in several decades, the national debate seems increasingly focused on what to do with budget surpluses, Americans

generally may be content with their circumstances. One can reasonably argue that, indeed, times are good. They are, unless you

happen to be in the military or a veteran seeking healthcare or

other benefits to which you may be legally entitled. From their perspective, they sense that America’s gratitude for their service, patriotism, and sacrifice may be a thing of the past.

We believe that, as a matter of urgent priority, your agenda for

the 106th Congress ought to embrace the precept that without national security, there can be no long-term Social Security. National

security is underwritten by the men and women in uniform today

and the veterans who preceded them. Were it not for their selfless,

dedicated, and professional commitment to our Nation through

military service, the freedoms we enjoy might be significantly diminished. ‘‘What have you done for me lately?’’ seems to be a question many have difficulty answering today. We seem incapable of

recognizing that today’s military personnel, like the millions of veterans who preceded them, maintain a 24-hour vigil around the

world in defense of America’s freedoms. Their personal sacrifices

today, and throughout our history, seem now to go unnoticed and

unappreciated.

We are at peace today, thanks to our historically strong military

posture. Yet, even in the absence of war, we have forces positioned

around the world ready to respond to national tasking. Whenever

this Nation calls, they answer. And yet when they call out for assistance, seemingly very few hear their plea. The message veterans

are hearing loud and clear is that they are no longer important—

the national agenda has other more vital issues with which to deal.

Mr. Chairman, within the very broad continuum of oversight responsibilities with which your committee is tasked, it seems to us

there are several related issues. For example, we do not believe it

is coincidental at a time when America is enjoying unprecedented

prosperity, that defense preparedness is down, personnel retention

within the military is down, and vital programs, keyed to helping

those veterans whose sacrifices helped to get us to this preeminent

international position continue to receive benign neglect. These

trends are troubling. The message to both our active-duty military

and veterans alike is that their service, patriotism, and sacrifices

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are no longer valued to the degree they once were. We believe this

message has to be reversed.

The Report of the Congressional Commission on Servicemembers

and Veterans Transition Assistance is now a matter of public

record. It discusses a number of key issues affecting both active

duty military and veterans which we believe deserve careful review

and action from the 106th Congress.

Separately, AMVETS, in partnership with the Disabled American Veterans, Paralyzed Veterans of America, and the Veterans of

Foreign Wars has introduced its Independent Budget for Fiscal

Year 2000. It identifies a funding shortfall in the Department of

Veterans Affairs budget in excess of $3 billion, compared to the

Clinton/Gore fiscal year 2000 submission.

As you are aware, the House Committee on Veterans Affairs recently recommended a $1.9 billion increase to the administration’s

VA budget, and while we commend Chairman Stump for the leadership and support he continues to provide, this recommendation

still leaves us at least $1 billion short of the funds required to sustain VA’s programs at an adequate level.

We believe we cannot continue to ignore our responsibilities to

provide the support our veterans have earned. We need to fully

fund VA at the level required to fulfill its mandate and, continue

to hold its leadership accountable for the stewardship of those

funds allocated.

The Clinton budgets have historically ignored this commitment.

It is time to correct that problem. Failure to do so will result in

a continuing downward spiral in VA’s ability to deliver quality

healthcare and other benefits which veterans have earned and

have a right to expect.

Finally, Mr. Chairman, there is the issue of America’s national

security. We need to pay attention to the lessons of history. Every

time we have failed to sustain a strong, capable military, war has

been the result. Americans today should be deeply concerned by

the news that the military services are losing their people, are failing to achieve their recruiting goals, and are unable to man ships,

aircraft, and other weapon systems at acceptable operating standards due to funding shortages.

Considering recent reports that China may now have both the

technology and means to deploy nuclear weapons, that the more

subtle threat of international terrorism is increasingly possible,

and that the threat of chemical and/or biological agents is rising,

our way of life continues to be very much at risk.

America may be at peace, but considering events around the

world, it is, at best, an uneasy international environment in which

we live.

For these reasons, we strongly support recent initiatives to increase DOD funding levels. We need to sustain our investment in

national defense. The price is not too great for the value received.

Mr. Chairman, this concludes my testimony. I will be happy to

answer any questions.

[The prepared statement of Mr. Woodbury follows:]

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Mr. SHAYS. Thank you.

I just want to recognize the presence of our ranking member, Mr.

Blagojevich, and, also, Mr. Sanders.

And what we will do is, keep on going and hear our testimony.

So, Mr. Wannemacher, you are up.

Mr. WANNEMACHER. Thank you very much, and I want to say

that we really appreciate the opportunity to appear here before

you. I am pleased to appear before you and present the views of

more than 1 million men and women who are disabled veterans

from all wars.

On the critical issues facing the Department of Veterans Affairs,

many challenges confront VA today, and we appreciate the opportunity to discuss them with you.

One of those challenges is the institution of the appropriate

measures to address the unique problems of our Persian Gulf war

veterans. Mr. Chairman, you have already devoted a great deal of

attention to that effort, and we especially want to take this opportunity to express our appreciation and commend you for your leadership on this issue.

In many ways, VA is an agency in crisis. While some of the problems are complex and difficult to overcome, others are susceptible

to relatively straightforward, practical solutions, but have been neglected for various reasons. Whether simple or complex, the problems and their causes, in most instances, are well defined, but the

remedies are either held hostage by politics of the Federal budget

or depend on the will of VA management to take decisive action.

Unquestionably, insufficient funding must bear a major share of

the blame for the current sad state of veterans’ programs. Regrettably, as obvious as it is that many of VA’s woes are directly or indirectly consequent to degradation of years of inadequate resources,

the administration’s fiscal year 2000 budget provides no relief. Indeed, the recommended funding for healthcare is so insufficient

that it only pushes VA closer to the precipice. That reality has become undeniable. While they are not unanimous in their assessment of the extent of the shortfall, your colleagues on the Veterans

Affairs Committee recognize the problem.

With inadequate resources, VA is already rationing healthcare

and denying or delaying urgently needed services to a large number of veterans.

If Congress does not substantially increase appropriation for

healthcare, VA medical center directors will be forced to do some

of the following things—and they will have to do them in Vermont,

Connecticut, Nebraska, California, and Illinois: eliminate entire

primary care teams; discontinue healthcare for thousands of sick

and disabled elderly veterans who are currently enrolled and depend on this healthcare as their only source of healthcare; to terminate or furlough thousands of VA medical care employees across

the country; close entire VA medical centers; discontinue contract

nursing home care; shut down hospice care units; and discontinue

kidney dialysis for service-connected veterans and other eligible

veterans.

We also note that VERA has been given a bad name—especially

in the Northeast—since its inception. But the more the inadequacy

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of the budget, the worse the name is going to become, because all

that VERA is, is the distribution system of the budget.

For medical care, the administration has requested a budget au- thority of $18.1 billion, which includes $17.306 billion for appropriated funds, and then relies on $749 million to be collected for

the treatment of non-service-connected medical conditions.

The independent budget, which Congressman Filner so eloquently referred to, is an annual alternative assessment, compiled

by the DAV, PVA, AMVETS, and Veterans of Foreign Wars, and

we have calculated—as you have just heard from my colleague—

a $3 billion deficit. Regardless of that amount of inadequacy, the

impact in practical terms is shocking, partly attributed to both the

immediate effects of the budget and partly because of the cumulative effects of past budgets that did not provide the resources necessary to maintain the system at the current service levels. For

well over a decade, VA has been faced with the dilemma of everincreasing demand for medical care and perennial inadequate

budgets.

VA has never been able to meet its target for third-party reimbursement. In fact, the best year that they did was in 1996 when

they received 35 percent of what they had projected. In hearings

before the House Veterans Affairs Committee last month, Dr.

Garthwaite identified that currently this year, they are not going

to meet their budget requests for third-party reimbursement. Now

we inflate the projections, and the VA is really going to suffer.

Also suffering is the prosthetics budget, which is frozen again this year at $319 million. This is $56 million below what the IB

had recommended and is incorporated in that $3.2 billion budget

that the independent budget recommended.

Mr. SHAYS. I am going to ask you to speak maybe for 2 more

minutes?

Mr. WANNEMACHER. OK.

Mr. SHAYS. Thanks.

Mr. WANNEMACHER. The budget also reflects that one of the most

critical issues facing VA is hepatitis C. The VA estimates that

there is $135.7 million in new healthcare spending that will occur

in the year 2000. We applaud the administration for taking this

step of discovery, however, the budget does not provide any new

funding. Given the new challenges and the potential for hepatitis

C epidemic represents, there must be a measure of comprehensive

process to identify, treat, and educate all veterans who may be at

risk for this disease. A registry of infected veterans would permit

VA to track outcomes and keep veterans notified of new developments. VA must monitor its facilities and ensure that they follow

the proper treatment modalities.

This will conclude my remarks, and I thank you very much for

the opportunity.

[The prepared statement of Mr. Wannemacher follows:]

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Mr. SHAYS. Thank you very much.

Mr. Weidman.

Mr. WEIDMAN. Thank you, Mr. Chairman. We appreciate the opportunity for Vietnam Veterans of America to share some of our

concerns with you and your distinguished colleagues here this

morning.

I would just second everything my colleagues had to say about

the budget.

