Floor Statements

Mr. President, if you talk to the people in Vermont, and I suspect in any other State in America, they will say the most serious crisis facing this country is the lack of decent-paying jobs, particularly when it comes to young Americans. This is an issue we do not talk enough about, and this is an issue on which we have to focus.

Yes, we are better off today than we were 6 years ago when we were hemorrhaging 700,000 jobs a month and the Nation's financial system was on the verge of collapse, but the truth is that the economy for working families and lower income families today remains in very difficult straits. The middle class of this country--the backbone of this country--continues to disappear and more and more people are living in poverty. In fact, we have almost more people living in poverty today than at any time in the history of this country, and all the while we are seeing more wealth and income inequality, such that 95 percent of all new income generated in America since the Wall Street crash is going to the top 1 percent.

The fact is that real unemployment in this country is not the ``official'' 6.1 percent we see on the front pages of newspapers. The truth is that if you count those people who have given up looking for work because they live in high-unemployment areas or the people--and there are many of these--who are working part time when they want to work full time, real unemployment is 12 percent. That is a crisis situation.

As bad as that is, the unemployment rate is far worse for young Americans. Today the youth unemployment rate is 20 percent--20 percent. We all paid a lot of attention to the tragedy in Ferguson, MO, a few weeks ago, but what was not discussed is that African-American youth unemployment is 33 percent, and in many areas of the country it is even higher than that. Today over 5.5 million young people have either dropped out of high school or have graduated high school. And do you know what they are doing? Nothing. They have no jobs. Many of them in Vermont and throughout this country are hanging out on street corners and many of them are getting into trouble. Maybe they are doing drugs, maybe they are involved in crime, but this I will tell you, and the statistics are very clear on this: If you leave school--either you drop out or you graduate high school--and you don't get a job in your first year, you don't get a job in your second year, you don't get a job in your third year, there is a strong likelihood you will never get a job, never get a career, never make it to the middle class, never be part of mainstream America.

Youth unemployment at 20 percent is clearly one of the reasons why in the United States of America we have more people in jail today than any other country on Earth. A lot of people don't know that. China's a great big country, a Communist authoritarian country. Doesn't China have more people in jail than we do? No. We have more people in jail than China.

I think the time is long overdue for us to start investing in our young people, helping them get the jobs they need, helping them get the education they need, helping them get the job training they need so they can be part of our economy, part of the middle class, and not end up in jail or dead from overdoses of drugs. The situation is so dire that there are studies out there that tell us now that one out of every three African-American males born today, if we do not change this, will go to prison in his lifetime--one out of three. This is a crisis situation, and it is one that cannot be ignored.

The legislation I have introduced today, along with Congressman John Conyers of Michigan, is called the Employ Young Americans Now Act. This legislation will provide $5.5 billion in immediate funding to States and localities throughout the country to employ 1 million young Americans between the ages of 16 and 24 and provide job training to hundreds of thousands of other young Americans. Under our bill the U.S. Department of Labor would provide $4 billion in grants to States and local governments to provide summer jobs and year-round employment opportunities for economically disadvantaged youth, with direct links to academic and occupational learning. There is another $1.5 billion in there to provide such services as transportation or childcare, which would be necessary to enable young Americans to participate in job opportunities.

I am very grateful this legislation has already been endorsed by the AFL-CIO, which is the largest labor union in the country, representing some 13 million workers; the American Federation of State, County and Municipal Employees; the United Auto Workers; the United Steel Workers of America; the Campaign for America's Future; and the National Employment Law Project.

I thank Senator Debbie Stabenow of Michigan for her support on this legislation as well.

We cannot continue to ignore the crisis of youth unemployment in America. We are talking about the future of an entire generation. We are talking about the future of the United States of America. Let's start focusing on this issue. Let's give millions of young people the opportunity to earn a paycheck and to make it into the middle class.

Mr. President, if you talk to the people in Vermont, and I suspect in any other State in America, they will say the most serious crisis facing this country is the lack of decent-paying jobs, particularly when it comes to young Americans. This is an issue we do not talk enough about, and this is an issue on which we have to focus.

Yes, we are better off today than we were 6 years ago when we were hemorrhaging 700,000 jobs a month and the Nation's financial system was on the verge of collapse, but the truth is that the economy for working families and lower income families today remains in very difficult straits. The middle class of this country--the backbone of this country--continues to disappear and more and more people are living in poverty. In fact, we have almost more people living in poverty today than at any time in the history of this country, and all the while we are seeing more wealth and income inequality, such that 95 percent of all new income generated in America since the Wall Street crash is going to the top 1 percent.

The fact is that real unemployment in this country is not the ``official'' 6.1 percent we see on the front pages of newspapers. The truth is that if you count those people who have given up looking for work because they live in high-unemployment areas or the people--and there are many of these--who are working part time when they want to work full time, real unemployment is 12 percent. That is a crisis situation.

As bad as that is, the unemployment rate is far worse for young Americans. Today the youth unemployment rate is 20 percent--20 percent. We all paid a lot of attention to the tragedy in Ferguson, MO, a few weeks ago, but what was not discussed is that African-American youth unemployment is 33 percent, and in many areas of the country it is even higher than that. Today over 5.5 million young people have either dropped out of high school or have graduated high school. And do you know what they are doing? Nothing. They have no jobs. Many of them in Vermont and throughout this country are hanging out on street corners and many of them are getting into trouble. Maybe they are doing drugs, maybe they are involved in crime, but this I will tell you, and the statistics are very clear on this: If you leave school--either you drop out or you graduate high school--and you don't get a job in your first year, you don't get a job in your second year, you don't get a job in your third year, there is a strong likelihood you will never get a job, never get a career, never make it to the middle class, never be part of mainstream America.

Youth unemployment at 20 percent is clearly one of the reasons why in the United States of America we have more people in jail today than any other country on Earth. A lot of people don't know that. China's a great big country, a Communist authoritarian country. Doesn't China have more people in jail than we do? No. We have more people in jail than China.

I think the time is long overdue for us to start investing in our young people, helping them get the jobs they need, helping them get the education they need, helping them get the job training they need so they can be part of our economy, part of the middle class, and not end up in jail or dead from overdoses of drugs. The situation is so dire that there are studies out there that tell us now that one out of every three African-American males born today, if we do not change this, will go to prison in his lifetime--one out of three. This is a crisis situation, and it is one that cannot be ignored.

The legislation I have introduced today, along with Congressman John Conyers of Michigan, is called the Employ Young Americans Now Act. This legislation will provide $5.5 billion in immediate funding to States and localities throughout the country to employ 1 million young Americans between the ages of 16 and 24 and provide job training to hundreds of thousands of other young Americans. Under our bill the U.S. Department of Labor would provide $4 billion in grants to States and local governments to provide summer jobs and year-round employment opportunities for economically disadvantaged youth, with direct links to academic and occupational learning. There is another $1.5 billion in there to provide such services as transportation or childcare, which would be necessary to enable young Americans to participate in job opportunities.

I am very grateful this legislation has already been endorsed by the AFL-CIO, which is the largest labor union in the country, representing some 13 million workers; the American Federation of State, County and Municipal Employees; the United Auto Workers; the United Steel Workers of America; the Campaign for America's Future; and the National Employment Law Project.

I thank Senator Debbie Stabenow of Michigan for her support on this legislation as well.

We cannot continue to ignore the crisis of youth unemployment in America. We are talking about the future of an entire generation. We are talking about the future of the United States of America. Let's start focusing on this issue. Let's give millions of young people the opportunity to earn a paycheck and to make it into the middle class.

Madam President, today, as chairman of the Committee on Veterans' Affairs, I applaud my colleagues for their support and Senate passage of S. 2258, the Veterans' Compensation Cost-of-Living Adjustment Act of 2014.

All of my colleagues on the committee, including Ranking Member Burr and Senators Rockefeller, Murray, Brown, Tester, Blumenthal, Hirono, Isakson, Johanns, Moran, Boozman, and Heller, joined me in supporting this important legislation, introduced by Senator Begich. I look forward to continuing our bipartisan efforts to improve the lives of our Nation's veterans.

This important measure directs the Secretary of Veterans Affairs to increase the rates of veterans' compensation to keep pace with the increasing cost-of-living in this country. The rate adjustment is equal to that provided on an annual basis to Social Security recipients and is based on the Consumer Price Index. Last year's cost-of-living adjustment of 1.5 percent affected so many important benefits, including veterans' disability compensation and dependency and indemnity compensation for surviving spouses and children. VA has projected that more than 4.5

million veterans and survivors will receive these benefits in fiscal year 2015.

I have been chairman of the Senate Veterans' Affairs Committee for nearly 2 years, but during that period I have learned several very important lessons. First and foremost, the cost of war is much greater than most Americans realize, and the cost of war does not end when the last shots are fired or the last missiles are launched. The cost of war continues until the last veteran receives all of the care and all of the benefits that he or she has earned. With this in mind, for those who claim that taking care of veterans is too expensive, if you are not prepared to properly provide the health care and other benefits that veterans have earned, then do not send them to war in the first place. Taking care of veterans is a cost of war.

As part of Congress's important responsibility of ensuring veterans and survivors receive all of the benefits to which they are entitled, we take steps to prevent these benefits from being diminished by the effects of inflation. Over the last several years there has been a lot of discussion about so-called entitlement reform. When people talk about entitlement reform what they really mean, in English, is cutting Social Security, Medicare, and Medicaid. The cuts to Social Security benefits were going to come in the form of a so-called chained CPI, which would have meant significant cuts in the cost-of-living adjustments that seniors received, that people with disabilities received, and, if you can believe it, that disabled veterans received.

The bottom line is that at a time when the wealthiest people in this country and the largest corporations are doing phenomenally well and enjoy many, many tax breaks, we should not balance the budget on the backs of some of the most vulnerable people in this country--including disabled veterans. I will continue to strongly oppose any proposal to adopt the chained CPI. Moving to a chained CPI would cut the benefits of more than 4 million disabled veterans and surviving spouses.

