More than 140 journalists at Health Journalism 2015 gathered early Friday to hear Veterans Affairs Secretary Robert McDonald – and to question him about VA policies, including the agency’s notorious opaqueness with reporters.
McDonald readily acknowledged that the VA has had what he called a “Kremlin-esque” mentality, and told the roomful of journalists that he was trying to change it. The VA is publishing patient access data (waiting times for appointments) on the website every two weeks, and he said he’s trying to promote a culture of openness.
“We’ll fix that, he said as reporters complained of being stonewalled by VA communications staff. “We’re fixing that.”
He stressed that much of the strain on the VA isn’t over – yet – because of the long wars and severe casualties in Iraq and Afghanistan. Nine million vets are enrolled in VA care, and much of what the agency is doing is caring for aging Vietnam vets. So the agency must care for the Vietnam generation (including PTSD that may manifest later in life as veterans age and develop dementia), address the needs of those injured in Iraq and Afghanistan – and prepare for the next wave of aging vets from the recent and ongoing deployments. “We’ve got to build the capacity today,” he said, before this generation hits their 60s and 70s.
In many ways, he said, the VA is the “canary in the coal mine” of American medicine. The VA sees the problems before they reach the rest of society.
McDonald also addressed the lack of services for the growing number of female vets. The VA doesn’t have enough OB/GYNs. Some VA buildings are so old that they don’t even have women’s restrooms. And the VA hasn’t yet done everything it needs to do to help women (and men) who have endured military sexual trauma, or MST in VA lingo. “We’re doing everything we can,” he said.
He also expressed his frustration with Congress. The House has cut the administration’s budget request, at the same time it presses the VA to rapidly improve. The agency also has a lot of unused facilities which are costing $25 million a year – but he said Congress hasn’t let it shut them down and use the money for other needs. Saving $25 million on unused space, for instance, would pay for 200,000 needed nurses, McDonald said.
He also complained that Congress not not granted him the flexibility he has sought in his agency’s funding, the ability to shift from one account to another as needs change (including paying for the new option of VA-covered individuals to seek care outside the VA). The budget woes are particularly frustrating as veterans’ needs are growing. There were 1 million claims in 2009, and that’s likely to rise by 50 percent by 2017. And claims grow more complicated, as older and sicker vets come in with more complaints per visit.
McDonald also announced a new 11-member Special Medical Advisory Group. It includes some members who may be familiar to AHCJ members who track policy, among them Dr. James Weinstein, the chief executive officer of Dartmouth Hitchcock, Deborah Trautman, the chief executive officer of the American Association of Colleges of Nursing, and Dr. Bruce Siegel, president and chief executive officer of America’s Essential Hospitals (formerly the National Association of Public Hospitals and Health Systems). (See more here.)