The hearing today, what does it deal with . Guest something called the commission on care. Something that was part of the choice act. When Congress Asked the robert to carve out six 2 60 of our budget million of our budget. Time, they came up with 18 recommendations. Of the 18, we said we agree with 15 of the 18. 12 of the 15 are already underway or already completed. For us, the commission and their findings reinforces but we are trying to do with our my v. A. Transformation in transforming the work of the v. A. To better care for veterans. Host although care delivered by the v. A. Is comparable or better than clinical quality generally available to the private sector, it is inconsistent from facility to facility. How would you respond to that . The Biggest Issue was inconsistency. Some were leaders and Lean Technology as a way to provide care. There are some who had never heard of lean. We tried to defuse best practices across. I came from the private sector, i was 33 years of procter gamble, the chairman and ceo of that company for my last years. Are diffusing best practices across the enterprise in order to make sure we raise the level of care are all veterans. Host one of the concerns about the commission was the wait time for a veteran to get care. Wit before youe started and what is it like now . Guest we had some problems. The most famous was phoenix where we had a long line of individuals waiting for care. We had wait lists. We have added capacity. In the last year, weve had more than 4 million more completed appointments. Weve added 1200 new doctors, 2300 new nurses. Clinical hours. Weve done more telehealth. Care in theirth homes oftentimes. Thanksone a lot of to expand care appeared that is great, but we need to do more. More veterans are coming to us for care. There are no copays. If you have a choice, which the , youity of veterans do want to get your knee replaced, lets a better 25,000 operation , copay might be 20 , that is 5,000. You do it at the v. A. , it is free. More veterans are coming. It is so critical that we get the congress to pass a budget for this fiscal year so we can continue to increase our capability. Its also critical that congress authorized the 24 leases we have waiting. We have 24 new leases waiting to be authorized. Theyve already been funded. But they have not been authorized by our committees. We need those to be funded so we can open up these 24 new spaces and provide even greater care to veterans. Host the hearing today deals with this Commission Report and ultimately deals with the department you serve. Will he be testifying . Guest i havent been invited to testify. Also, the invitation that was given to the American Legion and many of our veteran Services Organizations was revoked. I provided written testimony. A lot of what the commission came up with was consistent with what were doing. Im a business guy. Ive been on over 300 different trips to talk to members of congress, talk to veterans, talk to Veterans Service organizations. Is notn we put together my plan. Plan. The veterans im putting in place new leadership, 14 of my 17 top leaders are new. I put together an external that includesttee usaa. Rmer u. S. Ceo of the former surgeon general, special forces veteran from vietnam. They are advising me on this transformation because i need help transforming this organization. We are in the midst of doing that. Weve invited you to call and ask questions of the v. A. Secretary, robert mcdonald. 2027488000 for the eastern time zone. 2027488001 for the mountain and pacific time zones. Rely on thermation private sector . Put out more. Veterans into the private care system . Guest weve been doing that. ,2 of our appointments today every day, are in the private sector. The ability to do that, nearly 4 million more appointments, they rely on using private sector capability. We dont give up responsibility for that veteran, but weve been using the private sector. That was part of the choice act in the end of 2014. Even before that, we were using the private sector. Thathoice act formalized in a particular bill. Did the commissions report cite any case for more reliance on the private sector . The report was very clear on something we agree wholeheartedly with. We need to set up a broad network, integrated network of Public Sector and private sector medical capability for veterans. We dont think we should give up responsibility for taking care nature ofmary care veterans needs. But we should continue to use the private sector. The commission did not go cell so far as to say they want to privatize the v. A. I think that is a bad idea and veterans think that is a bad idea. It is not veterans suggesting it. I am a veteran. I served in the 82nd airborne division. The v. A. Is important to all americans. Done research that has resulted in breakthroughs in american medicine. The first Electronic Medical implantablety pacemaker. This last few months, weve done in operation in Salt Lake City called rather than fitting a prosthetic device on a remaining part of the limb, we put a andnium rod in the femur snapped the prosthetic device on. One of the veterans i had a chance to meet after the operation told me a week or so after the operation he could the cracks in the tile in his shower through his prosthetic. Is not yet fda approved, but we are in the process of getting it fda approved. Host one of the commissions recommendations was the establishment of an 11 member board of directors that would be accountable guest i think that is a bad idea. We dont need more bureaucracy. We have a board of directors. The Board Members is called congress. We Gave Congress 100 pieces of legislation that we need. 40 are new this year. Thanks both sides of the ill agree on. Things both sides of the aisle agree on. Leases remain from fiscal year 2015 that we need authorized. We have simple laws. An appeals backlog. We have over 500,000 appeals waiting to be adjudicated. That is way too many, it takes too long. We created a new