Congress's responsibility to ensure veterans and survivors receive all of the benefits to which they are entitled also requires that we ensure they receive their complete cost-of-living adjustment. For a number of years, VA rounded down cost-of-living adjustments. The negative impacts of the round-down were just one of the issues that were brought to my attention by the veterans service organizations. I am proud to say that passage of last year's cost-of-living adjustment ended this practice. This year's bill, sponsored by Senator Begich, would continue to ensure veterans receive the full adjustment to which they are entitled. To some, this is mere pennies, but I know these small amounts of money add up over time and make a significant contribution to the financial stability of millions of veterans and their survivors.

We have an obligation to ensure the benefits we provide veterans and their survivors do not erode over time. As the debate over spending and the national debt continues, we cannot forget the debt we owe to veterans and their families--after sacrificing for our well-being, the least we can do is ensure theirs. I commend the Senate's passage of S. 2258, the Veterans' Compensation Cost-of-Living Adjustment Act of 2014. It is another important step as we continue to work to honor our obligation to America's veterans and their surviving family members.

Mr. President, later this week, one of the most important Senate votes in the modern history of this country will take place, and that vote will be about whether the Senate begins the process to move forward on a constitutional amendment which overturns the disastrous 5-to-4 Supreme Court decision on Citizens United.

What the Citizens United Supreme Court decision was about 4 years ago is to say to the billionaires in this country, to say to the largest corporations in this country: OK, you already own much of the economy of the United States of America, but now by a 5-to-4 Supreme Court decision we are going to allow the billionaires and the large corporations of this country to own the U.S. Government because they will now be allowed to spend unlimited sums of money on political campaigns.

Poll after poll tells us that whether you are a progressive, as I am, a moderate, or a conservative, all over this country people are profoundly disgusted by the ability of big money to buy elections. What democracy means, what people fought and died for is the right of you, her, and him to have one vote.

What democracy is not about is allowing the Koch brothers--a family worth $80 billion, the second wealthiest family in this country--to spend hundreds and hundreds of millions of dollars to elect candidates whose job it is to make the wealthiest people in this country even wealthier while they continue to attack the needs of the middle class and working families of this country.

There was a piece the other day in the Washington Post talking about how the Koch brothers alone--just one family--has already in this election cycle put 44,000 ads on television and radio, and we have 2 months left before this election.

Does anybody believe that is what democracy is about?

In this country today we are suffering a major economic crisis. What that crisis is about is the disappearance of the middle class, the fact that since 1999 the typical middle-class family has seen its income go down by more than $5,000 after adjusting for inflation. The crisis is that all over America, working people are not working 40 hours a week, they are working 50, 60 hours a week. They are not working at one job-- they are working at two jobs, they are working at three jobs, trying to cobble together an income and maybe some health care to take care of their family.

The crisis in America today is that unemployment is not the official rate of 6.1 percent, it is the real rate of 12 percent if we include those people who have given up looking for work and are working part- time.

The crisis is that youth unemployment today is 20 percent; African- American youth unemployment is 35 percent. The American people are calling out. They are saying to the Congress: Why doesn't Congress create the millions of jobs our people need. Why don't you rebuild our crumbling infrastructure. Why don't you transform our energy system so we can address the crisis of climate change and move away from fossil fuel to energy efficiency, wind, solar, geothermal, biomass, and create huge numbers of jobs. Why don't you rebuild our crumbling bridges, roads, water systems, and wastewater plants. Why don't you raise the minimum wage to a living wage.

That is what people tell me in Vermont and that is what people are saying all over this country.

People ask that today, despite the modest gains of the Affordable Care Act, how does it happen that the United States is the only major country on Earth that doesn't guarantee health care to all people as a right?

We have 40 million people uninsured, even more paying large copayments and premiums.

Why don't we join the rest of the world and guarantee health care to all of our people?

The answer is very simple. The answer is that Members elected to the House and the Senate increasingly are dependent upon big money campaign contributions in order to win their seats. That is not what democracy is about; that is what oligarchy is about. Oligarchy is when you have a nation owned and controlled by a handful of wealthy families. That is where we are moving today.

On issue after issue, the American people are very clear about where they

want to be going. On this issue of Citizens United, the American people are very clear that we need real campaign finance reform to prevent billionaires from buying elections. That is what the American people want. That is what they say in poll after poll. Yet it remains to be seen whether, in a few days when we vote on this issue, we will get one Republican vote. And I can understand that because the Republicans today are the beneficiaries in a very big-time way of all of this billionaire money.

A couple months ago a constituent of mine in Vermont made a very interesting suggestion. He said: Bernie, do you ever see these guys in NASCAR, the racing car drivers, and they wear their jackets, and their jackets have all of the sponsors on them? They are sponsored by Goodyear Tire Company, and they are sponsored by this oil company, and they are sponsored by this brake company. Maybe we should have the Members of the U.S. Senate wear jackets which tell us who is sponsoring them. So somebody can come forward in their nice blue blazer and say: Hey, I am owned and sponsored by the Koch brothers. Somebody else can come forward and say: No, I am not owned by the Koch brothers, I am owned by the oil industry or I am owned by Big Energy or I am owned by Wall Street. It would be very instructive, when you see people get up and vote, about why they do not want to raise the minimum wage, to find out they are controlled by significant contributions coming from large corporations.

I think it would be very interesting to see Members of the Congress wear those types of coats.

The men and women of our country know there is something profoundly wrong when 95 percent of all new income generated in this country goes to the top 1 percent. They know there is something profoundly wrong when one out of four profitable corporations pays nothing in Federal taxes in any given year. Yet the reason we are unable to come up with real tax reform--so we can find the money to help our kids go to college, so we can deal with the fact that we have the highest rate of childhood poverty in the industrialized world--has everything to do with large corporations not paying their fair share, and that has everything to do with the types of campaign contributions these institutions make.

There was a poll that came out just the other day. They asked the American people: Should we cut Social Security? Do you know what the American people say, whether they are progressives, moderates, or conservatives? They say: You have to be nuts. We can't make it on Social Security benefits today, and you want to cut Social Security? You want to cut Medicare? But that is exactly what the Business Roundtable from corporate America wants us to do.

So we are living in two separate worlds. On the one hand you have an agenda here in the House and among many of my Republican colleagues that says: What we need to do is give huge tax breaks to the wealthiest people and the largest corporations. Is that what the American people want? Overwhelmingly, they do not want that.

You have an agenda among many who say: We have to cut Social Security, Medicare, and Medicaid. Is that what the American people want? No, they do not.

There is an agenda among some Republicans that says: Not only should we not raise the minimum wage, we should do away with the concept of the minimum wage so that in high-unemployment areas people could work for $4 or $5 an hour. Is that what the American people want? Quite the contrary. They want to raise the minimum wage to at least $10.10 an hour.

So you have an amazing dynamic right now in American society. On the one hand in the real world outside of the beltway, ordinary people are hurting. They are struggling. They are worried about their kids. They are worried about their grandchildren. They are worried about their parents. They want the U.S. Government to do something to create jobs, to raise the minimum wage, to change our disastrous trade policies. They want us to do something to make college affordable, to lower interest rates on student debt. They want us to create jobs by rebuilding the infrastructure. They want everybody in this country to have health care as a right. They want us to address the crisis of global warming. But we do not do that. Why not? Because increasingly the Congress is not responsive to the needs of ordinary Americans. They are responsive to the big-money campaign contributors, and that has everything to do with this constitutional amendment beginning the process to overturn Citizens United.

So of all of the issues out there--whether you are concerned about education, health care, the environment, the economy--the most important issue underlying all of those issues is the need to end this disastrous Supreme Court decision which allows billionaires to buy elections. That is not what people fought and died for in the name of democracy. That is called oligarchy. Abraham Lincoln talked about a government of the people, by the people, and for the people, not a government of the billionaires, by the billionaires, and for the billionaires, and that is where we are today.

I hope the American people are watching. The media has not paid, for interesting reasons, a lot of attention to this issue, but there is no domestic issue that I can think of more important for the future of this country.

Do we elect Members of Congress who are beholden to the constituents back home, to the middle class, to working families, or do we elect Members of Congress who are beholden to corporate America and the billionaire class? Do we fight to sustain the democratic foundation of this country or do we move toward an oligarchic form of society controlled by a handful of billionaire families? That is the issue. That is what this debate is all about, and that is what this vote in a few days will be about. I hope very much the American people will demand that every Member of this Senate vote for this piece of legislation which begins the process of overturning this disastrous Citizens United Supreme Court decision.

I yield the floor.

I suggest the absence of a quorum.

Mr. President, let me begin by thanking Senator Tom Udall for his extraordinary work over the years in calling attention to this disastrous Supreme Court decision called Citizens United which is doing so much to undermine the foundations of American democracy. It has been a pleasure working with him, and we will continue to fight.

My colleagues may not know it by reading the newspapers or watching TV, but this week we are going to be having a debate on what I consider to be the most important domestic issue facing the United States of America; that is, whether this great country retains its democratic foundations--one person, one vote--or whether we move into an oligarchic form of society where a small handful of billionaires is able to control not only the economic life of our Nation but the political life as well.

Whether one is a Democrat, whether one is a Republican, or whether one is--as the Presiding Officer and I are--an Independent, the overwhelming majority of the American people do not believe free speech has anything to do with billionaires being able to buy elections.

The Washington Post reported earlier this week that one family, the Koch brothers--a family worth $80 billion--has already put on the air some 44,000 ads, and this campaign has 2 months left to it--44,000 ads. America is supposed to be about debates on issues. It is not supposed to be a process where a billionaire can come into a small State such as Maine or Vermont and plop $50 million down or $20 million down to elect candidates whose sole job in life is to represent the wealthy and the powerful.

Men and women have put their lives on the line and died to defend American democracy--the right for all of us to be involved in the political process, not to create a situation where a handful of superwealthy families can elect the candidates they want.

I think some people, when they hear about Citizens United, say: Well, it is kind of an esoteric issue; it is not really relevant to my life.

