[Congressional Record (Bound Edition), Volume 160 (2014), Part 7]
[Senate]
[Pages 9885-9887]
[From the U.S. Government Publishing Office, www.gpo.gov]




                          VETERANS HEALTH CARE

  Mr. WHITEHOUSE. Mr. President, I very much appreciate the efforts of

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Senator McCain and Senator Sanders to get the VA health care bill 
through the Senate. However, I was somewhat disappointed with how 
abrupt and abbreviated the amendment process was; to wit, there was 
none. As a result, I think some very good amendments never had a chance 
to be considered. One of those amendments was mine, and I would like to 
discuss it briefly because I think it is something the Senate should 
pursue.
  I will note that everybody I spoke to about it--Republicans and 
Democrats alike--liked the amendment and thought it made sense. So I 
will describe it.
  A little background: Some time ago, as we entered the computer age, 
we figured out that there were better ways to maintain health records 
than in cardboard file folders stuffed away in file drawers. One of the 
leaders in solving that problem--lost information buried in file 
folders--was the Veterans' Administration. They developed one of the 
best electronic health records in the country. For years they were 
leaders in the technology of electronic health records. To this day, 
the VA electronic health record system is one of which they can be 
proud.
  It has one flaw, and that flaw is that it is limited to Veterans' 
Administration medical facilities and Veterans' Administration medical 
providers. If a veteran in Rhode Island is walking through Providence 
and trying to cross the plaza in Kennedy Square and gets hit by a 
vehicle and rushed to the Rhode Island Hospital emergency room, the 
Rhode Island Hospital emergency room has no access to that veteran's 
electronic health record.
  At the same time a number of States have really stepped up not only 
to have electronic health records but to have a hub that exchanges the 
information in an electronic health record. So when you go to get an 
MRI or go to see a specialist or are taken to an emergency room or have 
a lab test, the results of that encounter are loaded automatically into 
your electronic health record. That can only work if you have the whole 
system pulling together, and some States are doing that.
  Now you have the difficult situation where there are States that are 
building an information network for health records and the Veterans' 
Administration, which has one of the best electronic health records in 
the country, is not participating in that local effort to tie the 
medical system together for the benefit of local folks. That is an 
oversight that needs to be corrected, and my amendment would encourage 
and support the Veterans' Administration in taking its electronic 
health records and connecting them to the information exchanges that 
are growing.
  In Rhode Island it is called Current Care. It is run by the Rhode 
Island Quality Institute. It does a phenomenal job. We are reaching out 
to veterans to do it voluntarily, but it has been a real chore to work 
with the Veterans' Administration to move this along. It has taken an 
enormous amount of time despite the goodwill of the people involved. 
There has not been much in the way of resources available. We have had 
to go to private and nonprofit and charitable sources to try to fund 
this. That doesn't make sense.
  This bill is particularly important--where we are providing more out-
of-network access for veterans and more ability for veterans to go to 
doctors that will not be in the electronic health network record--
because it would allow the very good electronic health record of the 
Veterans' Administration to connect with these emerging electronic 
health records information networks. It is simply leaving veterans 
behind to leave them out under these circumstances.
  I hope I will have a chance to move this legislation on some other 
vehicle, but I have to say, as important as this bill was, it was 
disappointing that a piece of legislation as simple as mine--an 
amendment that would have enjoyed extraordinary bipartisan support and 
probably would have been agreed to on a voice vote--never had a chance 
to see the light of day because, as I said, of the abbreviation and 
abruptness, to put it mildly, of the amendment process.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Whitehouse). The Senator from Connecticut.
  Mr. BLUMENTHAL. Mr. President, I wish to begin by thanking a number 
of my colleagues, most especially our good friends who are very active 
Members of this body, Senators Sanders and McCain, for acting in a very 
bipartisan and courageous way to enable us to reach a compromise and 
vote on a truly historic step forward--as we did recently--to begin to 
bring an end to this crisis in our health care system and the VA.
  I also thank my colleague from Rhode Island for his amendment, and I 
hope it has some support in some form--as it and other amendments 
deserve as well--because as commendable as the bill is, it certainly 
does not solve all of the problems in the VA health care system, let 
alone the VA.
  Let's recognize that the disability claims backlog persists. The 
bureaucratic rigmarole and sclerotic bureaucracy of the VA in many 
parts of the country continue to plague our veterans, and we need to 
recognize that top to bottom the VA needs an overhaul in its culture as 
well as its management. But this bill represents a good faith and 
effective way to respond initially--the beginning of a solution to a 
health care crisis that is decades long in the building. The delays in 
the VA health care system are well known and longstanding.
  I spend a lot of time, as a member of the Veterans' Affairs Committee 
as well the Armed Services Committee, listening to veterans. I have a 
veterans advisory council that gives me extraordinarily insightful and 
important advice. I make a point of visiting the VA health care 
facilities all around Connecticut, and I spend a lot of time in places 
where veterans gather, such as the Veterans of Foreign Wars, the 
American Legion, and others. Listening to them is a major source of 
information for me in forming my judgment about what should be done 
with the VA health care system. What I hear from them--most commonly--
is that the health care is good, but it takes too long to get it. The 
doctors, nurses, and health care providers do very good work, but it 
takes too long to see them. The delays are what our veterans find most 
troubling about this system.
  What we have seen--disclosed first by CNN and then by others--is not 
only delays but false record keeping to disguise those delays and 
falsification of documents and lists to hide a failure to meet 
deadlines--in fact, to provide timely care. That kind of falsification 
of records and destruction of documents, and, in effect, cooking the 
books and then covering it up goes beyond simply delaying health care. 
It is, in effect, a form of fraud. We have taken a first step here to 
meet the immediate needs and help end the delays.
  This bill will enable veterans to seek private health care at private 
facilities or private clinics or private hospitals if they have to wait 
too long or live too far away to make use of the VA facility.
  It also increases resources--a longer-term effort to provide more 
doctors and fill the 400 vacancies that exist right now. Those 
resources are vitally necessary, not only to provide more providers but 
also to rebuild, renovate, and construct new health care facilities.
  In providing more resources, this bill will also aid 26 VA 
facilities, such as the Errera clinic and facility in West Haven.
  It also imposes accountability. It makes sure that officials in the 
VA who are incompetent or corrupt can be fired more easily and that 
bonuses or promotions can be stopped for those officials who betrayed a 
trust. It also shows that what is necessary here is more money and 
better management--not one or the other. Both together are necessary to 
really serve our veterans with the health care they deserve, which is 
first class, world class health care and nothing less. That is what our 
Nation's heroes truly deserve, and more and more of them will be making 
use of that health care--2 million more over the past 5 years and 
millions more over the next 5 years. That burden is not something to be 
addressed at the

