Good afternoon, ladies and gentlemen. I know its a purposeful gavel, wasnt it. Welcome to the National Press club. We have the trademark motto this worlds leading professional organization for journalists. Im jeff would baobab ballu. Candidate we are pleased to have as our headliners speaker, dr. David j. Shulkin. First of all, id like to ask you to please turn your mobile devices to vibrate. Why vibrate instead of off . Because we do encourage you tweet the modings and questions to press club using the npc live. Thats press club dc, using the hash hash npc live. Now well introduce or head table. And blows hold your applause until everyone has been introduced. The head table is usually reserved for members of the club, our guests, and guests of our headliners speaker. So, going from my far left, mike smith, ceo of green smith pr, the National Press club Headliners Team member. Jim noon. Vietnam navy veteran and commander of the American Legion post here at the National Press club, which is founded by general pershing. Myron belkin. The 107th pratt, vietnam veteran as well. The honorable john elliott, who ive been chasing around capitol hill in all kinds of places for almost 2025 years, too many years. John is the assistant secretary for mcand Intergovernmental Affairs at the United States department of Veterans Affairs. And catlyn kenny, producer at crabs radios connecting vets. Com. Thomas murphy, acting undersecretary for benefits at the u. S. Department of Veterans Affairs. Kevin wenting, mans book moore luncheons than i care to count. Captain, u. S. Navy, retired, and the National Press club headliners member who coordinated todays luncheon. Thank you. Were skipping over the speaker. You sever morton, Washington Bureau chief for the omaha world herald and a former member of the National Press christian board of governores. Writing simpson, chief of staff at the United States department of Veterans Affairs. Luke knitting, lieutenant colonel, u. S. Army retired and global war on terrorism veteran. Longtime member, John Sergeant shasbel, United States marine corps, vietnam veteran, president of the blind American Veterans foundation. Youve been a member for over 30 years, right, john . Sean buncher, Communications Manager at dave abled force u. S. A. [applause] like to acknowledge additional members of the headlinerred team for organizing the event. Betsy Fisher Martin and lisa matthews, our cochairs, jamie horowitz, lisa russo, kevin, away turner, and our press club staff, specifically lindsey underwood, laura coker and our executive direct york, william mccarran. So, secretary excuse me and radio audiences, please be aware that in the audience today are members of the general public, so any applause or reaction you may hear is not necessarily from the working press. Dr. Shulkin was nominate bid President Donald Trump to serve as the ninth Veterans Affairs or va secretary as commonly called and confirmed by the United States senate in february. Prior to his role as secretary, dr. Shulkin whats vas undersoutheast foreign actors health, 18 months, leading the nations largest integrated Health Care System with more than 1700 sites of care serving nine million veterans. Before he began his service with the va, dr. Shulkin held numerous chief executive roles at the morris town medical center, the Atlantic Health sncc, the Accountable Care organization, the Beth Israel Medical Center in yucker, held numerous physician leadership roles including chief medical officer at the university of pennsylvania health. And a fellow pennsylvanian. Always acknowledged that. Temple university hospital, Medical College of pennsylvania and held check positions include chairman of medicine at the Drexel University school of medicine. A boardcertified internist, dr. Shulkin is a fellow of the American College of physicians. And has been named one of the 50 most influential physician executives of the country and month the 100 most influence people in American Health care by modern health care with look forward to our dialogue today on the vas efforts to care for millions of American Veterans and improve the effectiveness of the va Health Care System. So, please give a warm National Press club welcome to secretary david shulkin. [applause] well, good afternoon, everybody. Its great to be here. And couldnt think of a better time to spend with you than five days before veterans day. Saturday i hope all of you are have that marked down and are planning on doing something meaningful on saturday. We have been celebrating veterans day really for 98 years. First as Armistice Day when world war i ended and then 54 years ago, changed to veterans day, and some of you may have seen before the president left for this trip to asia, that he signed a proclamation to claire the entire emergency of november veterans and military families month, which really i think is indicative of his real passion and respect for the countrys veterans, and so each day of this month, we have some Something Special going to be announced or an activity going to happen, today were here with you. That counts. But youll see things like for the first time a National Turn card for veterans being rolled out. Youll see the president S White House hotline, the 24 7 hotline answered by veterans and military families that will be rolled out in the month of november, and expansion of a new imagine cemetery in los angeles. Tomorrow will be ringing the bell on wall street in honor of veterans for the close. A Public Service announcement that is going out across the country this month, narrated by tom hanks, on reducing veteran suicide. And so the month is filled with a lot of recognitions and important events, but it really