Those who believe that are dead wrong. If people are concerned about the collapse of the middle class; if people are concerned about the fact that more people today are living in poverty than at any time in American history; if people are concerned about the fact that we have more wealth and income inequality in America today than any other major country on Earth; if people are concerned that we are the only major country on Earth without national health care, guaranteeing health care to all people; if people are concerned about the crisis of global warming and many other issues, people have to be interested in the issue of Citizens United and how we elect Members of the House and Senate and Governors, and so forth and so on, because ultimately what this is about is whether the wealthy can determine the agenda of the House and the Senate, whether they can say to candidates: Here it is-- we are going to put $50 million into your campaign, and all you have to do is support us on A, B, C, D, and E. You have to make sure the rich get more tax breaks--despite the fact that the wealthy are doing phenomenally well. You have to make sure we cut food stamps or education or we eliminate the Environmental Protection Agency. That is why we are giving you the money we are giving you.

People do not spend hundreds of millions of dollars on campaigns for fun, for the hell of it; they are spending money because they have an agenda. And the billionaire agenda is not the agenda of the American people.

I wish to read for a moment exact language from the 1980 Libertarian Party, whose Vice Presidential campaign and major funder was one David

Koch--one of the two Koch brothers. What I am going to read to my colleagues today is what I believe remains their agenda today because I see no evidence that it has changed.

When we turn on the TV and we see an ad coming from one of the Koch brothers' organizations, know what they stand for.

``We favor the abolishment of Medicare and Medicaid programs.''

That doesn't mean cutting them; that means ending them.

``We favor the repeal of a fraudulent, virtually bankrupt and increasingly oppressive Social Security system.''

That does not mean they are opposed to raising the minimum wage, which many of us want to do; they want to do away with Social Security entirely--not cut Social Security but do away with it.

``We support repeal of all laws which impede the ability of any person to find employment, such as minimum wage laws.''

What that means in English is that while we are trying to raise the minimum wage, they want to abolish the concept of the minimum wage. So in high-unemployment areas, an employer can pay a worker $3 an hour or $4 an hour.

This is also from the Koch brothers' platform: ``We oppose all government welfare, relief projects, and aid to the poor programs. All of these government programs are privacy-invading, paternalistic, demeaning, and inefficient. The proper source of help for such persons is the voluntary efforts of private groups and individuals.''

That means goodbye to good jobs, nutrition programs, Federal aid to education, and goodbye to unemployment insurance.

This is not a conservative agenda. This is not a small-government agenda. This is an extremist agenda designed to eliminate virtually every piece of legislation passed by Congress in the last 80 years which protects the middle class, working families, low-income people, seniors, and the system. That is their agenda.

I am not saying every Republican adheres to every aspect of this agenda, but these guys are pouring hundreds of millions of dollars into the political process for a reason, and that reason is to make the wealthiest people in this country even wealthier while they do away with all legislation that protects working families.

Citizens United is one of the worst decisions in the history of the U.S. Supreme Court. I hope every Member of the Senate votes this week to start the process for a constitutional amendment to overturn Citizens United.

Mr. President, I rise today in strong support of the VA conference committee report, which I expect and hope will be on the floor here in a couple of hours. That conference committee report was passed yesterday by the House with an overwhelming vote of 420 to 5, and I hope very much our vote here in the Senate will be as strong as the vote in the House.

The conference committee legislation that we will be voting on, frankly, is certainly not the legislation I would have written. I think it is fair to say it is not the legislation that the chairman of the House Veterans' Affairs Committee, Jeff Miller, would have written; it is, in fact, a compromise, but it is a compromise I can strongly support, and I hope all of my Senate colleagues will support it as well.

This bill does a number of very important things to address the problems facing the veterans of our country. Right now veterans in many parts of this country are on very long waiting lists before they get VA health care. I think in the last month or so the VA has made a concerted effort to reach out to those veterans and to get them

care when necessary in the private sector, and I think Acting Secretary Sloan Gibson did a good job in jump-starting that process and saying to veterans we are going to do everything we can to get them quality care in a timely manner. Obviously, this is an expensive proposition, but it is one we have to address.

This legislation we will be voting on in a few hours provides $10 billion to make sure every eligible veteran in this country will get timely health care, quality health care, and they will do that through the private sector, through community health centers, through Department of Defense facilities, and Indian Health Service Clinics when those facilities work for veterans. If there is a community health center in a community, the veteran can go in there and the VA will pay that bill. That is the effort we are making to significantly reduce these long waiting lines.

This bill also provides a remedy for a condition many of us consider to be terribly important, and that is it gets to the root of why it is that we have long waiting periods in many VA facilities around the country. The reality is that in the last 4 or 5 years we have seen, as a result of the wars in Iraq and in Afghanistan, some 2 million more veterans coming into the VA, a net increase of about 1.5 million patients. That is a lot of people. There is not the slightest doubt in my mind or in the mind of the VA that if we are going to do justice to our veterans, we are going to need more doctors, more mental health counselors, more nurses, more medical personnel in general, so that when a veteran walks into a VA facility, that veteran will get quality care in a timely manner.

I have heard testimony in the Senate Committee on Veterans' Affairs, which was very clear, and what virtually every major veterans organization has said is that when veterans get into the system, the quality of care they receive is good. It is good. That is not just what veterans are saying and what veterans organizations are saying; that is what a number of independent surveys and studies show us. The problem is access, and if we are going to on a long-term basis address that access problem, it is important to make sure we have the doctors, the nurses, and the medical personnel we should have. This bill provides $5 billion to make sure we get that personnel.

In addition to that, there are many facilities all over the country where there are very serious space problems. There are not the examination rooms doctors need in order to work efficiently, and this legislation addresses that with a $5 billion appropriation.

In addition, there has been legislation passed in the House overwhelmingly that says, quite correctly, we need to fund 27 major medical facilities all over this country in 18 States and in Puerto Rico, and this legislation does that as well.

In addition, what this legislation says--and this is mostly applicable to our rural States--is that if someone is a veteran living hundreds of miles away from a VA facility, when they are sick in the middle of winter or in the middle of summer, they are not going to have to travel hundreds of miles to get their physical therapy or to get the health care they need. If a veteran is living 40 miles away from a VA facility, they will be able to get their care in their community, again through a private doctor, through a community health center, through an Indian Health Service facility, through a Department of Defense facility.

This is a big step forward for many veterans in rural communities who will now be able to get care in the area they live rather than having to travel long distances to get health care.

This legislation also addresses some other very important issues that have not gotten a whole lot of attention but they are important, and I will mention what they are. All of us know that one of the outrages we have seen in recent years within the military is the very high level of sexual assault against women and against men as well. This legislation provides funding for the VA to increase their capability so women and men who are sexually assaulted will be able to come into the VA and get the care they need to address the problems associated with that assault, and I think that is a very important step forward.

This legislation also takes action we should have taken some years ago. The post-9/11 GI bill has been enormously successful in providing educational opportunities for the men and women who have served in Iraq and Afghanistan and people who have served since 9/11. There was a gap in that legislation, and that gap was that a spouse of someone who died in Iraq or in Afghanistan was not eligible for all of the educational benefits of that post-9/11 GI bill. This legislation remedies that omission. It expands the John David Fry Scholarship Program to include surviving spouses of members of the Armed Forces who died in the line of duty. That means many young women out there will now have the opportunity to get a college education who otherwise would not have, and I think we owe that to all of those people who have already suffered so much.

This legislation also allows for veterans--all veterans eligible for the post-9/11 GI bill--to qualify for instate tuition under that legislation. This was part of a bill previously passed in the House, and we are going to pass it in the Senate.

There is another provision in here which is very important. A program which provides housing for veterans with traumatic brain injury was about to expire. This legislation extends that program for a number of years, which will be a real relief for people who were worried they would be out on the street and not have adequate housing.

It has been from day one--from my first day as chairman of the veterans committee--my belief that the cost of war in terms of what it does to the men and women who fight our battles is a lot greater than most Americans fully understand. We all mourn the 6,700-plus men and women who died in Iraq and in Afghanistan, but we should understand the cost of war is much greater than that tragedy. The cost of war is the men and women who came home without legs, came home without arms, without eyesight, loss of hearing; the cost of war is the 500,000 men and women who came home from Iraq and Afghanistan with the signature illnesses of this war, which are post-traumatic stress disorder and traumatic brain injury. Those are the signature injuries of this war, and we are talking about 500,000 men and women coming home with those very serious problems. In fact, today--just today--and every day close to 50,000 veterans are going to get outpatient mental health care in VA facilities all over this country--close to 50,000.

It has also been my view that when we fully understand the costs of war and the needs of the veterans and their families, it is absolutely imperative that we do not make veterans into political pawns. We do not say, yes, we are going to fund veterans' needs, but we are going to cut Head Start, we are going to cut the National Institutes of Health or we are going to cut education. That is absolutely unfair to our veterans. A cost of war is the cost of planes and guns and tanks and aircraft carriers--those are a cost of war. An equally significant cost of war is the needs of men and women who fought our battles and who used those weapons. What this legislation says and what the House just passed by a 420-to-5 vote is that taking care of veterans is in fact a cost of war.

The CBO has come up with some recent estimates which lower the costs a little bit. But this bill will put close to--a little bit less than $17 billion into VA health care over the next several years. There is $5 billion in offsets from within the VA that I was comfortable with that will bring the total cost of this package down to somewhere around perhaps $11 billion. Is that a lot of money? It is a lot of money. But that is the cost of war, and that is what happens when millions of veterans come home and need the care they are entitled to receive.

As I mentioned a moment ago, the House passed this legislation by an overwhelming vote of 420 to 5. I wish to thank Chairman Miller in the House for the work he has done in getting that result. My understanding is that in a few hours we will be voting on that bill, and I hope we can pass this legislation with a very strong bipartisan vote.

I thank the Chair, and I yield the floor.

Mr. President, pursuant to section 904 of the Congressional Budget Act of 1974, the waiver provisions of applicable budget resolutions, and section 4(g)(3) of the Statutory Pay-As-You-Go Act of 2010, I move to waive all applicable sections of those acts and applicable budget resolutions for purposes of the pending conference report.

I ask for the yeas and nays.

