Sub-Hearing

Mr. William A. Boettcher National Commander AMVETS
Chairman Buyer, Chairman Craig, Ranking Member Evans, Ranking Member Akaka and members of the Senate and House Veterans' Affairs Committees, I am William A. Boettcher, national commander of AMVETS, and it is my honor to appear before this joint session to present AMVETS' legislative agenda.  On behalf of AMVETS, the AMVETS Ladies Auxiliary, Sons of AMVETS and our other related organizations, I thank you for giving us this opportunity. 
As you know, AMVETS has been a leader since 1944 in helping to preserve the freedoms secured by America's Armed Forces.  Through our National Scholarship Program, AMVETS has awarded more than $2 million in scholarships to graduating high school students. For the past 17 years, we have sponsored a high school, youth leadership program in cooperation with Freedoms Foundation at Valley Forge.  Last year, AMVETS, its Ladies Auxiliary and Sons organizations contributed nearly a quarter million hours of voluntary service, helping veterans and providing an array of community services that enhance the quality of life for our nation's citizens.
As a national veterans service organization, AMVETS believes as President Bush said at Arlington National Cemetery, ?We owe our veterans the life we know today. They command the respect of the American people, and they have our everlasting gratitude.?
It is true, after all, that our veterans have not only guaranteed the peace in Europe for more than 60 years, but they have also preserved it for us here at home.  And today, our ?Total Force??a name given for blending active and reserve military units into a cohesive whole?have a new assignment as part of a much bigger war on terrorism. 
Our military forces are dealing with the global war on terrorism, as well as challenges in Iraq and elsewhere around the globe. They are engaged in a difficult struggle to make sure that Afghanistan and Iraq are never again a source of terror or a threat to the United States and our most prized assets?our freedom and our citizens.
Mr. Chairman, this generation of soldiers, sailors, airmen, marines, and coastguardsmen are making a real difference.  They are changing the world for the better, exactly as America's military men and women have done for generations.  
And I hope that none of us need be reminded that one day these men and women will take off their military uniforms and take up the honor of being called American veterans.
I also trust that none of us need be reminded that it is the veteran who defended our national security, who risked life and limb to serve thousands of miles away from loved ones, and who sacrificed daily to protect the lives of innocent men, women and children.
Mr. Chairman, at an earlier time in our history, our most revered Founding Father George Washington gave an eloquent warning, ?The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive the veterans of earlier wars were treated and appreciated by their nation.? 
In a more recent speech, President Ronald Reagan echoed the wisdom of our first president's remarks when in signing legislation that established the Department of Veterans Affairs he said, ?America's debt to those who would fight for her defense doesn't end the day the uniform comes off.  For the security of our nation, it must not end.?
At a time when troops on the ground are protecting our security and defending our cherished freedoms, AMVETS is concerned that leaders in Congress are set to test the wisdom of these great leaders. 
We are told, for instance, that the budget recommended by the administration and the majorities in the House and Senate is sufficient to care for sick and disabled veterans.  We know it is not.  We have experience in this regard.
As recently as last year, AMVETS was told that the fiscal year 2005 budget approved by Congress was adequate.  Simply stated: not true.  If one asks VA, officials there will inform you that their equipment and maintenance accounts are being raided and transferred to healthcare operations accounts to help cover the current shortfall.
News reports make the same case.  From across the country, reports provide clear evidence that VA is straining and failing to make ends meet.
In Georgia, Augusta's veterans affairs medical center is looking at shortening the hours of its emergency facilities.  The Augusta unit already sends trauma patients to the trauma unit at the Medical College of Georgia Hospital, but administrators at the medical center say further changes must be made due to a lack of money, staff and existing resources. 
In Colorado, the Denver Post reports that shortfalls in funding and staff have forced the Denver veterans' hospital to cut nearly 100 beds and reduce housekeeping to stretch limited funds. To save money cleaning crews were directed to focus on patient areas and not to worry about offices and other parts of the hospital.  Four years ago, the article states, federal inspectors found most areas of the hospital clean and adequately maintained.  Recent inspections, however, find widespread filthy conditions.  According to the Post, the current operating budget for the Denver facility is actually $700,000 less than that provided two years ago, despite increases in the costs of drugs, technology, staff and related medical inflation.
