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Lawmakers announce bipartisan breakthrough on VA health care reform

July 28, 2014 at 6:20 PM EST
House and Senate negotiators reached a compromise on how to improve patient care in the VA health care system. The $17 billion proposal would provide money for vets to seek out private care if their access is limited, hire additional doctors and nurses and lease new clinics around the country. Vermont Sen. Bernie Sanders and Florida Rep. Jeff Miller join Judy Woodruff to discuss the deal.
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JUDY WOODRUFF: Lawmakers did something today that has become rare in this Congress, reach a compromise. House and Senate negotiators found that common ground over reforming the Department of Veterans Affairs. The bipartisan breakthrough to try and improve patient care at the VA came after weeks of tough talks to merge competing proposals passed by the two chambers last month.

The chairs of the Senate and House Veterans Affairs Committees announced the deal at a joint news conference this afternoon on Capitol Hill.

Independent Senator Bernie Sanders of Vermont:

SEN. BERNIE SANDERS, I, Vt.: Rather than go through why we didn’t do this a month ago and get it done, the important point is we are here together having done something that happens quite rarely in the United States Congress. So, I’m proud of what we accomplished.

JUDY WOODRUFF: Their total $17 billion proposal would provide $10 billion for veterans to seek out private doctors if they are unable to get an appointment within 30 days or if they live more than 40 miles from a VA facility, provide $5 billion to hire additional doctors and nurses, and another $1.5 billion to lease 27 new clinics around the country.

The agreement comes months after allegations first surfaced that the VA manipulated the appointment schedule at facilities in Phoenix and elsewhere to hide long wait times for veterans. The controversy ultimately led to the resignation of VA Secretary Eric Shinseki, amid an outcry from lawmakers in both parties.

The Senate is expected to vote by the end of the week on the nomination of former Procter & Gamble chief executive Robert McDonald to take over the department, which has more than 300,000 employees. Sanders and House Committee Chair Jeff Miller of Florida said they expect both chambers to vote on their plan before lawmakers leave Friday for a five-week recess.

Here to explain their proposal and provide insight into the problems facing the VA, we are joined by Senator Bernie Sanders. He’s the independent from Vermont and he’s chairman of the Senate Veterans Affairs Committee. And Representative Jeff Miller, he’s a Republican congressman from Florida and chairman of the House Veterans Affairs Committee.

Gentlemen, we welcome you both.

Congressman Miller, to you first. How did you arrive at these numbers? I ask because the last time the Congressional Budget Office took a look at what Congress was proposing, they came back with an estimate much higher than what you had thought.

REP. JEFF MILLER, R, Fla.: Well, it was.

And a lot of that money was dealing with the choice portion of the bill. We feel like CBO was wildly off on their estimate. We asked them to re-estimate. The number came down a little more. We still think that it’s not going to cost as much as they estimate.

So we are willing to look in a $10 billion number to start with.

JUDY WOODRUFF: Senator Sanders, it does appear that this amount of money is less than what you originally proposed, as I understand it, over three years. What makes you believe it’s going to do its job, that it’s going to make the difference that you think needs to be made?

SEN. BERNIE SANDERS: Well, I absolutely don’t think it’s enough money to do the job. But I think it’s a very, very good thought. I think it will give the VA what it needs in its first year, in terms of going out and getting the doctors and the nurses and the medical personnel and the space that they need to provide quality to care to our veterans in a timely manner.

Frankly, between you and me, I think we are going to be back discussing this next year.

JUDY WOODRUFF: Literally that quickly?

SEN. BERNIE SANDERS: Well, I think so.

And I think that the needs of the VA and the needs of the veteran community are very, very significant. Judy, we’re talking about a VA system in which, in the last four years a million-and-a-half more people have come into the system. You’re dealing with 500,000 people have come home from Iraq an Afghanistan with PTSD and TBI.

You’re dealing with an older veterans population from World War II and Korea who need some difficult medical help. So my hope is and my belief is that what we have done is a really good start. We want to see the VA get its act together. We want to see it be more efficient. We want to see doctors go to where they’re needed. But I have the feeling in a year, in a year-and-a-half, we are going to have to continue this discussion.

JUDY WOODRUFF: Representative Miller, do you think you’re going to be back at this next year too?

