[Congressional Record Volume 160, Number 120 (Tuesday, July 29, 2014)]
[Senate]
[Pages S5015-S5017]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                          Veterans Health Care

  Mr. SANDERS. Madam President, as the chairman of the Senate Committee 
on Veterans' Affairs, I rise today in strong support of the nomination 
of Robert McDonald to serve as Secretary of Veterans' Affairs.
  I also thank Majority Leader Reid for moving this important 
nomination forward as quickly as he has, and I very much hope that 
later this afternoon, with a very strong vote, the Senate will vote to 
confirm Robert McDonald as Secretary of the VA.
  Before I talk about Mr. McDonald's qualifications, I wish to take a 
moment to express my sincere thanks to GEN Eric Shinseki for his 
dedicated service to our Nation, first as a soldier and then as head of 
the VA, working tirelessly to provide for those injured during war and 
the families of those who perished on the battlefield. He set very 
ambitious goals, and under his leadership VA made significant strides 
in reducing veteran homelessness and transforming a paper-based claims 
system to one fit for the 21st century. I thank him and his family very 
much for his service.
  It is my strong belief that Robert McDonald will bring two very 
important qualities to the position of Secretary of Veterans Affairs.
  First, he is familiar with the military as well as the needs of 
veterans and their families. Mr. McDonald and his family have a history 
of service to our Nation. Mr. McDonald began his service as a cadet at 
the United States Military Academy at West Point. He graduated in 1975 
in the top 2 percent of his class with a degree in engineering and went 
on to serve as an infantry officer in the Army's 82nd Airborne, earning 
Airborne and Ranger qualifications during his military service. His 
father served in the Army Air Corps after World War II. Additionally, 
his wife's father was held as a POW after being shot down over Europe. 
Her uncle served in Vietnam and still receives care at the VA. Also, 
Mr. McDonald's nephew is currently serving and deployed with the U.S. 
Air Force. In other words, Mr. McDonald and his family have a deep 
understanding and service with the U.S. military.
  Upon hearing Mr. McDonald at the hearing we held in our committee for 
the confirmation process, I was convinced that he has a deep passion to 
do everything he can to protect our veterans.
  The other quality Mr. McDonald brings to this job is that he has been 
the CEO of one of America's leading corporations, a company which has 
tens of thousands of employees. His more than 33 years with Procter & 
Gamble gives him the tools to create a well-run and accountable VA. In 
other words, he will bring the tools of a CEO and a private corporation 
to the VA--a huge bureaucracy that needs a significant improvement in 
accountability and in management.
  As we begin debate on Mr. McDonald's nomination, I believe it is 
important that my colleagues understand the realities he will face in 
leading the VA.
  The VA operates the largest integrated health care system in the 
United States, with over 1,700 points of care which include 150 
hospitals, 820 community-based outreach clinics, and 300 vet centers. 
In fiscal year 2013 the VA provided 89.7 million outpatient visits each 
day--today, tomorrow, yesterday. The VA conducts approximately 236,000 
health care appointments. In other words, it is a huge system.
  VA's problems, which Mr. McDonald will have to address immediately, 
have been widely reported in recent months. In my view, Acting 
Secretary Sloan Gibson has done an excellent job in taking a number of 
critical steps to address the problems confronting the VA, but clearly 
there is much more to be done.
  We now know, among other issues, there is a significant shortage of 
doctors, nurses, and mental health providers within VA, as well as the 
physical space necessary to provide timely access to quality care. This 
is a major problem because at the end of the day, no matter how well 
run the VA is or any health care system is, we are not going to be able 
to provide quality, timely care unless there are the doctors, nurses, 
and other medical personnel available to do that work. As a result of 
the shortages, we know that we have tens of thousands of veterans today 
in many parts of this country on lists that are much too long in order 
to gain access to the VA. We also know that hundreds of thousands of 
veterans who have appointments scheduled are waiting too long to be 
seen and receive care.
  I think it is important that everybody recognize that as a result of 
the wars in Iraq and Afghanistan, in the last 5 years 2 million more 
veterans have come into the VA. This is on top of an aging population 
of VA patients who served in World War II, Korea, and Vietnam--patients 
who often need a whole lot of care as they age. So combine new people 
coming into the VA, often with very serious problems--including some 
500,000 veterans coming home from Iraq and Afghanistan with PTSD and 
TBI--and an aging population with difficult problems, and that is where 
we are, and those are some of the issues the VA is going to have to 
address.