is a symbol, think, of the progress that were making in the transformation and modernization of the department, and as you know, in this during this year we have seen some pretty important changes happen at the va. We have had five major bills go through congress, particularly proud that everything that were doing through congress is being done in a bipartisan way, with a real clear alignment between where congress, the department, and the president wants to take the department of veteran affairs. So we have had for the first time a new bill with authorities for accountability, we have seen an expansion of the g. I. Bill, called the forever g. I. Bill. We have seen two bills not only expanding options for care in the community but also investments in the va with 28 new leases, and we have seen appeals modernization, which a has not happened since then 1930s. So a lot of activity. Were also seeing progress on the five priorities i have stated are most important to me as secretary. Giving veterans more choice about how and where they get their care and benefits and that creates a system that really allows us to be more responsive and accountable to veterans as customer. We have seen progress in the timeliness of services, in our wait times, that now are publicly posted for everybody to see how long it takes to get appointments. We still are the only Health System in the country that publicly posts its weight times. And its wait times and we though the va does better than the private sector wait times. Member thats why they dont post their wait times. Were improving performance in disable timeliness and will be making progress on the timeliness of appeals. Were modernizing the va. A new Electronic Medical record, the same one that they department of defense use and also announced well be disposing of 1100 vacant and underutilized facility us the fourth priority is to focus more on the thing that matter most to veterans, what can he call foundational services. Conditions that veterans are. Pacted on in their connection to service, like spinal cord injury, blind rehabilitation, prosthetics and orthotics, posttraumatic stress disorder, poly trauma, traumatic brain injury, thing that matter mores. Youll see the va investing more in those services and commodity in services that can be accessed easily any private sector. Last and the only clinical priority of the five isss prevention. 20 veterans a take taking their life unacceptable. That that is still happening and we are focusing our efforts, working in lots of ways that we havent focused on before to try to get that number down, and down significantly. So, those are the areas that were working on. Disclaimer and im going to start by saying that i am far from an expert in the issue of benefits. I consider myself a healthcare expert as a practicing physician. I know a lot about health care, not as much about benefits. Im trying to learn every day more and want to thank you for being patient with me and also teaching me. Ive learned a lot since i became secretary, and i just want to say that whenever i approach an issue that i dont really know a lot about, i have to go back and understand how we got to where we got. Im going to do is give you a lesson in history about benefits just because i had to do this for myself and this will lead towards understandin understande history my thoughts about where we go from here and put those future opportunities are. When i started learning about benefits for veterans i went back to the time of the romans. The first time i could find the American History on supporting veterans was in 1636. Thats when the pilgrims of Plymouth Colony passed a law and stated the disabled soldiers would be supported by the colony. Virginia was the first colony of followed the law 1644 and maryland fle followed virginia n 1661. Next, 1776 the Continental Congress provided pensions to disabled soldiers but at that time, paper money was worthless so they really went destitute and had worthless paper. In 1778 this time the officers were offered half of the pay for life during peacetime the treasury didnt have any money. In 1818 president james munro introduced the First Pension benefit it was 20 a month for enlisted soldiers. Congress calculated this must have been a cbo that the total cost of 500,000 expecting very few people would actually applied at the cost turned out to be much higher six times as many veterans applied for the benefit that they had expected so in 1820, two years Later Congress had to amend the law to include only those. In 1829, president jackson tried tto increased attention to the congress defeated and said they were not going to go along with it. But due to the previous tension and concern for the escalating cost in 1834, Congress Held a hearing before the committee. You can see we still hold to some of these traditions and found that there were 32,900 men who were still receiving pensions from the revolutionary war 50 years earlier. So they concluded it was filled with fraud and abuse in the system but that didnt stop congress. A few years later in 1836, the expanded attention this time for the widows of soldiers. The first home for veterans in the United States, so this is the first time the government went out and started building places where veterans could go. In 1834 it began to accept its first navy sailors and that building still stands today in philadelphia although a new naval building was built in gulfport mississippi. March 31865 president lincoln a month before the end of the civil war signed the law establishing a National Soldier and sailors asylum. The next day on the second inaugural address that is where lincoln committed the nation that we stole as