Veterans groups seek dedicated funding for healthcare

The V.A. has yearly funding crunches because of lag time in Congress's appropriations process, they say.

Veterans' groups are lining up behind a plan they say would shield their healthcare benefits from political whim and a "dysfunctional system" that they say in effect shuts some war veterans out of medical care.

An initiative called Stand Up For Veterans wants Congress to give the Veterans Administration a more predictable funding stream by advancing its annual budget a year ahead of time. Such a move would protect the VA from political wrangling that results in funding delays and that forces it to freeze hiring, curtail services, and extend waiting-room time to the point that some veterans simply go home, veterans groups say.

It's an old issue with new life, as these groups seek to capitalize on attention they can receive during an election when veterans' issues are somewhat top of mind.

And while it may seem like special treatment, veterans say they deserve that.

"We believe unapologetically that veterans do deserve to be taken care of first," says Peter Dickinson, a coordinator for Stand Up for Veterans.

Sen. John McCain will speak Saturday before a group of the veterans in Las Vegas, where organizers like Mr. Dickinson hope the Republican presidential hopeful will signal his support. Sen. Barack Obama (D) will also appear, but by video teleconference.

Many in and around the military are surprised to learn that veterans' healthcare benefits are defined only by the level of funding set by Congress, not by actual need. As a result, political squabbling can delay passage of the pertinent spending bill, resulting in curtailed coverage for anything from counseling for post-traumatic stress disorder to routine medical treatment, veterans groups say.

Veterans' groups acknowledge that funding for VA healthcare has increased during the past several years. But the delay causes problems and has become standard practice. In 2003, Congress didn't pass VA funding until 142 days after the fiscal year began; in 2004, it was 114 days, and in 2007, it was 137 days, the National Journal reported last month, citing Library of Congress data.

The problem has existed for years.

"We'd rob Peter to pay Paul," says Bob Perreault, director of three veterans medical centers through the 1990s, now retired. "We'd stop buying equipment, stop doing much-needed maintenance, and divert money to maintain employment," he says. "The cadre of people who were working as facilities directors knew that that was the way of life, so we adapted to it. But ... it was a very unfortunate situation for the veteran population."

For several years, veterans' groups have called for veterans' healthcare funding through the VA to be essentially automatic, as with Social Security or Medicare. But lawmakers have fought that initiative, saying they want to maintain oversight.

As a result, veterans' groups are taking a different tack this year. They want healthcare funding to become an "advance appropriation," by which Congress approves the VA's budget one year ahead of time.

Congress would still be able to shape the budget, just a year behind. The advance would minimize the effect of funding delays on healthcare services and lock in funding a year at a time, they say.

"All we're asking them to do is fund VA at the level that is needed, not at the level the government wants to spend," says Joseph Violante, national legislative director for Disabled American Veterans.

Taxpayer watchdog groups cringe at the idea, saying an advance appropriation would diminish Congress's ability to monitor the way the federal government spends its money.

"I don't think anyone is suggesting that we stiff our veterans, but there is a level of flexibility that you need to have in the discretionary budget" to maintain oversight, says Steve Ellis, vice president at Taxpayers for Common Sense, an advocacy group in Washington.

Even with an advance, agencies and other groups typically come back "for another bite of the apple" a year later, saying they need additional funding on top of what they've already been allocated the year before. "You end up spending more through advance appropriations."

That is the strength of the advance appropriation, says Mr. Dickinson. "It's not rationed healthcare based on how much we choose to spend, but on how much it will cost based on the need."

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