  While I am on the subject, let me say that most people understand--
and that includes many of the veterans I talk to every day in Vermont, 
veterans across the country, and the national veterans organizations 
that represent millions of veterans--that once people get into the VA 
system, in general the quality of care is good. That is not just what 
veterans and their organizations say; that is what a number of 
independent studies show. Our problem right now is how to figure out a 
way that when people apply for VA health care, they get into the system 
quickly and that once they are in the system, they get the appointments 
they need in a timely manner. That is our job. It is not going to be an 
easy job, but that is the job we face.
  My hope is that tomorrow or Thursday the House and the Senate will be 
voting on a comprehensive piece of legislation authored by Congressman 
Jeff Miller, chairman of the House Veterans' Affairs Committee, and me. 
I think it is terribly important that we pass that bipartisan 
legislation with a strong vote in both Houses because

[[Page S5016]]

that legislation will give the new Secretary the tools he needs to go 
forward aggressively in addressing many of the problems facing the VA.
  I hope every Member of the House and Senate understands it is 
unacceptable that veterans in this country are on terribly long waiting 
lines and cannot get the health care they need in a timely manner.
  This legislation, which I hope will be passed this week by the House 
and the Senate, provides $10 billion for emergency health care so that 
if a veteran can't get into the VA, that veteran will be able to go to 
a private physician, a community-based health center, a military base, 
or whatever but will be able to get timely care.
  In addition, the legislation puts $5 billion into the VA so that they 
will be able to hire the doctors, the mental health counselors, nurses, 
and other medical personnel they need so that as soon as possible, when 
veterans apply for VA health care, they will get not only quality care 
but timely care.
  In addition, this legislation addresses an issue many veterans around 
the country, especially in rural areas, are worried about--that if they 
live long distances away from the VA, they will not have to travel 100 
miles to get the health care they need; that if they live 40 miles or 
more away from the VA facility, they will be able to go to a doctor of 
their choice in that community. This is an important step forward.
  This legislation will also do some terribly important work in making 
sure that widows--women who lost their husbands in battle--will be able 
to get the education they should be entitled to under the post-9/11 GI 
bill.
  This legislation deals with an issue passed by the House; that is, 
instate tuition for veterans who today may not be able to take 
advantage of the post-9/11 GI bill.
  This legislation also addresses a very serious crisis within the 
military today; that is, the issue of sexual abuse and providing women 
and men who have been abused sexually in the military with care at the 
VA.
  We are at a very important moment in terms of the Veterans' 
Administration. We will have new leadership at the VA after Mr. 
McDonald is confirmed. We have a significant piece of legislation that 
I hope and expect will be passed this week to give the new leadership 
the tools it needs to start addressing the problems facing our 
veterans.
  It seems to me that if this Nation stands for anything, it must 
protect and defend those who have protected and defended us. When 
people put their lives on the line and they come back wounded from 
war--either in body or in spirit--it seems absolutely immoral if we 
turn our backs on those men and women.
  The legislation we will pass this week begins to address those 
concerns, and I hope we will do so under the new leadership Mr. 
McDonald will provide.
  Madam President, I yield my remaining time to Senator Brown to hear 
his comments on the nomination.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. BROWN. Madam President, I applaud Senator Sanders for his work on 
the veterans conference report.
  I spoke at a breakfast today. I was with the Presiding Officer from 
North Dakota at the Air Force Caucus. As important as the Air Force is 
in North Dakota, it is equally important at Wright-Patterson Air Force 
Base in Dayton, OH--outside of Dayton.
  One of the things I talked about at this breakfast is how proud I am, 
when it looks as if the Senate does not get as much done as we would 
like, that Senator Sanders and Senator McCain--with a supporting cast 
but principally the two of them--were able to negotiate with a 
sometimes reluctant, sometimes erratic House of Representatives on some 
of these issues. They were able to negotiate a very good veterans bill 
that will primarily do three things: first, make those accountable at 
the VA actually accountable; second, take care of those veterans who 
have had to wait longer than 30 days for their care in the VA, veterans 
who have earned this care; and third, will scale up the VA--the most 
important parts--so there will be enough doctors and nurses, mental 
health therapists and occupational therapists, and enough beds and 
enough capacity at the VA centers and at the community-based outpatient 
clinics. If you are in the system, you get good care. It is just that 
too many haven't been able to get into the system, partly because when 
we went to war a decade-plus ago, the people running the administration 
in those days and the Congress said: This war will be short. We don't 
need to bother with scaling up the VA.
  That was shameful. They were dead wrong. Unfortunately, far too many 
veterans have paid the price. That is why this legislation is so 
important. The timing is perfect to get this reform at the same time 
that we have an opportunity this week to confirm Robert McDonald, a 
fellow Ohioan from Cincinnati who ran a company that had more than 
100,000 employees, one of the world's biggest, most prestigious 
consumer companies.

