American veterans — particularly those returning from combat with physical and psychological wounds — should not have to worry about getting the full financial and medical benefits they were promised by the Department of Defense or the Department of Veterans' Affairs (the VA). Nor should they have to wait for weeks or months for treatment, be cared for in substandard facilities, or be subjected to lengthy claims processing delays and errors at the hands of an under funded, ineffective bureaucracy.

The VA and its component Veterans' Health Administration have been unable to do what they were intended to do. That is largely because the Bush administration has been unwilling to plan for or budget the money for adequate care. Actually, Mr. Bush's administration is only the latest (but by far the worst) example of America's failure to deliver the pay and medical care veterans were promised when they enlisted. Historically, except for World War II, America has not done well by her veterans, and I intend to fight to change that.

Unfortunately, ending the war in Iraq and gradually withdrawing our troops will not fix the VA. It will only keep the system from spinning even further out of control. In the meantime, Afghanistan is accounting for increasing casualties, and many more of our men and women will have to be sent there in coming months.

A Crisis

Until the Walter Reed scandal surfaced, our medical treatment of veterans was pretty much a dirty little secret except to the veterans. It should not have been a secret to the Army: Walter Reed is an Army hospital, and the chain of command went from the commanding officer to the Army Chief of Staff and then to the Secretary of Defense. It should not have been a secret to the Congress at large, and it most certainly should not have been a secret to the members responsible for oversight of the armed services and veterans' medical care.

The failure of the House and Senate to exercise their legislative and oversight responsibilities for veterans' health care programs and research has been nothing short of disgusting. The House Committee on Veterans' Affairs and its Subcommittee on Health have either failed to understand the needs of veterans, or failed to convince national leadership to act, or both. (My opponent, Jeff Miller, is a member of both the House Armed Services Committee and the House Committee on Veterans' Affairs. In 2007 he was appointed as the Ranking Republican Member of the Veterans' Affairs Subcommittee on Health.)

Meanwhile, the VA's backlog of pending disability claims from veterans going all the way back to World War II is up to at least 400,000, and more than 100,000 claims are wrongly decided each year. Some 144,000 women and men sought care from the VA in the first quarter of 2006 — 23 percent more than the Bush administration had estimated for the entire year. Similarly, the government projected that 18,000 returning soldiers would seek treatment for posttraumatic stress disorder (PTSD) in 2006, but the VA treated 20,638 Iraqi war veterans for PTSD in the first quarter alone. All told, in 2006, the VA added 250,000 new beneficiaries. Veterans in disgraceful numbers have fallen through the cracks in the overtaxed VA system and are homeless. Many are Vietnam veterans, but veterans who served in Iraq and Afghanistan are now beginning to appear on our streets, as well.

In 2005, there was a multi-billion dollar VA funding shortfall which the Congress had to address on an emergency basis. This is a symptom of the problem. The proposed FY 2009 budget for the entire VA is $41 billion, with medical care accounting for about $30 billion of the total.

Judging by the number of combat veterans seeking help and the history of prior budgets, we will be lucky if $30 billion is even half of the amount actually needed in FY 2009. Harvard Professor Linda Bilmes and Nobel-Prize economist Joseph Stiglitz, co-authors of The Three Trillion Dollar War, estimate that the long-term medical cost of the Iraq and Afghanistan wars will be $660 billion.

In addition to its problems with sheer numbers of cases, the VA never knows for sure how much money it will have. Its funding depends on the budget for the next fiscal year, which is appropriated only months in advance — and sometimes not even then.

Advance funding — the appropriation of funds a year or more ahead of the upcoming fiscal year — is now authorized for a variety of educational and family services. Congress can and should authorize advance funding, which would definitely help to stabilize VA operations. Let's be very clear, however: advance funding is not a substitute for adequate funding.

Advance funding should extend out not 1 or 2, but 20 or 40 years into the future. Our ability to make precise estimates is limited, and they would have to be revised from year to year. Even with those limitations, such estimates would help define the size of the problem for many years ahead instead of 6 months ahead. Any business that plans on staying in business makes long-term estimates of its revenues and obligations in the same way.