The budget is so woefully inadequate, one doesn’t even know how

to comment on the irresponsibility of this administration submitting such a woefully inadequate budget.

I am reminded of a story repeated to me by a wonderful woman

who is a national VA voluntary services coordinator for our colleagues at the Jewish war veterans. She told us a story that her

father had told her often about adequate funding and resources for

whatever it is you are trying to accomplish.

There was a man in his village in Lithuania who decided that,

in order to economize, he would feed his horse a little bit less every

day. And that way, the horse wouldn’t notice. When he got down

to one straw a day, the horse died.

It is not too precipitous to say that the VA system is literally

being starved to death. You can go to any VA medical center in the

country and see the effects of the budget cuts that my colleagues

have so eloquently pointed out in some detail.

But I would urge you, not only to go to the VA medical centers

in your district, but you can go right up to North Capitol here and

try and explain to veterans at the VA medical center here in Washington why it is that we are building an atrium which will not add

one whit—not add one whit—to the quality of care or the range of

services in medical care available to them. At the same time, VA

is cutting back on prosthetics in that hospital, with people unable

to get what they need, and at the same time that the rehabilitation

staff and physical therapy staff have been reduced by almost 50

percent. This is a tough one. You can try and explain to them it

is a different part of the budget, but that is not what the veteran

sees. So the need for additional resources is clear and apparent and

pressing at this point.

Within the context of these budget cuts it becomes, then, also, a

convenient excuse about why they are not doing other things that

they should be doing.

Having said that, Vietnam Veterans of America believes strongly

that VA needs to make some fundamental changes in how it allocates those dollars, and that begins with a ‘‘mind set’’ of the entire

veterans’ benefits and services structure. At the VA medical system, in particular, it begins at the front door. When you tell people

who are not familiar with this system, that no one asks when you

walk through the front door of a VA hospital in detail, ‘‘What did

you do in the war, Dad? What did you do in the war, Mom?’’ They

are astonished, because they believe that the VA system is there

to, in fact, to address the needs of veterans, as veterans. It simply

does not happen.

A glaring example of that would be hepatitis C. Another would

be the maladies of DU exposure and perhaps heavy-metal poisoning that the Gulf war veterans have suffered through.

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What we are advocating here, and what we have talked with Dr.

Keyser and Dr. Garthwaite about—and will continue to press—is

for VA to be VA. The mission doesn’t really change. The means of

accomplishing that mission changes, but the mission, from our

point of view, is veterans’ healthcare and not a general hospital

system that happens to be for veterans and ‘‘let’s see what we can

do for those poor old guys and poor old gals.’’ It is a covenant that

we made between the people of the United States and the men and

women who placed their life and limb on the line in defense of the

Constitution of the United States that cannot be—it is that sacred.

It is that fundamental to our democracy that we honor that.

But one way of honoring that covenant is to make sure we utilize

our resources the best, and that begins with the military history

that documents all of the things that one may have been subject

to, given the time one served, what era, where one served, what

branch of service, and what one actually did. That can be easily,

and with virtually no expense, within 3 to 6 months, put on all of

the computers and done at intake, as everybody comes into the VA

system, to pick up on their neuro-psychiatric problems, to pick up

on yellow fever for World War II vets, strongliodies and melioidosis

among Vietnam veterans, et cetera.

Why is this important, and what does this have to do with

money? We churn people back and forth through this system simply because we do not focus on ‘‘wellness,’’ which takes into account

the entire human being.

I want to just comment on two other things—or three things—

that are productive lines of inquiry that I would suggest that you

and your distinguished colleagues, Mr. Chairman, address during

the remainder of this year.

The first has to do with the battlefield as a ‘‘hazardous workplace.’’ All too often, we have not thought of it that way. That

would get into agent orange and other adverse health impacts for

those of us who served in Vietnam—but in every battlefield, not

just in the Gulf war, but every battlefield in the future, given the

exotic weapons, will become more and more a ‘‘toxicological’’ soup.

The efforts to understand what we are getting into, and the effect

on our troops and personnel, as well as on the civilian populace,

is something that we believe DOD has not adequately addressed.

And the time to address it is before you deploy the weapons, as

well as going back and not deny, deny, obfuscate, for the men and

women who have already been exposed.

So we would urge you to follow through with that because, frankly, it doesn’t matter whether it is the retinopathies that veterans

suffer are due to post-traumatic stress disorder or whether they are

due to exposure to agent orange or one of the other chemicals we

were exposed to in Vietnam.

Second is the whole area of zeroing in on the Ranch Hand study,

in particular. They are differing, widely and dramatically, from

their own protocol and the way in which they are carried out; the

pace is being deliberately slowed down, we believe, and there are

significant issues there where we would be pleased to work with

your staff.

And last, but not least, is the issue of studies. I know that your

jurisdiction may not cover HHS and others at this point, but it

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would be worth zeroing in on ‘‘where are research dollars being

spent?’’ The problem for Vietnam veterans is that the alliance and

the Ranch Hand study is that it is too small a sample size. We

need to initiate other studies that can be turned around relatively

quickly, such as following up on the National Vietnam Veterans

Readjustment study, et cetera. NIEHS needs to put resources in

that.

And last, but not least, in that regard, Mr. Chairman, is take a

look at how VA uses its research dollars. The research dollars are

not there in order to just to benefit the medical schools, although

they may, as a commitment to the primary mission of VA. The research dollars should be there in order to look into and better treat

the needs of veterans, as veterans. But very few of those research

dollars are being used to deal with agent orange, post-traumatic

stress disorder, DU, et cetera, and other kinds of maladies that are

specific and particular to veterans, as veterans.

Mr. Chairman, thank you very much for this time. And I look

forward to answering any questions you may have, sir.

[The prepared statement of Mr. Weidman follows:]

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Mr. SHAYS. Thank you very much.

Mr. Sullivan.

Mr. SULLIVAN. Chairman Shays, members of the subcommittee,

on behalf of the 56 member organizations of the National Gulf War

Resource Center, I appreciate the opportunity to testify today regarding matters important to the Gulf war veteran community.

Mr. Chairman, every day Gulf war veterans are reminded of the

fact that the Gulf war rages on in Iraq with 1 million Iraqis dead,

plus the fact that another Gulf war rages in the homes of more

than 110,000 veterans here in America. More than 1 million United

States troops are serving, or have served, in the Gulf war. More

than 110,000 of those claim illnesses related to the war. An unexpectedly high number of 235,000 Gulf war veterans have sought

healthcare at the Department of Veterans Affairs since 1991.

There are long-term consequences to war, and the war against

Iraq is no different—only the many types of new toxic exposures

are different. Here is what veterans want to know, Congressmen.

‘‘Why are my family, my friends, and I ill? How, when, and

where can I get the right medical treatment for my toxic contamination? Who will cover the costs, especially if the VA healthcare

budget is underfunded? Finally, how can we prevent such needless

tragedies in the future?’’

Due to failures at the Departments of Veterans Affairs and the

Department of Defense, Gulf war veterans were given the burden

of being forced to show we were ill and to show we were exposed

to toxins. Specific evidence—a lot of it revealed by this subcommittee—shows Gulf war veterans are seriously ill at higher

rates than non-deployed veterans.

More to the point, according to the Department of Veterans Affairs data, as of January 1, 1999, Gulf war veterans who served in

the Gulf region between 1990 and 1991 are 39 percent more likely

to have a service-connected disability than those of the era who did

not deploy. The future appears ominous, Congressmen. Veterans

who served from 1990 to 1991 in the Gulf war are 53 percent more

likely to have filed a claim. This may mean many more VA claims

are in the pipeline.

The military now admits widespread toxic exposures to depleted

uranium, hundreds of thousands; chemical warfare agents,

100,000; oil well fire pollution, hundreds of thousands; pesticides,

hundreds of thousands; and military-administered experimental

drugs, more than 100,000—plus more poisons.

Mr. Chairman, I will focus on only 4 subjects out of the 15 points

listed in our written testimony, and I ask that it be entered into

the record.

The first subject that deserves your full attention is the immediate implementation of Public Law 105–277. Mr. Chairman, I am

going to digress for a minute—and on behalf of the Gulf war veterans, Congressman Sanders, Congressman Filner, we thank you.

That is now the law of the land.

Implementing the Public Law is our top priority for 1999. President Clinton signed the Persian Gulf War Veterans Act of 1998

into law on October 21, 1998. It orders the VA to sign an agreement with the National Academy of Sciences within 60 days to investigate the more than 30 toxins associated with the illnesses and

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to study the illnesses more prevalent among Gulf war veterans.

The VA has failed to enter into that agreement. The VA’s behavior

results in delays in new medical research, new treatment programs, new claims filings, timely adjudication of claims, and the

granting of service-connection to disabled veterans. In short, no

healthcare.

Under-explored areas of toxic research include: depleted uranium, oil well fires, chemical warfare agents, experimental shots

and pills, pesticides, and synergistic combinations of these. Areas

of more prevalent adverse outcomes among veterans include Lou

Gehrig’s disease and other neurological disorders, cancers,

immunological disorders, reproductive disorders, and birth defects

among the children of Gulf war veterans.

On December 8, 1998, the VA asked the Department of Justice

to review the new law. On March 12, 1999—Congressmen, I have

great news, the Department of Justice advised the VA that Public

Law 105–277 is valid and effective. Now the law must be implemented.