Mr. President, yesterday the House voted 420 to 5 for this conference report. They understood that taking care of veterans, as Senator McCain just indicated--the men and women who have put their lives on the line to defend us, who have sacrificed so much--is a cost of war, and in fact what we are talking about is an emergency. That is what the House said overwhelmingly yesterday.

On June 11, 2014, 6 or so weeks ago, by a vote of 93 to 3, the Senate supported the Sanders-McCain bill and it was emergency funded as a cost of war.

This bill, as Senator Coburn indicated, is about one-third of the cost of what we voted on in the original Sanders-McCain bill.

Let us defeat this point of order. Let us stand with the veterans of this country, let us reform the VA, and let us go forward.

Mr. President, Senator Coburn forgot to mention one point when talking about the increase in VA funding. He forgot to mention that we were in two wars.

He forgot to mention that 500,000 men and women came back from Iraq and Afghanistan with posttraumatic stress disorder and TBI, not to mention the loss of legs, the loss of arms, eyesight and hearing.

He forgot to mention that many of the veterans from World War II, Korea, and Vietnam are getting older and need more detailed care.

So I think it is important that we put $5 billion into the VA to provide the doctors, the nurses, the personnel they need, so that the veterans can get into the VA and have quality and timely care. That is what this legislation is about.

I ask for the yeas and nays.

Mr. President, before we vote, I wish to take this opportunity to thank Senator McCain for his intervention and making sure that we had serious negotiations.

I thank the staff of the Veterans' Affairs Committee: Steve Robertson, Dahlia Melendrez, Travis Murphy, Jason Dean, Carlos Fuentes, Becky Thowman, Ann Vallandingham, Janet Gehring, Elizabeth Austin- Mackenzie, Kathryn Monet, Katie Van Haste, Shanna Lawrie, Raphael Anderson, and Shannon Jackson. These guys worked really hard for months, and I very much appreciate what they did.

Madam President, as the chairman of the Senate Committee on Veterans' Affairs, I rise today in strong support of the nomination of Robert McDonald to serve as Secretary of Veterans' Affairs.

I also thank Majority Leader Reid for moving this important nomination forward as quickly as he has, and I very much hope that later this afternoon, with a very strong vote, the Senate will vote to confirm Robert McDonald as Secretary of the VA.

Before I talk about Mr. McDonald's qualifications, I wish to take a moment to express my sincere thanks to GEN Eric Shinseki for his dedicated service to our Nation, first as a soldier and then as head of the VA, working tirelessly to provide for those injured during war and the families of those who perished on the battlefield. He set very ambitious goals, and under his leadership VA made significant strides in reducing veteran homelessness and transforming a paper-based claims system to one fit for the 21st century. I thank him and his family very much for his service.

It is my strong belief that Robert McDonald will bring two very important qualities to the position of Secretary of Veterans Affairs.

First, he is familiar with the military as well as the needs of veterans and their families. Mr. McDonald and his family have a history of service to our Nation. Mr. McDonald began his service as a cadet at the United States Military Academy at West Point. He graduated in 1975 in the top 2 percent of his class with a degree in engineering and went on to serve as an infantry officer in the Army's 82nd Airborne, earning Airborne and Ranger qualifications during his military service. His father served in the Army Air Corps after World War II. Additionally, his wife's father was held as a POW after being shot down over Europe. Her uncle served in Vietnam and still receives care at the VA. Also, Mr. McDonald's nephew is currently serving and deployed with the U.S. Air Force. In other words, Mr. McDonald and his family have a deep understanding and service with the U.S. military.

Upon hearing Mr. McDonald at the hearing we held in our committee for the confirmation process, I was convinced that he has a deep passion to do everything he can to protect our veterans.

The other quality Mr. McDonald brings to this job is that he has been the CEO of one of America's leading corporations, a company which has tens of thousands of employees. His more than 33 years with Procter & Gamble gives him the tools to create a well-run and accountable VA. In other words, he will bring the tools of a CEO and a private corporation to the VA--a huge bureaucracy that needs a significant improvement in accountability and in management.

As we begin debate on Mr. McDonald's nomination, I believe it is important that my colleagues understand the realities he will face in leading the VA.

The VA operates the largest integrated health care system in the United States, with over 1,700 points of care which include 150 hospitals, 820 community-based outreach clinics, and 300 vet centers. In fiscal year 2013 the VA provided 89.7 million outpatient visits each day--today, tomorrow, yesterday. The VA conducts approximately 236,000 health care appointments. In other words, it is a huge system.

VA's problems, which Mr. McDonald will have to address immediately, have been widely reported in recent months. In my view, Acting Secretary Sloan Gibson has done an excellent job in taking a number of critical steps to address the problems confronting the VA, but clearly there is much more to be done.

We now know, among other issues, there is a significant shortage of doctors, nurses, and mental health providers within VA, as well as the physical space necessary to provide timely access to quality care. This is a major problem because at the end of the day, no matter how well run the VA is or any health care system is, we are not going to be able to provide quality, timely care unless there are the doctors, nurses, and other medical personnel available to do that work. As a result of the shortages, we know that we have tens of thousands of veterans today in many parts of this country on lists that are much too long in order to gain access to the VA. We also know that hundreds of thousands of veterans who have appointments scheduled are waiting too long to be seen and receive care.

I think it is important that everybody recognize that as a result of the wars in Iraq and Afghanistan, in the last 5 years 2 million more veterans have come into the VA. This is on top of an aging population of VA patients who served in World War II, Korea, and Vietnam--patients who often need a whole lot of care as they age. So combine new people coming into the VA, often with very serious problems--including some 500,000 veterans coming home from Iraq and Afghanistan with PTSD and TBI--and an aging population with difficult problems, and that is where we are, and those are some of the issues the VA is going to have to address.

While I am on the subject, let me say that most people understand-- and that includes many of the veterans I talk to every day in Vermont, veterans across the country, and the national veterans organizations that represent millions of veterans--that once people get into the VA system, in general the quality of care is good. That is not just what veterans and their organizations say; that is what a number of independent studies show. Our problem right now is how to figure out a way that when people apply for VA health care, they get into the system quickly and that once they are in the system, they get the appointments they need in a timely manner. That is our job. It is not going to be an easy job, but that is the job we face.

My hope is that tomorrow or Thursday the House and the Senate will be voting on a comprehensive piece of legislation authored by Congressman Jeff Miller, chairman of the House Veterans' Affairs Committee, and me. I think it is terribly important that we pass that bipartisan legislation with a strong vote in both Houses because

that legislation will give the new Secretary the tools he needs to go forward aggressively in addressing many of the problems facing the VA.

I hope every Member of the House and Senate understands it is unacceptable that veterans in this country are on terribly long waiting lines and cannot get the health care they need in a timely manner.

This legislation, which I hope will be passed this week by the House and the Senate, provides $10 billion for emergency health care so that if a veteran can't get into the VA, that veteran will be able to go to a private physician, a community-based health center, a military base, or whatever but will be able to get timely care.

In addition, the legislation puts $5 billion into the VA so that they will be able to hire the doctors, the mental health counselors, nurses, and other medical personnel they need so that as soon as possible, when veterans apply for VA health care, they will get not only quality care but timely care.

In addition, this legislation addresses an issue many veterans around the country, especially in rural areas, are worried about--that if they live long distances away from the VA, they will not have to travel 100 miles to get the health care they need; that if they live 40 miles or more away from the VA facility, they will be able to go to a doctor of their choice in that community. This is an important step forward.

This legislation will also do some terribly important work in making sure that widows--women who lost their husbands in battle--will be able to get the education they should be entitled to under the post-9/11 GI bill.

This legislation deals with an issue passed by the House; that is, instate tuition for veterans who today may not be able to take advantage of the post-9/11 GI bill.

This legislation also addresses a very serious crisis within the military today; that is, the issue of sexual abuse and providing women and men who have been abused sexually in the military with care at the

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, on June 11--a month and a half ago--in a very strong bipartisan way, the Senate voted 93 to 3--an overwhelming vote--to pass legislation written by Senator John McCain, a Republican, and myself to address crises facing our veterans community and the VA and to protect and defend the men and women who have put their lives on the line to defend us. I wish to take this opportunity again to thank Senator McCain for his very strong efforts on getting that legislation passed.

As you know, the legislation we passed was estimated by the Congressional Budget Office, the CBO, to cost about $35 billion. At just about the same time, the House of Representatives passed legislation dealing with, more or less, the same issues, and the bill they passed in the House was estimated by CBO to cost $44 billion--$9 billion more than what we passed in the Senate.

In the last 6 weeks, my staff, my colleagues, and I have been working very hard to refine this legislation, to come up with a more reasonable pricetag, and to address the needs of our veterans community in a significant way. In that process, I have been accused by some of ``moving the goalposts.'' I guess I have. I have moved the goalposts so the legislation we are introducing today is substantially lower-- substantially lower--than what passed the Senate and what passed the House. If that is called moving the goalposts, I suspect in this case it is moving the goalposts in a positive direction. In fact, the bill we are presenting would cost less than $25 billion--a lot of money, no doubt--but that is some $10 billion less than what we passed on the Senate floor, and it is $19 billion less than what the House passed.

Our proposal is a commonsense proposal which deals in a significant way with the needs of the veterans community. What it does is provide emergency funding for contract services so veterans can, when they find themselves in long waiting periods--as in fact is the case in a number of locations around the country--they can go outside of the VA and get private health care or care at a community health center or whatever. They no longer have to wait during this emergency period for long periods of time to get into the VA. I think that is a very important part of this proposal. It is something we have to do.

In addition, what we also say is if a veteran is living more than 40 miles from a VA facility--and there are veterans who in some cases are living hundreds of miles away--they do not have to, when they are ill, get in their car and travel for 3 or 4 hours to get health care at a VA facility. They will be able to go to a non-VA facility, a private physician, if they live more than 40 miles away from a VA facility. I think that is a significant step forward.

But what our legislation also does is address an issue of huge concern to the veterans community. Just yesterday--just yesterday--I received, and many members in the Veterans' Committee received, a letter from 16 major veterans organizations. I ask unanimous consent to have the letter printed in the Record.