  He went to West Point. He served veterans before. He understands 
veterans' issues. I talked with him a number of times, as has Chairman 
Sanders, and Mr. McDonald, as the soon-to-be--I hope the new Secretary. 
I ask my colleagues to support him--new Secretary will have these new 
tools because of this conference report which I am hopeful we pass this 
week
  Mr. McDonald understands the importance of VA health care. He knows--
he said this to me in my office and a couple of other times--that the 
Veterans' Administration has a hospital system unlike any other in the 
country. It knows how to treat unique illnesses and unique injuries--
unique mostly to veterans--various kinds of brain trauma, various kinds 
of physical injuries, other kinds of treatment. That is why it makes 
sense for Mr. McDonald to be the new Secretary of the VA. That is why 
this veterans conference report is very important.
  Mr. BROWN. I yield for my distinguished friend from Georgia.
  The PRESIDING OFFICER. The Senator from Georgia.
  Mr. ISAKSON. Madam President, I ask unanimous consent to address the 
Senate for up to 5 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ISAKSON. Madam President, I want to commend Chairman Sanders for 
his leadership. Last night at 9:30 p.m., I came back to the Capitol and 
executed a conference agreement that he has worked very hard on, and 
ranking member Senator Burr worked very hard on, and pulled together 
disparate factions to address the needs of our veterans in a bill that 
is going to be a toolkit for Robert McDonald, who I hope will be 
unanimously approved as the next Secretary of the VA in the President's 
Cabinet.
  I rise to talk about Mr. McDonald, but before I do, I want to talk 
about that conference report.
  Our veterans have been abused in the last 10 to 12 years because of a 
veterans' medical service that has not performed the services they need 
to perform for our veterans in America. One of the reasons they did 
this is, Admiral Shinseki, who was the former Secretary, was actually 
insulated from a lot of the information that was going on in his own 
Department by the senior leadership at the VA who had become 
comfortable and passive and not active in terms of the operation of VA 
medical services.
  The bill we signed last night that the Senate will vote on in the 
next few days is the bill that gives Mr. McDonald and the next 
Secretary to come the tools they need to enhance the VA and to make it 
a responsive organization to the 22 million veterans, 6.5 million of 
whom use veteran medical services, and to the 774,000 veterans in my 
home State of Georgia who deserve and demand, if you will, the services 
they were promised when they went into the U.S. military.
  Bob McDonald is an outstanding American. He was president, CEO, and 
chairman of the board of one of the most respected companies in 
America, Procter & Gamble.
  He is the father of two, grandfather of two additional children. He 
is an outstanding American and his wife Diane is an outstanding lady in 
support of him and his job at Procter & Gamble. He is going to need 
that support now as he heads to the VA.
  He was a captain in the U.S. military. He graduated from West Point, 
was trained in airborne warfare, desert warfare, and subtemperature 
warfare, and he is going to need those talents at the VA in each and 
every case because it is a mess.

