Failure to properly fund VA is a betrayal of veterans

It is seldom a surprise when politicians renege on their promises. But a failure to properly fund the Department of Veterans Affairs (VA) goes beyond politics. It is a betrayal. The VA has gone to Congress, as they have year after year, and requested an adjustment to their budget. The nearly $3 billion shortfall, if not funded, will have devastating consequences to those dependent on the VA for healthcare and other services, including the closing of entire hospitals.

In the past, Congress has routinely allowed for a mid-year supplement based on actual usage numbers and has given the VA some latitude to reallocate appropriated funds for one purpose to a new, more pressing need. But that was during a time when the VA was off limits for political maneuvering. That was during a time when responsible congressional leadership realized that promises made to veterans were sacred and actually meant to be kept. That was during a time when congressional budgeteers realized that no planning had been done and no money set aside to take care of veterans when wars had been declared. But now it is apparently acceptable to make political points and qualify, after the fact, the degree of commitment and the resources to be appropriated to take care of our veterans. This is a national disgrace.

{mosads}Put yourself in a veteran’s boots. You have gone to war based on the certainty that we, the people, will care for you after you put yourself in harm’s way to protect us and our way of life. You have risked your life and have now returned with chronic medical conditions directly attributable to taking that risk. You have reconstituted your life, career and family. Your complex healthcare, a right guaranteed under multiple declarations of human rights and by the U.S. government, is well organized and reliably delivered at the VA hospital. Now imagine having to contemplate moving or becoming unemployable in order to travel to another VA hospital, sometimes hours away and where your difficult issues are unknown, while Congress bats the VA budget request around like a political ping-pong ball.

Critics to the increase in funding blame mismanagement at the VA for the current shortfalls. There have been accusations of billions of dollars in waste and contracting violations, and a recent revelation that many of the over 800,000 veterans on the backlog of patients needing care in the system are actually deceased. They question why the VA should be given even more money when such problems exist.

The VA, however, is in a time of massive change. The nomination of Robert McDonald, the current secretary for Veterans Affairs, was approved based on his promises to create the much-needed reform. The recently appointed under secretary for Health, Dr. David Shulkin, was selected in part to bring fresh ideas and an outsider’s perspective to the changes needed at the VA. Many complain that change has been too slow, while others worry that change on the scale and at the pace required to see immediate results presents risks to an organization responsible for, as an example, more than 86 million outpatient visits per year.

Other critics will point to the faulty budgeting process. How many other agencies are allowed to come to Congress mid-year for such a substantial influx in cash? But how many doctors, nurses and other medical caregivers do you need to take care of an unknown number of patients with an unknown number and severity of medical conditions who can show up anywhere and anytime during the course of a year? What is the exact size of a budget that will accommodate these multiple unknowns and also be adequate to pay for new lifesaving drugs, treatments and equipment that becomes available during the course of a year? Whose crystal ball is so clear as to be able to forecast such a budget in advance?

Rather than hamstring the VA as a way to make political hay with the noisy far right, legislators should grow backbones, roll up their sleeves and help find ways to help fix the VA, rather than punishing the veterans that we sent into harm’s way.

Meagher is former deputy assistant secretary and deputy chief information officer at the Department of Veterans Affairs. He is also a service-connected disabled Vietnam veteran. Seres, M.D., Sc.M, is associate professor of medicine and a clinical ethicist at Columbia University Medical Center, where he is a fellow of Columbia’s OpEd Project.