Mr. President, 16 major veterans organizations, including the Disabled American Veterans, the Veterans of Foreign Wars--the VFW--Paralyzed Veterans of America, the Vietnam Veterans of America, the Iraq and Afghanistan Veterans of America, the Military Officers Association of America, and many others--wonderful veterans organizations that have worked for years representing the needs of millions and millions of veterans--what these organizations say in this letter is that while we must address the immediate crisis of doing away with these long waiting lines and allowing veterans to get private care, what they also say--loudly and clearly--is that the VA must have the doctors, the nurses, and the space capacity that it needs so that in the future it will be able to permanently eliminate these long waiting lines so that 2 years from now, 3 years from now, when veterans come into the VA, they will get quality care, they will get timely care. That is what the veterans organizations have said.

I will quote to you one small paragraph of a long letter. They say that the charge of the conference committee should be ``to ensure that all veterans currently waiting for treatment must be provided access to timely, convenient health care as quickly as medically indicated,'' and at the same time ``protect, preserve and strengthen the VA health care system so that it remains capable of providing a full continuum of high-quality, timely health care to all enrolled veterans.''

Last week, in a Senate Veterans' Affairs Committee meeting, Sloan Gibson, the Acting Secretary of the VA, stated that the VA needed over $16 billion in order to hire thousands and thousands of doctors, nurses, other medical providers. In many VA facilities doctors do not have the examining rooms they need. There are space problems all over this country. What the veterans organizations--16 of them--said loudly and clearly is that Sloan Gibson, the new Acting Secretary of the VA-- approved with wide Republican support--they said we support his proposal.

Our legislation does not give the VA all that Mr. Gibson would like, but we do provide them with the doctors and the nurses and the medical staff they need so we do not continue to have

long waiting lines at VA hospitals all over this country, so we do not come back 2 years from now in the same position, with veterans not being able to get timely care.

I have worked for a month and a half with my House Republican colleagues, led by the Veterans' Affairs chairman there, Jeff Miller, to find a compromise. Everybody knows the House looks at the world differently than the Senate--we all know that--and if we go forward, we need a compromise.

We have put good-faith offers on the table time and time again and we have tried to meet our Republican colleagues more than halfway, but I am very sad to say that at this point--and I hope this changes--but at this point I can only conclude, with great reluctance, that the good faith we have shown is simply not being reciprocated by the other side.

Standing here and saying this is the last thing I want to be doing. Our veterans deserve a responsible solution to this crisis.

Last night--this is an example of what has happened--somewhere around 10 o'clock in the night, the cochairman of the veterans conference committee, Mr. Miller in the House, announced unilaterally, without my knowledge or without my concurrence, that he was going to hold a so- called conference committee meeting in order to introduce his proposals.

Needless to say, his proposal is something I have yet to see. I do not know what it is. This is a proposal nobody on our side has seen. My understanding is he then wants to take this to the House on Monday to come up with a vote. In other words, his idea of negotiation is: We have a proposal. Take it or leave it. Any sixth grader in a school in the United States understands this is not negotiation, this is not what democracy is about.

I note the presence on the floor of the coauthor of the bill passed in the Senate, Senator McCain, and I am happy to yield the floor for Senator McCain.

First of all, I want to thank Senator McCain again for all of his hard work on this issue.

Let me ask a few questions. The Senator and I have been talking the last few days. Does the Senator not think--he has been here for 1 or 2 years--that the best way to go forward is for people to sit down at a table and knock out their differences? And then the idea of presenting it to a conference is absolutely right. But the Senator knows, and I know, that what conference committees are largely about are 5-minute speeches.

I have been disappointed that I have not--I think the Senator will agree with me, maybe not, that the best way forward is for people to sit down in a room and work out their differences, not to go forward with unilateral statements. Does that make sense?

Let me ask Senator McCain one more question. I thank the Senator very much. He is not on, at this moment, the Veterans' Affairs Committee, but he has jumped into this with both feet and is playing a very big role. Would the Senator be prepared if, generally speaking, what happens is the chairmen and ranking members of the Senate and the House get together--you are not the chairman, you are not the ranking member, but I think you could play a good role. Would the Senator be prepared to sit down with the other four members, myself, the other three, and help us reach a compromise?

One more second. I wanted to paraphrase. Tell me if I am misquoting. I do not have it in front of me, but when we were debating this bill on the floor, the Senator said--we were talking about emergency funding--something to the effect of if this is not an emergency, I do not know

what an emergency is. Is that a correct paraphrase?

I thank Senator McCain very much for his statements and for his hard work on this and would reiterate what he said; that is, my belief that what we have here on the Senate floor, that if taking care of the men and women who have put their lives on the line to defend us and who came home without arms or legs, or without their eyesight or 500,000 of them who came home with post-traumatic stress disorder or traumatic brain injury--if that is not an emergency, taking care of those brave men and women, I agree with Senator McCain, I do not know what an emergency is.

I am happy to yield the floor for my colleague from Alaska, Senator Begich.

I thank Senator Begich.

I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, as chairman of the Senate Committee on

Veterans' Affairs, I want to take a few minutes to update Members of the Senate as to where we are on some very important issues that impact veterans all over this country.

The first point I want to make is some good news. The committee had a hearing yesterday to hear testimony regarding the confirmation of Robert McDonald to be the new Secretary of the VA. I think I can speak for the whole committee in saying we were very impressed by what we heard from Mr. McDonald both in terms of his passion for the needs of veterans and also his administrative knowledge, his management skills, as the former head of one of the large corporations in America. I think he left us with a very strong impression. The result was that today, a few hours ago, by a unanimous vote, the Senate committee voted to confirm Robert McDonald as our new Secretary of the VA, and I hope very much his nomination will get to the floor as soon as possible. I think that is good news because the VA needs stable leadership. Sloan Gibson, who has been Acting Secretary, is doing an excellent job. He has already accomplished a lot. But it is important that we have a new permanent Secretary on board, and I hope the Members here see fit to confirm him as soon as we possibly can.

On an additional issue, I think as all Members of the Senate know, about a month or so ago we voted by a vote of 93 to 3, almost unanimously, to make sure the veterans of our country get quality health care in a timely manner, that we bring a new level of accountability to the VA, and I am very proud of the support that legislation, which was introduced by me and Senator John McCain, received. I thank again Senator McCain for his very strong efforts to make that happen and for his continued support of the veterans community.

Senator McCain made a statement the other day--I think it was yesterday--published in CQ, which I personally could not agree with more. He spoke in terms of the conference committee that we are in right now trying to merge the Senate bill and the House bill and come up with something that can pass in both bodies. He said and I quote: ``We've got to sit down and get this done, because we cannot go out for recess in August without having acted on this bill.''

I think he is exactly right.

Let me, picking up on that theme, relay to my colleagues what the VFW, which is having their annual convention in St. Louis, said:

The Veterans of Foreign Wars of the United States is

demanding that Congress immediately pass a compromise bill to

help fix the Department Of Veterans Affairs before they

adjourn for five weeks at the end of the month. ``Pass a bill

or don't come back from recess,'' said VFW National Commander

William A. Thien of Georgetown, IN. ``America's veterans are

tired of waiting--on secret waiting lists at the VA and on

their elected officials to do their jobs.''

I could not agree with the VFW more on that issue.

There was a bill a month ago that passed here. The CBO said that bill would cost $35 billion, and we voted for that for emergency funding because the Members here understood that taking care of veterans is a cost of war as much as spending money on tanks and guns and missiles-- $35 billion in emergency funding. The House passed its bill which was later assessed by the CBO at $44 billion. But here is the good news-- and without divulging the kinds of negotiations we are having with Chairman Miller in the House--and Chairman Miller is a serious man. I think he wants to get a bill passed. I don't want to go into all the details here, but I think it is fair to say the cost of that bill will be significantly less than what the CBO originally estimated.

A few minutes ago I and others received a letter from the major veterans organizations on an issue of important consequence. Again, without going into great detail about the nature of the negotiations which the House and Senate are having on the veterans bill, I think it is fair to say one of the stumbling blocks is that I agree and the House agrees it is imperative we pass funding to make sure that veterans who are in long waiting lines right now get the quality care they need now, and that means if the VA cannot accommodate them in a timely manner, they will go out to private doctors, community health centers, or whatever, and the VA will pay that bill. That is what we have to do because it is unacceptable that veterans remain on long waiting periods and not get health care. There is a general agreement on that. There is debate about how much that is going to cost over a 2- year period, but I think we can reach some resolution.

Here is where the difference of opinion lies--without divulging anything, and this has been in the newspapers--Sloan Gibson, the Acting Secretary, came before the Senate Veterans' Affairs Committee last week and he made it very clear that while we have to deal with the emergency of long waiting periods and get people the contracted care they need, simultaneously, we must make sure the VA has the doctors, the nurses, the medical personnel, the IT, and the space they need in order to deal with this crisis so that 2 years from now we are not back in the same position we are, and he came forward with a proposal that, in fact, costs $17.6 billion. I think we can lower that amount of money, because some of that request is not going to be spent this year or even next year.

But the issue here is we have to strengthen the VA, their capacity, so that veterans do not remain on long waiting periods and that we can get them the quality and timely care they need.

Now, what I wanted to mention was an hour or so ago I received and Chairman Miller, who is chairman of the House Committee on Veterans' Affairs, got the letter, Richard Burr, who is the ranking member on the Senate committee, Mike Michaud, the ranking member at the House--we received a letter from a variety of veterans organizations, virtually every major veterans organization, and they are the Disabled American Veterans, the Veterans of Foreign Wars, the VFW, the Paralyzed Veterans of America, the Vietnam Veterans of America, the Iraq and Afghanistan Veterans of America, the Military Officers Association of America, the U.S. Coast Guard Chief Petty Officers Association, and many other organizations.

I want to take a moment to read what they say, because this is terribly important. What they are saying in essence is yes, we need emergency funding to make sure that veterans tomorrow get the health care they need from the private sector or anyplace else, but we also need to strengthen the VA so that over the years they can provide the quality and timely care veterans are entitled to. I am going to read this letter because it is important that Members of the Senate and the House understand where the major veterans organizations are coming from.