[[Page S5017]]

  The conference committee report we have passed gives him two tools 
that are essential. It gives him the authority to hire and fire title 
38 and title 5 employees. Title 5 employs the senior leadership and 
title 38 the next step in leadership down, which is what the VA needs. 
The VA is an organization of 340,000 people which in the last 3 years 
has averaged 3,000 disciplinary actions a year. Each of those 
disciplinary actions meant people were moved from one job to another 
within the VA and did not lose pay. There is no accountability in the 
VA and there really has not been. That is why the systemic problems on 
appointments and veterans services and everything else going on in the 
VA has not happened. By giving him the opportunity to hire and fire, he 
will have the respect and attention of those who work in the VA to 
understand full well they are going to have to carry out the game plan 
of this leader.
  He understands metrics. He understands accountability. He understands 
leadership. He has taken a job he didn't have to accept, a job he 
didn't need to have to do at this time in his life, but a job he wants 
to do to give back to the country he loves and the country he served in 
the military.
  I am confident Bob McDonald will be an outstanding Secretary of the 
Veterans' Administration, and I commend him to my fellow Senators with 
my highest recommendation in the hopes that he will be approved 
unanimously.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Louisiana.
  Mr. VITTER. Thank you, Madam President.
  I stand today also with high hopes that the new leadership at the VA 
will bring much needed changes to a department that is clearly, quite 
frankly, in a shambles, failing our Nation's veterans. During his 
committee hearing, the nominee Robert McDonald promised to bring a high 
level of accountability and transparency to the VA, two characteristics 
that are sorely needed. This is extremely important in an agency where 
under the leadership of the previous Secretary it would often take 
months to get answers to routine questions--or in many cases you would 
never get answers at all.
  By the end of this week I am also hopeful that besides confirming the 
new Secretary, we will send to the President the Veterans Access Choice 
and Accountability Act. This important legislation includes many needed 
reforms to the VA, including bringing that accountability to the 
Department and actually providing our Nation's veterans with choices 
about where they can receive care.
  The bill also, perhaps most importantly for Louisiana, finally 
authorizes much needed community-based clinics around the country, 
including two which have been long delayed in Louisiana by pure 
ineptitude and bureaucratic screw-ups at the VA--clinics and expanded 
clinics in Lafayette and Lake Charles. For 4 years I have been fighting 
the Washington bureaucracy tooth and nail to get these new expanded 
outpatient clinics. They are vitally important to Louisiana veterans 
who now sometimes have to drive up to 4 hours to receive services that 
have been promised to them much closer to their community.
  The current clinics in Acadiana are overcrowded and don't offer the 
full range of services that these new clinics will. As I said, VA 
ineptitude delayed the clinics in the first place. If it weren't for 
their mistakes, these clinics would actually already be built. When 
they were finally teed up and ready to go, then the Congressional 
Budget Office made a ridiculous decision that again threw these clinics 
into limbo because of a scoring issue out of the blue. Finally in 
December, the House was able to pass a bill that dealt with these CBO 
concerns that passed 346 to 1.
  Normally when a bill passes with that sort of margin the Senate will 
quickly pass it by unanimous consent. Unfortunately, that didn't 
happen.
  First we needed to attach an amendment to address some marginal 
concerns. Then even after we had done that--even after that received 
full agreement in the Senate, unfortunately Senate Democrats, led by 
the Chair of the Veterans' Affairs Committee, held up the legislation 
basically as a hostage to try to get a broader VA package. Actually I 
had to come down and ask unanimous consent for the House clinics 
legislation six times on the floor. Unfortunately, six times Senator 
Sanders denied that unanimous consent. It was only after the VA scandal 
broke that momentum shifted and, thankfully, it looks as though we will 
finally pass this into law, the clinics legislation, along with this 
important reform bill.
  When the authorization occurs, I strongly urge Mr. McDonald and the 
VA to streamline the process to get these two clinics built as soon as 
possible, given the long and arduous history of VA delays and screw-
ups. The veterans of Louisiana have waited patiently, literally for 
years. These clinics are overdue. Let's get on with it. Louisiana 
veterans have had to wait for numerous delays caused by VA mistakes. 
The least the Department can do is to make sure these clinics are now 
built with the utmost haste and efficiency.
  Thank you, Madam President. I yield the floor. I suggest the absence 
of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  The PRESIDING OFFICER. The Senator from Kansas.
  Mr. MORAN. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. MORAN. Madam President, I ask unanimous consent to address the 
Senate for approximately 4 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.