the motto. That is something that today we still talk about. So you were offered 75 for a lost leg, 50 for a lost arm or if you decide not to take the payment if he would forgo it would be given an artificial limb from the government every three years they replace it for you for life. In 1866, this is the year the oe veteran Service Organizations were formed with the sole purpose may be like today to lobby the congress for more help for veterans and to build more homes. As the grand army of the republic and you still find those initials on a lot of the tombstones in National Cemeteries today. Now, right around 66 that is when morphine was developed, as was the hypodermic needles that you begin to see the rise for drug abuse among the veterans. They were not viewed as being related to conflict of the war that they were seen as criminals or week and they were completely shunned by society and often their families. In 1878, the treasury secretary estimated that the claims for veterans has reached 150 million president Rutherford Hayes at that time expanded benefits by signing the act which extended disability claims become five years. After the act by 1980. It is the single item in the budget as cleveland signed 1,453 o1,453at the shuttle veteran bi. So he was the most prolific in terms of expanding benefits. In 1887, so just two years later, cleveland actually be towed the bill to grant benefits to disabled veterans regardless of whether they were serviceconnected doorknob so he vetoed it and this was thought to be a major reason he was defeated for reelection next year. So even though he signed the 1400 bills, his unwillingness to support the one bill was thought to be the end of his political career. Congress passed that bill, the dependent pension act. In 1907 and 1912, congress graduated payment and continued to increase them. Congress established the new civility system with the implication rehabilitation for disabled veterans. It occurred in 1921 when the congress combined everything to create the Veterans Bureau. The budget of the bureau at the time was 477 million dot kernel was put in charge of the bureau in 1922, and he started to set out construction of the va hospitals across the country goes the world war i vets were coming back with tuberculosis and psychiatric issues are quite significant. I dont know how many of you know that Charles Forbes but things didnt end too well with him, he ended up arrested and going to jail for having stolen a lot of the money that was supposed to go to construct the va hospitals. The second time the veterans programs got consolidated was on july 211930, when president hoover elevated the Veterans Bureau to the veterans administration, what we call it today. In 1931, president hoover vetoed the compensation act which had borrowed up to 50 of their Life Insurance value and congress of course overrode president hoover and they took advantage of borrowing on the light incher ends. To demand the payment of a bonus that was promised on them and was never paid. They called themselves the Bonus Expeditionary force. And the marchers protested all through the white house and capitol and other federal buildings until president hoover to send the troops for the campsite the we were all living along the river. It included in the fin trade towel for me by a majo nature ge patton and army chief of staff Douglas Macarthur had the command. The bonus marchers and wives and children were driven out into the belongings were burned. Two veterans were shot and killed by police for resisting that type of eviction. The bonus army turned out to be a disaster and was one of the main reasons why they thought that he lost his 1932 election. We were in the great depression. Again, congress overturn the veto and above disabled veterans act of 1943 was passed for the veterans of the service can do disabilities and more than 68,000 veterans in world war ii benefited from that. The g. I. Bill was signed june 22, 1944 and represented a major advancement in the Veterans Benefits. They took advantage of the education benefits and a cost of 14. 5 billion. The Family Residences in the United States between 1944 and 1993. Part of the motivation of why he does g. I. Bill passed was still that fear of what happened with the bonus army after world war i. They didnt want to see that repeated in world war ii. The bill and the readjustment act of 1952 was put into place to help those that were newly discharged particularly coming home from the war. All of you have heard of general omar bradley, the secretary picture hangs in my office to this day. They brought him back in 19569 years after being the head of the va to chair the committee and the pensions. What he said at the time is the present structure of the veterans programs is not a system. It is an increase in the law based on precedents built up over 150 years of piecemeal development. So the commission he chaired a sad the practice of assisting the veteran and the immediate readjustment for life would be most effective. A veteran should receive help when he needs it the most seamless advocating a different approach towards looking at the benefits instead of it being piecemeal to help people in their transition. At that time veterans were 45 . Lets fastforward to 2007. The Dole Shalala Commission they found that there was no clear National Policy of the Veterans Benefits and recommended to the congress a complete restructuring of the disability systems to achieve the following objectives, to clarify the disability systems have to creatand to createa single compl exam to restructure the disability system to determine the appropriate length and amount of transition payments to update the disability