How Much Does It Cost to Fix the VA?

The Veterans Affairs Department wants to hire 10,000 new clinicians—including 1,500 physicians—to help fill gaps and meet what it calls a rising demand.

Just one small problem: Lawmakers have to approve the proposal first, and the ongoing scandal has made them skeptical.

"If they don't have the ability to accurately predict staffing needs, then how do we know that 10,000 more bodies is needed to solve the problem?" House Veterans Affairs Committee Chairman Jeff Miller asked at a committee hearing Thursday.

Philip Matkovsky, the assistant deputy undersecretary for health for administrative operations at the Veterans Health Administration, told lawmakers that the department reached the figure by trying to predict future veterans' needs and the number of veterans.

The additional staffers are part of a larger $17.6 billion request that Acting Secretary Sloan Gibson unveiled while testifying before the Senate Veterans' Affairs Committee last week. Lawmakers—particularly Republicans—have questioned if giving the VA more money, and particularly a lot more money, is really the cure to what ails the VA.

"You asked for the whole enchilada at one time, and that's caused a lot of us to struggle," said Rep. Jeff Denham, suggesting instead that the department should have requested a smaller amount and proved they could use it responsibly.

That struggle has spilled into the conference committee, the California Republican said, where lawmakers are still trying to hash out legislation that would increase funding for the VA and make it easier for veterans to get care outside of the VA.

Moving forward, Gibson outlined six priorities for the VA: Get veterans off wait lists and into clinics, fix scheduling problems, change culture, quantify what resources the VA needs, hold personnel accountable for mismanagement, and establish a routine for disclosing information.

But Miller warned that the days when the VA's budget was increased without question are over. "The VA can no longer consider itself a sacred cow," he warned.

The VA's budget has grown from $100 billion in 2009 to $154 billion in 2014. But veterans' advocates have long criticized what they view as an entrenched practice within VA leadership of hesitating to ask for additional resources.

"Where I am from, that's a lot of money," said Rep. Phil Roe, R-Tenn. " … How is it going to be spent? And how do I know it is going to be spent wisely?"

On the sidelines of the hearing, the Senate and House Veterans Affairs committees sparred through press releases.

The House committee sent out a release saying House and Senate members of the conference committee will hold a meeting Thursday to discuss potential amendments to the legislation it is hashing out.

But Senate Veterans Affairs Committee Chairman Bernie Sanders said in a statement that the "unilateral" push by Miller to call a conference committee "is a sad indication that the House leadership is not serious about negotiations."

"We don't need more speeches and posturing. We need serious negotiations," he said, casting further doubt on whether lawmakers will be able to reach a compromise before they leave for the August recess.

The Vermont independent outlined his proposal on Thursday from the Senate floor, which he said will cost less than $25 billion. Included in the proposal is funding for staffing, infrastructure, information technology, and a two-year program that would increase veterans' access to non-VA care.

And Sanders voiced frustration with his House counterparts, saying: "We have put good-faith offers on the table time and time again. ... I am very saddened to say ... at this point, I can only conclude with great reluctance that the great faith we have shown is simply not being reciprocated by the other side."

Sen. John McCain appeared on the floor with Sanders, urging everyone to "cool down some."

The Arizona Republican said it would be a "gross disservice to those who deserve our consideration most" if lawmakers left for the August break without an agreement.