Sen. Daniel Akaka: Bring VA Up To Date

The Senate Committee on Veterans Affairs quietly came into existence at the dawn of a calamitous year, 1970, when the world's attention was trained critically on America. Political anxiety was running high in Washington, where the Democrats controlled Congress and an embattled Republican occupied the White House. As U.S. troops were entering their sixth full year of fighting a controversial war in Asia, an emerging generation of young veterans was coming home with health problems no one would understand for at least a decade, if ever. At the time, a separate new legislative committee to focus purely on the needs of military veterans made more sense than the erstwhile situation, where the Senate's business with those who'd served their country in uniform had been relegated to the agendas of the Committee on Finance and the Committee on Labor and Public Welfare. The House of Representatives had a 23-year head start, having formed its distinct veterans affairs committee shortly after World War II. Today, 38 years after Indiana Democrat Vance Hartke dropped the gavel that gave veterans a place of their own in both houses of Congress, the relationship appears to have come full circle between the federal government and those who served in its armed forces. The number of Americans already discharged from military service in the global war on terrorism is now approaching 1 million. The majority of veterans from World War II, the Korean War and Vietnam, meanwhile, are now either nearing or well into their retirement years, filling VA health-care facilities and nursing homes past capacity. Gulf War Illness is as little understood today as Agent Orange exposure was in the 1970s. A growing backlog of unresolved VA benefits claims today stands at more than 400,000. Appointment delays and waiting times continue to mount at VA hospitals and clinics, while authorized construction projects await real dollars. And the war continues to generate more VA-eligible veterans, many of them combat-exposed, physically or mentally disabled, and looking squarely to their elected leaders in Washington for help. This is the situation faced by 83-year-old Hawaii Democrat Daniel J. Akaka, a World War II veteran of the Army Corps of Engineers and the eighth chairman of the Senate Committee on Veterans Affairs. Akaka recently spoke with The American Legion Magazine at his Washington office about the committee's approach to the second half of the 110th Congress. Q: The volume of legislation handled by the Senate Veterans Affairs Committee has increased dramatically in recent years, from just 62 bills in the 106th Congress to more than 100 only halfway through the 110th. Is that by design? A: This committee has been very aggressive in trying to meet the needs of veterans, of all veterans, World War II up to the present. Because of those needs, we have had to be very aggressive. When we started out, we planned to do two hearings a month. Well, we have had as many as five a month. The members, I will tell you also, have been very active in the affairs of VA, as well as veteran problems in their own home states. Q: How important is it to check your party affiliation at the door when you work on a committee like this? A: For me, that's very, very important. As chairman of the committee, I have tried to put this ahead of whatever the committee does - bipartisanship. I feel the concern should be about the veterans and not about partisanship. And I think the committee members feel that way. So we've been really moving. The problem we have is, once we get it out of committee, getting it to the floor. Q: How do you think the committee will be affected with a new ranking Republican, Sen. Richard Burr, who replaced former Chairman Larry Craig? A: He's been on the committee, and we both commit to work together in a bipartisan manner. So that's what I am looking for. Q: Senate Veterans Affairs Committee hearings often are not well-attended by members themselves, two of whom - Hillary Clinton and Barack Obama - are now on the presidential campaign trail. A: The problem we have in the Senate is that members are busy. As a result, they are not able to attend all of our meetings and our hearings. But I want to tell you that the spirit, the energy and the interest is there. Q: How is the 110th Congress living up to veterans' expectations? A: First, we are going back to including the (veteran service organizations) more in what we do here. I feel personally that the VSOs are partners in what we try to do to help veterans. We need feedback from the VSOs - their experience, their legacy, their passion. I feel that's a major step, including them back as partners in what we do. When we assumed the leadership here, it was clear that there were areas where we needed to work. One of the first areas was funding. As a result, what we have now (the VA budget passed by the House and Senate veterans affairs committees) exceeded the budget of last year by $6.5 billion. That's a lot. When I say a lot, that's the most we've ever had before from the committee. It was $3.6 billion over the president's budget. I want to continue to increase it. As a matter of fact, I want to find ways of tagging (the VA budget) onto the cost of war, rather than standing in line with the rest of the committees for whatever funds we have to distribute. As a result, it will bring resources to us that we need to really take care of veterans. Q: How do you see VA health-care demand changing? A: It's going to increase. Today, as we know, we are saving so many