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Sen. Patty Murray, D-Wash., said in an interview that Washington’s cost-cutting culture helped spark the growing Veterans Administration hospital controversy by encouraging VA officials to understate their financial needs both internally and to Congress.
Murray, a top appropriator and former chairwoman of the Senate Veterans Affairs Committee, had strong words for a department that she said not only faces chronic management issues but also consistently underestimates its funding needs and how many veterans will seek care each year. Though many Republicans have called for current VA Secretary Eric Shinseki to step down from his post in light of reports of secret waiting lists at VA hospitals across the county, Murray focused on cultural issues that extend deeper than one official.
“In an environment where everybody is told, 'Keep the cost down. Don't tell me anything costs more.' — it creates a culture out there for people to cook the books,” Murray said in an interview with Yahoo News. Administrators learn to “hide the facts, because they don't want to be told by their bosses, 'Don't tell me you need more money, because we can't say that,'” she added.
“Well, in the VA, if they need more money, they need to be able to tell us, because how else are we going to solve these problems,” Murray said. “So we have to change that culture and mindset.”
For the upcoming fiscal year, current Veterans Affairs Committee Chairman Bernie Sanders, Independent-Vt., has requested an additional $1.6 billion above the Obama administration’s medical services request. Though funding for the VA has gone up in recent fiscal years, the number of patients also has increased substantially, and Sanders has challenged the way the VA estimates the number of patients it will see. In 2012, the VA underestimated its increase in unique patients by 78,534, and in 2013, it underestimated patient growth by 57,955 veterans.
According to an April letter Sanders sent to the Senate Budget Committee, which Murray runs, the VA “doesn’t take into account changing factors, such as the looming reduction of forces by the Department of Defense,” which removes members of the armed services from the active duty military health care system and permits them to rely on the VA. That means the VA’s estimate that it will gain 125,000 new patients in the coming year also could be a gross misestimate. On Tuesday afternoon, President Obama is expected to announce a reduction of troops in Afghanistan to fewer than 5,000 by the end of 2015.
“Despite this increase, the overall health care inflation rate and demand for a greater variety of health care services, the President’s FY 2015 budget request reflects just a 3 percent increase in medical care spending over the previous year,” Sanders wrote.
But what Murray is suggesting is an even more serious charge: That the problem is not just a flawed formula for predicting needs at the VA but a deliberate downsizing of the agency’s budget request of Congress in deference to the culture of austerity that has pervaded Washington since Republicans recaptured the House of Representatives in 2010.
If VA staffers or administration officials do not feel comfortable asking for more funding out of fear of being criticized or rejected, then it’s difficult for Congress to deliver increases in spending. Already, the VA is one of the few departments exempt from automatic spending cuts enacted in 2013 and known as sequestration.
“It's what I've told every VA secretary for as long as I can remember: It's your job to tell us what you need on behalf of those veterans. And it's our job to make sure we've got the resources,” said Murray. “But we can't provide the resources if we aren't being told the truth.”
The VA has now made its case to Congress that much tougher, because lawmakers may question why they should appropriate more funds to an agency that can’t properly use the funding it has.
“The frustration I have is that this isn't a new problem. It is something that we have been talking about for a long time,” said Murray. “What I want to make sure happens is that this isn't just a political fight for the moment but it actually solves the cultural problem that we have today.”