MilitaryTimes Leo Shane reports on the VA

Leo Shane of Military Times discusses the community of reporting on the US Department of Veterans Affairs, the potential for medical center closures, and politics surrounding veterans issues.

Transcript

Leo Shane: 0:01

I know there will be VA is closed. We haven't as of this taping, we don't have the names yet, but they have talked about building a few more VA medical centers and closing four or five, maybe even a few more what they're talking about replacing these, these VA medical centers with our outpatient clinics are partnerships with other local clinics. So if you say we're going to close down to the hospital, that's going to panic everybody, if you say we're going to build three more outpatient clinics all around town, and it's going to be easier for everybody to get there. That's that's great for veterans.

Charlie Malone: 0:36

Welcome to Season Two of the policy vets podcast, engaging with leaders, scholars and 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. That's Louis Celli. Today's guest Leo Shane, an award winning national reporter focused on military and veterans issues for Military Times.

Louis Celli: 1:05

So Mr. Secretary, big, big week for the Department of Veterans Affairs, a lot of announcements. You know, we're starting to come out of the pandemic. And it looks like people are starting to wake up again.

Dr. David Shulkin: 1:17

Yeah, and not not too soon with this beginning of theirs commission process, I was really worried about VA not having its appointees in place. And that's going to be really important that the VA and veterans be represented by people who know what they're doing. So that this isn't a complete political process, that this really is one that makes sense for veterans,

Louis Celli: 1:42

it really is refreshing a lot of the names that came out on the nominee lists or names that that we're familiar with in the community. And that does give us a sense of comfort, to know that there are folks that at least have worked in the community that are now being tapped. But listen, more specifically, the the undersecretary for health, I mean, a position that that hasn't been filled in quite a long time as you as you well know.

Dr. David Shulkin: 2:04

Yeah. And, you know, it's great to see that the nominee is a person that I have such confidence in, he was my White House fellow, which, which meant that he and I spent every day together, you know, the way which I work with my White House Fellows, my calendar was theirs, they would get sit in on all my meetings, and I gave them projects and really tested the mountain. In fact, he was such a good fellow that after his year was over, he stayed at VA took on a position and that really showed his commitment, it really showed my confidence. And in doing that, and then he's since left VA to go out and get great experience as the Commissioner of Health of the state of New Jersey, and now currently the CEO of the University Hospital in Newark, New Jersey, which is a large, important underserved health system that serves people throughout Northern New Jersey, and to see that that experience will all be accrued to the benefit of VA and VA and veterans I think is really terrific.

Louis Celli: 3:15

Well in and the nominee for the Under Secretary of benefits Ray Jeffers. Great, I think that's a great pic great nominees, oh, he's a wonderful guy, and he's taking over a shop that's fairly healthy. You know, Murphy has really, really held things together quite well for him. So it looks like veterans are in pretty good shape now.

Dr. David Shulkin: 3:35

Yeah, I think so that doesn't mean that there aren't significant challenges ahead. And that the, you know, wheels aren't squeaking a little bit, just from from not having leadership in place for some time. And so I think that this is, as you said, an opportunity to really get the administration's agenda into gear. And, and to make sure that not only no harm is done with with, you know, the new initiatives going on, but that there is a vision that's implemented, and we can really make progress.

Louis Celli: 4:13

Well, I think this is an exciting podcast, I'm really excited about this episode, because we we get to take a look back at where, where the Department of Veterans Affairs has been, where they've come from, you know, just over the past 10 years, the the, the budget has essentially doubled$268 billion. And that's a lot of money. Right? So it's got to be managed, and are we being good stewards of the people's money? So, you know, as as we look at that, you know, we're looking at folks that have been in this community for a while and who can walk through this with us? And I think Leo Shane is probably really just one of the best people to do

Dr. David Shulkin: 4:52

that with. Yeah, well, you know, I've always taken the position that the problems of VA were never due to lack of money, and I think it's easy in Washington to say, if there's a problem, throw money at it, I think that this has always been an issue of getting the getting the structure, the vision, the the focus of the organization in the right direction and making it clear where this organization's going. And quite frankly, political turnover, VA, you know, every two years changing leadership, no organization stays with a consistency and, and, and is able to implement that agenda in such a large place with that constant turnover. So I'm hoping that, as we talked about, we're now seeing the team being put in place and giving them the chance to do their job. But Leo Shane, who we're going to hear from real soon, I think is one of those people who has the really good ability to understand these issues, because of his length of time covering these issues. He is not afraid to tell you like it is he is a fair guy, whether you like his questions or not, are usually not coming with a specific gotcha agenda. So I think that he is in a unique position in Washington to be able to comment on this very special time that we're watching.

