The new Republican chairman of the House Veterans Affairs Committee says its time to learn where a lot of those dollars went and to provide better oversight of how VA budgets are shaped and spent.
Rep. Jeff Miller (R-Fla.), interviewed before the 112th Congress convened, said his predecessor as chairman, Democrat Bob Filner of California, was inclined to address veterans’ needs with more dollars.
Miller said he will be “more focused on helping to increase resources through efficiencies.”
“This is a huge government agency and there is a mindset within the agency that is hard to change,” Miller said. “But I think we need to focus not only on delivery of services but the cost at which those services are being delivered to the veteran.”
“You know,” he added, “the Department of Veterans Affairs really has grown immune to oversight from Congress. And I hope to reinvigorate the process.”
Like Filner, the 51-year-old Miller is not a veteran. He was a real estate broker and former deputy sheriff before entering politics in Florida.
In fall of 2001, after Joe Scarborough, now a TV personality, resigned his House seat, Miller won a special election to fill it and has represented Florida’s 1st Congressional District in Congress ever since.
It is home to Eglin Air Force Base, Pensacola Naval Air Station and many veterans, which helps explain why Miller has chosen to serve on both the veterans’ affairs and the armed services committees.
He was picked by leadership to chair the VA committee after former ranking member Steve Buyer of Indiana said he would retire, and the next most senior Republican, Cliff Stearns of Florida, tried but failed to gain chairmanship of the energy and commerce committee in the new Congress.
Miller listed closer oversight of VA’s $125 billion budget as his top priority along with, as always, improving delivery of services to veterans.
“The [Veterans] Benefits Administration is woefully behind with a backlog on benefit claims,” he said. “The only way we’re going to be able to solve that is good, strong oversight of the cooperative effort of both VBA and the [VA’s] Office of Information and Technology.”
Some veterans’ service organizations agree that tighter supervision might be timely. One executive at a major VSO pointed to a VA inspector general report last year that found $6.3 million appropriated by Congress to fund traumatic brain injury research had diverted to priorities.
“This could be just one of a multitude of issues considered under the greater oversight role” Miller promises, he said.
Miller referred to “a culture in some areas of the VA system that has got to be brought up into the 21st century.”
For example, he noted lapses in sterilization at the St. Louis VA hospital revealed last year and other incidents involving possible spread of infection.
But the notification process, said Miller, was “done in a very cold, callous way. Folks need to understand we are dealing with human beings who served their country and deserve dignity and respect.”
One issue Miller raised in our interview, as something he wants to expand, worries vet advocates. He wants to allow more veterans to get health care from private-sector doctors and hospitals, at VA’s expense, in situations where VA facilities are inconvenient to use.
In northwest Florida, he said, veterans still must travel to VA facilities in Biloxi, Miss., New Orleans and on to Birmingham, Ala., for care that they could be receiving locally at private hospitals.
“We need to find a way to allow for expansion of veterans use of local medical facilities instead of requiring them to drive great distances … It’s something that Congress has worked on for a number of years but we still don’t have a handle on it,” Miller said. VA should expand fee-for-service exceptions beyond “rural communities.”
That raises alarms for veterans’ groups. They view such a move as a first step toward weakening the VA health care system. They also see it as a threat to VA continuity of care, particular for veterans with multiple health issues, all of which now get tracked and treated by a single system.
But Miller said he worries about older veterans or those with critical health issues having to travel too many miles to get the care the need.
Veterans in his district who need heart surgery, he said, “are required to leave the panhandle of Florida, and there are great cardiac physicians in our community.”
Localizing care would be “a benefit for the doctor to have the patients” near and “for the patients to have their physicians as close as possible, not only for the surgery but in the recovery.”
VA has run some pilot programs, Miller said.
“But I think we need to look at expanding it so that the veteran can receive the care as close to home as possible.”
Vet groups worry that sending more vets to private hospitals and doctors for care will make lawmakers reluctant to fund new VA medical centers and hospitals in areas of rising veteran populations if those areas also have plenty of private physicians and hospital beds.
“So rather than build a $300 million VA hospital,” said one worried advocate, “Congress could easily say ‘Hey, let’s just kind of farm them out to the local community.’ Does that give them the care they deserve through the VA, which is the best care in the world? Does that give the VA system the pool of veterans from which to learn and provide better care? Does that give the VA system the care from which to practice new techniques? No.”
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