schedules and to develop flexibility within the rehab and educational programs. So, looking back over these 150 years at least we can do the coe following conclusions after sort of immersing myself in this history that the country is never really fully prepared for the impacting returning veterans and they always seemed to be surprised. The changes in the benefits weve seen over the 150 years are always contentious and related to the Economic Conditions of the country whether we expanded them more essentially have to renege on their commitment to the veterans. And they tend to have no real rationale for why they happen. And thinking about this with a systems approach. Some of the disability payments look like they require the veteran to remain disabled and they create disincentives to the recovery. Why the other benefits and enablers help people restore the functioning independence. The system it appears puts in an adversarial relationship with veterans where they have to come to us and ask if we are trying to help them with some of our benefits and glass i would say the cost projections always fall short on the actual cost of the programs they always tend to be more than what is initially thought. It is filled with red tape and uncertainty and difficulty in navigating. The compensation and the exams as we call them our examinations that the doctors use equipment weve never heard of and are based in the rule rules into sys that are outdated. We have a system of the ratings that constantly need to go back and look for adjustments. It is difficult often to distinguish the Service Related disabilities from agerelated disabilities. And we have built into systems to maximize getting more disabled. There are some parts if you are not above the 50 Service Connected, you will not be able to access other benefits. Before 2004, military veterans couldnt receive Retirement Benefits and disability compensation but with 59,000 590 receivin59,000receiving the cond payments of the retirement va disability compensation, social security, Disability Insurance and just for the 59,000 totaled more than 3 billion. In the past 20 years, we have seen a dramatic increase in the average degree of disability. How severe the disabilities are. And it stayed almost flat for the previous 45 years at about a 30 disability. That would be the average interstate flat until about 1995 and since then it has increased by two thirds from 30 in 1995 to over 50 this year. We see veterans coming back for more and more decisions and filing disability claims. Ed 1 of the veterans who filed supplemental claims are receiving already monetary compensation from the veterans. 48 filing claims are already rated at 50 or higher. 10 of those file are already at 100 disability rating in the flailing. In 1999, just to give you a sense about what is happening in the disability system, 10 of the veterans have disability for ringing in the ears. By 2016, from 1999 to 2016, the rate of ptsd had doubled across the country and now over 50 of new claims filed so it was 10 and now it is about 50 . It accounts for 24 of all disability payouts about 15 billion a year. We have nearly 900,000 veterans receiving payment averaging a yearly 17,000 a year. The next most costly disability is sleep apnea and 3 billion. Heart disease followed by depression, hearing loss and the diabetes. Mandatory benefits have really been growing in recent years. Years. Thin 1980 was 13. 7 million. In 2017 is 95. 3 billion, huge increase. The biggest causes in 2005 we had the presumptions for exposure to diabetes and several positions that have adjusted payments. In 2011 we had three presumptive for agent orange. We had an average degree of the disability increase that we talked about up to and about 50 now and we have seen a large number of new veterans filing because they are dissatisfied with the current rating system. The administrative costs have increased dramatically from 1 billion in 2000 to nearly 5 billion now in the administrative claims. Our contract medical exams are about 20 of the discretionary budget. But when you think about the benefits program to the most successful programs i believe are those that are enabling veterans to have meaningful lives and have independence and security. So, when you think about those that have been the most successful, i think of the g. I. Bill of the vocational rehab program, the support for those that are severely disabled, the group Life Insurance programs. So, what should a benefit programs to . In my opinion i would suggest they should be providing Financial Security for those that are severely disabled. They should be providing mental and physical wellbeing to the veterans helping them with Economic Opportunities and pursuing their professional and Career Development and reintegration into the civilian community as was suggested by omar bradley and the dole shelley of the commission. With those four names in mind here are some things we should consider in the future policy. We have to make simpler benefits to serve the nations. We are spending too much on administrative costs and we have to let the veterans know what they can expect. They shouldnt have to be constantly reviling the claims to get what they deserve. We have to emphasize Service Connection for disability so we are not compensating veterans for agerelated issues. We have to focus benefits on enabling independence so the veterans can succeed on their own, because that is what i think leads to feeling a sense of wellbeing. The need for there to be continued support for things that are truly dependent to the veterans of the Service Connected disabilities making it impossible to get by without the assistance, the country has