Louis Celli: 6:20

Now, I think you're right, Leo is very well respected in the industry. I've been interviewed by him, you know, a great number of times. And there was one occasion when I was I was young, in, in my position over at the American Legion. I've only been there for a couple of months. And I was always studying an issue. And he wanted to interview me on it. And I was I was giving him the best answer that, you know, that I possibly could give him and he had to stop and correct me. He's like, Well, no, actually, the law says this. And I knew right then in there, that, you know, if I was ever to speak to a reporter, especially Leo, Shane, I better have my facts together because he knows him. If not as well, sometimes better than the person he's interviewing does.

Dr. David Shulkin: 6:58

Yeah. And it will be fun to turn the tables, napkins questions.

Louis Celli: 7:03

That's exactly right. I I think he's looking forward to it as well. And he's such a great sport, too.

Dr. David Shulkin: 7:09

Yeah. So why don't we get him in here? I can't wait.

Louis Celli: 7:21

Leo, welcome to the policy. That's podcast. It is really great to have you here with us.

Leo Shane: 7:25

Thank you for the invite. You've been you've been trying to get me on here for a little while. And I've always got some breaking news that I'm dealing with. So I appreciate appreciate your patience.

Dr. David Shulkin: 7:34

But Leo, we're glad to have you on today. And I think before we get started, you know, we've all known each other for a while. But why don't you tell our listeners how you started focusing on veterans in the first place?

Leo Shane: 7:48

Yeah, I sort of I kind of wandered backwards into it. Actually, I wish I had like this inspiring story that I always wanted to cover the military veterans but I, I moved to a move to DC I had a politics career was looking for just another reporting job and started to work at Stars and Stripes, you know, convinced them that they had never had a congressional reporter before it convinced them that I could do that. Since they didn't have congressional Reporter They didn't know that. I didn't know what I was doing yet. But I learned on the job as much as I could. And it fascinated me covering the military community, how much people focused on the active duty military and not the veteran side. So as I got to do more of those stories, as I got just more welcomed in by the veterans community, it became a natural segue to focus on those stories focus on the stories of the folks after they came back and, and really just just hone in on those issues.

Louis Celli: 8:40

Well, and to be fair, I mean, you've been you've been recognized pretty much as an expert in this area. I mean, other news agencies and and outlets invite you on to tell them about veterans issues is is a kind of weird, you know, helping them with their news stories. When when you're reporting yourself. It's

Leo Shane: 8:59

It's terrifying. Whenever anybody says that you're an expert on this, I'm like, There must there must be somebody who knows more. I know there are people who know more than me so not like it's it's it's a it's a blessing in the sense that I think that it's tough for a lot of news organizations to cover veterans issues. I think that they don't always think about it until there's some terrible breaking news until there's some issue, you know, burn pits is now the big issue. I don't think I heard from several news organizations who said they didn't know anything about this issue. They haven't been covering it. So to be able to share what I've learned from the community be able to share what I've written on it's great to feel that that thing Yeah, it's it's weird. I'm used to being on this side. I'm used to being on the side where I'm asking the questions and, and you know, I get to poke you and ask what's going on. So it's, it's odd to be on the other side, but it's also I feel like I've got a comfort level to say I'm just relaying what you would what you would hear if you covered the veterans community better.

Dr. David Shulkin: 9:59

Well leave Sometimes I think that you fill a really needed void, because the department itself always doesn't make itself available to comment on these issues. They sort of aren't out there filling, you know, speaking on these topics, they they are much quieter in some cases. And you've been following the Department of Veteran Affairs and veterans issues for so long. Do you see major changes in the way that the political appointees make themselves available to the media in different administrations? Or have you worked with different secretaries or or press officers that are much easier to work with than others? Does it change a lot? Or is it been pretty consistent?

