Good afternoon, everyone.
I am honored to be here today and honored to be serving at the Department of Veterans Affairs. For me, this is a calling that offers me the opportunity to give back to those who served with and for me in uniform, and to the men and women on whose shoulders I stood as I grew up in the profession of arms.
For 38 years I was privileged to serve as a Soldier—and blessed with the opportunity to both serve and serve with the finest and most selfless people I know and their families. It was a unique preparation for my duties as Secretary of Veterans Affairs. When I retired in August 2003, and folks asked me what I was thinking about doing, my answer was to collect some really good retirement jokes and find a second great calling. I can report I did find a couple of really good retirement jokes, none that I’ll repeat today, and thanks to President Obama, I’ve also found that second, great calling.
Your compassion for Veterans and wounded warriors and their families is deeply appreciated, and I want to thank all your members through your chapter presidents for the work your members are doing to ease many of the burdens those warriors face. Operation helping hand—led by Captain Bob Silah down in Tampa—is just one example of MOAA’s generosity and tireless community spirit.
Thank you for your service to our Nation; for your continued dedication to keeping America strong; and for your commitment to preserve the benefits that those, who serve in uniform, have earned through noble sacrifice.
Norb Ryan and I were together at the White House earlier this month, with Secretary Gates, when the President announced his tasking to both Defense and VA to define and build a single VA and DoD electronic record that will serve the needs of both our personnel—active, guard, reserve, and Veterans. I’ll talk a little more about that, but I want to thank Norb and MOAA for your strong support of that long-awaited initiative.
I’m just coming up on my first 100 days in office—quite a learning challenge. I wasn’t sure, when I accepted the job President Obama offered, how my 38 years in the Army would translate into VA’s culture and traditional processes. I’ve found the missions are not all that dissimilar. As Army chief, my mission was to prepare the Army to protect the nation, to be ready, when called, to fulfill our nonnegotiable contract with the American people to fight and win our nation’s wars. My part was to ensure soldiers had the best possible tools and resources required to meet any of a number of contingencies. To accomplish those missions, the Army embraces a number of branches comprised of a host of military occupational specialties, but all working together for common purposes.
Much the same at VA. Our mandate is clear: provide the best possible care and benefits for our Veterans, and make sure VA employees have the tools they need to see the job through—many different specialties within VA, but all working together. Our three administrations—Veterans Health Administration, Veterans Benefits Administration, and National Cemetery Administration—are our version of jointness. Add to that the President’s mandate for VA and DoD to work more closely together, and we are now fielding a strong team for our troops and our Veterans.
There is more that VA can, and will be, doing. Collaborations are not limited to DoD, but will be developed with other departmental partners—Labor, HHS, Education, HUD, SBA, to name a few—and a host of state and local agencies and non-profits, as well.
We must cultivate those relationships that generate initiatives which will improve employment, housing, education, and healthcare opportunities for Veterans, and then take on the debilitating issues of homelessness and mental illness that devastate a number of our Veterans and their families. Our goal will be to prevent homelessness, but if that’s not possible, to find ways of returning homeless Veterans to being full-fledged members of their communities. Today, we estimate that 154,000 Veterans live on the streets of our nation - - men and women of every generation of warriors, including the generation currently doing the heavy lifting in Iraq and Afghanistan.
While looking at today’s critical concerns, we must look longer term at what initiatives we should launch that will address the requirements of future generations of warfighters and Veterans—before they need us. All too often, we address issues that had their roots in events 20, 30, even 40 years earlier. An example: We knew about Agent Orange in Vietnam; we had inklings of developing health problems within a few years of the war’s end; but it took many years before there was a vigorous national debate about the effects of Agent Orange and then years of prolonged study—the scientific method, if you will—to lay the groundwork for disability claims. The last use of Agent Orange was in 1970, but decades passed before a comprehensive list of Agent Orange-related illnesses were compiled and considered for service-connected disability claims. If we had been more responsive then to the immediate needs of Veterans exposed to Agent Orange—well, we might not be facing the claims backlog issues that haunt us today.
Other examples include the Gulf War and the extensive list of studies that came out of it concerning depleted uranium, oil well fire smoke, sand-borne pathogens, chemical weapons exposure—all of which were put to the rigors of the scientific method, while affected Veterans waited for help.
This is not a system based on advocacy for Veterans, our clients—it is an adversarial system that places the burden on the veteran to demonstrate the validity of the claim. It’s too early for me to suggest I’ve figured this all out, but I don’t believe this is where we want, or need, to position VA.
And what of today’s wars and the men and women fighting them? They face TBI, polytrauma, a host of mental stressors, new environmental health threats. Do we need to wait 20 years to see how these factors affect those then-aging Veterans? That’s adversarial. Or can we begin to put in place proactive policies that lay the groundwork for more responsive care and timely benefits delivery? That’s advocacy for those who have earned our best efforts.
And our responsiveness—our forward thinking—must be more attuned to specific needs of groups within our veteran population. Women are an increasingly large percentage of that population, just as they are in DoD. We estimate that, by 2020, 15% of Veterans will be women. That may not sound significant, but the current, total veteran population is more than 23 million. You can do the math. We’d better prepare now. 2020 is right around the corner. Doing so would suggest advocacy.
