Policy Vets
Policy Vets
The Honorable Dr. Phil Roe and the 115th Congress Veterans Bills - Where Are They Now?
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Dr. Phillip Roe, the former Chairman of the House Veteran Affairs Committee, speaks with Secretary Shulkin and Lou about what he's doing now, what should be a priority for congress with regards to veterans, and what he wishes he could have done while in office.
I don't think a lot of people understand from a quality of care standpoint, how important the implementation of the Cerner Electronic Health Record system is actually a lifetime health record. You can literally take a person's entire medical life and pull it up and determine very quickly. Is their disability claim valid? Is it is it not? Did their service with the burn pit in Saudi Arabia, Iraq, wherever it was Afghanistan? did that affect it? Well, they weren't even there. I mean, it is a treasure trove of information.
Announcer:Welcome to the policy bets podcast, engaging with leaders and scholars in strong voices to fill a void in support of policy development for America's veterans. With your host, former Secretary of Veterans Affairs, Dr. David shulkin. And the Executive Director of Policy beds, Louis Celli, today's guests Dr. Phil row, an American politician and physician, who is the US representative for Tennessee's first congressional district, and the former chairman of the House Veterans Affairs Committee.
Louis Celli:Mr. Secretary as Secretary of the Department of Veterans Affairs, how did you organize your time between overseeing and running the agency, getting involved with veterans and employees, stakeholders working with the hill focusing and implementing on legislative mandates?
Dr. David Shulkin:Low I was pretty deliberate about it, I would prioritize. Number one were the veterans. That's who I was working for him. So making sure that I understood what was important to them, and spending time with them. Number two, probably was Congress. And you know, so much of VA has to be done legislatively. And then third, are employees. And then finally, the administration. And obviously, the White House. And so sometimes you didn't have a lot of choice as to where you spent your time. But I would try to deliberately spend my time in that order.
Louis Celli:You know, you've attended a number of Bill signings while serving as secretary. And, you know, as the bill was being crafted, I remember you having strong opinions on some provisions, and being very vocal with advocates and lawmakers on what you thought the downstream effects would be. Were you always able to convince lawmakers to write legislation the way you thought that it might work out for the best for the agency? And for the veteran?
Dr. David Shulkin:No, of course not. I didn't think it was my job to impose my will, I thought it was my job to be candid and express my best opinion. And I would try not to do that in a way that would grandstand or, you know, do sound bites on television interviews, I would sit down with members of Congress and hear their concerns. And, frankly, I found the more that I listened, the more that I was able to give my best candid advice to them.
Louis Celli:To be fair, some provisions were directed to be implemented almost immediately. And some were actually put off for years, did you ever think to yourself? Well, it's gonna be some other secretaries problem, I'm really not going to kill myself over this.
Dr. David Shulkin:I always knew that I served at the pleasure of the president and that every day was a true privilege and trying to get as much work done as you could in a 24 hour period of time. Nobody who serves knows exactly how long they're going to be in those positions, particularly in the political environments we find ourselves in. So it was always trying to make sure that the decisions were made were set up for long term success, but trying to get as much done on the short term as you could.
Louis Celli:Now having history as your wisdom. Is there any language that you fought hard to include that just didn't work out the way you had hoped?
Dr. David Shulkin:Yeah, the biggest concern that I have was and still remains on these access standards for veterans, that really tough balance between ensuring that the VA has the ability to continue to reform and be there for generations of future veterans, but at the same time, not trapping veterans into a system that doesn't work for them. And so if you put the veteran at the center, how do you define access standards in a way that it really allows them to get the best from what the VA can offer and the best from what the private sector can offer?
Louis Celli:You know, good intentions can go awry. Sometimes I remember we've talked about this before, I fought hard for a provision that required community care physicians to turn the veterans record back into VA before they could get paid. And that was a disaster. We had to go back and fix that is a fact you worked on that.
Dr. David Shulkin:Yeah, of course. You know, often in Washington, there aren't black and white issues, and you have to learn the art of being able to not only compromise but do it in a way that looks at some of those concepts. quences that are going to be down the road first and over second consequences. And so sometimes, despite having done the very best, you don't get it right the first time, and you have to be willing to go back and make revisions and changes to the law in order to get it done. Right.
Louis Celli:As a political appointee, you reported to a lot of people, of course, your direct boss was the president of the United States. But in addition to working for the veterans and the people of the country, you also reported to Congress is sort of a board of directors.
Dr. David Shulkin:Yeah, lots of masters. But that's what that's what running a big agency is about. And, you know, I actually found my time with Congress to be extremely valuable in the effect of, fortunately, on the veterans issues, much of this was not being done on a partisan level, it was being done for by people who served on the committees, because they were there because they cared about veterans. So I didn't approach people, members of Congress as Republicans or Democrats, but just as other people who cares deeply as I did about getting this right for veterans. And there probably was no better example of that, then Phil roe. He was the chairman of that house Veterans Affairs Committee when I was secretary and he would work very closely with both sides of the party, we never really spent a lot of time talking about politics. But we spent more time thinking about this as physicians that cared deeply about getting our health care system, right for our veterans. And, you know, I just don't have anything but gratitude and, and respect for the way that he led that committee.