In Maine, the Bangor Daily News reports that the medical center at Togus is proposing some dramatic changes in mental health care, specialty medical services and medication coverage veterans receive.  The report suggests switching veterans to less expensive medications and, in some cases, substituting different formulations altogether. Staffing changes also are proposed, including not filling existing vacancies and replacing pricey temporary staff with lower-paid, lesser skilled employees.  According to the hospital's documents, specialty services such as physical rehabilitation and audiology are already operating with fewer staff than needed, ?resulting in long waiting lines, poor quality of service and poor customer satisfaction.?
In Michigan, a lack of funding is forcing clinics to stop taking new patients. Clinics in Oakland and Macomb counties as well as the main clinic in Detroit and the one in Pontiac have capped access, disallowing patients who seek basic medical services. The staff assistant to the director of John D. Dingell VA Medical Center in downtown Detroit said, ?We're aware that it's an inconvenience for the veterans, but given our financial situation, we need to do some things to put a cap on our spending, and this is one of the ways of reducing our facility expenses.?
In Pennsylvania, the Altoona Mirror reports that the Van Zandt VA Medical Center will cut back on funding for patient services, eliminate money for military celebrations and strike all capital projects and hiring to erase a projected $5 million shortfall this year.  The Mirror tells readers and veterans alike that at Van Zandt, treatment of patients and services provided will be decided on a ?case-by-case basis.?  The reports goes on to say that Van Zandt does not plan to add new jobs nor replace anyone who leaves a position at the center to help ends meet.
It is the same story all across the country.  Yet, we're told by administration spokes persons that this year's appropriation and next year's request will allow VA to continue providing of the highest quality of care for veterans. 
AMVETS cannot believe that this astonishing situation is something the American people would support.  We know that Americans are blessed to be citizens of this great nation, not just when times are good, but at all times.  Together, we are part of something special, endowed by our creator in a great experiment to prove to the world that representative democracy is not only the most effective form of government, but also the only moral government.  Generations of us have fought to build a better nation and we won't sit idly by and forget the debt we owe these heroic men and valiant women. 
Veterans are told that VA health care costs too much.  This is the reason that some in Congress have decided the lives and health of certain veterans do not matter.  Frankly, that kind of thinking can get America into trouble.  You cannot recruit future military if the word gets out that America does not keep the promises made to those who served her.
With troops on the ground defending American interests across the globe, keeping faith is not only the prudent thing to do; it's the right thing to do.
Keeping faith with veterans requires that adequate resources be in place to provide for the benefits and services veterans earned through their military service.  Attending to this obligation is one the highest priorities in the nation.  It ranks with our national defense and homeland security requirements. 
The Office of Management and Budget and the Congressional Budget Office may not buy that story, and there may even be some folks on the Hill that feel the same way.  But the majority of Americans remain grateful and appreciative of the sacrifices veterans made for them.  And they recognize that the expense of veterans earned benefits is a cost of war. 
As for those who say veterans are clogging the VA healthcare system, no one at AMVETS would knowingly stand in the way of a disabled, sick military comrade seeking medical treatment at VA any more than they would deny being a citizen of this great country.  We are American Veterans, and we are organized to help, not hinder. 
In complete candor, I cannot tell you that in these past months, or under the present circumstances, we are comfortable with the direction taken by our congressional or executive leadership. 
For instance, undersecretary of defense for personnel readiness David Chu told the Wall Street Journal that updated veteran and retiree benefits were damaging national security. Secretary Chu said that earned benefits ?have gotten to where they are hurtful. They are taking away from the nation's ability to defend itself.?  Mr. Chairmen, Chu's comments are hard to swallow.  Simply stated, the brave men and women veterans of this great country are not the enemy of national security. 
What we see and hear disturbs us, because we do not see that this direction points the way toward improved services.  For instance, we observe that Congress failed to include additional VA funding in the recently approved emergency supplemental.  VA, for its part, tells veterans not to worry, because the shortfall will not deprive any veteran of department service.  But department policy continues to close the door to nearly 300,000 veterans, unable to this service due to a lack of resources.  And as outlined earlier, hiring is frozen, equipment replacements are not being made, and maintenance is being delayed.
Even in a time of war, veterans are being told, ?the cupboard is bare.?  It is clear, however, to members of AMVETS that if congressional leadership cannot arrange priorities within a $2.6 trillion budget to meet the benefits veterans earned and richly deserve, something is wrong with the priorities being selected.