Our mission is advocacy; we need to think in those terms, when we consider our clients, rather than in terms of policy, processes or procedures. Even the scientific method may be less perfect to our necessary deliberations. We need to be more responsive to the present and pressing needs of Veterans, while also, having our heads up to extrapolate those needs into the kinds of issues that might affect those same Veterans 40 years from now when MOAA is hosting the Secretary of Veterans Affairs at your 2049 annual meeting.
We can take Wayne Gretzky’s advice about all this based on his legendary ability to be at the right place on the ice at the right time to score, “I don’t skate to where the puck is . . . I skate to where the puck is going to be.”
We’re moving in the right direction now, leaning forward with a budget that, if Congress approves it, will resource the initiatives we need to achieve, maintain, and advance the highest quality care and services for Veterans.
And though the President’s budget is generous, even if it is passed by congress with no losses of proposed funding for VA, we face significant challenges in the months and years ahead:
The economic downturn stresses Veterans and their families, in turn, straining local, state, and federal resources for Veterans’ care;
Implementing the new G.I. Bill, the outreach improvement act, and the re-authorization of VA benefits to priority group 8 Veterans challenges our own agility as an organization;
Budgetary pressures, given the state of the economy, will likely collide with increasing demand for our services and benefits;
The connectivity between TBI, PTSD, mental health, homelessness, substance abuse, and suicide ideation requires quick and effective solutions for all affected Veterans;
And the constant need to expedite access to high quality benefits and services in a timely, consistent, and equitable manner remains a priority.
This is clearly a time of great challenge, but it is also a time of great opportunity—perhaps even greater opportunity. It provides us an interval to re-set the VA’s key vectors for the 21st century, and we are going to leverage them.
In the end, we will be measured by our accomplishments, not by our promises. Veterans, Congress, and the American people expect that, and I do, as well.
Earlier, I mentioned that Norb and I and Secretary Gates were at the White House to hear President Obama announce the VA-DoD partnership to develop and implement a seamless health care records protocol between our two departments.
There are few things more important to our returning Soldiers and our Veterans than continuity of health care information from active-duty to civilian life. Everyone in this room knows just how frustrating it can be to have to re-acquire long-lost or stored paper records reflecting a lifetime of military health care. And most of us have been around the track a few times, and we have learned hard lessons on maintaining our records and files—or at least how to mitigate the pain of frequent moves and packing boxes that end up challenging our records management skills.
But today’s youngsters—the E3s and E4s—to them the transfer of records between DoD and VA is a warren of frustrating procedures. They can take on the Taliban—they can fight and win in places like Fallujah—yet the truth is that many, in their haste to leave the service and start the rest of their lives, cringe at the thought of taking on VA. We can fix that. And we’re going to. We intend to be their advocates, not their adversaries.
Last month I traveled to Chicago and visited the North-Chicago VA Medical Center which is co-located, and shares medical resources with, the Great Lakes Naval Station. It is the only VA-DoD joint health care operation in the country, and it is a model for cooperation and seamlessness—to a point. The point is the interface between DoD and VA health records—friction. Navy docs can care for VA patients, and VA docs can care for Navy family members. But in one room are two computers—one for VA patient data, one for the Navy’s patients’ data—yet, the computers can’t yet talk to each other. So near, and yet so far. But that is going to change, too.
Seamlessness—one health care record started on the day a young man or woman commits to uniformed service should already be in the VA system the day he or she walks through the front door of a VA medical center or outpatient clinic. That is the President’s goal, and it is mine and Secretary Gate’s mission to accomplish, to exorcise the devils that always dwell in the details.
We can work together in other ways, too, if we can just get over some speed bumps. In 2002, we tried a joint VA-DoD pharmacy pilot program, where DoD beneficiaries were allowed to get their prescription refills from VA’s mail out system—one of the most cost-effective programs going. By all accounts it was a booming success, but the Army and Air Force opted out of it, and the Navy uses it only in San Diego, where it is a tremendously popular program. The program didn’t stop for lack of enthusiasm by the users; it was curtailed by leaders unable or unwilling to adopt new ways. I was leading the Army then. Given my bent towards doing things faster and better for people, do you think it ever reached my level of visibility?
VA is ready, today, to link up with all DoD facilities to share the benefits of our prescription services—our head of pharmaceutical services assures me we are good to go on a moment’s notice.
Before I wrap this up and take a few of your questions, I want to respond to a question passed along to me a couple of weeks ago as I prepared for today: “What can MOAA do to help me with my mission?”
First, that’s an unselfish question typical of your organization’s history of service to others. After all that you have already done for the country, I appreciate the generosity. Thank you. Now, let me answer that question. You can help me and all our Veterans by constantly beating the MOAA drum for a strong and vibrant VA—helping us acquire the resources required to transform into a 21st century organization with all of the tools to provide care, services, and final tributes for our clients. You can help with ideas and initiatives for a VA that is as responsive to our youngest Veterans as we are to our oldest Veterans; a VA that seeks to return to functionality the men and women wounded in service to America—preserving their dignity along with their health. And you can help with frequent reminders that VA must never forget that honoring the veteran and his or her family is why 280,000 VA employees wake up every day and go to work.
Thank you for inviting me to share this time with you.
God bless you and God Bless our Veterans.
Now, and I’m happy to take your questions.