Congressional casualties
ELECTION JITTERS last fall kept Congress from passing appropriations bills that members feared could provide fodder for their opponents. Even during the lame-duck session after November, Congress failed to vote on the bills, resorting to a continuing resolution that keeps funding for programs at last year's level until mid-February. While this is adequate for some government services, it is a prescription for disaster in areas like veterans' healthcare or efforts to combat AIDS, malaria, and tuberculosis.
Congress based its appropriation for fiscal 2006 veterans' medical care on 2005 casualty data. Since then, the number of wounded has increased sharply. According to Linda Bilmes , who teaches public finance at Harvard's Kennedy School of Government, the VA will have to go to Congress for emergency funding, as it has in the previous two years. The VA, she wrote in a recent op-ed in the Los Angeles Times, "is buckling under a growing volume of disability claims and rising demand for medical attention."
The VA medical system, she wrote, "has a reputation for high-quality care, but waiting lists to see a doctor at some facilities now run as long as several months." Representative Stephen Lynch of South Boston hopes that the next continuing resolution will ensure that the VA is not held to inadequate 2006 spending levels. He worries that the annual uncertainties about funding cause VA nurses to leave the system in favor of other hospitals. As a long-term solution, he has favored changing the funding for veterans care from one based on annual, discretionary appropriations to mandatory funding, putting it on a par with Social Security and Medicare.
The consequences for level funding of the US effort against AIDS, malaria, and TB would also be severe. Last year, congressional committees saw the need was rising and passed bills raising US outlays for 2007 substantially over 2006 levels. The Senate's committee-approved appropriation would increase spending from $3.43 billion to $4.37 billion. With that new funding, President Bush's ambitious AIDS program in Africa, Haiti, and Vietnam would be able to add 280,000 patients to the 822,000 receiving drug treatment in 2006. The extra money would also pay for more TB drugs, millions of bed nets to prevent malaria, and greater efforts to cope with the increasingly common and lethal form of TB that is extremely resistant to conventional drug treatment.
The new Congress will have much on its plate as it addresses the 100-hour priorities of its Democratic leadership. But near the top of its to-do list should be the unfinished business of the old Congress. At stake is the healthcare of US veterans and victims all over the globe of TB, AIDS, and malaria.