Louis Celli:I couldn't agree more, I can't even tell you the countless number of times john towers would call my office and say, Hey, listen, you know, the boss wants to meet you have time, later on today or or tomorrow at three. And, you know, we would go in and sit down with a member and it was his Chairman row, and he'd say, Hey, listen, I have a job to do. And I'm trying to do it the best way that I can, and here are the options. I if I had another option, I would give it to you. But here are the options I have. And let's figure out how to make this work together.
Dr. David Shulkin:Yeah. And, you know, watching as the situation continues to be so divided in Washington, as the country continues to be divided. It's hard when you lose members of Congress like Phil Roe, and certainly I think Johnny Isaacson was this way as well. And others who have left recently that had the ability to reach across the aisle to do the right things for the country, and particularly for our veterans. So I'm, I'm so glad we're going to talk to Chairman rode today. He is really, I think, an example of what policy vets is about low which is, even though people leave their official duties, they bring with them a wealth of knowledge that still has so much to contribute. And in so many cases, people like Phil row continue to work on behalf of veterans and continue to be a tremendous resource to those who are in office and those in the community about how to make people's lives better and make a difference. And I think we're going to hear that from him today.
Louis Celli:I absolutely couldn't agree more. Let's get him in here and get started. Perfect. Mr. Chairman, thank you so much for being a policy that scholar Hey, and welcome to the policy. That's podcast.
Dr. Phil Roe:But thanks for having me on. It's great to talk to you guys and hook up again.
Dr. David Shulkin:Great, Mr. Chairman, it's, it's really good to talk to you I do have to say I miss our many conversations that we used to have all the time. And you know, before we get started, I just want to ask you, I know you and I being doctors have left government right before the pandemic really happened. And at least for me, it's been somewhat hard being on the sidelines, you know, having having this knowledge and used to being you know, central to what was happening in Washington. What's it What's it been like for you not being in Congress during this pandemic?
Dr. Phil Roe:Well, I got part of it I it fortunately being co chair the doctors caucus in January of 2020, I actually got to see it all unfold and operation warp speed and having left just to January of this year. So I was able to do that. But I it and I have done a lot since I've been home obviously tried to message and encourage people to get vaccinated and to be careful and use common sense really. I took one of the first shots out I actually volunteered for the Pfizer trial, but I think they already had enough old geezers I didn't even know so they turned me down for the For all but immediately when it came out, I had enough faith in the system and, and volunteered to be one of the first people to get vaccinated. And certainly I've already had a booster shot. For those vets out there there may be and Bill and I would recommend as you would whatever your particular circumstances talking with your doctor and see what your particular circumstances are, if it's right for you and your family, that's what I would recommend you do.
Dr. David Shulkin:Yeah, that certainly is good advice. And you know, it, you feel bad when people are getting information from sources that probably don't know what they're talking about. So I agree with your advice. And that's the reason we're talking to you today about veterans issues, because you are one of those voices, one of those leaders that I think that people still do look towards that, get it straight and avoid all the BS that happens in Washington, but you know, to do what's right and hear what's right for veterans. So before we jump right into some of the issues, I just wanted our listeners to get a sense about your background, you served as army physician, you spent time once you got out of service, running a very big practice in Tennessee as a ob gyn, and then entered politics in 2003. So that was a while ago. Can you tell us a little bit about that decision and and the reason why you decided to go into Congress.
Dr. Phil Roe:I was in the service during Vietnam, but I actually served in second entry division in Korea near the DMZ camp Casey, many of Lu probably has been there. And I know a lot of friends have served there. You know, as you did, I was so blessed to live in a community dad, and it's an OB doctor, I could never be on any of the local community service boards because when babies come when they come so you can't schedule noon to go to the quanis Club. And when I finally retired from ob, but did just GYN saw his patients and went the operating room. I wanted to volunteer back to my community. So I volunteered for a planning commission which someone asked me to do and then I chaired that. And I said why don't someone then talk me into running for city commission, which I did and in our city, which is about 70,000 people. It's really a board of directors. We have our professional city manager and I was elected to the to the board to commission five of us in 2003 and then was elected vice mayor and then later mayor of Johnson City, but I work full time and it was basically a volunteer position. I think you got paid$100 a month. And as mayor you got $150 a month and many of my constituents thought I was overpaid. So that's that's how I got started. And in I grew up in a military town, Clarksville, Tennessee, where the 101st airborne is headquarter huge military base and many of my friends growing up, fathers were in the military. So I had a real close connection. And then as you did I'm sure get some of my medical training in a VA hospital, as many doctors are like 75 80% do some of their training there. So I had a really good connection. My Scoutmaster was a first sergeant in 100 first Airborne Division and when I went in did my basic training in Fort Sam I said I can do all this stuff, but as a Boy Scout I've done it a half a dozen times already at Fort Campbell masons right it was pretty easy for me when you have a first sergeant as your Scoutmaster, so the congressional seat came open in 2006 and I thought you know i can i can work here a while longer as a physician, I will or I can run for Congress and serve my country and I had some things I wanted to do health care was a huge issue. And I knew the way our veterans were treated after Vietnam was just atrocious and I thought we need to do something about that unfortunately for the country, I do want to to speak up after Desert Shield Desert Storm. You saw a definite change and certainly after 911 and and that's a very good thing I think. I don't think anybody appreciates that you probably do. But when you we came home from Vietnam, we were treated incredibly poorly and I felt that should never happen again in this country was shameful what happened so I ran 2006 and I with that when I lost and climbed back up in the saddle Two years later, 1 billion in conflict and the last 12 years I spent in the US House fortunately all of it on the on the VA and Education Committee.