to always uphold that so much what some of these new benefits Solutions Look Like when we think about the benefits defined . Are already beginning to see the va provide some of those solutions. Under tod murphys leadership we are now introducing this discharge determination. When you leave service, getting the decision on the day we are working towards the day that we can do the instant education just like you can get a credit score on your phone or computer and see whether you are approved for a new credit card, and adjudications where people get decisions. I think we need more incentives for achieving wellness and independence. This should be a system that focuses on the veterans abilities, not on their disabilities. And i believe that the va needs to transform into an organization where we are veterans advocates and we facilitate them getting benefits, not being the gatekeeper of the benefits decisions. So, today here at the National Press club, i call for a new way of thinking about benefits. I want to see an ongoing dialogue with stakeholders about rationalizing the Veterans Benefits. Veterans benefits Advisory Board thabenefit Advisory Boardthat ct we are trying to do for veterans and what is best and how he can do that in the best way. I think as history has shown me, policymakers havent fought strategically about the Veterans Benefits over these past 150 years they just keep piling on the benefits without a clear objective in mind other than patriotic gratitude and political expedient sometimes more of the latter than the former. The original g. I. Bill might be the exception. It started in the veterans Service Organizations who were looking ahead to the end of the war with clear but limited aim of getting returned benefits back into the civilian life and that is the kind of thinking we need to do again and i look forward to having that discussion with the veterans benefit Advisory Board. Let me be clear this isnt about taking away the benefits for veterans. This is about making them work better for veterans and transforming the department of veteran affairs to do better for the years and generations for future veterans. I think they deserve no less than that. Thank you very much. [applause] now the questions are starting to fly forward. Theres a lot of different questions that have come up during the luncheon. We are going to start with headlines actually. As we know we are barely 24 hours after the mass shooting at the First Baptist church in texas. The shooter was a veteran and also was discovered in his history to have a bad conduct discharge with Domestic Abuse and somehow he got his hands on a dime an gun and committed to s awful tragedy. We have the governor of texas and the president of the United States sort of issue from the hip proclamations that this is a Mental Health matter. As a medical professional, the sound thing to do to come from government and the really dont know what is going on especially now that the shooter is deceased. Second, does this cause you to sort of look at the notion of what benefits should go away depending on what kind of a discharge a veteran receives not just here but the attorney argued for him to not have a disHonorable Discharge because that would take benefits away because of what happened to him during captivity. Can you just address this since we are talking about benefits . I think that it should go without saying that this is a very sad situation and a tragedy not only for the families and the talent but for the country. In my opinion i do not consider him a veteran. That would give more respect than he deserves. He is a criminal and i think that he was convicted with a disHonorable Discharge does not deserve to have the same title as the men and women who served this country and have honorably been discharged. There is a distinction between those that have received and other than Honorable Discharge and those that have received a disHonorable Discharge. Weve distinguish between the two. They are in need of the assistance to help with Mental Illness and i have as secretary authorized the positions of the emergency Mental Health servic services. They violated the law and the morals of ethics and i do not believe deserve the type of services and benefits and va wouldnt be providing those benefits. This isnt a person thats ever been treated in the va system and wouldnt be eligible for those benefits. Its sad. I dont think we know enough about his state of mind to give him a diagnosis. In this world there are people that are evil and there are people that are criminal, and you cannot alway do not always e reason why the i certainly believe that he was an evil person. Person. What about in the case of the former sergeant because of what happened in captivity in the circumstances . He is a person that has received a bad conduct discharge and we wouldnt recognize him as having the ability to receive benefits and va. I do not believe he honors those that served and wore the uniform proudly. It doesnt mean as a physician and as a compassionate person that i do not, i certainly want them to get the help he needs and believe he should have access to treatment, but they by wouldnt be in the system supported by the department of Veterans Affairs. So the system should change. I think the system does need to change in recognizing many of those that have other than Honorable Discharge not bad conduct discharge our very because of a need for Mental Health services and behavioral issues and i do believe the system needs to change to begin to start providing the services to them. I believe that there is a very small segment to the individuals we are talking about today that have violated basic legal, moral and