American soldiers and Marines are receiving extraordinary, state-of-the-art care from skillful Army surgeons at the edges of the combat zones. As Dr. David E. Lounsbury, internist, retired colonel and coauthor of a new book issued by the U.S. Army called War Surgery in Afghanistan and Iraq, explains, "The average surgeon, civilian or military, has never seen this stuff. Yeah, they've seen guys shot in the chest. But the kind of ferocious blast, burn and penetrating trauma that's part of the modern I.E.D wound is like nothing they've seen, even in a Manhattan emergency room." Dr. Lounsbury also notes that the use of body armor has created new types of injuries, and that both injuries to the brain and the number of wounds for every death have increased. In short, more of our men and women are receiving horrible wounds, both physical and psychological, and more of them are surviving and coming back home permanently disabled.

Back in the USA, however, the government medical facilities are overwhelmed by the needs of soldiers injured in Iraq. Survivors of these awful wounds wait months for an appointment for physical or emotional help. The VA medical staff has a reputation for providing excellent care, but there are not enough doctors to go around.

Issues of Just Payment

A hot-button item right now is that of "concurrent payment" for retirement and disability. Mr. Bush's government has argued that payment of retirement and disability is payment for the same service at the same time, which is commonly called "double-dipping." The problem with that argument, as pointed out clearly and simply by the National Commander of the American Legion, is that disability from combat wounds and longevity retirement (i.e., length of service) are not the same.

Bilmes and Joseph Stiglitz, co-authors of The Three Trillion Dollar War, offer another, expanded rebuttal. "Budgetary expenditures also underestimate the true economic costs to the soldiers wounded because the outlays do not include adequate compensation for what tort law calls pain and suffering, or additional health care," said Professor Bilmes in an interview. "We believe veterans and their families receiving full disability payments bear costs equal to those who die in combat, and therefore we should assign each case a non-budgetary cost of $6.5 million (the number that economists calculate as the value of a human life). We assign a modest 20 percent of that figure to those who are wounded less seriously."

There are several pieces of legislation in the U.S. House and Senate that address this issue. I will certainly work hard to see that retired, disabled veterans receive both retirement and disability pay.

There are other instances of veterans being deprived of pay through policy and legislative act. Around the mid-sixties, the government began to withhold social security from military pay. Then, once a soldier retired, the military retirement pay was docked by the amount of social security that was being received. In addition its fundamental silliness, think of all the additional bureaucratic person-hours that little accounting twist chewed up. There are other, more recent examples, but that one is a classic.

I will wind up with a comment on a story that appeared in Florida Republican Senator Mel Martinez's April 15 E-Newsletter. This piece told about a Korean-war veteran who resided in an assisted-living facility. In December 2006, the vet had submitted an application to the VA for a pension to which he was entitled. When he was unable to get a response, he finally contacted Senator Martinez. Not surprisingly, the VA acted swiftly once it heard from Senator Martinez. The vet is now receiving his pension and back payments. I am happy for the veteran. The troubling thing, of course, is the fact that the veteran had to go to a senator to get a pension that rightfully belonged to him. Veterans deserve at least as much efficiency as they get from the IRS! Adequate funding and oversight can ensure that happens.

Jim Bryan's Pledge

Veterans' issues should matter to all Americans — not just to veterans — for two main reasons. First, how we treat our veterans directly affects both military morale and enlistment. That makes veterans' affairs a national security issue. Second, if the government shirks its obligation to those who have served our country, it violates our basic tenets of governmental fairness and integrity — and the failure to live up to those principles in one segment of our population is likely to spread like cancer to other groups.

I will take with me to the Congress the combat wounds that caused me to retire at 20 years, and I am going to take a sharp interest in veterans' matters whether or not I am appointed to the Committee on Veterans' Affairs. I will honor the service given by thousands of members and veterans of the armed forces in District 1, and I will fight hard to see that all American veterans are treated right.