We believe the VA must fund outreach about the new law to veterans and those assisting veterans with filing claims. The Resource

Center stands ready to assist the VA with that outreach.

The Resource Center is not alone in our support for the new law.

The independent budget, endorsed by more than 50 veterans’

groups, also calls for the immediate and full implementation of the

new law.

The second subject, Mr. Chairman, that merits your immediate

attention is the Resource Center’s support for funding of private research as well as research by the CDC, VA, and DOD. Three weeks

ago Congressman Sanders and 16 Gulf war veterans groups attended the CDC conference in Atlanta. The Resource Center believes that appropriate CDC research should be funded—not discussed—that Gulf war veterans and our advocates should participate in all research review panels, that more conferences should be

held, and that Gulf war veterans should be included in future conferences.

Because the Gulf war rages on today in Iraq, with more than 1

million Iraqi dead, the best Government and private-sector research is needed now into the many toxic exposures present in the

Gulf. This will improve medical care, improve toxic detection and

protection doctrine and training, plus improve the Government’s

tarnished reputation among Gulf war veterans.

Our third subject that merits your attention is the VA budget.

We believe the VA needs $3.2 million more than what was proposed by the administration and $1.3 billion more than what was

approved by the House Veterans Affairs Committee.

Since the current economic boom has created a Federal budget

surplus, the VA budget cap should be lifted.

Gulf war veterans are deeply concerned about underfunding at

the VA. This is because under Public Law 105–277, more than

235,000 Gulf war veterans—out of 1.2 million eligible—are entering an already overburdened VA healthcare system. Flat-lining appropriations during the war, while expenses soar and the number

of patients demanding care increases, is a recipe for disaster.

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Our fourth subject is that we hope you hold additional hearings

on anthrax and depleted uranium.

We understand you announced hearings for March 24 on the experimental anthrax vaccine. Gulf war veterans have a lot of questions about that, and we hope that your hearings will address that.

In conclusion, Mr. Chairman, after legislative victory was declared with the passage of Public Law 105–277, Gulf war veterans

thought the VA would get the message and start addressing this

issue with vigor. With their delays, it is clear the VA still doesn’t

get it.

The new law and our efforts on behalf of veterans may all be in

vain unless there are ongoing congressional hearings, unless Public

Law 105–277 is implemented, unless vigorous, unbiased research is

funded, unless the VA has full funding for healthcare, and unless

there is extensive outreach to Gulf war veterans.

Finally, the Resource Center strongly believes that research delayed or not funding equals healthcare denied for more than

100,000 sick Gulf war veterans. How long must we wait, twisting

in the wind, sick, and dying? How long? How long, Mr. Chairman?

Thank you.

[The prepared statement of Mr. Sullivan follows:]

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Mr. SHAYS. Thank you, Mr. Sullivan.

Let me just get some housekeeping out of the way, first, before

I go into our questions.

I ask unanimous consent that all members of the subcommittee

be permitted to place any opening statement into the record, and

that the record remain open for 3 days for that purpose. And without objection, so ordered.

I further ask unanimous consent that all witnesses be permitted

to include their written statement in the record. And without objection, so ordered.

Let me say, at the outset, it is wonderful to have all of you here

and to have you put on the record what we need to know and what

we need to focus on. And say that this committee—as you know,

but stating this for general conversation—we don’t appropriate and

we don’t authorize. We look at programs for waste, fraud, and

abuse. But we have an advantage the other committees don’t have.

One is that we have an interdisciplinary look; we have VA and

DOD. And, frankly, I asked to chair this committee and brought

VA with us—because it was under the other committee I chaired—

so that we would have the advantage of looking at, for instance,

Mr. Weidman, your point that we need to track a veteran, a soldier, sailor, Air Force, Marine record from day one. And that when

they get in the VA, the first question that should be asked is,

‘‘What did you do in the service?’’—and go from there.

And so we can rightly apportion, then, work with the authorizing

committees to have them become law or have them be appropriations, and that is, in fact, what we did with the whole issue of our

look at the Gulf war illnesses. So we are interdisciplinary and we

can look at.

And the other thing is that we are going to sometimes offend the

service organizations, because we don’t know your organization as

closely as say the veterans do or the DOD does, but, in that, we

are going to break out of the box. For instance, I might ask a question of, ‘‘Why don’t we just give a veteran a card?’’ And I know

some of you don’t like that, but I am going to want that dialog. And

that they can go to any hospital in the world and get the best

healthcare. Now I know there are answers to that. I know that the

hospitals focus in on the special needs of veterans, and I know that

you want to know there is a place, and I know those other questions, but I am going to want that kind of dialog as well.

Mr. Blagojevich is going to start the questions off. We are going

to, obviously, just keep moving because we don’t want to have a

break and then have to have you come back.

Mr. BLAGOJEVICH. Thank you, Mr. Chairman.

I have a question for the whole panel, and it is a very broad

question. I think it is probably a good way to start out.

And what I have noticed as a common theme, irrespective of

what war the veteran fought in is that there seems to be two factors that you guys are lamenting: insufficiency of funding and lack

of access to healthcare, which are, I think from a moral perspective, very troubling.

If you can just briefly, anybody in the panel, or as many of you

that would like, tell us about how we got in this position and why

that happened.

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Shall I just isolate somebody or do one of you want to volunteer?

Mr. WANNEMACHER. Well, I would just say that, as you recognized, it doesn’t matter which war you are in, we all became disabled or have—because of our economics—become eligible for VA

healthcare. Whether it be VA pensions or VA compensation, all of

us are eligible for VA education benefits. And we all fought different wars for the same purposes, and that was to keep America

free. None of us went to war as a Republican or a Democrat. We

all went to serve that American flag that sits behind you. And the

inadequacy is in my written statement and in my oral statement,

also.

The consistent inadequacy of the budget has caused the Veterans

Administration to be trying to stay ahead. And now they are at a

point where they have reached a wall. The efficiencies have been

taken away within the VA. There are still some efficiencies that

might be able to be found, but as veterans’ age, consistently age,

they need healthcare, and the budget just hasn’t kept up with that.

Mr. ROBERTSON. The American Legion agrees with that. The escalating cost of healthcare in the private sector has just driven the

price through the ceiling. And year after year, after year, after

year, after year, the veterans’ organizations kept saying, ‘‘You are

falling behind; you are falling behind. You are a dinosaur system,

and the rest of the world is out here in this type of managed care

healthcare.’’

The problem is, is at one time, the VA healthcare system was

probably ‘‘the example’’ of medical care in the country. We are affiliated with 107 medical schools. This is a teaching institution for

the future generations of healthcare providers. And we are watching this system implode on itself.

And everybody is saying, ‘‘Well, you know, we will just throw a

little bucks this way and a little bucks that way, and it will pacify

them for another year.’’ We have gotten to the point where veterans are being said, ‘‘You have got to leave a long-term care facility, and we will drop you off at the homeless shelter.’’

We are at a point when veterans come back from a war like the

Persian Gulf and say, ‘‘We are sick; we need help. We need medical

attention.’’ And you are telling us, ‘‘Prove to us you are sick.’’

My God, let’s talk logic here. That is not difficult to understand.

If you send me halfway around the world, and I come back and say,

‘‘I am sick,’’ you have an obligation to take care of me. I did your

job; now you do yours.

Mr. WOODBURY. There is a more fundamental reason, I think,

sir. VA and DOD are easy marks in the appropriation process. If

you are trying to make a ‘‘bogey’’ in some other program that may

be more political expedient, you can get the money from DOD; you

can get the money from VA, and you don’t have the advocacy in

that appropriation forum that you have here. And I think that is

one reason we got ourselves in this position in the first place.

Mr. WEIDMAN. It is the public conception that VA does everything for all veterans that people have that make it an issue that

becomes difficult to address. So if you feed that horse a little bit

less and a little bit less each year, and the VA hospital is still down

the road, and you haven’t gotten the message out that veterans

quite literally are dying albeit because they are denied needed care

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under, ‘‘cost savings,’’ VA denies that is happening. And it is true,

people aren’t turned away, but, you know, ‘‘they use euphemism’’

about reorganization.

One of my favorites is they reorganized the Alcohol and Drug

Treatment Program in Albany, Stratton VA Medical Center. What

‘‘reorganization’’ was, they closed the program there and have a

van every 2 weeks to take somebody 200-miles-plus to Batavia.

And folks who were ready to dry out and get clean weren’t going

to wait 2 weeks. Therefore, they discontinued the van because nobody used it. It is that kind of euphemism of not denial of care.

And make no mistake about it; the savings mean services denied

to veterans, and I think that is how, little by little, we slipped into

the point where the horse is just about to die.

Mr. CULLINAN. I would just add to that. I agree with my colleague’s apocryhal tale of the horse and the straw. And it doesn’t

just pertain to funding. It pertains to the efficiencies and the reductions and the realignments that have been going on in the VA for

over 10 years now, perhaps 20 years.

It is an ongoing—it has happened gradually, slowly. We have

protested; we protested, but seldom were we heeded.