law. It is ready to go. Weve had hearings in both the house and the senate. We simply need to get it passed. Johnny isakson and big blumenthal and our committee have put together an omnibus bill called the Veterans First act. Both sides of the aisle held a press conference to praise each other for bringing it out. We cannot get it to the floor to get it voted on. Its time to not have veterans be political pawns. Its time for veterans for us rather than just thanking them for their service, lets do something and look back on 2016 as the year that we really turned the corner for veterans. Host our first call is from mike from minnesota. He is retired. You are on with v. A. Secretary robert mcdonald. Caller good morning, gentlemen. Im actually going to the v. A. Today. One of the worst things we could possibly do is privatize the v. A. System. Several surgeries and i prefer the health care i get there. I would rather use the minneapolis v. A. Rather than the mayo clinic. They do an excellent job. I would hate to see it privatized. Guest thank you for your comments. Whenever someone approaches me and say they like us to privatize the v. A. , i ask than three questions. Are you a veteran . Generally, they are not a veteran and certainly not a disabled veteran. If you talk to a veteran, they have generally not talked to a veteran. Their thoughts come from political ideology. Have any interest in a private Health Care System that would benefit if the v. A. Were privatized . Service Organization Called out the fact that many of the commissioners on the commission for care actually had interest in private Health Insurance companies. North carolina, diane is next. Good morning. Caller good morning. Thank you for taking my call. My husband is a retired vet. He has recently become disabled. He finally got in the process. My concern is with the education benefit. We have three sons, two in college. Ive been going through all the the military chapter discover two days later that he was not able to use it because he was disabled. Way forsome kind of bad my son not to be able to use the is in anecause he intellectually developed program the v. A. Process is not tied up with. This is a four your certification at the university of North Carolina greensboro. What do i need to do in order to academics d the funds heics needs to go to college . Guest i have a lot of empathy for your statement. Many of the limitations we have on the benefits we grant are baked into the law. We need to go back to the law and see what changes we might eat in the law to be able to provide that benefit to you. At bob. Mail me va. Gov. V. A. Becomeuld the better in taking advantage of the Technological Innovations to provide Better Services and support for veterans . Over 40 apps for smart phones and many of our veterans are finding these apps very helpful. We have an app that helps for ptsd treatment. We have an app we are working on for scheduling. These are things we are trying to do. Did, i changed 14 of our 17 top leaders. One of the leaders are brought in with the new head of i. T. Who had been the head of i. T. At Johnson Johnson and dell. She is transforming our i. T. Organization. Systems was a big problem at the v. A. Our scheduling system in phoenix date back to 1995. Our Financial Management system is written in a language i wrote at west point in 1971. We deal with over 700,000 veterans in telehealth. Telehealth is the wave of the future in american medicine and we are leaving it. Been on the cutting edge of innovation for american medicine. We need to continue that and technology will play a huge role. Host how does the v. A. Stay competitive with the private sector . Guest we spend 1. 8 billion a year on innovation. Thats a big part of what we do. A big part of it is the relationship that we have with the best medical schools in the country. When omar bradley was the head of the v. A. In 1946, he set up a system of affiliation where many of our v. A. Hospitals are right next to the best medical schools in the country. , our v. A. To durham across the street from Duke University medical school. We share doctors. We share hundreds of doctors at duke. We share over 300 doctors with the university of utah. We are getting the best doctors in the country who are doing the research, who are teaching we train 70 of the doctors in the country. Who will train those doctors . We train 70 of them. Have to doctors who teach it every day and they are doing research. Innovation becomes very important. In dayton, ohio. Good morning. Go ahead. Caller good morning, everyone. Privatization is what is killing us. Now, weentists only have four. The private sector cannot take care of our veterans. The cost is high. You came from cincinnati, you know the dayton area real good. Issues is thathe we need help recruiting doctors, dentists, nurses. One of the things i did when i became secretary, i went to medical schools to recruit doctors. I went to over 24 medical schools to recruit doctors and nurses. What i discovered was we are not competitive with the private sector. Legislation that would allow us to make sure all of our medical personnel become rather called title 38 than title 35, which allows us to pay competitive with the private sector. I look at the salary bands and i increased the salary bands to become competitive. We also loan rim person. Our loand reimbursement. We are being successful. Thething holding us back is way sometimes our doctors and nurses get treated. Host cedarcrest, new mexico. Dave, your next. Caller i was wondering if you ever thought about turning all intoureaucrats at the v. A. Auditors and have them audit the v. A. Every two years. Have you ever thought about getting the Watson Program from ibm to help with diagnosing and treating patients . Guest on bureaucrats, the percentage of employees in s head office is lower today than it was in the past. We are working on putting more more people against and more people on care for veterans. We had a meeting last week. We get a lot of help from the gao, the comptroller general of the country to audit us. We have lots of auditors and overseers. On watson, we do have a partnership with ibm, we are working with ibm and watson. The Computing Power of watson showed tremendous capabilities in our million vet project. , we haveading research over 550,000 veterans who have given us their blood samples, including my own. We have 20 i did 30 years medical history. 