Last week Acting Secretary Sloan Gibson appeared before the

Senate Veterans' Affairs Committee to discuss the progress

made by the Department of Veterans Affairs over the past two

months to address the health care access crisis for thousands

of veterans. Secretary Gibson testified that after re-

examining VA's resource needs in light of the revelations

about secret waiting lists and hidden demand, VA required

supplemental resources totaling $17.6 billion for the

remainder of this fiscal year through the end of FY 2017.

As the leaders of organizations representing millions of

veterans, we agree with Secretary Gibson that there is a need

to provide VA with additional resources now to ensure that

veterans can access the health care they have earned either

from VA providers or through non-VA purchased care. We urge

Congress to expeditiously approve supplemental funding that

fully addresses the critical needs outlined by Secretary

Gibson either prior to, or at the same time as, any

compromise legislation that may be reported out of the House-

Senate Conference Committee. Whether it costs $17 billion or

$50 billion over the next three years, Congress has a sacred

obligation to provide VA with the funds it requires to meet

both immediate needs through non-VA care and future needs by

expanding VA's internal capacity.

And I continue. Again, this is a letter from almost every major veterans organization:

Last month, we wrote to you--

They wrote to the chairmen of the House and Senate Veterans' Affairs Committees--

we wrote to you to outline the principles and priorities

essential to addressing the access crisis, a copy of which is

attached. The first priority ``must be to ensure that all

veterans currently waiting for treatment must be provided

access to timely, convenient health care as quickly as

medically indicated.'' Second, when VA is unable to provide

that care directly, ``VA must be involved in the timely

coordination of and fully responsible for prompt payment for

all authorized non-VA care.'' Third, Congress must provide

supplemental funding for this year and additional

funding for next year to pay for the temporary expansion of

non-VA purchased care. Finally, whatever actions VA or

Congress takes to address the current access crisis must also

``protect, preserve and strengthen the VA health care system

so that it remains capable of providing a full continuum of

high-quality, timely health care to all enrolled veterans.''

I ask unanimous consent that this letter be printed in the Record.

Essentially what the letter goes on to talk about is that many of these organizations have been looking at this issue for years, and in their independent budget have noted that the VA needs more space, because you have many hospitals where there are not enough examination rooms and that slows down the ability of doctors and nurses to treat patients, and we need more doctors and nurses. So for many of these organizations this is not new news. They have known it for years.

Here is where we are. The good news is that I think we can bring forth a bill which deals with emergency contracted-out care for veterans today on long waiting periods. I think we can deal with the issue that Senator McCain feels very strongly about and that is making sure that veterans who live 40 miles or more away from a VA facility will be able to go to the private physician of their choice, and I think we can also strengthen the VA in terms of doctors and nurses and information technology and space so that we don't keep running into this problem year after year. It is going to take the VA time in order to bring in the doctors and nurses and do the construction. I don't want to get into the details of the discussions we are having with the House, but I did want to make veterans, and, in fact, Members of Congress aware of where I believe we are at this moment.

With that, I will yield the floor.

I thank Senator Leahy for yielding.

Mr. President, every now and then there are figures who come along who play a profound and transformative role in the period in which they are living. Phil Hoff is one of those people. We are here to celebrate his 90th birthday and the work he has done in Vermont and around the country and the life he and his wife Joan have lived, both of whom have done so much for the people of the State of Vermont.

Phil Hoff was the 73rd Governor of the State of Vermont. He was in many ways the founder of progressive politics in our State. It is now recognized--and we say this proudly, although not everybody necessarily is as proud of it as we are--but Vermont is now one of the more progressive States in the United States of America. We have been a leader for the rights of working people, for the environment, for women's rights, for gay rights, for kids, and we are proud of that, but none of that would have happened--we would not be where we are today-- if it had not been for the work of Phil Hoff, who has Governor of our State and was elected in 1962.

I am going to yield to my colleague Senator Leahy now. I have a lot more I wish to say, but let me begin the discussion by saying that we in Vermont are extraordinarily fortunate that one of the great Governors of his time is a real visionary, a man who led the beginning of making profound changes in the State of Vermont.

I yield back to the senior Senator from Vermont, Mr. Leahy.

Mr. President, way back in 1968 as a young man, I got a job at the Department of Taxation in a small building on State Street across the street from the statehouse, working for the administration, then-Governor Hoff, and that was a very important experience for me and helped me shape some of my views which I carry today.

Phil Hoff's career of public service began during World War II when he put his studies on hold and joined the Navy, eventually joining the submarine service. He served on the USS Sea Dog in the Pacific theater, going on a number of combat tours in the dangerous waters near the main islands of Japan.

While in naval training in New London, CT, a friend of his set up a blind date with a Connecticut college student. Her name was Joan Brower, and she and Phil would be married after the war--a marriage that was to last for six rich decades.

I know Senator Leahy and his wife, as well as myself and my wife Jane, know the Hoffs very well. We know Joan and know of her years of dedication to the people of the State of Vermont, especially in the area of education. So she in her own right has been a very important figure in our State.

After Phil Hoff's graduation from Cornell Law School, he and Joan moved to Burlington, VT, in 1951. Deeply committed to social justice, he became involved in Democratic Party politics and did that despite the fact that he grew up in a Republican family.

Senator Leahy will remember that way back then, there was a group of what they called the Young Turks--younger Democrats who came into a very conservative Republican legislature. Most of them were under 40. Many of them were veterans of World War II. They moved forward to try to bring about some long needed change in the State.

Their experience in the legislature motivated Phil Hoff to run for Governor in 1962. As Senator Leahy indicated, if my memory is correct, he was the first Democrat elected Governor since the Civil War; is that right?

For more than 100 years--I think many people don't know this--the Republican Party dominated Vermont politics, controlling both Houses of the legislature and the Governor's office.

This is a funny story. Even in the landslide Presidential election of 1936, when FDR--Franklin Delano Roosevelt--won a huge landslide victory, Vermont joined Maine as the only State in the country to vote against Roosevelt and vote for Alfred Landon, and thus came the well- known expression: ``As goes Maine, so goes Vermont.'' What Phil Hoff helped do is lead Vermont out of a one-party State, badly in need of reforms, and brought that State in many significant ways into the second half of the 20th century.

I yield back to the senior Senator from Vermont.

Mr. President, Senator Leahy talked about the influence Governor Hoff had on the State. Let me give some examples of what he did.

Senator Leahy will remember in the early 1960s we had the situation in Vermont where the Vermont State House of Representatives, people were represented by every town. I lived for a while in the town of Stannard, VT, which has maybe 100, 150 people, and they had the same vote in the legislature as Burlington, VT, the largest city in the State, which has 40,000 people. Under Phil Hoff, what we moved to in the State--and with the Supreme Court ruling dealing with proper apportionment--was person, one vote, so the house began to reflect the population locations of the State and not just every town.

In addition to that, when Phil Hoff was Governor of the State, he successfully insisted on repealing Vermont's poll tax. Now we think that is ancient history. What the poll tax said is that in order to vote, you have to pay a certain amount of money, which, obviously, is discriminatory to lower income people. That was repealed under Hoff's era as Governor.

He understood and his wife understood the importance of education. What Governor Hoff did was he quadrupled State aid to public schools and organized the three State teachers colleges into a new, revitalized State college system that better met the needs of Vermont's students. That system endures to this day. We have a very strong system of State colleges in Vermont, and that began under the Hoff era.

Under Governor Hoff's leadership, Vermont's judicial system was modernized. Always a path breaker and an advocate for justice, Phil Hoff led the way to Vermont becoming one of the first States in the country to abolish the death penalty.

No aspect of State government was beneath his notice, and he took Vermont forward in many ways, including terminating the outdated ``overseer of the poor'' system. That was something he changed as well. He established the Vermont district court State court system, the Judicial Nominating Board, the Vermont State Housing Authority, and the Vermont Student Assistance Corporation--a program which today plays a very vital role in making sure young people in Vermont can get a college education.

What was also--and Senator Leahy knows this better than I--rather extraordinary about Phil Hoff is he understood that positive change could not take place in Vermont unless change was taking place throughout the country. In that area, being the Governor of one of the smallest States in the country, this man showed extraordinary courage, and he said: Do you know what. That war in Vietnam is not good for Vermont, it is not good for America.

He was one of the first public officials, as I recall, I say to Senator Leahy, to speak out. That took a whole lot of courage, to speak out against the war in Vietnam. He took it a step further. Here you had Lyndon Johnson at that time--who I think will go down in history, except for that war in Vietnam, as one of our great Presidents--and Phil Hoff said: Do you know what. Maybe we need a change in the White House, and maybe we should be looking at somebody like Bobby Kennedy rather than Lyndon Johnson.

But, I say to Senator Leahy, I know he was involved in some of that as a young man.

Let me concur with Senator Leahy. We take this opportunity to wish Governor Hoff a very happy 90th birthday. Jane and I see him quite often, and we just bumped into Phil and Joan recently. We look forward to continuing that relationship.

The bottom line is, as Senator Leahy said, we are very proud that Vermont is a leader in so many areas in terms of social justice, in terms of environmental sanity, in terms of protecting the needs of ordinary people. That transformation and those efforts did not come about by accident, and certainly one of the great leaders in moving us in that direction was the man we honor today; that is, Philip H. Hoff. We wish him the very, very best in the years to come.

With that, I yield the floor.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, I wanted to inform the Members about an important hearing that was held this morning in the Senate Veterans' Committee. I also wish to thank the Members of the Senate who, in the midst of a very partisan environment last month, voted with 93 votes-- overwhelming support--to pass a very significant piece of legislation to help the men and women who put their lives on the line to defend our country--legislation that was written by Senator McCain and myself, and I thank him very much for his help in this effort.

One of the important provisions in that legislation was an understanding that the needs of our veterans are a cost of war. They are a cost of war just as much as guns and tanks and planes and missiles are a cost of war. It seems to me to be fairly obvious that if we spend trillions of dollars fighting the wars in Iraq and Afghanistan, it is absolutely appropriate to make sure we have money available on an emergency basis to take care of the men and women who use those guns and tanks and missiles and who put their lives on the line and, in some cases, never come home.