Mr. SULLIVAN. Congressman, I would quickly answer that by

saying the public and many Members of Congress—I have met

with them—are under some bizarre false impression that the Gulf

war ended. There is a war going on, and when a war like World

War II or Vietnam ends, that doesn’t mean that since the soldiers

are home, they are suddenly healthy and everything is done. There

is a public impression that the day the war is declared over that

there is closure. That is not true with war.

And the main thing I would like to impress upon the Members

here is that the Gulf war is continuing; we are bombing them every

day, and it is the most insane, moral outrage to consider cutting

veterans’ benefits and healthcare while our troops are dropping

bombs and getting shot at and breathing in DU and receiving experimental anthrax shots. It is insane.

Mr. BLAGOJEVICH. Thank you very much.

Mr. SHAYS. Mr. Terry.

Mr. TERRY. Thank you, Mr. Chairman.

I have a short statement that will lead into a question that, really, you hinted or stated in your statement, Mr. Chairman, and that

is, ‘‘What is the future role of the VA hospitals?’’

Let me just say that I am not a veteran, but I am here because

I am very interested in the issues. I truly believe that, even though

there was no law passed, but this Government made promises of

healthcare. We need to uphold that promise that was in the recruiting propaganda that you were given, the promises that you

were given when you made that oath. One of the tasks I have assigned myself is to try and uphold that.

Again, that may require that we think out of the box on occasion.

How do we do that? If the No. 1 goal is to ensure half the

healthcare, my first question is going to be exactly what the chairman raised. Does that necessarily mean a separate healthcare

physical system? Do we need the brick and the mortar of the VA

hospital? And let me tell you, I have taken your advice. I visited

our VA hospital; we have a great one in Omaha, NE. A guy I have

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coffee with almost every morning that has heart problems that is

connected to—that is a service-connected disability—moved back to

Omaha from Texas because he thought our facility was one of the

best in the area or in the Nation.

But I also hear, in visiting our VA facility, that they are becoming more like a regular hospital with their administrative duties,

and having to fill out codes. What I am saying is, in many ways,

they are operating like the University of Nebraska Hospital that is

only 10 blocks away. So my first question is, why do we need a separate system if our goal is to ensure healthcare?

Mr. CULLINAN. Mr. Terry, I would just say, first of all, some of

our best friends through the years have been non-veterans in the

Congress, so you should know that.

Mr. TERRY. Good, and I appreciate that.

Mr. CULLINAN. And I will briefly address—really, what you have

introduced here is a complete separate hearing or hearings.

Mr. TERRY. Yes.

Mr. CULLINAN. What I would say, though, off the cuff, is that,

first of all, VA has a very special mission and a very special expertise—caring for combat, disabled veterans. You know, through the

years, they have been in the forefront in everything from trauma

injury to prosthetics to certain pharmacological concerns for veterans serving from, you know, tropical maladies. So there is that

issue.

Then there is another point. If it weren’t for the Department of

Veterans Affairs, do we really believe that would somehow keep the

cost down to the system? Do we really believe that private providers would somehow fill the gap for VA? We don’t think so, both

from the perspective of cost and from the perspective of those specialty areas.

You know, let’s face it, if it weren’t for the Department of Veterans Affairs, I mean we would still have 100-pound wheelchairs

and probably wooden prosthetics. The reason for that is, is that

years ago, there was no money in it so the private sector didn’t

pursue it. And that is true of a host of other areas as well, so it

is important.

Does VA have to change the way it does business? Yes, of course

it does, and it is starting to do that. There is some pain and some

trauma, in a metaphorical sense. But we also—along with the complaints that we hear, we hear from veterans who like the fact that

there is now an outpatient clinic, reasonably within access to their

home.

Mr. ROBERTSON. Mr. Chairman, Mr. Congressman, in answer to

your question, if Desert Storm had produced the ‘‘mother of all

ground actions’’ and our guys had been exposed to chemical and biological agents that required long-term care, name me the private

hospital that would like 100,000 troops showing up at their doors

with diseases that maybe they don’t know how to take care of. You

are talking about a system that is the backup to the Department

of Defense, that when it is time for the balloon to go up and the

DOD people deploy overseas and fight on the battlegrounds and

serve at field hospitals, there is not a whole lot of private physicians that are going to want to walk away from their practice and

their 3 o’clock tea times to go fight in the Persian Gulf.

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So I think that there is a real mission that you need to look at

that is very valuable that the VA provides, and that is the backup

to the Department of Defense.

In answer to your question, Mr. Shays, about the credit card—

you have a system like that, and it is called ‘‘Medicare,’’ and it is

not working very well either.

Mr. WEIDMAN. I would just add, Mr. Terry, to that entire issue,

that if VA truly addresses the needs of veterans’ healthcare in a

full and holistic way, then we need VA.

You may know already, sir, that over $1.2 billion is already contracted out in medical services by VHA. I suspect that number is

going to go up dramatically in the future.

The real question at the heart of what you are talking about is

changing the power of relationships between the VA versus the veteran who walks through the front door. That is our interest. And

if it took something like that in order to change that ‘‘power relationship’’ between the individual veteran who seeks care, then

maybe that is the way to, at least, look to proceed. But the real

question here—is VA hospital system, Veterans Health Administration, currently addressing the needs of veterans, as veterans?

What I am talking about that, incidentally, is that all too often

when a veteran walks into a VA hospital in Omaha or anyplace

else in this country, they are regarded as a supplicant, as a

supplicant, and not as a veteran who is deserving of dignity and

respect—or at least are made to feel that way by certain staff.

It is always remarkable to me how many people get good treatment at the VA healthcare system, given how messed up the system is and anatomizing in many ways. Contrary to people preserving their dignity in the very way in which it is set up. And if

you can change that ‘‘power relationship’’ and have quality assurance within the VA to focus on the needs of veterans, as veterans,

then, by all means, you absolutely need a separate VA healthcare

system.

Mr. WANNEMACHER. Just a short—the DAV did an analysis comparing Medicare and VA. We took the $17 billion that VA has and

the appropriation from Medicare and we showed—our executive director, Dave Gorman, did a commentary. ‘‘In Modern Healthcare,’’

February 12, Mr. Gorman said there is a real good reason why the

Federal Government just can’t even afford to provide the same

healthcare that the VA does.

One thing that wasn’t mentioned—it was mentioned about being

an educator in that, but the research that VA provides, also, is for

the American economy. There would be, you know, we have already

discovered the pacemaker, the CAT scan, the virtual elimination of

tuberculosis—things that wouldn’t have happened without the Veterans Administration, just like there would be a lot of advances

that wouldn’t have happened without the space program. And to

say that the Veterans Administration should just go away like a

bad penny is completely unwarranted.

And I agree with what was said, too—many of our strongest advocates aren’t veterans. You hear the rhetoric that, ‘‘Well, the Congress isn’t doing the right thing because there is a decreasing veteran population.’’ I don’t believe that; we don’t believe that.

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Mr. SULLIVAN. Congressman, if I may answer your question. I

am considered a very, very harsh critic of the VA. The Resource

Center has been very, very vigorous in attacking the VA for not

doing what they are supposed to do to help out Gulf war veterans.

That said, there are some people at the VA who really care and

who really work hard. And we have gone more to being harshly

critical to keeping them honest in their work. And toward that end,

the VA is actually looking into radioactive depleted uranium toxic

waste contamination among Gulf war veterans. A lot of that came

about as the work of the publicity of this committee. That is something that only the VA can do. Who else is going to breath in lungfulls of radioactive toxic waste on a battlefield in a foreign country?

The second is the vet centers—that is a beautiful VA program

that is a legacy of Vietnam veterans that opened up the door for

readjustment counseling for combat veterans of the Gulf war when

they came back. With that program, we may see reductions, the

saving of lives, because people had someplace to go to talk about

their war experiences.

That is something that only the VA is going to do, and it is a

moral and legal contract. So we may criticize the VA, up and down

until tomorrow, but it is something that we need, and it has to be

there because we are still fighting a war right now.

Mr. SHAYS. Let me tell you how I am going to suggest we continue. Obviously, each member is really not going to be able to ask

a lot of questions. We really have six excellent witnesses. The purpose of this first hearing is to kind of just introduce the issues, just

to expose us. Be assured, we are not going to recommend or do anything without extensive research and involvement with your organizations, as it relates to the VA.

We are really trying to determine what our agenda should be.

Should we focus in on what the hospitals do? Should there be a different system, a combined system? I mean, obviously, we all agree

on the funding issue. So I just want to make that point.

The other point I am going to make is that I am going to leave

at 10 o’clock, but I am going to give the gavel to any Member who

is going to stay—be it a Republican or Democrat, and we can close

the hearing with a Democrat, for instance.

Bernie, you may want to go on for awhile, and I will just give

you the gavel, but, also, acknowledge that Mr. Filner is here, and

since he is not an official member of this committee, he is just having to wait until the end if he does want to ask questions. But his

involvement in this issue is paramount, and we will be inviting

him to participate in any future hearings we have.

Also, may I just acknowledge the presence of Mr. Mica, who

chairs the committee I used to chair, which has HHS. And so he

gets involved in this issue, and we will be sharing some work with

him as well—and Mr. Souder, who serves, I think, on both committees as well.

Mr. Sanders.

Mr. SANDERS. Thank you very much, Mr. Chairman.