Louis Celli:Well And let's not forget being a banjo player, right?
Dr. Phil Roe:Well, actually, it's a guitar I I wouldn't be a terrible banjo player. But I do help. Lou way too many guitars in the house.
Louis Celli:It's the Bluegrass connections. bluegrass connection. Exactly. Sick and you know, I think the impression that most Americans have of congressional representatives is seared into their brain. From these little micro clips that they see on the evening news or or online, and, you know, the public image of politicians is really what they see when you're at a hearing. The truth of the matter is that in your case, as a veteran and the former chairman, and later ranking member of the House Veterans Affairs Committee, the laws that you helped develop and create and get passed, directly affect you and your family.
Dr. Phil Roe:Well, I definitely do and, and many members of my community, I mean, and as I traveled, I had the opportunity. And Dr. shulkin knows this. It's a process. I remember in 2009, when I first went on the committee, they had to make a spot, they move someone off the committee, leader, banger dad, and I said, Look, I need to be on the Veterans Affairs Committee. I'm a veteran. I'm a doctor. I've trained at a VA hospital. I grew up in a military town, I said, I need to be on that committee. He moved someone and put me on there. I was very grateful for that. And and stayed on that committee. And I learned and I remember the first blue I remember the first one first hearings, I went to junction second Secretary Shinseki was there. And there were a million backlog disability claims, I was flabbergasted by that number. And I thought that it that shouldn't that's disgraceful to have people out there waiting, can't pay their bills with disabilities that occurred because of service to our great country. And, and and the homeless veterans, I remember, there's numbers over 100,000 homes fettered during the housing crisis of 2008, and nine. And so that's sort of set the platform for me, I thought we need to do something about this. And then Dr. shulkin, remembers this extremely well. And 2014, the the scandal that occurred in Phoenix, really began to set the stage and then Chairman Miller at that point, began to hold hearings late into the night I remember one night I had to leave at midnight because the the train shuts down. I said I gotta go because I got no way to get back to my camp. So we passed the Choice Act and and and that set the stage. And I also want to give a shout out, there was a piece of work done and most people wouldn't have looked at called the Commission on care. And being the being the nerd that I am. And Dr. shulkin knows this as a doctor, when there's some information out there, I don't care who did it if it's good information y'all look at, and I read that in detail. And there was a lot of incredible information, a tremendous group of people that put that together. And I used a lot of that, and, and developing a consensus for the mission later on.
Dr. David Shulkin:Yeah, you know, you've mentioned just so many things that I think are important to talk about, let me just try to quickly go through some of what you just mentioned. So let's talk about that commission on care report. I too, spent a lot of time with that, and thought that there were some really good efforts, I think there were something like 18 major recommendations, the administration at the time, the Obama administration, rejected most of them, they accepted some of them, but not the major reforms, I thought the most significant major reform was to that the Commission recommended was to potentially pull out VA j, out of the traditional political structure, and to create it more like a quasi government structure with a board with a term designated leader of it the way that you would run a not for profit health care system. And that that got rejected out of hand, because it would take away the control from the administration and frankly, from Congress. Was that something that you were open to at the time? Oh,
Dr. Phil Roe:absolutely would have been, I would have been very open to that. And was one of the things I want to talk on this podcast. One of the problems that the VA has in any organization has is leadership. And I don't care whether it's a small congressional office, it's a small donut shop in Johnson City, Tennessee, you have to develop good leaders. And I know you know, the VA is a massive system, over 170 hospitals. And you know, this Dr. shulkin very well, that finding a great leader and administrator to top of the at the top of that hospital, I'm looking at my own VA here locally 100 acre campus, multiple buildings, over 2000 employees, that requires a very sophisticated person to run that. Well, guess what? You're competing at the VA with the private sector for those folks, whether it's a hospital administrator, or an outpatient, whatever, and you have to deal with pay and all those things. So we know it's a huge problem. And the other problem is, is that secretaries come and go congressmen come and go and so you won't always find somebody like yourself or Secretary Wilkie or Shinseki, McDonnell, all those folks that are willing to put the time and effort in to do that, and the people in their their 375 know that you're going to be gone in a short period of time. I think going long term, that's a that's a recommendation, it should be very, very strongly looked at long term for the VA, and he pulls it out politically, we can fund it from the Congress, but let it run more like a public private partnership would run.