In reading last year's appropriations, we see that there is enough money to spend on Ground Hog Day, the Rock and Roll Museum, the Paper Industry Hall of Fame and more than 13,000 thousand other lesser priority, non-veteran pet projects. Even the extraordinarily wealthy Professional Golfers Association received money?$2 million for the First Tee program.  And Congress earmarked funds for the GRAMMY Foundation, a wing of the music recording industry and an organization composed of millionaire singers, producers and executives.  While individually each of these earmarks may account for only a small fraction of federal spending, the total cost to taxpayers for these projects in fiscal year 2005 is $27.3 billion?a 19 percent increase over the previous year.  To paraphrase Senator Dirksen, ?a million here and a million there and pretty soon you're talking about real money.? 
And incredibly, there is more.  Congress last year approved a four-year $1 billion program to pay the medical care costs of treating illegal immigrants.  What signal is being sent here, when budget priorities allow health care for illegal immigrants to trump care for veterans?
We have faith in our leaders, but we are not blind.  Before we start tapping veterans programs and services, let us make certain that we have selected our most important programs over our less important ones. The priority given health care for illegal immigrants is a stark reminder that this budget proposal is bad news for the nation's veterans, especially when our courageous troops are engaged in battle overseas.
 Mr. Chairman, AMVETS recognizes the VA healthcare system as the primary source of health care for our nation's veterans, especially those with service-connected injuries, those in need of specialized care and those who are indigent. It is a unique and irreplaceable national investment, critical to the nation and its veterans.  In fact, many veterans consider access to high quality health care to be one of their most important benefits. 
 Over the years, AMVETS has reported on chronic funding shortfalls that have resulted in denial, delay and rationing of veterans healthcare.  Our goal is to fund the Department of Veterans Affairs at levels necessary to allow the healthcare system to deliver the world-class services of which it is capable.
The members of AMVETS, however, remain deeply troubled by the current policy banning access to VA healthcare for certain veterans.  Naturally, we continue, as always, to support generous assistance to those who have special needs arising from service in the Armed Forces, particularly combat service.  We want to ensure that severely disabled veterans receive prompt care.  But denying access only devalues the service of those who seek care with VA.
AMVETS would like to see VA begin the process of restoring Priority 8 access, which could be started by enrolling those veterans who can identify their private- or public-health insurers and making certain that VA is eligible for medical reimbursement.  The secretary has this discretionary authority under statute and, for our friends who hinge veterans' access to their ability to pay for it, this type of enrollment would ensure that third-party payers would be maximized to the fullest extent.
 To augment direct appropriations, which are clearly needed, AMVETS also supports Medicare subvention as a way to enhance funding of VA health care.  Medicare subvention could prove beneficial to veterans and the government.  For veterans who have paid into Medicare throughout their working lives, VA subvention would mean greater access to care. And for the government, there would be savings, since nearly 60 percent of enrolled veterans are Medicare-eligible and, according to VA, Medicare services can be delivered less expensively than in the private sector.
Mr. Chairman, one of our greatest presidents once said, ?It is common sense to take a method and try it.  If it fails, admit it frankly and try another, but above all try something.?
It is time to take President Franklin Delano Roosevelt's advice.   It is time to try something different.  AMVETS asks you to recognize that the current system of funding veterans health care is broken.  It simply doesn't work.  Too many sick and disabled veterans either cannot enroll in the system or wait too long for care.
AMVETS calls on Congress to replace the current discretionary funding process with assured funding for veterans health care.  Assured funding of VA health care would provide a comprehensive solution to the current funding problem.  Once healthcare funding matches the actual average cost of care for the veterans enrolled in the system, with annual indexing for inflation, VA can truly fulfill its mission.
 Mr. Chairman, until assured funding is in place, AMVETS calls on the Congress to provide an adequate level of discretionary resources necessary to care for America's veterans. 
In this regard, we recommend an increase of $3.4 billion over last year's VA medical-care spending.  This amount would ensure that the medical treatment and care-taking of our veterans would be answered with timely medical treatment, not delay of care.  AMVETS?together with the Disabled American Veterans, the Paralyzed Veterans of America and the Veterans of Foreign Wars?makes this recommendation in our 19th annual publication of The Independent Budget. 
Some will say we can't afford it; it costs too much.  We believe the IB is a balanced and responsible analysis of VA's funding requirements, and that the price is not too great for the value received.
Another of our top priorities is to see the Department of Defense and the Department of Veterans Affairs work as a team to provide proper and seamless care for our soldiers and veterans.  No veteran leaving military service should fall through the bureaucratic cracks.  Both departments should improve the system for handing over responsibility from DoD to VA for the continuance of medical care to those leaving service.  The hand-off should include a detailed history of care provided, including mental health services, and an assessment of what each patient may require in the future.