And we welcome Mr. Filner and congratulate him for his outstanding work that he has done for veterans.

And, Mr. Chairman, let me congratulate you for the work that

you have done over the last several years in Gulf war illness.

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Steve, thank you very much for coming to Vermont to be part of

the Gulf war illness conference that we have. And, Rick, thank you

very much for your advice on agent orange, and that is something

that I hope very much, Mr. Chairman—I think there is a scandal

out there, and I think we should get to it. And, Paul, thank you

so much for all the great work you have done on Gulf war illness.

And, Dennis, and, David, and, Robert, I look forward to working

with you.

I am the only Independent in the U.S. Congress, so I sometimes

look at things a little bit different than my colleagues, and sometimes a little bit franker than my colleagues. Sometimes I say

things that I regret having said after I say them, but that is——

Mr. SHAYS. That just relates to your personality, not—[laughter.]

Mr. SANDERS. That is my personality—[laughter]—I know, but I

can’t help it.

So, let me be as straightforward as I can.

I consider myself, along with some of the folks up here, to be a

very strong defender of veterans, and do you know why? I happen

to be an anti-war Congressman; I vote against the wars. But I happen to think that when a man or woman takes the oath and goes

out and puts their life on the line and does everything that is being

asked of them, then this Government has the moral responsibility

of fulfilling its end of the bargain. And if it doesn’t do that, if that

contract between the Government and the men and women who

put their lives on the line is broken, then, this country does not

stand for very much at all. So, while we can argue about the wisdom of this or that war, after the decision is made, it is the moral

obligation of this Government to stand with the people who are

making the ultimate sacrifice.

Now I happen to believe that the way the U.S. Congress, and

various administrations, have treated veterans is an absolute disgrace. At this moment now, I am spending far more time than I

ever wanted to making sure that the VA hospital in White River

Junction, VT, has the services that it needs, that it treats our people with the minimum standards that are required. But I know

that problem exists all over the country, and it is an outrage.

Now I think it was Dennis who may have made the point—I

don’t know that—who talked about this problem going on for 10 or

20 years under the Reagan administration, under the Bush administration, under the Clinton administration, OK?

Now what I have a hard time understanding is that with millions of millions of folks in your organizations, with an understanding we are all politicians, and when I go home in my State

and I say, ‘‘Do you think we should treat veterans with respect and

provide the care they need?’’ Everybody says that we should. So I

don’t understand how for 20 years, under Republican administrations and under Democratic administrations, veterans have not gotten their fair share.

I don’t know if you have not been doing your job. I don’t know

if we have not been doing our job, but somebody has screwed up

royally. Because I am tired of getting calls from veterans in the

State of Vermont who tell me that they are not getting the care

that they need. And Mr. Filner is getting those calls; and every

Member here is getting those calls.

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Now I want to get back—and here is where I am going to get into

some trouble. I came in a little bit later and I think, David, you

were talking. And you were telling me how we need that old antiballistic missile system to protect us from North Korea. Right?

Or whatever—I may have not gotten the whole point.

Well, I find it amazing that when we need a few billion dollars—

and I am not sure that your proposal—your independent budget

may be too conservative—I would suggest that you need more than

that. But be that as it may, I find it rather amazing that President

Clinton is proposing $110 billion more for the military over the

next 5 years. The Republicans thinks that is much too little; they

want to put $150 billion into the military over the next 5 years.

And you are sitting here telling us that you need a few billion dollars for the veterans.

So when I go down on the floor today in opposition to the ballistic missile system, you know what I am going to say? I am going

to say, ‘‘Scratch that system and use that money for veterans’ medical care.’’

And I want to know where your voice was 2 years ago on the

Balanced Budget Amendment, when we gave tax breaks to billionaires. We have $115 billion in tax breaks, most of which went to

the very wealthy—but apparently we don’t have enough money for

the veterans. We didn’t have a few billion dollars to make sure that

our hospitals were open.

Now I am glad you are here telling us how important it is to

have a ballistic missile system. But when I hear the guys who

make billions off the ballistic missile systems, I don’t hear them

telling us that it is important that we have an adequate veterans’

care.

So let me, respectfully, make this suggestion about how we can

all work better together. I am going to do everything I can to go

beyond this budget. I don’t think that is enough. I don’t want to

get any more calls from veterans in the State of Vermont that they

are not getting the care. I want more outreach, because I think the

VA hospital is not outreaching enough, bringing in enough veterans.

I would respectfully make a suggestion that the veterans’ organizations fight like hell to protect the veterans, in terms of the

healthcare needs, that we start an investigation about agent orange, that we are going to make some progress, finally, in dealing

with Gulf war illness, that we want to understand the scandal of

radiation illness and why the VA and the DOD did not react appropriately to that, and that we want this Government to keep its contract to the veterans.

As citizens of this country, you have every right in the world to

give your opinions on defense spending, and so forth and so on. But

I would hope very much that your focus would be on the needs of

veterans and work with us on those issues, because I don’t hear the

guys from the DOD and the big contracts because Lockheed-Martin

doesn’t come in here and say, ‘‘Worry about the veterans.’’ Lockheed-Martin has enough lobbyists in here to take good care of

themselves.

So now I have gotten you all angry. Steve, am I crazy?

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Mr. ROBERTSON. No, sir, you are not. And just for the record, I

want to tell you that the biggest opponents of war are sitting at

this table. We’ve been there, done that, got the t-shirt, and we adamantly don’t like war. But that, also, is part of our philosophy in

the American Legion, is to maintain a strong national defense, to

prevent us from doing this again.

My son just went into the Army Reserves, and I don’t want to

see him going overseas into combat, any more than you do. But I

think that there is a balance that we have to strike. And the American Legion and my colleagues here from the other organizations

have been fighting. But you have got to remember, Congressman,

we represent less than 1 percent of the U.S. population. And you

are right; there is a lot of people that aren’t in there fighting and

battling with us on our side on these issues, because we don’t impact their lives day in and day out. They forget the freedoms that

they enjoy were purchased with the blood of our comrades and

many of ourselves. And, you know, it is kind of, you know, ‘‘when

you need me, I am here; otherwise, get out of my way and don’t

bother me.’’ That is why, we, as veterans’ organizations and military service organizations are supposed to be the conscience of this

country to remind you when the scale is being tipped in the wrong

direction. And we are screaming. And I will tell you—I will be very

honest with you, Congressman. When military war decorated combat service-connected veterans start showing up in homeless shelters instead of long-term care facilities, when hospitals are closing

around the country and veterans are going home to die, you will

start hearing more people become involved, because it will be family members who are saying, ‘‘How can our country reach this level

of disrespect for those who have won the freedoms and are willing

to die tomorrow to protect you again?’’ And if they call me tomorrow, I will pack my bag, and I will be on the next plane if that is

what it is going to take to keep these freedoms.

Mr. SANDERS. Steve, my question is, what goes on when people

are proposing tens of billions of dollars in tax breaks, right now,

and you are here asking for a few billion dollars for veterans? And

every person up here understands they are needed. What is going

on?

Mr. ROBERTSON. The American Legion doesn’t—[laughter]—endorse tax breaks.

Mr. SANDERS. I am not even asking——

Mr. ROBERTSON. It is not part of our legislative portfolio.

Mr. SANDERS. No. No, I am not suggesting that you do. But,

why—why, in your judgment, does that go on, Rick?

Mr. WEIDMAN. I think it really comes back to that whole analogy

of slowly starving the horse. Somehow people don’t get it—as long

as we don’t close the hospital in my district. The administration’s

budget was the equivalent of closing 26 hospitals. Some of us suggested to the Veterans Affairs Committee that they take the unprecedented step of bringing it immediately to the floor and rejecting it, or unanimously, sending it back to the President, and said,

‘‘For God’s sake, send us a serious budget that is going to address

the healthcare needs of veterans.’’ And they did not do it.

If you take the next step—some of us suggested, privately, but

not publicly, that you take the step of—if you close some hospitals

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first, instead of reducing all hospitals by little bits, starving each

one of the facilities. And you closed all the hospitals in the budget

committee members’ district, by God, you would have another $10

billion for the system. You would, wouldn’t you? But because it is

by attrition. I think that is one element.

The second thing is that popular conception that I talked about

before that veterans have too much, that is still driven by a lot of

people in our society. If you think about it for a minute, if any

other discrete group of Americans had their healthcare costs frozen

for 5 years in a row—suppose that the Congress had decided to do

that for African-Americans, all African-Americans, suppose the

Congress had tried to do that for all women, suppose the Congress

had tried to do that for everybody of Lithuanian descent, then all

hell would have broken loose. But somehow, somehow, because it

is veterans, people think they can get away with it.

Mr. Mica, I am glad to see is here, because he played an extraordinary role in trying to put some teeth back into the veterans preferences. The same sorts of remarks that the Federal unions made

about veterans, they would not dare make about any other discreet

group of Americans. And Mr. Mica knows all too well what I am

talking about here. Well, they would say, ‘‘We want a quality work

force, therefore, we don’t want veterans’ preference.’’ Excuse me?

The same people you trusted with the weapons that could destroy

the world, that were worth billions of dollars 2 years ago, now

aren’t worthy of being a GS–9? And shuffling papers? Excuse me?

