The memo could have been reprinted from Joseph Heller’s “Catch-22.” Togus VA Medical Center, which has worked assiduously over the last several years to reduce its waiting lists for care, solved the problem in recent years several ways, including attracting more staff. The regional directors noticed that this, naturally, has produced higher costs, so the solution is to reduce staff – 52 full-time equivalent positions by Sept. 30.

“And it was also pointed out that there will be no reduction in quality and no increase in waiting lists,” reported Togus Director John Sims, without giving in to irony.

Though the Department of Veterans Affairs is known for providing good care and for taking money-saving actions such as negotiating prescription drug prices, it is not funded adequately to meet the demand for care, a demand that clearly will be rising for the next several years as the generation of servicemen and women in Iraq and Afghanistan return to the United States. Merely trimming here and there won’t reduce costs and large-scale layoffs will hurt quality.

This situation became apparent in January when an internal document showed Togus had a projected $14.3 million shortfall in its budget for this fiscal year. Togus already has one of the nation’s most extensive fee programs – costing $1 million a month – to provide services to veterans through non-VA physicians and hospitals that either are not available at Togus or have long waiting lists. The document suggested a review of eligibility standards for these services, which include hospitalization, radiation therapy, physical therapy and cardiology, and reducing staffs at centers in Calais, Rumford, Saco and Bangor.

Sen. Susan Collins the other day asked Secretary of Veterans Affairs Jim Nicholson to review the budget allocation for Togus and to maintain staffing levels, pointing out, “Any reduction in force at Togus would be contrary to the goals and mission of the VA, particularly given the increased utilization of services with the return of many of our brave servicemen and women who have been serving overseas.”

That is correct, but while the funding issue has many layers, two stand out most prominently: how the regional VA network distributes money and how much Congress allocates to VA health care. The perennial fight to get money to northern New England would be made much easier if the second problem, of federal funding levels, were solved. Unfortunately, President Bush’s 2006 budget contains increased enrollment and prescription drug fees for veterans “while driving an estimated 220,000 veterans away from the VA, to include those who may not have access to other forms of health care,” according to the Veterans of Foreign Wars organization.

Togus’ problem is then a congressional problem. Congress can make funding for veterans’ health care a priority or the cuts planned for Togus will become permanent, the waiting lines will return and everyone will wonder why the nation treats its veterans badly. The answer lies in the budget.