So the first point I wish to make is that if we send people to war, we should always understand that a cost of that war is taking care of our veterans.

I recall--and I see the chairperson of the Appropriations Committee and she will recall this as well--that when this country went to war in Iraq and after in Afghanistan--and let me be clear, I voted against the war in Iraq--but when we went to war in Iraq and in Afghanistan, the understanding was that this is emergency funding; that our troops, no matter how one voted on the war, needed the equipment to take care of themselves, to protect themselves, and to win the mission. That is exactly where we are today. We want to win this mission. The mission we are involved in now is making sure the men and women who served this country in the military get quality care in a timely manner. That is the mission we have to win now, and that, in my view, is a cost of war.

I think there is not widespread awareness of what the cost of war is, and I hope, A, we never get into more wars in the future, but that if we ever do, people understand that any budget for war must include the needs of veterans--not 2 years after the war but 70 years after the war. When some veteran is sitting in some room in an apartment without legs, without arms, without eyesight, that is a cost of war and we don't desert those people--not tomorrow, not 50 years from now, not 70 years from now. Our moral commitment is to make certain we provide for those who defend us.

I think there is not sufficient understanding about what the cost of war truly is. I wish to mention just a few facts people should understand. Over 2 million men and women served this country in Afghanistan and in Iraq. Studies are very clear that 20 to 30 percent of those men and women have come home with post-traumatic stress disorder or traumatic brain injury. That is between 400,000 to 500,000 men and women who are coming home with PTSD or TBI. What that translates into is men and women who are struggling every single day. It translates into outrageously high rates of suicide for younger veterans, substance abuse, inability to hold on to a job and earn a living; many of these folks have a difficult time being around people. It translates into divorce. It translates into emotional problems for kids and for other family members.

Since fiscal year 2006, the number of veterans receiving specialized mental health treatment has risen from over 927,000 to more than 1.4 million in fiscal year 2013. Today, and every day, approximately 49,000 veterans are receiving outpatient mental health appointments. Let me repeat that. Today, some 49,000 veterans in 50 States in this country are receiving mental health appointments. That is a staggering number. During the last 4 years, VA outpatient mental health visits have increased from $14 million a year to more than $18 million a year. This is just one of the problems facing the veterans community. How do we provide the psychiatrists, the social workers, the psychologists, the counselors we need? It is a huge issue because PTSD and TBI are very tough illnesses.

In addition, what we are looking at now--and every Member of the Senate is familiar with this--is outrageously high waiting periods for veterans to get into the VA. Time and time again I hear from veterans in Vermont and I hear from veterans all over the country; I hear from veterans organizations and I read independent surveys which tell me that when veterans get into the VA, the quality of the care they get is good. I just met 2 hours ago with a veterans organization--same thing: Once people get into the system, the quality of care is generally good; the problem is accessing the care. The problem is appointments.

I will not read to my colleagues all of the statistics, but trust me the waiting lines all over this country are much too high in many parts of America. There are other people who never even made it to the waiting lines. This has to do with a whole lot of issues that we have discussed.

The bottom line is we must address the waiting time issue and make sure that in the very near future, every veteran who is in need of health care gets that health care in a timely manner.

Sloan Gibson, who is the Acting Secretary of the VA----

Could I ask my colleague just for 3 more minutes?

I thank very much the Senator from Idaho.

Let me wrap it up by making the point that Acting Secretary Gibson made this morning which was a very simple but important one. What he said is we must address the immediate crisis of ending these outrageously long waiting periods that veterans are now experiencing in order to get into the VA. Right now--and I am proud of what he is doing--they are moving very aggressively to get veterans all over this country into private health care when necessary and any other form of health care, to make sure those waiting periods go down. I think they are doing a pretty good job. They have to continue to do that, but we should be mindful that this is going to be a very expensive process.

The other point he made, which is equally important, is that long term, if the goal is to end these unacceptable waiting periods, we have to give the VA the staffing and the space and the facilities and the infrastructure they need.

He came forward with what I recognize is a very big pricetag. His pricetag was $17.6 billion, so we can get the 10,000 more staff we need, the doctors, the psychiatrists, the primary health care physicians, the mental health counselors we need, get the space we need, because in many facilities around the country the staff can't operate because they don't have adequate space.

So what I would say to my colleagues, if we are serious about addressing this very important problem, we will go forward in two ways. No. 1, immediate crisis, let's end those waiting lists. Let's contract out when necessary to private physicians.

Long term, it is absolutely imperative that the VA have the infrastructure it needs so we don't have this crisis again 2 years from today.

The last point, I reiterate. If we send people off to war--if we make that enormously difficult, painful decision--I hope every Member in this body understands that taking care of veterans is a cost of that war and that we have a moral responsibility to do everything we can with them and for them and their families.

Before I yield the floor, I ask unanimous consent to have printed in the Record a memorandum submitted by Acting Secretary Sloan Gibson at our committee hearing earlier today.

Madam President, I wanted to say a few words about the conference committee in terms of legislation protecting the health of our veterans. We are working hard on it in the Senate, the House is working hard on it, and our staffs have been meeting. I have been in touch often with Chairman Miller in the House. We had, I thought, a very productive conference committee before we left.

As we continue to proceed, if there is anything I have learned since I have been chairman of the Senate Committee on Veterans' Affairs, it is that I think as a people, as a nation, we underestimate the cost of war, and before anyone votes to go to war again I think they should fully appreciate the repercussions of that vote.

What going to war means is not--as in the case of Afghanistan and Iraq--losing some 6,700 brave men and women. That is a terrible loss, but I also want people to remember the families, the wives, the kids, the mothers, and the impact that loss has had on their lives and the need for us to protect those wives and those children to make sure they can have the quality of life they are entitled to despite their loss.

But it is not only loss of life. We have had in this war a horrendous epidemic of men and women coming home with post-traumatic stress disorder. I am not sure of exactly the number, but it could be as high as 500,000 men and women coming home from war with PTSD and that is a very difficult illness which needs a lot of care and that illness, again, impacts the entire family--wives, kids. It impacts the ability of a worker to go out and get a job to earn an income. That is a cost of war.

Needless to say, the cost of war is the many who came home without legs, who came home without arms, who came home without eyesight. The cost of war is a high divorce rate for folks who come home who cannot readjust well into their family life. The cost of war is an extremely high rate of suicides. The cost of war is widows who are now having to rebuild their lives. And on and on it goes. The bottom line is the cost of war is enormous in terms of human suffering and the impact on not only the individual who fought in that war but on the entire family.

As I think our colleagues know, several weeks ago Senator McCain and I put together a proposal to deal with the current crisis at the VA, and I am very proud that legislation passed the Senate by a vote of 93 to 3.

What are we dealing with? What is the cost of this proposal? This is an expensive proposal because the cost of war is expensive. What a VA audit told us is that more than 57,000 veterans are waiting to be scheduled for medical appointments. These are the folks who are on these waiting lists, some of which were secret, some of which had data manipulated. These are folks who should have been getting into the VA for timely health care but who were not. On top of that, there is an unknown number of veterans who are on no lists because of poor work being done at the VA. They were not on any list. How many there are we don't know, but many of those people need to be seen.

So what our legislation does is say we are going to make certain that all of these veterans who are waiting for health care--who have waited far too long for health care--will, in fact, get health care as soon as they possibly can, and they will get that health care either through private physicians, they will get that health care in community health centers, they will get that health care at the Department of Defense military bases, they will get that health care at the Indian Health Service, but they will get that health care in a timely manner, and that is going to be an expensive proposition. We cannot provide health care to tens and tens of thousands of veterans in a short period of time outside of the VA without spending a substantial sum of money.

No. 2, long-term, what is clear to me and I think to anybody who has studied the issue is that if we are serious about eliminating these waiting lists and getting people into the VA in a timely manner, we have to make sure that at every facility in this country the VA has the requisite number of doctors, nurses, and other types of personnel they need in order to accommodate the growing numbers of people who are coming into the VA.

If we are talking about hiring thousands of doctors in a moment, by the way, where we have a very serious doctor shortage in this country, that is going to be an expensive proposition, as well as hiring the nurses and other personnel and building or leasing the space we need. That is issue No. 2. That is going to be expensive, but long term, if we are serious about keeping our commitment to the men and women who put their lives on the line to defend this country, that is exactly what we have to do.

The third area in this legislation which is going to be expensive is we have now for the first time said to veterans that if they are living a distance away from a VA facility, more than 40 miles, they are going to be able to go to a private doctor. That will cost us some money as well.

I am happy to yield the floor to the Senator from Illinois.

I very much thank the Senator. Let me answer the very last question first, and I will go through the others.

I think throughout the history of this country, not only in Iraq and Afghanistan, I think as a people we have underestimated the real cost of war. There was no word called PTSD at the end of World War II, but anyone who thinks that men and women did not come home from war suffering from that ailment would be very mistaken. So the cost of war is real, and it is not just missiles and tanks and guns. If this country means anything, we take care of all of those who serve, to the last day of their lives, when they need that care. I don't have the date in front of me, but I think it was about 3 weeks ago when we passed that legislation by a huge vote. I think there were only 3 people who voted against it. It was a vote of 93 to 3--huge bipartisan support for the bill.

But equally important, to answer the important question raised by the Senator from Illinois, there was also an overwhelming understanding that paying for this bill is a cost of war. It has to be emergency funded, and in a strong bipartisan vote the Senate said, yes, that is how we are going to pay for it.

In terms of the House bill, the House bill was a reasonable bill, but they did not go into the detail we did in terms of how it will be paid. But the major point I do want to make--I was just going to get to that and I appreciate the Senator from Illinois raising it. This bill is not going to be paid for by cutting education or food stamps. That isn't going to happen. That isn't going to happen, first of all, because it is not going to happen and, second of all, it would be grossly disrespectful to the veterans of this country. The veterans of this country need help. They need help now. This legislation must be passed as soon as possible, and it must be passed in terms of the emergency funding. This is a cost of war.

I would ask my friend from Illinois, the whip, can he recall what kind of programs were offset and what kind of taxes were raised to pay for the wars in Iraq and Afghanistan?