I mean it is just extraordinary. People deny that there is

‘‘veticism’’ within their society that is every bit alive and well as

sexism and racism within this society, but it is there.

Veterans are for Veterans’ Day and for Memorial Day, and in between time, those guys with funny hats can take care of themselves

because they already have too much. We have to change that perception.

Beginning this May, it will be a relatively small effort, but a lot

of veterans are going to be focusing, the night of the 27th or 28th,

at a march on Washington, with a view toward 2000, of really feeling them all up, 1931. And if it takes going back to the damn

streets to do it, then that is what we ought to do in order to crack

through this myth. We have been marginalized, at the same time

everybody is paying a pieoa a couple of times a year. And sometimes folks say, ‘‘The only good vet is a dead vet.’’ That is why they

honor us on Veterans’ Day and Memorial Day, for christ sake.

What happens in between? And I don’t think it is an issue of

whether—the percentage within this society. I really don’t believe

it is that. One of the finest veterans’ advocates I have ever met is

on your staff, Jim Rader. There is a lot of people walking around

in Vermont because of Jim’s work at the vet center in the early

1980’s. However, within the context of the society at large, there

is a Gulf, particularly in the generation in power right now, between those of us who went—irrespectively of what we thought

about the policy—and those of us who did not go. And I don’t think

you have to have served in order to be a veterans’ advocate, and

you and Mr. Filner certainly are representative of that. But it is

true that, within the Congress, when it comes to the nut of where

the dough goes, suddenly folks aren’t there; $1.1 billion the Senate

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Budget Committee finally provided on top of the President’s budget. And if you take the Medicare inflation rate for the last decade

and apply the same rate of Medicare and the Federal funding of

Medicaid, whichever—but a lot of people believe is inadequate—the

VA budget now would be over $22 billion a year for VHA.

Mr. SHAYS. Let me just recognize Mr. Mica—but also say, I know

some of you had an obligation. If you do, feel free to go. I know one

reason we started it was because of the briefing on the floor, but

also because some of you had an obligation or two.

I am going to ask Mr. Mica to have the floor. And then, Bernie,

you know, give you back the gavel if you want to be here and if

you want to pursue the questioning.

So, Mr. Mica, you have the floor.

And I am going to just apologize for leaving, but I have a budget

meeting that I have to go to, and then I want to try to get on the

floor to some of that hearing. I have not voted against performance

of the Defense, and I am leaning close to doing that, thinking that

we really need to do that.

So, I will give Mr. Mica the floor.

Mr. MICA [presiding]. I thank you, Mr. Shays, Mr. Chairman, for

holding this meeting, and I am really pleased to see that we have

organized this subcommittee in this fashion. I had recommended

that to the Speaker and to Mr. Burton and others that we have National Security, Veterans Affairs, and International Relations because I think that we do need to conduct investigations. We do

need to conduct oversight, and this is a very good beginning.

So I thank you, Mr. Chairman. I thank you for your testimony,

and I also want to thank you for helping me to get a few things

passed, although, as you all know, it has been very difficult, both

on veterans’ preference and expanding healthcare access for our

veterans, our military, and dependents.

The availability of healthcare really disturbs me. Even this past

weekend, I was the recipient of calls at home for, in fact, a veteran

who was a survivor of the Bataan death march who was not receiving adequate care, who I personally know and admire. Those things

really disturb me, when someone who—this man has literally been

through hell and back, and is one of the few survivors we have, and

to have to grovel for healthcare at his age is just shameful for all

of us. But, trying to do something about this—this is not the only

case. I hear it all the time from people—the delays, the access to

specialty care, the waiting lists. Some of them die before they ever

get treatment or even to proper diagnosis, which disturbs me even

more. So I think what we need to do is look at how we can develop

that.

One of the things that we did try to do was open the Federal Employees’ Health Benefits Program, which will have a small demonstration project. Are there other areas that you think we can—

and we need some immediate attention. We can’t—[laughter]—the

tendency of Congress is to have a study, a demo project—[laughter]—and most of the people die before we get to where we want

to be. But are there any specific ideas that you have that we could

address in the very short-term, in this session now past, that would

bring healthcare immediately to these people who are on waiting

lists, who need special kinds of treatments, both for that type of

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treatment. Then the other area I have a grave concern for is longterm care, because of the aging demographics of particularly our

World War II and our Korean war—some of those veterans. Longterm care is a disaster right now in trying to place folks. And sometimes when we find the placement, it separates the veteran from

the family in a very awkward fashion.

So those are two areas, and maybe you could comment with some

suggestions.

Mr. CULLINAN. Mr. Mica, for one thing, we are urging that the

Federal employee benefit package, the pilot you just referenced,

that should be implemented fully and now. We don’t see any reason

to wait. Can that be accomplished quickly in this Congress? Probably not.

We are looking for additional funding streams outside of the conventional appropriations process—Medicare subvention, allowing

VA to collect and retain Medicare dollars for the care it provides

for Medicare-eligible veterans for their non-service-connected disabilities. Can that be accomplished in this Congress? I don’t know;

I would hope so, but when I say, ‘‘I don’t know,’’ I am really saying,

‘‘I think not.’’

There are any number of areas. Right now VA has opened—right

now, it has pledged to enroll all seven categories of veterans who

come to it seeking healthcare. Does VA have the money to sustain

that? If this administration’s budget goes forward, without amendment or improvement, no, it doesn’t. There is something right now.

But to sustain that effort, to sustain VA and its ability to care for

all veterans who want to enroll into the system, that is something

that we can do right now that will be of a measurable benefit to

veterans.

Mr. MICA. Thank you.

Mr. ROBERTSON. Yes, sir. Under the Medicare subvention, Medicare plus choice, why a veteran can’t say, ‘‘I am Medicare-eligible;

I am not service-connected; I am not currently entitled to VA

healthcare at no cost?’’ Why they cannot choose the VA healthcare

system, as their healthcare provider, is beyond me. And could that

be done in one Congress? I think absolutely. I think that the House

Republican leadership in—what was it—in 1992, when they came,

had their contract with America, and showed how much you could

do in 100 days.

Well, I think if you set your mind to it in a bipartisan manner,

that anything can be accomplished in this chamber. And I would

strongly encourage that be a quick-fix. That is something that I

think would last for—be part of a solution to your Medicare problems. If you have a managed care system that you can put these

people into, and it would bring money into the VA healthcare system to offset those costs.

The other thing that is kind of a problem is the MCCF, the Medical Care Collection Fund, offsets third-party reimbursements

against discretionary funding. Discretionary funding was designed

to take care of service-connected veterans. But what happens under

the budget accounting is that they reduce the third-party reimbursements rather than add that as a supplement, so that VA benefits as they collect more money for treating non-service-connected

veterans.

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What you are doing now is you are using discretionary dollars

which are supposed to be healthcare dollars to pay for non-serviceconnected conditions, and that is wrong. That is fundamentally

wrong.

Those are two things that I would recommend.

Mr. MICA. Sir.

Mr. WANNEMACHER. The Medicare subvention bill that was on

the floor last year that Representatives Thomas and Stump had,

the DAV’s—only objection was that VA didn’t have an accounting

system that was going to be able to guarantee that only serviceconnected disabilities were going to be charged. The DAV has long

endorsed—and the independent budget has long endorsed—Medicare subvention, and we call for it again this year. And as Steve

mentioned, in 100 days, you could get a lot of things completed.

For a short term, you could probably do some things that would

help the Montgomery GI bill proposal that was made by the Transition Commission. There are some good recommendations in there,

and we support that. We have seen some language that there is

about $881 million that would have to be appropriated to provide

an education tool for the Montgomery GI bill. There is also some

homeless projects. We have seen some language on some homeless

projects that could assist. It is only about $5 million needed to enhance Homeless Veterans Reintegration Program.

Those are a couple, and I would be glad to submit some others

for you.

Mr. MICA. I would appreciate, actually, all of you following up.

I will try to get one of my staff assigned to that. I no longer chair

Civil Service, but we can get one of our subcommittee staffers to

work with you.

Did you have anything you wanted to add, then? Then, I am

going to turn to Mr. Souder.

Mr. WEIDMAN. I think it could be done in one Congress, Mr.

Mica.

But the real problem is, is breaking out of the mind set as ‘‘business as usual,’’ and people say, well—in fact the majority counsel

for the House of Veterans Affairs Committee said that to me about

Vietnam Veterans of America legislative agenda. ‘‘This would be

great if you were starting over.’’ And I said, ‘‘Maybe we need to.

Have you taken a look at what is going on?’’ Those aren’t hypothetical stories about VA hospitals, for instance, in the State of

New York, discharging homeless veterans after 4 o’clock because

they know that the State-funded shelters have to take them. I

mean those are real stories happening in Mr. Lazio’s district right

now. And we do need the drive, and if certainly this committee can

help raise that conscientious among your colleagues—and I might

add, as importantly, among the public at large, because even in

Florida—in your district, Mr. Mica—people think that veterans are

well-taken care of. They do not understand that veterans are not

being well-taken care of, that people are literally being denied services that are vital, that keep them alive.

Mr. MICA. Thank you.