Dr. David Shulkin:Yeah, it doesn't surprise me, I think you and I would look at these issues and just look at them from sort of a common sense point of view, knowing that it would book the political trend. But ultimately, if we don't tackle that exact issue that you've talked about, I'm afraid we're just going to continue to see the same issues time and time again, arise. And, and that's really been the history of the VA, you know, things, things get better, but then they pop up again.
Dr. Phil Roe:Well, what, what surprised me was, look, when I was a mayor Johnson City, we had a $200 million budget, I can tell you what every school teacher made a police officer made, how much we put into paving, how much water and so all that stuff. When I got to DC that the VA budget for health care, disability and cemetery is about 98 billion, it's now north of 240 billion. I'm traveling around the country to all these centers, and I'm finding out something the VA does. When I left, I was still finding out things. And I'm thinking I'm in charge of the committee that does all this. And I'm still finding things out the VA does. It is a massive organization. And it does need stability at the top, I absolutely believe that and it can't be run, it shouldn't be run as a political, or it should be run as a health care system and a disability benefit system.
Dr. David Shulkin:The other thing that I'm going to mention, at least at the date of this podcast that we're talking today, the VA j, the health system that as you know, is the largest in the country. I am still the last confirmed under secretary. It there has not been even a Undersecretary that has been nominated by the administration for somebody to run it. So I think it just makes your point, Mr. Chairman, that without somebody who has the authority to really run and make those hard decisions, this is going to be an organization that can't achieve the type of reforms that it needs. Yeah, great.
Louis Celli:I remember very much the Commission on care and VSOs, were nervous about it. I was I was running a VSO at the time, as you know. And we we struggled to to get our message across. We wanted to work comprehensively with it. But there were you know, there was there was a lot of fear in some of the commission members, or fear of some of the commission members who were who were very vocal in that, that we were afraid that they were, you know, not only going to try and carve out some of those services to privatized it. But ultimately, and privatization wasn't the biggest concern. To be honest, it was really the fear of losing services for veterans. We we were concerned that that you know that veterans would in the end end up losing services, specifically, because we felt that the cost of even Kwazii privatization would just be so unsustainable. And you're right, though there were some some real quality recommendations in there. Some of them came from some VSO recommendations, some of them came from some of the hospital administrators that were on there that had seen ways that had worked in the past. And I think the VSOs, by and large, were either ambivalent, or somewhat supportive of the board model and the board structure that you talked about, but we knew that as soon as that, that that commission on care report was finalized. The Obama term was coming to an end. And they were getting ready then to switch over to another administration. And we all we all saw the writing on the wall that no matter who or what the next administration was, it wasn't going to be their initiative. So they were going to look for something that they could start to, to, to put into play as well. And that really brings us to all of the stuff that your Congress did. The 115 Congress, I mean, arguably is one of the most productive congresses in decades. Your your committee past 25 bills into law. I remember the hearing you talked about with Chairman Miller by the way I was at that hearing and you know, we started to we started to call the Veterans Affairs Committee. The primetime committee because many of these hearings were were set during primetime in the evening. And it really teed up a lot of the information that was used by the 115. Congress to go ahead and pass these laws and between the Choice Act and the veteran's treatment courts and enhancing cares, enhancing care for veterans act in the komori GI Bill, adult daycare appeals modernization, you just talked about how the huge backlog of appeals, you know, there was a million appeals in the backlog, the mission act of valor act, National Suicide Prevention hotline, so all of these bills. So I mean, honestly, if you count all the provisions wrapped up in the National Defense Authorization Act, the NDA or other Omnibus type bills, the list is quite extensive. So let's start with an easy one. Can you tell our listeners looking back, if there's a bill that you're most proud of working on and getting past?