ethical behaviors that we do not have the same rights to them. They have other systems that i believe they could get the help they needed, whether they are prison systems were other communitybased systems, but not the department of Veterans Affairs. Recently they unearthed in all these places that were concealed and unauthorized and a number of veterans were basically are you aware and confident that these issues are not resolved . We had a lot of talk about trying to reduce the backlog and wait lists. Are you confident that this effort to drill down as result or do you have a long way to go . It looks like they are our problems and we were not thinking about the wait times in the way we think about them today which is in a clinical lens which veterans need urgent care now which is the way we do it so we have come a tremendous way that lets put the situation in context we have over 350,000 employees in the department of Veterans Affairs. We are the largest system in the country. We are talking about two employees that scheduled and didnt follow the proper procedures. To label the entire department as having a systemic issue. They no longer work for the department of Veterans Affairs and they were discovered and actually found by the omaha va facility. They were monitoring their own policies and procedures, identified the employeeidentifyt were not following the procedures, took appropriate accountability actions and then read trained all their staff to make sure they were following the procedures. We have 30,000 people who schedule appointments in the va and they are often four and five employees. Of coursand for use. Of course we always have to be vigilant for monitoring the systems and training and improving but this doesnt necessarily represent that its falling back. We still have a way to go and we will stick at this until we get better and better each day i think we are getting better. One aspect of that is whistleblowers and theres still a lot of colleagues that have reported the whistleblowers still feel retaliation is an issue which would go back to dealing with issues like secretly twists and things of that nature. What reforms are you implementing to make sure the system becomes better . One of the First Executive orders i asked him to support this can allow me to establish the office of the whistleblower protection accountability reporting directly to me. Today we stood up and we have whistleblowers themselves like Brandon Coleman who was at this and exposing the problems in 2014 in phoenix. So, we are taking seriously the whistleblower protection and the accountability law gives protections and we are not only a taking them seriously but making sure retaliation doesnt occur. People are claiming that they win and that is not an appropriate definition. Its not acceptable to be a whistleblower when its your job to do the job and you are falling short and rather than be held accountable you declare yourself a whistleblower. We are going through a concise accelerated course on how you change the culture to allow people who are identifying the issues and declaring themselves whistleblowers appropriately to get the information so we can act on it but also to hold people and managers accountable for what their jobs are and not be able to just claim whistleblower status. Without the true accountability is going to be a learning curve and we are going to have some ups and downs as we go through the process but thats why the Office Reports directly to be and it is part of my job as the secretary to define what that culture is into transform the organization. You touched on opioids as a massive problem. In the country in particular since you specified the history within and among veterans with specific analogy to the declaration has been made by the president , what are the next steps that your office is going to get their recommendations up and running and to try to get back devito at reducing the crisis as it relates to the nations veterans . Like many of the problems is the va system sees and recognizes these issues first. We have identified hepatitis e. But this is a publichealth pubh crisis and the Opioid Crisis was no different. They recognized this as a Major National problem in 2010 when nobody else was talking about the opioid addiction we initiated a Safety Initiative and since then we brought that use down by 36 across the country. I was at a facility last week in pennsylvania where the raid on twave is 4 , the National Average is around 12 so we have sites like coatesville and Cleveland Ohio where the rates are down at very low levels. We have an acronym into this one shows others in American Health care how to effectively begin to address this i and it says on te website but we not only will continue to work on what we know works which are best practices in healthcare but having participated in the opioid reduction committee, the president S Committee Chair by governor christie of new jersey. It allowed me to refocus the Organization Efforts to double down on what is working to go out there and talk about this more and destigmatize the issue of Substance Abuse and Mental Health to be able to help people talk about it and family members to ask for help on the veterans so they are focusing the efforts and it is important to the president you know he shared about his own Family History of addiction and this has allowed us i think i can to acceleratee progress and keep focus on this very important issue. Thereve been several questions received on the issue was agent orange and benefits. Where does the review stand, and are you ready to make the announcement on whether or not a policy has been revised in terms of allowing more elements to expand