Mr. SULLIVAN. Congressman, specifically related to Gulf war veterans, because the Gulf war is a toxic soup with things that folks

never dreamed that would be on the battlefield, like radioactive

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toxic waste and mixes of pesticides and experimental pills to protect people against chemical warfare agents, plus chemical warfare

agents—the main thing Gulf war veterans are looking for in

healthcare is, the VA and DOD have acknowledged widespread

contamination to radioactive toxic waste. At first they said it was

nobody; then it was 30; then it was 100; then it was 800. Now it

is hundreds of thousands, Congressman. When will the VA launch

a comprehensive program into depleted uranium contamination?

The stuff is radioactive. We are finding depleted uranium now,

Congressman, in the semen of Gulf war veterans. They want to

know ‘‘what does this mean? Should I have kids?’’ This is right in

their face. Gen-X, that is my generation, the young folks are asking

every morning. ‘‘Do we want to have kids?’’ I mean that is a

healthcare issue right in our face that has implications for generations.

It also has implications on the experimental anthrax shot the

Pentagon is using. We need to know what kind of health effects

that has. Veterans want to know, when is the Pentagon going to

do some new research on this experimental vaccine? They love to

say, ‘‘Oh, it is FDA-approved.’’ There is no FDA approval for the

use of a vaccine against an unknown biological airborne agent. The

Pentagon is lying through their teeth. Now what we have to find

out is, when are we going to get healthcare for the known and unknown, or yet to be known, side-effects of the use of these experimental vaccines?

That is what Gulf war veterans want to know in a healthcare answer, because the Gulf war was an exotic, toxic soup of stuff, and

we are waiting for answers, and we are trying to get healthcare.

Thank you, sir.

Mr. MICA. Thank you, each of you, for your testimony. I look forward to working with you. I think this is a good beginning and a

good opportunity to get an overview, and, hopefully, our subcommittee with this new responsibility, can be effective. Thank

you.

And I would like to recognize now, the gentleman from Indiana.

Mr. SOUDER. I thank the chairman.

One, I wanted just to say up front that I don’t believe that veterans’ benefits ought to be separated or be viewed as put in contrast with weapon systems, whether they be anti-ballistic missile

systems or other strong national defense, because the last thing we

want to do is have any current soldier go into war and not have

the best plane, the best weapons; that is a nightmare. And as a

country—as the gentleman from the Legion said—we need to make

sure that we are protected as best as possible, because our goal is

‘‘peace,’’ not ‘‘war,’’ and as few wounded veterans and as few civilians as possible.

At the same time, a number of these things, if we don’t address

them, if we don’t treat veterans fairly, in addition to the equity

question, when we are in a voluntary military, it becomes a problematic question of how we are going to recruit if we are not fair.

Or are we going to go back to draft days? So, it is not only an equity question, it is a practical question that we are facing as a Government.

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We all have many cases in our district. I have had a couple that

have come up to me with an unusual wrinkle, and I wondered, first

off, if—I have gone through your testimony. I saw a couple of references that were tangential to this, but I would appreciate it if

you can make some allusions here or check back, because it may

be something we can actually, fundamentally, address, in addition

to the broader questions that you have raised today.

One veteran—and it has to do not so much with war-related injuries, because while the veterans’ facilities are tightening down and

moving to more outpatient, it seems that if it is a direct war-related injury, they are still trying to accommodate that. But there

are many injuries or health problems that come up that weren’t directly war-related, and then as they try to seek outpatient service,

what I have been running into, is something like what we seen in

senior citizens case of almost it is requiring a ‘‘spend down’’ of any

assets that the individual has or using those up before they are eligible for care, which wouldn’t have happened in a veterans’ hospital.

And, in particular, I had one whose wife was working as a greeter at Wal-Mart, but because he had another pension, her salary as

a greeter at Wal-Mart, part-time, put him over the cap, where he

would lose his benefits if she didn’t quit her greeting job. And the

argument was that his income sources were less than the welfare

benefits cap, and that veterans aren’t even up to what a welfare

recipient can earn in the discretionary income.

A similar, but a different variation of this—and then if you can

comment on these—that another veteran came to me the other

week where we, I think—it is a similar thing on tax cuts and economic growth. Most veterans, after they leave the military, have

other jobs in the society. So they want to make sure our society is

functioning, that they have those jobs, but then that means, often,

that they have other benefits they have accumulated which bring

in pensions in addition to military pensions or sources of income.

And this person was told—he was, I think, in the veterans’ hospital for 90 days, but because it wasn’t long-term care—it wasn’t

war-related, he now had to leave. The problem was, is to get the

intensive care that he now needed, it was going to cost a large

amount of dollars. But because he had assets and a pension, he

was not eligible for the subsidy because he was above the so-called

income level. Yet, once he paid his home health costs of a constant

care, that would use up all of his income.

So part of my question here is, do you hear variations like this?

Because there are two fixes to this, possibly, at a minimum could

be. One is, is that the cost of the care related to your income should

be a calculation. A second should be that there is no way a veteran

should be treated less than anyone else in the society, and wherever we have an income test for benefit of eligibility, that the veterans ought to be at the high-end of any scale like that, not at the

low end.

Mr. CULLINAN. Mr. Souder. In the first instance, you are referring to a healthcare benefit?

Mr. SOUDER. Yes.

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Mr. CULLINAN. It is not supposed to work that way. And we have

a staff who would be glad—[laughter]—more than happy to look

into it. It is absolutely not supposed to work that way.

The second instance, you are touching on the issue of long-term

care. A number of us mentioned earlier, long-term care is not mandated under law, and that is the problem. And VA, for budgetary

reasons, is actually eliminating, paring-down, its ability—its already eliminated ability to provide long-term care.

So really the answer is, is to get it mandated under law. In other

words, we want at least some veterans to be guaranteed long-term

care, under law. Then, we expect that the appropriations support

should follow to sustain that.

You know, second, in the issue—with respect to long-term care,

there are, given our current budget—what we would prefer is, is

a guarantee for all veterans long-term care, period. Given the current budgetary climate, we are not going to realize that soon, so

perhaps, then, there are veterans who would like to buy into VA

as a long-term care provider. We would certainly support that effort as well.

There are certain veterans—if a veteran needs long-term care by

virtue of a service-connected disability, he or she should get it—no

co-payments, no means test, nothing. There are other veterans,

though, who, of course—the veteran population is considerably

older than the aggregate, than the population at large. There are

a number of veterans who are seeking access to VA’s long-term

care provider. Right now, they are not getting it. As I already mentioned, VA is paring away its limited ability to do that. These veterans should be able to buy into VA, as a long-term care provider.

And there are a number of veterans, especially among military retirees, but other veterans as well, who are very comfortable with

VA and VA services. They should have that option.

Mr. WANNEMACHER. I would just like to say, Mr. Souder, the scenario that you put up, that veteran—right now the VA is caring for

all categories, whether they are service-connected, non-service-connected, multi-millionaires; they can all receive healthcare, under

the proposal. But what you are referring to, that individual that

you referred to is classified, because he is receiving non-service-connected pension, is classified as a category 4. If he exceeded his income, he would be classified as a category 7. And, under the current law, categories 7’s are subject to co-payments, so he would

have to pay a co-payment on his medical care, and that is probably

what the frustration was. You know, if my wife works, I am going

to be classified as a category 7 and, then, not entitled to VA pension and, then, be subject to the co-payment.

And just one thing in your opening statement you said about defense and not subjecting veterans to that. There is something that

you might want to share with your colleagues, that the response

would be without sacrifices made by veterans, we would not have

the level of peace and prosperity we enjoy today. The President,

when he recommended that the virtual integration of VA and Department of Defense, when he said that, without Defense, there

would be no veterans, that is arrogance. That is sheer arrogance.

This country has to be a backup for DOD. The Veterans Administration has to be able to provide the services for veterans, and to

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think that DOD—that veterans owes something to DOD is just ludicrous.

Mr. ROBERTSON. Congressman, the long-term healthcare issue is

not unique—the problems they are facing are not unique to the veterans community. We all know that.

The American Legion, several years ago—4 years ago—developed

a plan that we called the GI Bill of Health. And it sets up the VA

healthcare as a network, in which veterans that are entitled to

healthcare, i.e., service-connected veterans and the other categories

of veterans that qualify economically, et cetera, would get their

healthcare covered by the Federal Government. All the other veterans, and their dependents, that wanted to use the VA healthcare

system could buy into the system, just like they would be buying

healthcare from Great West or Aetna or whoever was selling those

policies.

The idea being that veterans would be willing to pay for a system

that they wanted, a system that they could depend on in their golden years, that there would be options for specialized services, that

if I wanted to buy into a long-term care program, I could pay the

VA, at the age of 45, start paying them, in the event, that somewhere down the road, my wife and I would need to be in a longterm care facility. This seems like a logical business-like approach

to meeting this problem.

One of the tragedies that we see in the veterans community, is

that we get a veteran taken care of in a State veterans’ home, only

to have his wife who he has been married to for 60 years at the

other end of the State in a federally subsidized home, and the next

time they are going to see each other is at a funeral.

That is a tragedy. On the side of a VA hospital it says, ‘‘to care

for him who has borne the battle, and for his widow and his orphan.’’ We are doing a good job in relative terms taking care of the

veteran, but those other two are completely out of the box.

