[Congressional Record Volume 160, Number 86 (Wednesday, June 4, 2014)]
[Senate]
[Page S3426]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. LEAHY:
  S. 2428. A bill to amend title 38, United States Code, to ensure that 
the Department of Veterans Affairs provides temporary care in the most 
cost effective manner when patients are relocated during medical 
facility construction and renovation projects, and for other purposes; 
to the Committee on Veterans' Affairs.
  Mr. LEAHY. Mr. President, following the resignation of Secretary 
Shinseki last week, it is time for some deep soul-searching about the 
future of the Department of Veterans Affairs. As details slowly emerge 
from the inspector general's investigation, I am struck by a disturbing 
aspect of organizational culture within the VA that prioritizes meeting 
goals and checking boxes instead of providing true quality care for 
veterans. Secretary Shinseki himself was a decorated veteran, and I am 
sure he must have been as frustrated as all of us to find some of the 
things that were happening.
  There is an overwhelming current rushing toward the path of least 
resistance for ``reporting'' care for the men and women who served this 
Nation admirably and with dedication. But we should not lose sight of 
the hard work and commitment of the many men and women working in the 
VA system every day striving to provide effective and timely care to 
veterans. We have to tell ourselves that there is really no shortcut to 
quality care for veterans. The VA has rightly been under intense 
pressure and scrutiny to live up to the promise we made to veterans 
when they agreed to serve.
  We have many people in this body and the other body who voted for a 
war that I think historians will call a disaster--the war in Iraq. For 
the first time in America's history, they voted for a war and did not 
do anything to pay for it--no tax to pay for it or anything else. Ten 
years later, though, they say: We have to watch the cost of VA health 
care and all that; we have to find the money. Well, that did not bother 
them when they sent these men and women to war. Let's take care of them 
now.
  It has become apparent that at facilities across the United States 
some VA employees have decided to choose to simply tell those above 
them and those of us with oversight responsibility what they want to 
hear, over providing quality care in a timely fashion. And that is 
appalling and unacceptable.
  But most VA employees are tireless servants. Many are veterans 
themselves. For those men and women who give their all for our 
veterans, it is becoming evident that the system of incentives and 
disincentives may have worked against them. For example, it appears 
that the criteria for bonuses are too weighted towards reported 
metrics, rather than toward taking the time to understand the outcomes 
behind the statistics. What sort of message is sent to good employees 
when their ``success'' depends only on a small part of the picture of 
veterans' care?
  There should be no shortcut to quality care for veterans in 
Washington policymaking circles either. The mere replacement of a 
cabinet secretary results in neither accountability nor reform. Even 
widespread firing of SES-level government employees will not 
automatically result in providing quality care for veterans. Other 
meaningful and more comprehensive reforms are needed, and without 
delay. Earlier this year my distinguished colleague from Vermont 
Senator Sanders introduced an expansive collection of many needed 
reforms. Unfortunately, like so many bills we have tried to consider 
this year, partisan objections stalled progress based on procedural 
rather than substantive matters. Some of the same people who have been 
so critical of this administration and the VA were the same ones who 
voted to block going forward with needed reforms.
  Well, the Senate is going to get another opportunity to consider a 
comprehensive collection of reforms. It must prompt some meaningful 
bipartisan action here in the Senate. Let's not play ``gotcha.'' Let's 
play ``help you'' to the veterans. That is what we need to do. Congress 
has an obligation to consider, debate, and vote on the reforms needed 
to make our system of care for veterans both efficient and effective.
  My wife began her nursing career as a brand new registered nurse in a 
VA hospital. I know how hard she and those around her worked. They were 
veterans of a different generation, but they needed help and care just 
as much as everybody else.
  So I look forward to the Senate's consideration of the legislation 
introduced yesterday by Senator Sanders. I am proud to cosponsor it. 
Many reforms are needed within the VA, and the Ensuring Veterans Access 
to Care Act takes important steps toward achieving these changes.
  Of course, additional reforms are needed. So today I am introducing 
legislation to address one shortfall at the VA that has existed far too 
long. Current law provides a disincentive to cost-effective, onsite 
medical care solutions when operating rooms are refurbished or rebuilt 
within a VA hospital or care facility. Because the VA must report any 
major medical facility costs exceeding $10 million to Congress, the VA 
is encouraged to pay for veterans care at outside facilities, including 
travel to and from those facilities, out of the medical services 
account. It is robbing Peter to pay Paul. It is a different pot of 
money. So that way they do not have to have an extensive report. But 
the best solution for veterans and the bottom line may very well be a 
temporary onsite facility.
  The bill is simple but attempts to take the allure of a shortcut away 
by ensuring that the expenses of temporary offsite care are also 
calculated and reported.
  Senator Sanders, the chairman of the Veterans' Affairs Committee, has 
said: ``If you think it's too expensive to take care of our veterans, 
then don't send them to war.'' He is right. We paid for two unfunded 
wars on a credit card. Now it is time we invest in those who put 
themselves in harm's way to protect our security. It is time for us to 
worry about some of the things we need to do here at home. It is time.
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