REP. JEFF MILLER: Well, I would expect that we may come back, but this is one of the differences between the chairman and myself.

I think the choice option is critical to give the veteran an opportunity, if they choose to do so, to opt out. We have done that in this particular piece of legislation for those that have been waiting in line, and particularly for those that live 40 miles or more from a VA facility.

We believe that this is an important first step. But I will tell you, neither one of us believe that you can fix the culture from within by just throwing money and people at the system. There has to be a systemic change within the system. And I hope that the new secretary, once he is confirmed, will begin that process.

JUDY WOODRUFF: So you’re saying this bill will make some difference, but you’re saying bigger changes are going to have to come from somewhere else?

REP. JEFF MILLER: Well, I think one of the first steps — and I’m glad we were able to reach, again, a bipartisan agreement — is an accountability side.

People are still shocked to find out that many of the same people that have been involved in really lying about the numbers in regards to wait time are still on the job. What we have done is we have come up with a crafted piece of bipartisanship that will, in fact, give the secretary the ability to fire those that have lied to him with an appeal process built in.

And I think that that will send a clear message to those who want to fudge the numbers.

JUDY WOODRUFF: Senator Sanders, do you believe this is going to pass the Congress this week?

SEN. BERNIE SANDERS: I am quite confident it is going to pass the Senate, because I know that virtually every member of the Senate understands we just cannot turn our back on men and women who have put their lives on the line to defend us and who are hurting today.

It really would be an obscenity to go home in August and not address this issue. So I’m confident it’s going to pass the Senate. And I will let Jeff make the determination as to what happens in the House.

JUDY WOODRUFF: Congressman Miller, what do you think about the House?  I heard you say at the news conference today that your background as a salesperson is going to come in handy because you’re going to have to do some education I think is the way you put it of some of your fellow Republicans.

REP. JEFF MILLER: Well, and, Judy, that particularly deals with some of the more conservative members and trying to educate them and describe how we arrived at this particular number to agree upon to bring forth in the conference committee.

I believe that both sides of the aisle, both Democrat and Republican, will support this in very large numbers. The important thing — and it’s a date that Senator Sanders and I had set out really early on — and that was to finish this conference report, have it voted on by both sides of the Capitol Building and then send it on to the president.

JUDY WOODRUFF: But you do think you’re going to get it through the House; is that what I hear?

REP. JEFF MILLER: Oh, I have no expectations of anything less than passage by a wide margin.

JUDY WOODRUFF: Senator Sanders, it’s so unusual to see an agreement between Republicans and Democrats in the Congress.

(LAUGHTER)

JUDY WOODRUFF: What is the secret? Because just a few days ago, the two of you, you and Congressman Miller, were at odds over at least a big part of this.

SEN. BERNIE SANDERS: Look, here’s the problem that we have.

I mean, it’s no great secret, number one, in my view, and I think the view of most Americans, that Congress itself is pretty dysfunctional. We are not addressing the real needs of the American people. And second of all, philosophically, there is a huge division between the House and the Senate.

But what I think Congressman Miller and I understood is that failure in this sense wasn’t an option. It would be reprehensible, it really would make me sick to think that we would go home and not address the very serious problems facing the veterans community. And I think Congressman Miller shared that same perspective.

JUDY WOODRUFF: Congressman Miller, so do you have a secret you want to share with others seeking consensus on Capitol Hill, or was this just a one-off proposition here?

REP. JEFF MILLER: No. And I think Senator Sanders and I both can be as partisan as needed during particular debates.

But in this issue as it relates to the wait times with veterans, partisanship wasn’t appropriate. We worked as hard as we could. Even during the time when the press was making out like this particular conference report was dead, we continued to talk to each other. Our staffs were negotiating back and forth.

JUDY WOODRUFF: So no advice for the others in Congress seeking consensus?

SEN. BERNIE SANDERS: Well, they should have great personalities as we do. That’s what it is.

(LAUGHTER)

JUDY WOODRUFF: We will take that. We will take that for an answer.

Senator Sanders, Congressman Jeff Miller, we appreciate it. Thank you both.

REP. JEFF MILLER: Thank you.

SEN. BERNIE SANDERS: Thank you.