And maybe it is time to look at a quasi-Federal Government-type

healthcare system for veterans. Because you remember, military

retirees—a lot of people forget this—but military retirees are veterans, and we have them right now having brought battles over in

Tricare trying to figure out a place to go. And to show you how the

Government works, DOD has contracted with however many private healthcare companies, for-profit companies, to run Tricare,

when VA has the same type of network already in place. So why

are we paying a private-sector company to refer people back to

military healthcare or back to veterans healthcare? That just

doesn’t make sense. We think that there can be some headway

made in this area, and maybe address some of the long-term care

problems.

Mr. MICA. I thank the gentleman from Indiana.

And I would like to recognize Mr. Filner, from California.

Mr. FILNER. Thank you, and I thank you for your courtesy.

Just quickly, a lot of these issues will be moot if a budget is not

adequate, so I think, you know, we all have to focus on the budget

at this moment. And I would just—I guess in the tradition of Mr.

Sanders, be very frank. We all have flailed the President’s budget—Democrat, Republican, all VSO’s, bipartisan, nonpartisan—but

let’s get off—the President made a suggestion. Budget, by law and

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Constitution, is Congress. He made his ideas, you guys, in my opinion, have to move on band. He kept within, by the way, the budget

caps that the majority of Congress passed. So, it is not his budget,

it is really the balanced budget’s budget.

I don’t see you flailing at the Veterans Affairs Committee budget

that just came out. I mean the Legion now supports it, which, even

by the independent budget, is too small. So I think we have to turn

our attention to the congressional budget and start attacking that

and making us accountable.

Steve, you said your members are only 1 percent of the population or—I mean the combined, I guess. Just give me those 2 million people, and I will pass anything in the Congress. You guys

have incredible power to deal with this issue.

As I understand the process—and my colleagues can correct me

if I am wrong—we have a budget resolution. It will be the next

stage in this process. It looks to me that the leadership of the Congress is committed to keeping within the caps that we had previously agreed to, which means that we are $3 billion, plus, short

of what we need for veterans.

I think your membership has to demand of their representatives—I don’t care, Republican, Democrat—that they don’t vote for

that resolution unless there is a $3 billion increase for veterans.

Because what will happen in the politics—and you have been all

through this many times—if there are no changing of those caps,

folks are going to use you and give lip service to you. They are

going to propose ‘‘X’’ billion dollar increase if we cut the Housing

budget, cut the EPA budget. So we are all in a completely unattainable situation. They are going to pit us, one against another,

and say, ‘‘Oh, you are not for veterans. You voted to keep the

EPA.’’ And I will make the same argument about the EPA that you

made about the Defense Department, you know—[laughter]—so

unless we increase those caps, we are dead, in my opinion. And

that is coming up next week, I think—at least in the House.

So I think you have to switch your attention away from the

President’s budget. It has nothing to do with anything right now,

and say, ‘‘Unless we get $3 billion more in that budget resolution

to be accountable to you.’’ We are all giving lip service; everybody

is talking the talk. You know, we are all for you. But unless they

vote against that thing, it doesn’t mean anything, because there is

nothing we can do after that vote, except with untenably pitting

forces against one another, to raise the level of the budget to what

we have talked about today.

So, I—that is a political issue; I don’t think it is partisan, but I

think you all have to begin to attack the congressional budget—

[laughter]—and not the Presidential budget, and hold us accountable for that next vote that is going to occur.

Mr. WANNEMACHER. Congressman, I——

Mr. SULLIVAN. Congressman Filner, I would like to be able to restate what the Gulf war veterans said.

We believe the VA needs $3.2 billion more than what was proposed by the administration and $1.3 billion more than what was approved by the House Veterans Affairs Committee. Since the current economic boom created a Federal budget surplus,

the VA budget cap should be lifted. Flat-lining appropriations during war, while expenses soar and the number of patients demanding care increases, is a recipe for

disaster.

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They might as well just close the VA.

Mr. WANNEMACHER. Congressman——

Mr. FILNER. I would hope that the other five would agree with

you. [Laughter.]

Mr. WANNEMACHER. We would agree with that, and we, as you

know, we had our members—we were in town all this weekend,

and they were all sent out to talk about lifting the caps. And I

want to tell you that last year, Congress had no problem lifting the

caps when Transportation identified a need. They took away $15

billion from the VA account. We wouldn’t be in this situation today

if it wasn’t for what happened last year. So we encourage all of you

that are still here, and I hope you pass it on that the Veterans Administrations appropriations are just inadequate and we need additional resources.

Mr. SANDERS. So you are in agreement with what Paul said——

Mr. WANNEMACHER. Absolutely.

Mr. SANDERS [continuing]. In terms of lifting the caps?

Mr. WANNEMACHER. Exactly.

Mr. SANDERS. Is that true for all of you?

Mr. CULLINAN. For our part, we are agitating to lift the caps. We

have our people addressing that specific issue. You may have seen

in the Congressional Monitor that we were specifically saying,

‘‘Raise the caps.’’

Once again, am I optimistic? We are doing the right thing. We

are agitating to get those caps lifted. Are we going to do it?

Mr. SANDERS. OK. One of the reasons——

Mr. ROBERTSON. Well, I am the odd man out, because the American Legion, last October, testified before a joint session of the Veterans Affairs Committee and said that we felt that we were $1.9

billion low now, on what our current funding levels were. And we

asked the President’s budget to include that increase. We have

been consistent with that number. We are at a point where we are

talking about need versus wants. We, in our estimation, believe that the $1.9 is a solid figure to

meet the current needs of the VA. Does it make the best VA in the

world? No; but what we are talking about is what we need to keep

from shutting down hospitals and turning people away. Do we need

additional funding? Yes. And I, you know, the $3 billion number is

probably a good number to make us whole again.

And the American Legion started our lobbying efforts last October before the budgets were even introduced, and we have continued that process. We, too, will have people in this next week that

will be attending a conference here in Washington. But we are

using the Internet, we are using our magazines and our other publications to make sure that everybody understands what needs to

be done as far as the appropriations process.

And just for the record—and I don’t think I am speaking out of

the school—and folks from the independent budget can correct me

if I am incorrect in my statement. But almost every year, the independent budget has been around $2 to $3 billion increase request,

historically, for the last 10 years that I can remember.

I am sorry, go ahead.

Mr. CULLINAN. I know that this isn’t quite the forum for this. Actually, a number of years ago, the independent budget’s baseline

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was adjusted. And, actually, this touches on a question that you

posited a little while ago, Mr. Sanders. How do we get into this

past?

Perhaps we are trying to be too reasonable; I don’t know. Perhaps we are trying to be all too reasonable. I think that you would

say that we are. When we adjusted our baseline, the situation

then, we were about $6 to $7 billion out of whack with reality. For

the sake of creditability, that baseline was adjusted. Was that

wrong? I mean you would say, ‘‘Yes.’’ I can see you——

Mr. SANDERS. I think I would——

Mr. ROBERTSON. But that is the problem we have had, is that we

have had two tiers—what we have been asking for versus what we

have been getting, and that gap has gotten wider over the years

to where we are at in the situation we are now.

So, do we all agree that, yes, we need a lot more money? You are

absolutely right.

What we are facing right now is what we are going to be able to achieve. We are only talking $1.1 billion difference between the

two groups of numbers that we are throwing out here, but the important thing is that it sets the baseline for 2001. That is the thing

I am concerned about. If we wind up getting nothing, then we have

got—looking at a $4 billion request for next year to make up for

the shortfall we had this year.

Mr. WEIDMAN. I just wanted to add in, Mr. Filner, that the dif- ference between the $1.9 and the $3.2 billion—there is no guarantee that the budget committee is going to come up even $1.9 billion. What we are looking for is some leadership out of the administration. Our executive directors all met with Vice President Gore

on Tuesday and said, ‘‘You have to do something.’’ Frankly, we are

not getting that leadership out of the Secretary of Veterans Affairs

that we have every right to expect. Images of Nero come to mind.

We need to have the leadership of the administration. If the administration decides to get into this budget battle as a player, those

caps can be lifted and, frankly, would make the jobs of those of you

who are pushing for $3 easier. You would have to break the budget

cap just to $1.9 billion. We need Presidential leadership on this.

Forty commitments to harms way in the last 6 years. That seems

to me to merit a response on the part of the President to say,

‘‘Gosh, we goofed on the VA budget. We are going to try to get into

this and raise the caps and do what is necessary in order to start

down the road toward fixing this problem.’’

Mr. FILNER. I thank the gentleman, and the leadership has to

come from everywhere, because they are not going to be broken,

even for the $1.9 billion or $1.1 billion that the Senate passed anything, unless we have leadership and your folks are politically involved at the grassroots.

Thank you, Mr. Mica.

Mr. MICA. Well, I want to thank the panelists of the various veterans service organizations for being with us today, for helping us

launch our effort with this subcommittee which, again, is entitled

National Security, Veterans Affairs, and International Relations.

I think we have had a good airing of some of the challenges that

face us, and I tend to be an optimist. I think if we all work together

that we can make some great progress, particularly in this time

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when we are fortunate, as a Congress and a Nation, to have a

small, annualized surplus. Certainly, our veterans should be first

in line as a priority of the Congress and the country.

With there being no further business to come before this subcommittee this morning, I call this meeting adjourned.

[Whereupon, at 10:32 a.m., the subcommittee was adjourned.]

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