The backlog of claims and unnecessary delays in veterans' care has broadened despite a 235 percent increase in the budget of the Department of Veterans Affairs between 2001 and 2013.
That finding has prompted veterans' advocates to contend that it is a lack of accountability, not funding, that is at the root of the systemic crisis.
"While everyone claims increased funding is the answer to what ails the VA, I am not sure that a bigger budget will necessarily fix the underlying issues," retired Marine Sgt. Maj. Joseph VanFonda
, CEO of the nonprofit Disabled Veterans National Foundation, wrote in a recent blog post.
"The VA has been overburdened for years, but the real issue is a systematic failure to put proper procedures in place to meet the needs of veterans and prevent these types of abuses in the first place," VanFonda said.
Budget increases at the VA have come as the total number of veterans is decreasing due primarily to the deaths of aging World War II participants.
According to figures from the Office of Management and Budget, funding for medical care, which composes 40 percent of the VA's annual budget, increased 193 percent from 2001 to 2013.
During the same period, the overall veterans' population declined by 4.3 million, Investor's Business Daily reported.
Tal Coley, senior policy analyst with Concerned Veterans of America
, agrees that the current problems at VA hospitals are not due to budgetary skimping.
"The department has experienced budgetary increases since 2006, yet it continues to fail to meet its own goals. And as the VA's performance has failed to meet basic standards, nobody has been held accountable — making it nearly impossible to change VA's calcified culture," Coley said in a statement.
According to the OMB
, the VA budget increased in real terms from $45 billion in fiscal 2001 to $150.7 billion in fiscal 2014. Only the Department of Defense experienced a larger increase. And from 2008 to 2012, per-patient spending at the VA climbed 27 percent.
Nevertheless, Democrats continue to cite inadequate funding as the source of the ongoing VA scandal.
Sen. Jay Rockefeller, a Democrat from West Virginia, argued the delays in delivering care were a consequence of inadequate funding. "If the VA does not have enough doctors to see these patients, then these problems are a result of a lack of funding," he said.
His position was echoed by Rick Weiland
, a Democratic candidate for the Senate in South Dakota, who urged veterans to "get out there today" and "demand that Congress stop pretending their refusal to properly fund the VA is not the real problem."
Defenders of the VA also contend that budget increases are needed to handle an increase in claims related to traumatic brain injuries among Iraq and Afghanistan veterans.
However, in Senate testimony in 2013, VA Secretary Eric Shinseki said the department's budgetary request for traumatic brain injury (TBI) would be lower because he anticipated that even while the number of veterans being treated for TBI would increase, they could be treated at less cost.
In the VA's proposed 2015 budget, TBI funding was reduced from $232 billion to $229 billion. VA Under Secretary for Health Dr. Robert Petzel, who recently resigned, said although the VA had budgeted for increases in care for TBI, the actual spending had gone down slightly in the past few years.
According to the Military Times
, Petzel testified that there has been a 70 percent decline in the number of severe TBI cases, while more moderate cases had increased.
In 2013, the VA sought $164 billion, including $68.4 billion for healthcare spending and $95.6 billion for disability compensation, pensions, and to deal with a disability claims backlog.
Verna Jones of the American Legion said part of the backlog is due to VA officials hastily and improperly processing claims.
"The claims are being processed, but are not done correctly, so they are remanded back to the regional offices, who are having to redo them," Jones told Newsmax.
"This just adds to the delays in care. The officials need to have better training and incentives to get it right rather than having in place incentives that result in officials just trying to meet numbers. [The VA] is placing stress on the number of claims and less on the actual accuracy of the claims," Jones said.
"There is a long laundry list of areas of mismanagement that is far too long, and Phoenix is just the straw that broke the camel's back. There needs to be some accountability so that our veterans get quality and timely treatment," Jones added.
Jones referred to the scandal that erupted last month when it was revealed that at least 40 veterans at the Phoenix Veterans Affairs Health Care system had died while waiting for treatment. Many of the patients succumbed to their illnesses as their names sat on a secret waiting list that was intended to conceal how long they actually had to wait before being seen by a physician.
A House source familiar with a probe of the VA told Newsmax the problems plaguing the system are due to a lack of accountability.
"Across the board the main problem is an extreme lack of accountability. We have seen this in every healthcare scandal from Pittsburgh, where six veterans died of Legionnaire's disease and no one was disciplined, to Atlanta, where six veterans committed suicide and officials were only issued temporary written warnings," said the individual, who spoke on background.
The lack of accountability also is reflected in the awarding of bonuses.
In 2011, the Government Accountability Office reported that the Veterans Health Administration's "oversight is inadequate to ensure that medical centers comply with performance pay and award requirements" and that VA officials asserted the purpose of performance pay is to improve healthcare outcomes and quality, but had never codified that goal in its policy.
And in 2011, about 80 percent of VHA's nearly 22,500 providers received about $150 million in performance pay.
That figure included a bonus to Columbia, S.C., VA Regional Office Director Carl Hawkins, who received almost $80,000 in bonuses despite a doubling in the office's backlog of disability compensation claims, according to The Washington Examiner
And despite chronic management failures, which directly led to the deadly Legionnaire's disease outbreak in the VA Pittsburgh Healthcare System, VA Pittsburgh Director Terry Gerigk Wolf was given a perfect performance review. Also, Pittsburgh Regional Director Michael Moreland received a $63,000 bonus.
Regardless of four preventable patient deaths, former Atlanta VA Medical Center Director James Clark received $65,000 in bonuses over four years.