The Senator is exactly right. While no one is quite exactly clear how much those two wars will end up costing us, the estimate is between $3 and $6 trillion. The point Senator Durbin made is even those who voted against the war--and I did as well--understood that when we sent men and women off to battle they would have to have all of the resources they needed to do their mission. Equally important, what we are saying now is when they come home wounded in body, wounded in spirit, we need them to have the resources they require to make their lives whole again. That is a moral obligation. I thank the Senator for raising that point.

I will yield the floor in a second, but first I will conclude by saying that I want to see this bill passed as soon as possible. We are working as hard as we possibly can, but anyone who magically thinks the only problem facing the VA is more accountability and better management is not correct. We do need better management at the VA, we do need more accountability at the VA, and this legislation will provide that.

People who are incompetent and people who are dishonest should be fired. There must be more transparency, and there certainly must be a much clearer chain of command that goes from Washington to regional hospitals and facilities and back up again.

At the end of the day, the best management in the world is not going to provide the quality and timely health care veterans need unless we have the doctors, nurses, and other medical personnel, and that is the simple fact. Excellent management, yes; transparency, yes; fire incompetent people, yes; but we also need the doctors and nurses to provide quality and timely care to the veterans of our country.

With that, I yield the floor.

I thank the Chair.

(The remarks of Mr. Sanders pertaining to the introduction of S. 2548 are printed in today's Record under ``Statements on Introduced Bills and Joint Resolutions.'')

I yield the floor.

Madam President, as chairman of the Senate Veterans' Affairs Committee, I would hope that every American understands that the cost of war does not end when the last shots are fired or when the last missiles are launched. The cost of war continues until the last veteran receives the care and benefits he or she has earned on the battlefield.

War is an incredibly expensive proposition in terms of human life, human suffering, and in financial terms. In my very strong view, if we are not prepared to take care of those men and women who went to war, then we should not send them to war in the first place. Taking care of veterans is a cost of war, period.

In terms of Iraq and Afghanistan, the human cost of those wars is almost 7,000 dead. The cost of war is 530,000 veterans seeking care at the VA in 2013 for post-traumatic stress disorder, not to mention those struggling with traumatic brain injury.

The cost of war is too many servicemembers coming home with missing arms and legs, lost eyesight, or lost hearing. The cost of war includes veterans each day dying by suicide, high rates of divorce, wives trying to rebuild their lives after losing their husbands, kids growing up in one-parent homes, and a too high rate of unemployment for returning servicemembers. Those are some of the real costs of war that this Congress cannot ignore.

Several weeks ago, Senator McCain and I hammered out an agreement which I think goes a significant way to address many of the serious problems facing the VA. I am very proud that the Sanders-McCain bill passed the Senate with overwhelming bipartisan support, with a vote of 93 to 3. In terms of funding, very importantly, by a vote of 75 to 19, an overwhelming vote, the Senate made it crystal clear that the current crisis in the VA, the crisis facing veterans who are not getting health care in a timely manner, is an emergency and should be paid for through emergency funding. I am very proud that in a bipartisan way the Senate made that important vote.

In the last 4 years we have seen a significant increase in the number of veterans utilizing VA health care. In addition, many of our other veterans from World War II, Korea, and Vietnam require a greater amount of care as they age.

Further, a recent VA audit revealed that more than 57,000 veterans are on too-long waiting lists in order to be scheduled for medical appointments.

In addition to that, there are many other veterans who were never put on a list in the first place, which is what this whole scandal is largely about.

Clearly, these waiting lists and veterans not getting care in a timely manner are unacceptable and must be dealt with immediately, not 6 months from now, not a year from now, not in a great debate about national priorities. This is a crisis which must be dealt with now. I could not agree with Senator John McCain more when he said on the Senate floor during this debate:

If there is a definition of emergency, I would say that

this legislation fits that. It is an emergency. It is an

emergency what is happening to our veterans and the men and

women who have served this country. We need to pass this

legislation and get it to conference with the House as soon

as possible.

Senator McCain is right. I concur with what he said. We need to get this legislation moving as soon as possible and get it to the President's desk. Veterans in this country must get quality care and they must get that health care in a timely manner. We need to provide the funding the VA needs to accomplish that goal and do it as quickly as we can.

The simple truth is that the VA needs more doctors, the VA needs more nurses, it needs more mental health providers, and in certain parts of this country more space for a growing patient population. That is the reality.

Does the Veterans' Administration need better management? You bet it does. Does it need to be more efficient, more accountable? Absolutely. But at the end of the day, if you do not have the doctors and the nurses and the medical staff you need, there will continue to be waiting lines unacceptably long and veterans will not get the care they need.

I received, as did the chairman of the House Veterans' Affairs Committee, a letter on June 17 which was signed by virtually every major veterans organization. That is the American Legion, the DAV, the VFW, the Paralyzed Veterans of America, the Vietnam Veterans of America, the Iraq and Afghanistan Veterans, and many other organizations. They made a number of very important points in their letter talking about the kind of legislation we need to pass. I want to quote from one section of their letter, which they entitled ``Protect and Preserve the VA Health Care System.''

Any legislative, regulatory or administrative changes

designed to respond to the VA health access crisis, whether

temporary or permanent, must protect, preserve and strengthen

the VA health care system so that it remains capable of

providing a full continuum of high-quality, timely health

care to all enrolled veterans . . .

Then the letter continues:

Unless the legislation simultaneously sets VA on a path to

intelligently strengthen health care delivery, expand access

and capacity, reallocate resources and ensure that overall VA

funding matches its mission, the current problems confronting

VA and veterans will inevitably recur.

In other words, what they are saying is that unless we strengthen the VA, give them the staffing and the space they need, this problem of waiting periods of time will continue. In order to address the long waiting periods, the Senate legislation says to veterans around the country that if you cannot get into a VA facility in a timely manner, you will be able to get the care you need outside of the VA. That means access to private doctors, community health centers, or Department of Defense or Indian Health Service facilities.

Furthermore, what the bill says is to veterans who live 40 miles or more from a VA facility, that if they choose, they also have the option of seeking care outside of the VA.

Just as the letter from the veterans service organizations articulated, it is critical to address the current waiting period crisis. But we also have to make sure that that crisis does not continue to occur. We do that by providing the VA the tools it needs to ensure sufficient capacity for veterans seeking care at VA medical facilities. Clearly, no medical program can work unless we have the necessary medical staff.

Today, the VA has thousands of vacancies for health care providers. These vacancies, along with an untold shortage of health care providers to meet the demands of veterans who want to get VA care, has a direct impact on the ability to get veterans in the door for appointments. To fill these positions, the Senate bill provides for the hiring of VA doctors and nurses, and it does so in an expedited fashion by ensuring VA's hiring efforts are not hamstrung by Federal bureaucracy.

During the discussion of VA health care, let us not forget that today alone some 230,000 veterans will walk in the doors of VA facilities for health care--230,000 veterans today, 6.5 million veterans in a year. While it is absolutely true that not every veteran is satisfied by the care he or she is getting, the overwhelming majority--well over 90 percent of them--believe they receive high quality care. Over and over, I hear from Vermont veterans and veterans across the country who say that once they get into the system the care is good.

That is just not my view, it is the view of virtually all of the major veterans organizations and a number of independent studies that have compared VA health care with that in the private sector. We owe it to these veterans, to our veterans, to fix the current problems and bolster the system to ensure that quality care is available in the VA for years and decades to come.

I have heard a lot of criticism of the VA. Much of that criticism is valid. But when we talk about VA health care, we must put it in the context of health care in the United States of America. Does anyone seriously believe the VA is the only health care institution in America that has problems? It is absolutely the case that not everybody outside of the VA gets timely, quality, affordable health care. That is just not the reality.

Today some 40 million Americans have no health insurance. According to a Harvard study of a few years ago, 45,000 Americans die each year because they do not get to the doctor when they should. That is outside of the VA.

But it is more than that. Let me read you a few headlines from the last couple of weeks. I make this point not to argue the whole health care debate again but to say that anyone who thinks it is only the VA that has health care problems does not understand what is happening with health care in America.

Here is a quote from a few weeks ago.

A report released Monday by a respected think tank--

That is the Commonwealth Fund.

--ranks the United States dead last in the quality of its

health care system when compared with ten other Western

industrialized nations.

Then the report further tells us that the United States has maintained this dubious distinction while spending far more per capita on health care than any other country. We are spending far more on health care than any other country.

Let me read you another headline published September 20, 2013 by FierceHealthCare. ``Hospital Medical Errors Now the Third Leading Cause of Death in US.''

Medical errors leading to patient death are much higher

than previously thought and may be as high as 400,000 deaths

a year, according to a new study in the Journal of Patient

Safety.

I mention all of this to make clear that the VA, of course, has its problems. Our job is to strengthen the VA, to provide better accountability, to make sure that incompetent and dishonest people are not working in the VA. But we also have to make sure the VA has the doctors, the nurses, and the other health care providers it needs in order to provide the quality of care our veterans deserve.

The last point I want to make. I hope very much the House will agree with the Senate that we are in an emergency.

It is absolutely imperative that we move as quickly as possible to get the funding we need so that all veterans enrolled in the VA health care system get quality care in a timely manner.

I hope very much that we don't once again have a major debate about whether we are going to cut food

stamps or education or roads and bridges in order to fund the Veterans' Administration. When this Congress voted to go to war in Iraq and Afghanistan, it said that it was an emergency. Some of us disagreed with that, and I don't want to debate the Iraq war again, but when Congress said it is an emergency that we go to war, well, if it is an emergency that we go to war, it is more of an emergency that we take care of the men and women who fought in those wars. If you don't believe that is the case, don't send Americans off to war. Taking care of veterans is a cost of war.

I hope very much that we don't go back to the same old, same old of having a debate where some people say: Well, if you want to fund VA health care, you are going to have to cut education or cut Medicaid or cut Medicare or cut some other program. That is not the issue. This is an emergency. Our veterans have put their lives on the line. Now is the time for us to defend them, and we have to get this legislation moving.

With that, I yield the floor.