Measuring Success at the VA

The United States will spend $98 billion this year on services for military veterans.

Yet tens of thousands of veterans are on waiting lists for urgently needed counseling and psychiatric care. A backlog of more than 400,000 disability claims awaits processing. Millions of middle-income veterans are excluded from receiving care at Veterans Affairs hospitals because of budget shortfalls.

And dozens of returning veterans reach out to total strangers on websites like USAtogether.org for help with things like food expenses, furniture, auto repairs or a place for their families to stay near medical facilities.

And while it's heartwarming that individual Americans are willing to extend a hand to veterans, that they must do so is a shameful indictment of the nation's failure to carry out Abraham Lincoln's promise "to care for him who shall have borne the battle and for his widow and his orphan."

Last week, retired Army Gen. Eric Shinseki was sworn in as Secretary of Veterans Affairs. Few are better qualified than he to understand the crucial role played by the VA or the epic scale of its recent failures.

Shinseki is a twice-wounded veteran of Vietnam who lost so much of his right foot that the Army wanted to muster him out. He persevered, and his 38-year military career culminated in his appointment as Army chief of staff.

Shinseki was forced to retire in 2003 after telling a congressional committee it would take hundreds of thousands of American troops to maintain peace in Iraq after an invasion. That prediction was at odds with what Bush administration officials were saying in the days leading up to the Iraq invasion.

But it proved to be correct.

Shinseki probably will find few similarities between his old Army job and his new position in the Obama administration.

Running the VA will involve no small amount of consensus-building and political skill in the face of rising demands for service and limited budgets.

Shinseki took office promising swift action, but the problems he faces are staggeringly large and stubbornly complex.

Those problems continued to mount last week with the release of a Government Accountability Office study that found that the VA repeatedly, and perhaps intentionally, miscalculated its long-term budget needs for rehabilitating veterans.

The VA sends disability checks to about 3.2 million veterans every month. That money automatically is added to the department's budget. But spending for VA hospitals does not automatically increase. Largely because of the war in Iraq, the gap between demand for care and its availability is widening.

VA health care spending doubled between 2000 and 2008. But as the cost of the Iraq war mounted in 2005, the agency was under enormous political pressure to limit the cost of veterans' care. That resulted in a $1 billion budget shortfall that year that imperiled care for veterans.

Veterans groups want to prevent a recurrence of that fiasco by moving the VA to a multi-year budget for health care. Health spending would be approved by Congress a year in advance.

Making that change, especially during the worst economic collapse in a generation, will be difficult. But if we really mean what we say about our obligation to returning veterans, it's unavoidable.

Shinseki has a difficult job ahead. We'll know he has succeeded when the backlogs and waiting lists are gone. And when no returning veteran has to reach out to strangers to get the benefits he or she already has earned.

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