Voice for the VA: former Colorado developer Jim Nicholson now lends power to vets nationwide.

• Author: Burtt, Christine

"Mr. Secretary," the congressman said, addressing former Colorado real-estate developer Jim Nicholson, who is now Secretary of Veterans Affairs. "I'm just struck by the fact that you brought us a budget that contains projected savings of about $775 million. That will not happen."

U.S. Rep. Ted Strickland (D-Ohio) continued with Nicholson, "I don't know how many times this bipartisan committee has to say no to these increases in co-payment and user fees. It's just unrealistic in my judgement."

Jim Nicholson was testifying before the House Veterans' Affairs Committee in February, and, as seems usual, he was between that famous rock and hard place. Unusual for the head of a cabinet department, Nicholson, a fiscal conservative, had personally taken the lead in writing the fiscal '07 budget for the huge department, the second largest in the federal government and the largest integrated health-care system in the U.S. The budget Rep. Strickland was looking at already asked Congress for an $8.8 billion increase, or 12.2 percent from 2006 funding, to an unprecedented total budget for the department of $80.7 billion.

Yet members of the House and the Senate want to boost that total number even higher, anywhere from $2 billion to $4 billion higher, and Nicholson is the man in the middle.

"We must take care of those who need our help," he said later. "But we don't have unlimited resources."

The savings Strickland referred to relate to health-care services provided to veterans who sustain a non-service related injury or medical condition and who hold a job. For these vets, the Bush administration and Nicholson propose an annual enrollment fee of $250 for VA health plans, and an increase of pharmacy co-pays from $8 to $15. Of the 24.8 million veterans currently alive, an estimated 235,000 would be affected, according to Nicholson's department.

But the budget debate cuts to the heart of a philosophical question: Exactly how much does a grateful nation owe its servicemen and women, and their dependents? Especially since hundreds of thousands of those vets are currently and continually returning from two war zones overseas.

Should a veteran who saw action abroad receive the same benefits as one who remained stateside? Should a veteran who made the military his or her career be treated the same as the citizen soldier of the Reserve or National Guard? What does the public still owe older veterans of other wars who have succumbed to self-induced illnesses, such as the diabetes that accompanies obesity, or lung cancer from a lifetime of smoking?

Jim Nicholson has a clear answer to all those concerns.

"Our priority is the men and women who need us most--service-connected disabled veterans, veterans with no other health-care...