Leo Shane: 10:46

So this is this is where I would turn it back around and get you on these on some of these questions. If we were in a different, different? Look, I think it changes from it changes from Secretary to Secretary. So I felt that that you were very open personally, during during your administration there. I know there were constraints with the White House, after you left, we had almost no communication with with senior leadership over at VA and that has turned around dramatically under this administration, we do have a much more, much more open, we're having monthly press conferences, there's a lot more communication. Is it always 100% truthful? Is it always everything I want? No, there's always a push and pull. But but there is a there is a feel as we go along. You know, even even Secretary Shinseki, you know, back when in the beginning of the Obama ministration. He was someone who I respected greatly, but was not media savvy all the time was someone who was very reluctant to engage with the media. So you know, there's there's this continual change. And that's that I think that's always been the Achilles heel of the Department of Veterans Affairs, there are great stories, there are important stories, this is a this is a agency that has a very big budget that takes care of millions of veterans that provides a critical backbone of support for veterans, whether or not the department wants to, it needs to be talking about this, not just to me, not just the veterans community, but to the American public, the public needs to know what veterans how veterans are being taken care of, and when they're not and what else their needs are. So. So it's it's something that can always be improved. I have seen under this administration, some really big steps forward. And I hope that this is just the start of that.

Dr. David Shulkin: 12:28

Leo, I think that's really good to hear that you're getting that type of openness right now in this administration, because I do think that's important. And I think you made some really good points that it probably does depend upon how comfortable the Secretary or other political appointees are in terms of their own ability to speak to the media, but you know, regardless, but I always felt as secretary, that I had an obligation that if I took a job that represented my fellow, you know, Americans and and I was doing this with taxpayer dollars, that whether I wanted to or not that I had an obligation to make myself available to the media to ask questions that needed to be answered.

Leo Shane: 13:14

And it's, it's a, it's a philosophical approach to it. I mean, I always I always, we had plenty of times that we sparred on things, but I always felt like you were available. And you were not reluctant to talk to the media. It was exactly how John McCain operated on Capitol Hill, John McCain, there were plenty of times he would come over. And he would curse out reporters because he didn't like what they were asking. But he always made sure to come over because he said part of my job is communicating to the public. There's there's a trend with, with conservatives now and even some some members Democratic Party that I can communicate with voters, I can communicate with the public on my own, I don't need the media, I don't need to answer. And, you know, as a reporter, that's disheartening. Because my goal is not to tear someone down. My goal is not to, you know, push an agenda. My goal is to inform the public. And I know we have a lot of veterans and military members who are reading us who just want to know what's going on. So. So even if you're not giving me an answer that I like, all the time, I just I care that you're giving me an answer.

Louis Celli: 14:12

You know, you've brought up some things about the, you know, about the environment, about the the political environment, about the personnel, and we're going to talk about that a little bit later. And one of the things I'd like to like to get your perspective on is because you've been doing this a while, what are some of the biggest changes you've seen over the VA and in this, you know, in this community over the past, say 10 years?

Leo Shane: 14:32

Yeah, I mean, I think it's, I think it's people caring. I think like, I remember when I started covering these issues I had, I had folks from the Veteran Service Organization saying no one will no one will talk about us. No one will talk about our issues. And especially when I started at Stars and Stripes, this was back in you know, 405 it was the height of the the Iraq War, the Afghanistan wars. Everything was focused on the the current operations and the active duty stuff. There was very little thought given to what happens to these folks when they come home. Very little thought given to all the folks who'd already come. I mean, when people hear how long the agent orange fight has been going on, when your average civilian hears that they're astounded that, that that wasn't taken care of sometime in the 80s, or even the 90s. That, you know, as late as the 2000 10s, we're still dealing with some of these health conditions and learning about it. So. So there is a there is just a more cultural awareness. Some of that is the size of the VA budget VA budget was $40 billion back in 2000. It's $270 billion dollars. Now. I mean, that's, that's a gigantic sum of money. There should be more reporters tracking that money. It shouldn't just be me. I'm happy to get all the stories that I can. But there should be some other folks who are who are digging in as well.