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margins. It has to be addressed head-on and fully and generously 
because that is the promise we made to our veterans--first class, world 
class health care, and nothing less.
  I will close by saying that accountability means something more than 
just firing corrupt or incompetent officials. It means holding them 
responsible for criminal culpability when they cook the books, falsify 
records, make false statements, and in effect lie to the American 
people as well as to their superiors in the VA. That will require a 
criminal investigation by the Department of Justice, which is the only 
law enforcement agency that has the resources, expertise, and authority 
to conduct a prompt and effective criminal investigation on the scope 
and scale that is required.
  There are more than 50 locations where evidence of criminal 
culpability has been found. Thirteen percent of VA schedulers have 
indicated to the auditors that they were coerced or threatened into 
adopting, in effect, improper practices. Another 8 percent kept secret 
or unofficial lists, and many at those facilities and others may have 
cooked the books. I am not jumping to conclusions. I am not rushing to 
judgment. That is why an investigation is necessary and appropriate.
  Only the Department of Justice can convene a grand jury. Only the 
Department of Justice has the FBI resources. The VA inspector general 
has 165 investigators for the whole country, and that is not enough. 
That is simply not sufficient for this investigation.
  The VA is overwhelmed and overworked in its health care facilities, 
caseloads, and the needs that VA clients and patients are bringing to 
these facilities. The VA does some things very well when it comes to 
amputees, post-traumatic stress, traumatic brain injury, and many kinds 
of injuries associated with the battlefield. Combat medicine is more 
advanced than it has ever been before, and the VA is part of a very 
progressive effort to increase and to deliver health care more 
efficiently to that population.
  But the population of veterans who have fought in the longest wars in 
our history--although they may be a smaller part of our population than 
ever before in our wars--has been through multiple deployments, and 
they deserve the kind of intensive and comprehensive health care that 
the VA has committed to provide, and that will take more resources.
  This bill is a beginning. It is only a downpayment on what we owe our 
Nation's finest and bravest. We owe them the best that we can provide 
in health care and nothing less. That is part of what we promised, and 
that promise must be fulfilled. Thanks to the action of this body today 
we have begun on that path.
  I urge the House of Representatives to adopt this measure and to help 
us fulfill that promise. I hope they will do it soon.
  Thank you, Mr. President.
  I yield the floor, and I suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Heinrich). The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. REID. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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