Dr. Phil Roe:it? The answer is yes. I think the mission Act and the forever GI Bill. And the reason I've go back to every GI Bill is nobody education did for me. And I was raised on a farm. And the first home I remember had had two rooms, no indoor plumbing or running water. So that's, that's where I started. And I looked what a a good public education and the opportunity after I got out of the military to use the GI Bill, and how it helped transform my life and my family's life. So that when that came up, and the pandemic, absolutely, I think, exemplifies why we needed it, because people's jobs may have gone away forever, and they can use that forever GI bill to retrain something else. So that was very important. To me. The mission act was the other I think, the idea of the mission act, and and let you know how I think when I think about a bill, especially a health care bill, I think of it from the examining room, me as a doctor walking in the room, does it make it better for the patient? Does it make it easier for the physician in the in the team, the health care team to provide the care for people, and I was at an Oregon at this thing out there with Greg Walt and he asked me to come out and I went through a band and all the way down in his district. He said, Phil, my congressional district has more square miles in the state of Tennessee does not fall can't possibly be right. turned out it did. And so it was ours for some veterans to get from point A to point B. And I thought, we've got to write a bill that's good for rural America and urban America. And that isn't easy to do. And try to provide the same quality of care for some veteran that's two hours from band or Medford, Oregon, where he was that you can get if you live here, Johnson City, Tennessee, again, rural area, but we got a major VA Medical Center here. So I looked at that, and then Elizabeth Dole came in, you can't say no to Senator Dole. That's impossible. And and senator bob dole was one of my heroes. I mean, I think he is a true American hero 50 Cal round the chest in Italy in World War Two, and it could have could have shriveled up and gone away and had an exemplary life. But his wife served as a caregiver for many of those years. And it really brought to me I came home, and he did live with all of my fat I didn't, I could practice medicine, go the operating room operate, whatever, I didn't have any disabilities, but many people do. And some of them are severe. And when she explained that to me, and I thought, and you were part of this, I mean, and I've got to give a shout out for you out here to the VSOs input they gave me and helped me through this process, also incredibly helpful. And the knowledge you all have is very helpful. So the caregiver part. And then the last was the air commission. And those are the three major parts of that bill. I think those are the two that come to mind for me, many others are very important. But those ones we work really, really hard on.
Dr. David Shulkin:We're watching in Washington right now, Congress and the Senate struggle over almost getting anything done, you know, fighting over the infrastructure bills fighting over, even keeping the government open. And yet, as Lou said, during your time in Congress, that that that first year of the Trump administration in particular, where you got so much done when you were chairman of the House Veterans Affairs Committee, tell us about what it takes to get things done in Washington. If you're in Congress, you know, how did you reach out to members of the other party to get them to work together? What are the lessons that people in Washington today should be taking From a period of time that more reform was done for veterans, and in a very long time,
Dr. Phil Roe:well, what you have to do is to say it's not about you, it's not about the next soundbite. And you have to have a concept of what you want to do. And those eight or so years I had prior to that gave me a lot of institutional knowledge. So I had a good bit of knowledge and meeting with the VSOs. with veterans, look, a lot of times you can just go down the local post, and sit and listen for a while, you'll pick up a lot of thing, a lot of stuff, you need to leave it to post. But that's, you can, you can, you can learn a lot by just listening. And I did a lot of that. And what I did when I had the idea of the mission act, was I sat down either in small groups, or with every single person on committee and listeners, what do you want in yours? And then I sat down with the White House, then I sat down with the veteran service organizations, and listen to them, not told them, but listen to them. And I said, What do you all want in your bill, not my bill, your bill. And not everybody gets everything. If I had written that bill, as a dictator would have had some different stuff in it, whatever. But that's not how you get to consensus. And that's not how you get something done. For the majority of people. It's a lot of hard work, and a lot of stuff that doesn't get you any kudos on TV, nobody at home knows you're doing it just doing the hard slog. And then when I go down to the floor, instead of, you know, you see that mask on there, people walking everywhere. Well, believe it or not, I got a lot of work done down there, I would go down and pull somebody off to the side, hey, let me tell you about this, and what concerns do you have? And I would listen to them, and then answer their questions, and then go back with the staff. And by the way, you guys know this also, and as a secretary, you're only as good as your staff. And your staff really has to conceptualize all this and get this down into words and, and policy that you can then take back to the committee and and debate and I think the committee process. Dr. shulkin is one of the things that we're missing right now, instead of writing these big huge bills that nobody knows, it's hard work. But go to the subcommittee then go to the committed intubated, get it out there. And, you know, the good, the bad, the ugly with it. And if you're going to have a red face yelling, match, have it out there in public, get it all out. And people have a right to have different opinions and work to a consensus that way. That's how I was able to do it. Just a lot of long hours and hard work.
Louis Celli:You know, I think to your point, the mission act is probably one of the most comprehensive bills that is that a pastor that committee in a very long time. So there are different types of bills, right? There are standalone bills or Omnibus bills, there are some they call Christmas trees, because they have so much you know, so many things hanging from it. But the the mission act was very well focused. As you mentioned, there were pieces in there that addressed a multitude of different different things. But But to be fair, I mean, it was mostly focused on being efficient at VA, wasn't it?
Dr. Phil Roe:That's correct. Louis was and and one of the things that as I've stepped out now, and and I am home and now and if we have time, we can get to some of the veterans things I'm working on here now. But I, it's good to be here as a former member of Congress. Hey, Doc, man, I'm getting great care of the VA. I just want to tell you, and they're they're looking after you wouldn't believe how good care I get. I hear that all the time. And that's it. That's what I hear. Then my 12 years was morphing. If that if that's what I hear and I do hear it or not that's perfect no healthcare system is people get issues and personalities involved in all that. But the majority of what I hear by far locally is positive. And that that's a good thing. And I think I think the committee both Democrats and Republicans and they can take a victory lap on that.