Dr. David Shulkin: 15:47

Are you saying that you don't have colleagues and peers that there's not, there's not a group of you who meets together secretly for breakfast that follows all the VA, you know that the the lease arrives from the bank will not

Leo Shane: 16:02

reveal any of the names on our secret VA Chatlin on this podcast, but there there is a very healthy VA press corps. Now, I think I think you know, you remember from your time, there's a few regulars that you saw, but you're really talking about three or four folks whose whose face you saw, were probably closer to 10 or 12. Folks, when you look at the DOD, there is a cadre of about 70 people who are regularly covering every aspect of that department. And it's I am not taking anything away from it. It's a major department, it is a major part of America, it needs to be covered. But so does VA there's like there are major papers that that have had people part timing this that people sort of wandering in and out on on different issues. And unfortunately, I've seen some great colleagues who have done great VA work just sort of fade off because their papers don't don't support them. So luckily, Military Times, this is a core audience for us. We you know, they're not going to take me off the veterans beat but but it's a tough sell. Even though every community in America has veterans, everybody's got veterans, everybody should care about this. It'll be interesting to see with with this, and maybe we'll get into this. But this upcoming asset and infrastructure review, when we start to see some facilities being closed down, we start to see some facilities being built, is that going to have more of a local community effort, people are going to all of a sudden say, wait, wait, what is? What is VA doing? What does it mean to have a VA hospital in my backyard? Is that just is that just another landmark? Or is that actually reflective of the number of veterans and the number of veterans needs in this area?

Dr. David Shulkin: 17:39

All right. Well, you mentioned there's commission so you know, you brought it on? Why don't you tell us whether you think that there really are going to be VAs that are going to be closed,

Leo Shane: 17:51

I know there will be VAs closed, we haven't as of this taping, we don't have the names yet, but they have talked about building a few more VA medical centers and closing four or five, maybe even a few more. It's it's a it's gonna be an interesting restructuring. We've already heard some of the leadership pitch this but look VA needs to evolve to there are other health clinics out there, what they're talking about replacing these, these VA medical centers with our outpatient clinics are partnerships with other local clinics. So if you say we're going to close down a VA hospital, that's going to panic. But if you say we're going to build three more outpatient clinics all around town, and it's going to be easier for everybody to get there. That's that's great for veterans. And that's this gets to the inherent access issues of all the complaints I've heard about VA over the years are not the quality of care or not the care, the actual sincerity of care people, the veterans, I talked to love their VA doctors, they love going to see them, it's a matter of whether or not they can get in and if they've got a three hour drive to get there. So so does does, you know, in places like Ohio, and places like upstate New York, do, they need to have these large VA facilities when there's not the demand there. And conversely, then they need to have like seven VA hospitals in Arizona, because everybody in the world is moving down there. And they've got all these veterans that need care,

Louis Celli: 19:13

you bring up a really good point about interview one of the few people that cover this and you're happy to get all the stories, but you know, you get caught up in the emotional rollercoaster of each issue and report as an advocate spent a lot of time trying to forecast and predict like, what the announcements will be about and who the nominees will be whether someone will be resigning or getting fired. And you know, it's a fast moving train, is it is it hard to keep up with all that?

Leo Shane: 19:38

It's it's a lot and it's, you know, part of part of the job is figuring out what's worth highlighting and what's not. Well, I mean, I tell I tell people who aren't reporters all the time you don't. The part you don't understand is that why I don't write certain stories and why I can't get to certain stories, how you prioritize things. So And from my perspective, It's a different priority than a lot of a lot of folks perspectives are getting getting back to the earlier idea of VA doing a better job talking to reporters marketing themselves. I want to write stories about PTSD pilot programs and about education and, you know, job training programs that are out there. Those are things that I know the Washington Post can't cover, because there's just not the concentration of interest on that. But but for me, for my audience, for military veterans, audience, those are those are huge things. They want to know if there's a this this program that's going to help 15,000 veterans, okay, I understand why the New York Times can't cover that. But like, please talk to me about that. Please let me get that out there. So and as you said, there's there's always, at the heart of all this is is the veterans themselves. So I get I get emails, several emails a day of folks, I lost my benefits, my caregiver benefits are in danger. I have this question about burn pits. I will tell you that the the most rewarding thing I've done in my career when people ask me what's what's my favorite story was, was back when the when the post 911 GI bill first passed when I was at Stars and Stripes, we we just did a mailbag. We just did a mailbag of people sending in questions, we did our best to answer all of them. And I felt like I was helping veterans all over the world, figure out their education plans for the next 10 years, potentially changing their whole life. And I can't, I can't point to a single person and say, I know because you read my story, you got this career and your life's better. But I sure hope those folks are out there because I poured a lot of time and effort into doing that. And I, I know, just from the response, I got that a lot of people were appreciative, just be able to say, thank you. I just I just needed these questions answered at a time when VA setting up stuff, and it's a hard bureaucracy, and you could just get down to helping some individual folks understand what was going on.