lives on the field that we lost in former wars, because our training is so much better. But as we save them, we've got to take care of them. Some of them need a lot of help to stay alive. We need funding to do that. Q: You support lifting the current new-enrollment suspension of Priority Group 8 VA patients. How can that be accomplished? A: We've taken steps in committee to do that. We have passed it in an omnibus bill, to bring back the middle-income veterans who were eliminated from enrollment. The other part (of the bill) is to increase the mileage fee, so it will be better - not sufficient, but we're increasing it. Q: The bigger remedy, it seems, is mandatory or assured funding for VA health care. A: No question. We need it for the veterans. It's what I mean when I talk about the cost of war. Q: Do you foresee a dollars-per-veteran formula for VA health-care funding? A: That's a possibility. Right now, I am trying to set up an authorization that would give us that level of funding rather than standing in line with the rest of the committees. If we could get an authorization for the cost of war, we would do better than we are now. Q: At one point not long ago, VA was reportedly collecting less than 50 cents of every dollar it billed to insurance companies. What can be done to improve VA's efficiency in such areas? A: We know that a lot needs to be done. Our committee has put a priority on oversight. I have been sending staff around the nation and getting direct information. This has helped us with our legislation. Members have had hearings in their states. Sen. (Sherrod) Brown went back to Ohio with our staff and had hearings there. The senator from Montana, (Jon) Tester, went with our staff. Sen. (Patty) Murray from Washington and Sen. Johnny Isakson from Georgia - these senators are so grateful to have our staff with them. They say, "Hey, thanks so much for that." They are bringing back information that can help us restructure VA. Q: You propose a full restructuring of VA? A: We've got to change the structure from the World War II structure up to the Iraq structure. We've got to bring it up to date. Q: You just received a report on waiting times at VA facilities. Apparently, VA has understated the amount of time veterans are forced to wait for their appointments. You described the report as "disturbing." What drove you to call for the study? A: We have been hearing from veterans all across the nation about waiting times. The reports we have received from our staffs have not been good. Terrible, about what's happening out there. It gives a good idea of what kind of restructuring needs to come about. This is what we're working on. What's been coming up recently - PTSD (post-traumatic stress disorder) and TBI (traumatic brain injury) - I'm working on as a category I call "invisible wounds," different from physical wounds. The thing about this is we need new policies for invisible wounds. Some of the veterans, even after they return - maybe two years have gone by - go back and say, "Hey, I'm having a problem." And they are being asked, "Is it service-connected?" TBI and PTSD are a different kind of thing. We need new policies in there so that when they come in for help there will be no question. Q: Do you think the delays are attributable simply to too many new patients and not enough providers? A: This is where restructuring comes in. They have to devise a different system of dealing with this. Q: Veterans often complain that VA care varies too greatly depending on where you live. A: This is something VA really needs to work on, to equalize service quality throughout the country. We need to continue to work on this as we change secretaries. As soon as we have a new person on, we need to continue with restructuring, with funding, with oversight. Q: What other legislative priorities do you see heading into the second half of the session? A: One is the GI Bill. There is an effort to update it, which is a good idea. That is something we will be working on. The GI Bill needs restructuring - very important - with more balance and better quality of service, directly to the veterans. Q: Even if they were National Guard or reserve? A: We want to be sure, at least for now, that those who were deployed would receive this kind of service. We have to take care of the Guard and reserve, when they go back home and go back to their jobs. Sometimes they have problems with the workplace, as well as with families. We need to help them with these problems. Q: What about the federal government's poor record of living up to the law that mandates no less than 3 percent of government contracts be awarded to companies owned by service-disabled veterans? A: Our staff needs to check on that and see where it is now, with the hope of trying to draft something that could improve it. Q: It seems this is a committee facing many priorities. A: The other big thing is the claims backlog. And funding. We have our work cut out for us. We will be busy this year. Interview: Jeff Stoffer Akaka on the flag amendment Q: Sen. Akaka, you consistently vote against legislation that would protect the U.S. Flag from desecration. Can you explain your position? A: My position about flag burning has been the effect it would have on the Constitution. I’ve always been on the side of giving citizens the right of expression. I would tell you I don't like flag burning, but for me to say that no citizen can voice themselves in a way - I just back up a little bit. Personally, I don't like it. Legally, what affects the rights of citizens causes me to back up.