Dr. David Shulkin:Yeah, I think that's really great to hear and I to really like it when I hear that I think part of the mission act in some ways was designed to create a little bit of competition so that the VA felt that they had to competitively step it up and I think I always had confidence that the staff there could could do that and and could deliver great quality care. But I think the mission act wasn't so much about privatization, as it was allowing the VA to be able to actually successfully compete and provide veterans the best service
Dr. Phil Roe:yo you're right and the other thing that I realized is it gets harder right pandemic is gonna go to amplify that this pandemic is burned are people out and everywhere it can't be lucky where we are in this VA and have all of these services many places are and and have a seebach close by and by the way, I think that's one of the greatest things that the VA has done is to take the care to the veterans where they live. And that shifting that out, we learned that in the Commission on care. In other words, the demographics of the whole country shifting from the north and east to the south and west, that's where the population growth czar, so you need to make sure you put your assets there. And you also know Dr. shulkin, that more and more and more carries being tape driven to the outpatient setting. And not to the inpatient setting, the inpatient settings now are used for very sick people, and the outpatient settings where we hopefully keep you where you don't need a hospital. And so the big idea over eight, 900, seebach, to get that care out where the veterans lives. I think one of the smartest things a VA is done. Yep. So
Louis Celli:I think it's fair to say that the mission Act has been an unqualified success. And and you've talked about a couple of bills that you were proud of. And one of them is a component actually, one of the measures in the mission act, and that's the Air Act. And I remember you, personally holding meetings, talking about why the Air Act is important and helping work helping the VSOs understand what your vision was for that, as a matter of fact, it was it was the red herring of the bill. And without that the bill would not have gone through, is that correct?
Dr. Phil Roe:That's correct. That's correct. And I hope that that works. And I'm going to, I'm going to do a father confessional here, I was asked to be on the air commission. And quite frankly, the process of getting on there is so difficult, I mean, all the bad all the stuff you have to do, I thought, this, this is his heartburn, I don't need as I remember stages like you have stepped up. And so as Dr. shokan, held my hand up and supported the constitution nine times once as a young army officer, twice as a city Commissioner six times as a congressman. And it just, they just made it so difficult. And and I think that's a hugely important part. Because every big organization needs to have an internal look. And he needs an external, an objective person looking at and Doc shokan will tell you this, everybody always thinks you're doing a great job until you have some objective person come in and say, maybe it's not as good as you think it is. Because we've done that in our practice, every business needs to do that from time to time. And I can tell you, when I was in Congress, every year, I held a staff meeting with my congressional staff in DC and my VA staff and all that, to have a self look and objective person come in and say, What are our goals this year that we meet reach the goals we had set for last year? Why didn't we and if you don't do that, you're going to do the same thing over and over and over again, and do it poorly.
Dr. David Shulkin:You know, it doesn't surprise me that you said earlier that you're continuing to still work on Veterans issues. You know, once this, once you are involved in helping veterans, I think it's something that you're always going to be committed to. So tell us a little bit about what you are doing now, particularly in the work around veterans?
Dr. Phil Roe:Well, I volunteered and they asked me to do this, to serve on ideas, was elected about three or four months ago to the Dole Foundation Board. So I'm going to I'm serving on that. I'm also serving on a US, US Israel Education Association, which is a faith based organization that uses congressional trips to go to Israel to help bring Palestinians and Israelis together. So I'm working on that. And also just the governor just called me and asked me to serve on the Board of my college, which I'm doing. And also working here locally on and this is something that I would have the Congress look at and you and I talked about this I did with Secretary Wilkie, sometimes a congress give the VA too much to do, and you need some times to digest what we've sent you. And the mission act certainly is one of those that that took some, I mean a lot of time to walk through the provisions of that and allowed VA time to do that. But what I'm working with now is a non for profit where drug addicted veterans are at the local VA, they go through the process of being treated. You have a HUD Vash voucher program and in a case manager, but not the intense looking at that someone needs it. I'll fall right back into it. The VA is this is the Salvation Army that's doing it here. But the VA is given a three quarter million dollar grant and we got to raise more money to build to expand their infrastructure to allow someone to come and live. They're under intense scrutiny for six months, nine months to a year where they go back to the VA they're supervised tested with an education To then they can go out and get a HUD Vash voucher and live on their own. Because if you don't have that intermediate step, and we have one civilian one call families free here we take young drug addicted women with children and have a home that they can go live in until they get on their feet, to get their own apartment without that intermediate step. Failures there and think about this. I know you were 93,000 people during this pandemic, your data of drug overdose deaths in the United States of America, that is unbelievable. So we're getting the resources to be able to have that step down unit. That's what we're working on. I'm kind of shaking down the city and the county where I was the county mayors, a good friend of mine, we got together, the local city folks are all friends and we're trying to come I'm trying to convince them that that's an investment they also need to make along with private donations to fully fund this organization. So you know, still keep my toe in the water.