Also, AMVETS believes DoD must ensure that all troops are given pre- and post-deployment medical examinations. Such examinations would identify troops who should not be deployed or who need help after returning home.  They would be completed for all active duty personnel, as well as Guard and Reserve troops.  Questionnaires are not sufficient to establish physical or mental fitness.
Here, I would like to make special mention of the tremendous contribution the National Guard and Reserves have made to the defense of our nation. 
Clearly the mission of the Reserve Components has changed as they account for increasingly more of our national defense and homeland security responsibilities. 
Without these Americans who make up the Guard and Reserve team, our nation's military capability would be seriously diminished. The increased reliance on these citizen-soldiers and their performance on active duty demonstrate that if force becomes necessary, they are ready. 
On the other hand, this reliance places a lot of pressure, not only on those who serve, but also on employers and families.  With operational tempos increasing significantly in all areas of competency, it is essential that our national government's commitment to these volunteers and their families keep pace. 
As such, Congress needs to realistically understand the changes that have occurred in the use of the Reserve Components and continue its efforts to upgrade and update protections and benefits for those called away from family, home and employment to active duty.
While the past Congress has done a good job in reauthorizing and revitalizing training, education and jobs programs, I encourage you to continue close oversight of the Transition Assistance Program and related programs to ensure an appropriate balance of aid and effective assistance for our returning troops, including those in the Guard and Reserves.
In addition, AMVETS supports legislation to protect the reemployment rights and benefits of guardsmen and reservists who voluntarily leave employment to serve in the Armed Forces. 
When mobilized, these citizen soldiers have enough to worry about.  The last thing they need to be concerned about is the situation their families face in leaving their private-sector health plan and entering a military one.  Indeed, for family members of those deployed for long durations, the challenge of maintaining continuity of health care for spouse and dependents can be daunting.  We cannot afford to take their military service for granted or let it go unnoticed.  We can help and we should.  
Among other initiatives, AMVETS continues to support the overhaul of a disability-claims process in dire need of attention.  Quality, timely decisions should be our aim.  Today, it takes too long to settle a claim.  The error rate remains too high.  And veterans continue to face delays that effectively deny appropriate, legitimate compensation for disabilities resulting from military service.
Despite the job retired U.S. Navy Vice Admiral Daniel L. Cooper is doing, the workload of the Veterans Benefits Administration continues to increase.  As of mid-March, VBA had more than 500,000 compensation and pension claims pending decision, an increase of nearly 35,000 from this time last year.  In addition, nearly 20 percent of these pending claims have been in the hands of VA more than 180 days.
The challenges, which have historically plagued this system, are not insurmountable, but making progress requires a stronger budget than the one proposed by the administration.  Failure to fully fund the department's requirements will fail veterans seeking resolution to their claims to secure compensation for injury or illness received during military service.
Another area that requires congressional oversight is the management of VA education services.  Agency records indicate that about 75,000 veterans' education claims awaited processing as of March 19, more than double the number this time last year.  AMVETS is informed the current backlog results from too few claims processors and a computer glitch that last fall that has kept claims from being processed.  As these veterans try to advance their education, they shouldn't have to worry about delays in processing their earned benefits.
The AMVETS membership also supports increasing the response to help our severely wounded soldiers returning home from the field of battle.  We recognize the benefits of the Disabled Soldier Support System (DS3), introduced by the Army to provide disabled soldiers and their families with a system of advocacy to assist their transition back to civilian life, but the current program is understaffed and underfunded.  Congress needs to legislate reprogramming authority for adequate staffing of the DS3 program. 
These soldiers have lost a limb, been blinded or lost an eye, suffered a disabling brain injury, or disfiguring burns or wounds.  They have served their country without question honorably and bravely, and they deserve our help now as they strive to put their lives back together.
While speaking about returning troops, AMVETS urges your committees to keep a close eye on the implementation of Public Law 107-288, which provides the Department of Labor Veterans Employment and Training Service (DOL-VETS) a number of new tools to help servicemembers make the transition to the civilian job market following military service.  As these former troops return home, the employment service dedicated especially for them needs to be primed for use and ready for delivery of service.
It is important, therefore, that your oversight responsibilities ensure that programs currently in force, as well as those in development, support the strongest veterans' preference laws as possible. We ask you, as well, to remain vigilant in seeing that employment programs at all levels of government continue to help veterans on that basis and that you oppose any attempt to weaken such laws. 