the list of what qualifies the benefit for the va covering related agent orange . Im glad to clarify the situation since it may be a little bit murky. The va has undergone extensive study of the issue of agent orange and its relationship. We added more presumptive sin 2011 and weve been studying initial conditions. That report was handed to the va back in early 2016 and was required to give a report within 60 days within the data coming back and. This is an example they are not performing at an acceptable level. It has been decision i would not delay that any further as the secretary i would make a decision by november 12017. I can assure you people who know me understand im not usually a gray person, ive made the decisions to pass that on in the process that we follow in the federal government so that it can go to the appropriate parties that have to take the decisions i made and put a financial figure and go through the vehicle ramifications of the decision and then that will be put into the rulemaking process and that is what is happening. I am not announcing what the decisions ive made our other than i have made those decisions and pass them on along the process. So it should be in a few short months before the rulemaking process and that is part of not allowing things to sit in the va. Its to do what is right for the veterans and not honor the process that is used. The process that has been used by previous secretaries and administrations and thats the reason. Its not because i dont know what the right answer is, its because i want to get to the right outcome for veterans. Two months, three months . I usually announce the date exactly when we will be announcing things. I wish i had a date since i do not control this proces that prt have a specific date. I asked for one and hopefully will get one soon but it is a matter of a few months and not anything longer than that. You talked about in the Financial Management how the benefits have ballooned in terms of the budget. The fiscal management improved in your view in the number of arenas and Veterans Affairs. No we had great difficulty in doing financial projections so that we could understand our needs and also how we can provide services and we had a great deal of problems on delivering projects on time and on budget. Many have decided not want to deflect the responsibility and accountability that we have. We clearly owning one of those issues, but much of this when i look at this from privatesector background where as a chief executive i have to be accountable for Financial Decisions and financial protections much in the difficulty have to do with the complexity of the law that we are given by congress, so i will give you an example. We have been very challenged multiple times and projecting the choice fund and, which is to care and community funding. If you had to run a program that was in seven different silos and Checking Accounts and you have to use the following rules, you cant reword your checks and Checking Account when you spend the money. You have to guess at the time when you are thinking about a decision what it is going to cost. So, we have to report our obligations at the time that we spend a fair amount for care. We havwe have two guests are thy going to see the doctor one time, ten times, 15 times and require surgery homecare, so the financial projections when you are asked to be looking through a crystal ball is something ive never experienced in the private sector, nor would i ever recommended to anybody that wanted to run a fiscally sound organization so we are working with congress and the committees in the senate and the house to come up with financial rules that will serve the American Public and veterans better that are predictable come easier to use and manage and let us be accountable for the rational system rather than what we have now which is a system that is completely irrational. Before we get to the last question and before we have to give you what he did al we givee headliners, the Traditional Press club bug. Is of course is it worth less than 20. And upcoming attractions this week we will be talking about the book bobby kennedy. We also have the former dnc chair coming through on decemb december 12. I think that is the eagles all the way. [applause] go to www. Press. Org. We are assured. [inaudible conversations] im kind of concerned about the Foreign Policy we had a change in the administration and it is a little different than its been in the last year were eight years, so hopefully we can continue to go smoothly. Its been a little rocky at the start that cspan is what helps me keep up to date on this. I am concerned about Womens Health care. It seems like it is always under attack. My issue with what missouri needs as we need good paying jobs we have a project called homeless connect and several other different significant events in the community and that can be done statewide on every community. I think that it would make the state may be one of the models for the nation and i would love to see that. My issue is we need more leaders in the world war ii era. Im a little on the edge on bass and i just thought ive been listening to Winston Churchill in the museum over to fulton. They just did some wonderful things. Georgetown University Institute of politics and Public Service discuss the legacy of the former president bill clinton. This included a panel with former clinton officials including chicago mayor rahm emanuel talking about domestic policy. This is just over an hour. Welcome back. I am the executive director of the institute of politics and Public Service here at Georgetown School of public policy
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