Caregivers And Veterans Omnibus Health Services Act Of 2009

Floor Speech

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Mr. DURBIN. Mr. President, I thank my friend and colleague from Oklahoma. Although we disagree on many things, we also agree on many things. We work together and will continue to do so.

We have a difference of opinion on the matter before us. This bill, S. 1963, is the most important piece of veterans legislation this year for several reasons. I congratulate Chairman Akaka and Ranking Member Burr for bringing this matter to the Senate with a unanimous vote in committee, with both Democrats and Republicans supporting it, and for good reason.

In addition to the provision that was part of an earlier bill I had introduced, there is dramatic change in the law to help women veterans. More and more returning veterans from Iraq and Afghanistan and around the world need special care. Unfortunately, the VA system wasn't providing that care as we believed it should. This bill takes care of that. It is the most dramatic expansion for women veterans and their health needs we have seen.

The same is true for rural health care. I know that. The Presiding Officer is from downstate Illinois, as I am, and he knows the Marion VA Center is a critical part of the treatment of veterans in southern Illinois and the surrounding States. Literally thousands of hard-working people there provide care for veterans, which they desperately need, close to their homes. This bill addresses the enhancement and improvement of rural care for veterans.

The same is true for mental health issues. It is an excellent bill. The part of the bill that is near and dear to me relates to caregivers assistance. It relates to the fact that many veterans who come home are not in institutional settings, not in a hospital, not in a convalescent center; they are home. But they survive every day because of the loving care of a member of their family--a wife, a husband, a mother, a father, a sister, or a brother--who gets up every morning and worries about that veteran and makes sure that veteran receives the medical care needed to survive another day. They are in the setting of their home where they feel secure and happy.

Great sacrifice takes place. I cannot tell you exactly how many of these caregivers there may be. Estimates range as high as 6,000 or 8,000. I have met some of them, and I know them personally. I have heard their stories. They are heroic--just as heroic as the veteran who needs their care. They are literally giving their lives to keep that veteran alive, healthy and happy, at great personal sacrifice. Many times they cannot go to work. Many times they give up a business because they want to stay home with that husband they love.

A young woman came into my office the other day who is moving from North Carolina back to the Chicagoland area after more than 5 1/2 years. She has been the caregiver for her husband who was the victim of a traumatic brain injury in Iraq. For this young woman, who is in her thirties, it is an amazing show of love and sacrifice on her part.

We have also spoken of the family in North Carolina we know very well--the
family of Eric Edmundson, a young soldier who was the victim of a traumatic brain injury. He is alive today--I can say this without contradiction--because his dad quit his job, sold his business, and cashed in the value of his home. With his wife, they moved in to take care of their son and little granddaughter. That is the most loving family I can remember seeing, and they are doing it for the son they love, but they are doing it, as well, for a veteran who served our country.

The purpose of this bill is to give these caregivers a helping hand and the medical training they need so they can do what is necessary to keep that veteran alive and as well as possible, improving if possible. It is also to give them a respite maybe for a week or two each year so they can go on vacation and have a visiting nurse or someone who will come and provide assistance. They need that with the stress and burden they are carrying. That needs to be lifted--at least temporarily--so they can recharge their battery and come home and be dedicated once again.

In the discretion of the Veterans' Administration, it can give a monthly stipend or health care as well. The first thing the Edmundson family found when they sold the business was that they couldn't afford to buy health insurance. Mom and dad are taking care of their son under the care of the Veterans' Administration, and they have no health insurance.

We are trying to find a way to provide health insurance for these caregivers. In my mind, it is simply fair and right that we would do this. That is why I thank Senator Akaka and Senator Burr for including it in this bill.

I also want to address the issue before us, the pending amendment by the Senator from Oklahoma. The Senator from Oklahoma has come to the Senate floor several times and expressed his opposition to this bill, primarily for budgetary reasons. I understand that. But I say to him I was worried this day would come. I was worried the day would come when the war, which we paid for by borrowing money, would generate victims and veterans who needed care, and when it came time to give them the care many of the people who voted to fund the war by going into debt would say: But we can't help the veterans unless we pay for it.

In my mind, it is all the same. If we vote to go to war, we vote to accept the consequences of war. That means an obligation that we have to these veterans. It is a solemn promise we gave them. We said to these men and women if they would hold up their hand, take an oath to defend the United States and risk their lives, we would stand by them when they come home. If they are injured, we will be there. If their family is disadvantaged, we will do our best to help them too. I think that is part of our solemn obligation to these veterans.