2030 years of medical history for those veterans. We are mapping genomes. We will be able to predict future potential diseases and solve them before they become a problem. I was with a young lady the other day who unfortunately, we had to do a hysterectomy. She had cancer of the uterus. Genome, weping her discovered that she was susceptible to colon cancer. We increased the frequency of her colonoscopies. We discovered precancerous polyps and we were able to remove them. Cancer talking about the moonshot. She said the v. A. Saved my life and this new technology has saved my life and we need Computing Power for that. Ibm andpartnered with watson and the department of energy. Host a retired vet, anthony in North Carolina. I had a unique question. , ive been seen at the v. A. Because they determined that what was considered just abrupt and stupid behavior on my part from when i was 17 was the start of schizophrenia, which im dealing with now. Anybody with anything other than a dishonorable can get the a car. Get v. A. Care im waiting on them to determine whether im honorable or v. A. Purposes four v. A. Purposes. Other than honorable is a relatively large category. Its a very diverse category of discharges. Wes not one answer need to get into your situation. At bob. Mcdonald va. Gov. Can based onas we the law the law is what prohibits us from dealing with dishonorable discharges. You should apply to the department of defense to have your discharge reviewed. Back in the days when i was a captain in the army, many of the times people may have had Something Like posttraumatic stress, bipolar conditions, schizophrenia that we didnt know then. You may be able to get your discharge changed. Host tracy from facebook asks guest we have a stateoftheart program we are leading the country here. We track the dispensing of opiates. We track it by dr. , by facility. We track it on a national basis. Doctor, by by facility. Other treatments are just as effective if not more effective than opiates. Things like acupuncture. We are the largest user of acupuncture in the country. , equine therapy, yoga. We are trying to develop a library of database evidence that shows these other treatments are effective. Will try whatever treatment the veteran requires in order to find something to be able to get them off of opiates. Host leonard from missouri. A retired vet. Caller in 1975, i got an honorable discharge. I have all the effects of agent orange. Because i do not go to south vietnam, they are refusing to label me as having agent orange effects. My private doctor put in a request for three years ago and they did not give it to me. Host email me and let me know. We thing we got to do have to go to the department of defense and get the proof that agent orange was used at your facility. Once we have that, we are able to help. The department of defense holds the information on where agent orange was used and not used. Host mark in chico, california. Caller good morning. They used to pay veterans to go and when you got you saw itafter doctor and everything, and now, they changed it to where you get paid the following month in a a lot of people cant or dont want to ride a bus. Its really hard on the individual to come up with that money to go down there. I dont know why they changed it. Thatr as opiates, i agree they were overprescribing them at one time. s been on opiates for 20 years, you dont drop 40 milligrams all at one time. It took me 68 months just to get over that di. They still want to get me completely out of opiates. Im a 63yearold disabled veteran. I dont think thats reasonable. Guest thank you. On transportation, transportation is a big issue for our veterans. Work withrd, we disabled American Veterans to provide transportation. We are working on finding ways to make sure people have available transportation to get to their facilities. , if you arees unhappy with the care you are getting from your provider, please raise the issue within your facility. They will take a look at it and get another providers point of view. If youve been on an opiate for a long time, finding a clinically appropriate way to get you off of it is terribly important. Host milwaukee, wisconsin. This is paul. He works for the v. A. System. Caller i have assignment, i will do 34 rooms, sterilizing them and whatnot. We have a lot of guys that callin and dont come to work. I end up doing not only my job, but someone elses job. The nurses look at us like we are the underbelly. They will play with their computers admit to constantly clean up behind them. A lot of times come im pulled , theto do isolation isolator room, a veteran who has , we have to suit up and clean that up. When are they going to get more employees to get people to come to work consistently so i dont have to do some of the elses job . Guest thank you for your service to veterans are the v. A. I think housekeepers are our heroes. The ones who prevent Infectious Disease from being transmitted through our hospitals. Has one of the best records in the country for the lack of Infectious Disease going for a hospital. Make sureekeepers things like ebola and hiv and all these Infectious Diseases dont transfer. It sounds to me like we have a personnel problem and discipline problem in pauls area and i will look into that when i get back. From a letter was sent out the House Veterans Affairs committee. Jeff miller said guest since ive been secretary , weve terminated 3755 people. Individual, a an a gusto, employee in georgia who is currently facing that already been found guil