Dr. David Shulkin:Yeah, I remember talking to you when you were considering about not running again, for Congress. And you were saying that you were going to potentially think about going out and enjoying things and relaxing and living life differently. So what I just got from what you've talked about, Phil is is that you failed retirement. You're working harder than ever, but you're working for free. So congratulations. Thank you working for free. That's true. No, but seriously, thank you for for your continued commitment. I think I think the work you're doing is amazing. And I know how important this is to
Louis Celli:you. I'd like to take you back for a minute to talk about the Air Act, the asset and infrastructure bill. And I think it's timely because the committee has not or the commission rather, has not yet been assembled. So that means that their work is up and coming. And, you know, you just told us that you weren't even asked to be on it. But it was it was so cumbersome. Just getting on the commission, that and who who I can't think of a more qualified person to guide them through even whether you made a decision or not, you know, just to help them understand what this was supposed to do. Can you take Can you talk to us a little bit about what what the Air Act is supposed to look at?
Dr. Phil Roe:You like Dr. shulkin and Secretary Wilkie really help me lose zero you know, yes, the VA is a huge organization and and the VA our local VA will give an example. It wasn't there wasn't a VA it was opened in 1903 for Civil War soldiers. I mean, that's that was open for in Mountain Home. That's not the VA now the VA is a modern first rate world class Medical Center. And you can't use the facilities. They had these antiquated facilities and I've been through many of them want to have Tom Swasey, Congressman Swasey asked me to come along out, well, my democratic friends, and I'm going to have a beautiful campus drove on the campus there, and there was a roof on in the bill. I mean, it was embarrassing to see that. And that's not how you provide the care today, you need a much more narrow, structured, efficient system to be able to provide today's healthcare. And what this allowed us to do, I think, and Secretary shulkin can can correct me, but I think the number I remembered was over 1000, either underutilized or not utilized bill as well, the taxpayers are paying to keep those up, mow the grass, keep them from falling in. And the veterans not getting any benefit from that. So we need to look at the VA and law and we set it up, it's going to be hard if you say we're going to do this building or that building. Everybody has a vested interest in keeping everything. And that's why the Air Act was set up like it was so that we could help provide those hard decisions and someone like myself on there could help make those in the President could say yes or no. Whether he agreed with it or not. And so I think it's hugely important for the future VA to get to get I would say right sized?
Dr. David Shulkin:No, I, I think you're exactly right. You know, my experience in Washington was that a lot of people can keep things going in the status quo, governments good at just continuing to do the things that it had done the year before. The hard part about leadership is figuring out what are those big decisions, the hard ones and figuring out how to get them done if they're really going to help reform the organization. And, you know, unfortunately, as we've talked about in this podcast, there's still many big issues that people have surfaced, how we do benefits, how we continue to maintain such a large system. Whether the The problems in the VA are because there's not enough money. Well, you know, I don't think that's the case, I think it's a matter of that we have to make some of these hard decisions about reforming the way that the system works. And frankly, the private sector changes all the time because marketplace forces change, you know, in the VA, you need to change law often. So I think you're right. And you know, really the question, which I wanted to ask you is, whenever you leave a job, you always leave in some sense, some unfinished business. Is there something that you still feel if you were back, and you had one more chance to do another bill? You were Chairman, and there was one bill left? Is there anything that you feel like is unfinished business?
Dr. Phil Roe:Well, there's always unfinished business, she never, never get it all done, nor should you get it all done. It's a continuous process. And and this is something that that probably I stayed an extra term for this and we didn't, because a pandemic kind of lead kept us a little bit. But I don't make a lot of people understand, from a quality of care standpoint, how important the implementation of the Cerner Electronic Health Record system is, I know you talk about that's pretty wonky stuff was that the earth system computer screen? Well, actually, it's not. And it's actually a lifetime health record. And it would make going forward if it's done correctly. And I tend to think in 10 2030 4050 years from nobody ever knows who I was, when a young soldier goes in at 18 years of age, and they're going to be my age one day, you can go back and look at that record and pull it up and not have a manila folder, carry it around and have it burned up and St. Louis and you can't adequately you know, all that you can literally take a person's entire medical life and pull it up and determine very quickly, is their disability claim valid? Is it? Is it not? Did their service with a burn pit in Saudi Arabia, Iraq, wherever it was Afghanistan? did that affect them? Well, they weren't even there. I mean, it is a treasure trove of information done properly. And and you know, we're going back to the mission I just a little bit, we're going to have to cooperate the private sector and the in the VA sector, because not every sector has everything for everybody. So you want to use the best of the private sector and the best of the VA to so that that veteran can get the best quality of care. So I guess that would probably be if a smaller version would be a bill that I would work on would be something along the transitional housing I was talking about, along with helping prevent VA veteran suicide and, and substance abuse. That's a huge problem, not just for veterans, but for America, we've got to address in this country. So that's probably something I would jump into.