We also encourage you to pursue additional avenues into the civilian job market for the tens of thousands of troops who demobilize yearly.  In this regard, we believe that there is a place for first-rate, well-structured apprenticeship programs for separating service members that, hopefully, build on an individual's military experience and lead to mainstream careers or satisfying self-employment.
 The members of AMVETS also urge Congress to exempt as eligibility criterion for all federal programs disability compensation, pension payments and Dependency and Indemnity Compensation Benefits (DIC).  An elderly veteran should not be barred from senior assisted living because he receives a small pittance of pension. A veteran's old-age pension should not push an individual over the allowable financial threshold for admittance to an assistance program available to others who never served in the military.
On the matter of homeland security, we recognize a role for VA in America's preparations for and defense against terrorist attacks and threats.  It seems to me that if we are to have a comprehensive national policy, we should give the department a role in that strategy.  After all, VA operates the largest integrated healthcare network in the world, with more than 800 outpatient clinics and 160 medical centers.  And Congress has already agreed in statute that an integral part of VA's mission is to provide backup medical resources to the military healthcare system and local communities in case of emergency. 
In addition, Mr. Chairman, AMVETS stands solidly behind the right of Americans to protect their flag.  This flag of ours is a symbol of all that is good about our country.  It is also the symbol of a nation willing to sacrifice its most precious resource to be free.  Though said nearly two centuries ago, Henry Ward Beecher, an American clergyman, was on target when he said, "A thoughtful mind when it sees a nation's flag, sees not the flag only, but the nation itself."  The men and women gathered here understand this perfectly. We ought to honor it and protect it, if for no other reason than the fact that Americans throughout history have fought and died to keep it flying.
On this issue, we recognize and appreciate the members of the House who helped assure overwhelming passage of the flag-protection amendment in the last session of this Congress. 
And we ask our senators to stand up and be counted.  I ask you to pause for a moment and think about our flag?the symbol of this great nation and an inspiration to Americans everywhere.
For more than 200 years, the American flag has flown proudly here and around the world as a testimonial to freedom. Martin Luther King once taught, ?There is glory in citizenship.  Our country may not be all we want it to be, but that will change.  Respect your country.  Honor its flag.?  
We look for our elected officials to bring this issue to a vote as soon as possible.  This is a high priority, and we ask senators and members of Congress to support us in allowing the American people an opportunity to debate overturning the 1989 Supreme Court decision that legalized flag desecration. 
We also want the fullest possible accounting of our missing servicemen and ask for your support in the effort to find and identify their remains.  This is important.  It is a duty we owe the families of those still missing and unaccounted for as well as to those who served or are currently serving.  As President Bush said, ?It is a signal that those who wear our country's military uniform will never be abandoned.? 
We encourage Congress and the administration to take action that will lead to the firm cooperation of foreign governments in revealing the whereabouts or assisting in the recovery of our missing or captured from all conflicts and military operations worldwide.
Additionally, as the committee is aware, there is a growing need for long-term care in VA.  While the veterans population is projected to decline from 24.3 million to 20 million over the present decade, those aged 75 and older will increase from 4 million to 4.5 million and those over 85 will more than double, from about 640,000 currently to nearly 1.3 million in 2012.
Mr. Chairman, with the sharp increase in the projected number of elderly veterans, AMVETS believes that VA's extended care services are indispensable to its overall mission in providing veterans health care. 
We urge you to explore the challenge ahead for providing long-term assistance to veterans.  And we seek action that will provide enrolled veterans with affordable access to a continuum of extended care services that include nursing home care, domiciliary care, as well as home and community-based extended care services.  In this way, we can assure improved healthcare delivery and enhance the measure of care for elderly veteran patients.
Finally, we urge Congress to maintain the federal supply schedule for pharmaceuticals to ensure VA continues to receive maximum discount in drug purchases. A number of recently introduced bills threaten the department's purchase program and would, if approved, adversely affect its cost for pharmaceuticals and veterans' co-payments.
Mr. Chairman, great decisions and challenges await us in the months ahead.  The membership of AMVETS looks forward to working with you to establish a clear policy of national recognition for those who serve. 
We have much to do, but we are encouraged in knowing that our work will help determine the future of our nation and that of millions of others around the world who love freedom.
This concludes my testimony.  Again, thank you for extending me the opportunity to appear before you today, and thank you for your support of veterans.  I hope all of you will be able to join us tonight for our AMVETS congressional reception and Silver Helmet presentation to the Honorable Thomas M. Reynolds to be held here in the Cannon Caucus Room from 5:30 to 7:30 p.m. 
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