Now the question is raised as to whether we can afford to do that, unless we come up with a sum of money to pay for it at this moment. I say to the Senator from Oklahoma, and those who take his position, if we paid for this war to start with by borrowing money, how can we turn our backs on the veterans and caregivers who keep them alive arguing that it is simple budgetary justice? It is just not. It doesn't track. I don't believe those two approaches are acceptable.

Also, the Senator from Oklahoma does two things in this amendment I wish we could do--one I wish we could do. I have talked to him about it on the Senate floor--and that is to expand coverage for caregivers of those who served before 9/11. I would like to do that. Currently, we believe there are about 2,000 caregivers who would qualify for this caregiver amendment, this demonstration project. If we expand it to all veterans caregivers, the number rises to over 52,000. It is a just thing to do. It is something we may ultimately do. But, clearly, if we are going to make that commitment, it is a dramatically larger commitment than this demonstration project, this bill for those who suffered serious injuries since 9/11. To increase the scope of it from 2,000 caregivers to 52,000 caregivers is to increase the cost of it dramatically. That is something we have to measure and decide at some point--whether we want to do that.

I will work with the Senator from Oklahoma to expand that. I think all veterans' caregivers deserve this. I hope we can prove with this approach that it is a reasonable thing to do--that keeping these veterans home where they want to be, in a safe, happy surrounding, is not only right but it is cheaper than institutionalization.

The second part of Senator Coburn's amendment related to this provision says the money would be available for caregivers if the veteran would otherwise be institutionalized. I think that may be drawing a line that is too harsh. I think there are those who need the help of a caregiver but may not technically need to be institutionalized. I think those who are suffering from post-traumatic stress disorder, a traumatic brain injury with seizures--to say they need to be institutionalized may be overstating. To say they need the help of a caregiver and then move forward to treatment, I understand that may happen. On the one hand, I think the Senator from Oklahoma expanded this bill from 2,000 to 52,000. On the other hand, he draws a line on institutionalization that may go too far. I think what we ought to do in this demonstration project is give the VA the authority to measure this and see what is appropriate. I think there are so many individual cases that, when we generalize like this, it is a mistake.

The Senator from Oklahoma believes the money to pay for this should come from the money set up for international peacekeeping through the U.N. I will not stand here in defense of every decision made by the U.N. It is hard to do that. We make mistakes in the United States, and the U.N. does too. They have been caught and so have we. I want to make sure money is not wasted. We should be vigilant, whether it is money being spent by our government or agencies we support. I worry that the proposal before us by Senator Coburn is going to cut back on international peacekeeping in areas of the world where I think it is critical.

I visited the Democratic Republic of Congo 2 years ago with Senator Brownback of Kansas. But for the U.N. peacekeeping forces there, the massacres of innocent people would go unchecked.

This has been going on for over a decade. During this period of time, innocent men, women, and children have been literally hacked to death and killed. The international peacekeepers make a difference there. They make a difference in Haiti where I visited twice and have seen firsthand the degraded poverty in our own hemisphere and, unfortunately, the fact they are on the verge of violence almost every moment.

I also think it is a mistake for us to cut back on those international agencies that monitor the spread of nuclear weapons. If we want to keep an eye on Iran and make sure they don't develop nuclear weapons to threaten their neighbors in the Middle East and the rest of the world, we need this international force to come in and do its inspection work. They are the only credible third parties that can come in and decide whether the Iranians have gone too far. Their judgment through the United Nations is one that is credible to other nations. To cut back in their efforts at monitoring the spread of nuclear weapons is, in my mind, shortsighted and invites instability in a world that is already too dangerous.

I urge my colleagues to defeat the Coburn amendment. I say to my friend from Oklahoma, at the end of the day, after we start this program, if the Veterans Administration can find the resources through the appropriations to move it forward, I am open to working with him to expand it to caregivers from previous generations of veterans and to see if there is a way to make sure it is spent exactly where it is needed and as we have described it.

That is the nature of this work. We are not perfect in what we do, but we start with good intentions and hard work and try to put the language together. But at this moment, I say to the Senator from Oklahoma, first, I am glad he no longer put a hold on this bill. It is an important bill. I am glad he has had his chance to offer his amendment. I urge my colleagues to defeat it, but I say it in good faith to my friend from Oklahoma.

I will work with him if this bill, in fact, is enacted into law and implemented to make sure it meets the goals we both share--fairness to all veterans and providing care to those who need it. This is a good start, but let us promise to work together, if it is enacted, to make sure we continue in that vein.

I yield the floor.

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