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ENDING THE VA'S FUNDING CRISIS - by Larry Scott
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While veterans' lives hang in the balance,
Congress
disregards the root cause of the VA's funding
difficulties.
The old budget process must be replaced by a
real-time,
mandatory funding mechanism based on actual
need.
Story below:
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Time for a change
The concept of mandatory funding for VA healthcare has been tossed
around for years. Congress has voted on and voted down mandatory funding
measures with great regularity. This argument was simple: Too much
money. Another argument was that the formulae for mandatory funding
would lock the VA into a fixed budget amount for a given fiscal year and
that amount could be inadequate.
What hasn’t been considered is mandatory funding for all VA agencies. If
the VA is to serve all qualified veterans, why shouldn’t the VBA and VCA
receive mandatory funding as well as the VHA? So, let’s consider that
option.
Real-time budgeting
The concept is simple. The VA needs a real-time budget based on
real-time needs. This would not be a budget negotiated from the top
down, full of political deal-making. It would be a budget dictated from
the bottom up based entirely on need. The VHA, VBA and VCA all work in a
real-time environment. At any given moment each hospital or clinic,
Regional Office or cemetery can quantify their budget needs.
Let’s use a VA hospital as an example. The hospital director knows how
many veterans are seeking care and what services they need. The director
also keeps records on equipment and facilities needs. The cost of all
these needs is easily quantifiable. That data would be transmitted to
VACO who would forward funds to the hospital.
Each VA facility would have to justify their budget on a quarterly
basis. This would be done with a new budget request and funding would be
adjusted according to need. Budget planners at VACO would work in an
oversight capacity to ensure adequate funding levels and proper use of
all funds.
But, can it work?
The obvious question about such a simple and radical plan is: Can it
work? The answer is: Yes! But such a change would be met with opposition
on every front.
We would hear: We just don’t give money to government agencies because
they ask for it. But, the VA is not just any government agency. The
three VA administrations are set up to provide veterans with earned
benefits. If they aren’t properly funded, then veterans are not getting
those earned benefits. So, this argument doesn’t hold water.
We would also hear: What about the role of senior VA officials who
usually handle these budget matters? Those officials have proven over
and over that they cannot put together a proper VA budget. This plan
would take them out of the loop and put control at the “hands-on” level
where budget needs can be calculated in real time.
And, we would hear: What about Congress and its role in funding? Well,
what about Congress? Our elected representatives have played politics
with the VA budget forever. It’s time to give them a rest.
The real question is whether or not a budget process like this could
ever become a reality. I think not. Political appointees at the highest
levels of the VA would have to give up too much control and power. The
same can be said of Congress who, every election year, belly-up to the
microphones and cameras and pledge their never-ending support of
veterans, then return to Washington and underfund the VA.
So, let’s look at the above as what could happen in a perfect world
where politicians really meant it when they talked about caring for
veterans. I ran this by a number of friends in the veterans’ community.
They all would like to see it happen, in the perfect world. None of them
were terribly optimistic.
***** END *****
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Larry Scott --