Louis Celli:I think those are great points. And so with that, and we're we're starting to come to the end of the time here. I'm just I'm curious, with all of the bills that you were instrumental in helping get passed with the landscape, taking into consideration what we learned from COVID. What do you see as the future for veterans health care in America going forward?
Dr. Phil Roe:Well, I think it's I think it's very bright. And I think folks, one of the things that is occurring is that fewer and fewer people are serving so as a different military than when I was in, you know, a little, I'll make the I'll make it as a joke. I said, I've volunteered for the military to, I've volunteered to go to the mailbox. And I got a draft notice along with millions of other people my age, but the draft is gone. So we have an all volunteer military, and we have an obligation to serve them and provide them the absolute best care and benefits that they've earned protecting this country. And I know you just you've just seen, I mean, tragically heartbreaking for me what happened in Afghanistan, there are a lot of shattered lives out there. And remember, there's a family at home, that that a lot of those veterans you don't hear about they got wounded in that explosion. We've got to take care of them. And they've got a wife or a husband or a brother or sister at home, and making sacrifices for them. Everybody else is going on about their life. And their biggest worry is you have to wear a mask inside provers when I go in, well, that's not the biggest word that a lot of these veterans have. I'll tell you, Lou, if you've done this, I'll get probably choked up talking about it. I go to some of these meetings where the Gold Star families show up and their children show up and they think they never got to see their dad or their mom. I did. And that's the that's the passion I have because of the sacrifice that these men and women have made. And so yeah, the answer is yes. And what we need to do now is to make the system more functional and more responsive to the veteran. I think that's where I know that Dr. shulkin feels like adding it needs to be patient centered and they need to be the focus of the healthcare not the system. But the better of the patient.
Louis Celli:Mr. Chairman, thank you. So you've been, you've been a stalwart in this community before we go. Is there one veteran that you've worked with after all of these years throughout all of your your work in this community is there one veteran that you can think of where the the laws and the policies that you helped put in place has really changed their life?
Dr. Phil Roe:A lot, I think they're Lou I could spend hours the other day at a tractor dealership. And, and this was a world war two vet who had died. And his and his wife was in a assisted living or nursing home facility type, and they had never received any benefits. And they had applied and waited months and months. And he had called me up and said, I'm just worried about my mother and I'm only she can stay. So let me make a couple of phone calls. So I call Dr. Paul Lawrence up. And I said, this, we need to get to this and I just saw this car like a week ago, I'm buying all these altering vehicles, I'm gonna I'm gonna have some fun while I'm out here. From this man, he said, Doc on what you did, but he said in a week, I had $18,000 my mother's account, she is now getting 1000 whatever it is, $1,700 a month, she could live there safe for the rest of her life. Now that's a world war two vets widow, that's able to do that. I hear stories like that all the time. And and so does every Congress man and woman that serves if they if they listen to their veterans and take care of and that makes it again, really worthwhile when you hear that, that that's a person that was young at one time in 1943, when that husband or boyfriend left to go to war? Well, now they're old, and we need to take care of them. The VA is doing that. Now just a very skinny little part of that. Well, Mr.
Louis Celli:Chairman, I know that you have continued support from from us here in Washington DC from the Secretary and myself as you continue to work for no pay with a mayor that earns $100 a month
Dr. Phil Roe:as a one one last shameless promotion here who the the 20th are going to be back into in 1920. They're unveiling my portrait at the the 20th of October. You have a portrait knowledge. It's all that folks listening? No, it's all private money, says no government money.
Louis Celli:Believe me, we know.
Dr. Phil Roe:Yes, that's true. I've been shaking them down. So they're unveiling my portrait and I really appreciate that. And the artist is a phenomenal person. I hope that people get to know her more than me almost. I got to know this. This artists work to emigrated from China, and survive the purge of mild say, Tom. It's an incredible story of Hercules. So where's
Dr. David Shulkin:the unveiling, though?
Dr. Phil Roe:It's it's at, it's going to be in the Rayburn room, I believe, will get you the information on the 20th of October. So he's looking forward to being there. Thank you. Absolutely. Thanks for all you guys what you've done. I don't say it enough. I was always always felt really good. We could have frank and open discussions about what was better, always felt that you were looking at not after your interests, but the veterans interest and that in and I appreciate that very much.
Louis Celli:Thank you, Mr. Chairman. And we absolutely felt the same about you and your leadership.
Dr. David Shulkin:Thanks so much, great talking to you.
Louis Celli:And that really is all the time that we have for today. On behalf of policy vets, and all of the folks here that helped bring this podcast he thank you so much for listening. We really appreciate it. You're gonna want to join us next week when we're speaking to veterans education success, Christmas, Dale and will Hubbard and we're going to be talking about predatory schools, the GI Bill, and really what this means to veterans and citizens, and why you need to have a watchdog. Join us next week.
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