Dr. David Shulkin: 21:52

So Leo, I have to go back to your predictions on the errors Commission and the restructuring of the system. Because, you know, you make it sound easy. You make it sound rational. It seems like it's in the best interest of everyone. But you've been covering this long enough to know that that isn't always the way the story gets written in Washington. And so why don't you see the IRS commission really deteriorating into a political battleground? You know, this is typically been the issue that has divided, you know, Congress on where and what the VA should look like and should be structured. And is this really simply another stalking horse to downgrade the VAs capabilities?

Leo Shane: 22:44

Yeah. And that, look, you're right, this is going to be a massive fight over the next year, I guess, I guess my my perspective on this is I have I have covered base closing rounds, way back in the day. They were always contentious, they were always a mess. But they did ultimately go through. So there is a level of you know, we've seen the commissioners who are named to the to the commission. Now, there's a level of, you know, Carl Blake's on there, Pat Murphy's on, there's a bunch of names of folks who I know are connected, who I know are really going to listen to the veterans community. You know, without without putting myself too far out there, I have some faith that they'll at least be able to put together some intelligent consensus steps forward. And if they can really make a convincing argument as to why closing a few VA Medical Centers is beneficial if it's replaced by these other things that so what we know right now is that a total the number of VA medical facilities is going to increase by about 100. So that means that there will be more partnerships, more building. So if they are successful, they'll sell it as we are providing more care, even if we're seeing some individual buildings go out. But you're right. This is for folks in South Dakota, if they closed down that hotsprings. Va, it's going to be messy, it's going to be a very angry situation. And they're going to need to justify it. If they code Chillicothe, Ohio and they say that VA is gone. That's going to be messy for the entire Ohio delegation, there's going to be a big fight there. So you know, of course, Congress is always rational and calm and has no emotional outbursts. So I can't imagine Congress will, will take apart like, it's, it's politics, and it comes down to politics to come down to how well they how well they pitch some of this, but there's going to be communities that are hurt by this. The question is, in the aggregate, is it going to be better for veterans as a whole?

Dr. David Shulkin: 24:40

Well, you know, Leo, I love this where I get to ask you questions instead of the other way around.

Leo Shane: 24:45

Very uncomfortable.

Dr. David Shulkin: 24:46

Yeah, but it's so much easier, I'll tell you. But listen, you say that the commissioners have been named to the heirs commission. That's not exactly true. The Democratic commissioners have been there The chair of the commission has been named but the Republicans,

Leo Shane: 25:04

that one Republican has been named, the Republicans still are waiting on the other one. And that is that is a bad sign that is a sign that this is already becoming politicized. We're supposed to have that name a year ago, almost a year ago. Right? You have to wonder if, and I have heard, you know, the groups involved. I've heard from quite a few groups who are already saying, the Democrats have ruined the purpose of this, the purpose of this was to trim down VA, the purpose of this was to push more care into the community and McDonogh is not doing that McDonald instead is building up VA, and this is all going to be a disaster. So you know, look, the Congress is probably going to switch hands in the fall. So this is probably going to be a decision to be made to be made by a Republican controlled Congress around this time next year, whether or not to accept these recommendations. And that could be a real big hot potato. I do wonder if even even with those ideas, if VA is proposed, while while there is an overarching feeling on the Republican side that VA needs to scale down, and it needs to push more care into the community. If VA comes to Kansas and says we're building 10 More VA facilities there is is Jerry Moran going to say, No, I won't support this, or is Jerry Moran gonna say? Well, it's really good for Kansas, I wish you would do a better job. But it's really good for Kansas, it's really good for Arizona, it's really good for Texas, like there are certainly places that that as much as they say in this, this gets back to the whole thing. Everyone wants it to be down grid, it's just not in their own backyard. Everyone wants the extra VA facilities for them. So

Dr. David Shulkin: 26:44

the funny thing hearing you talk about this, of course, when I used to go before Congress, the last thing they wanted was for VA to build anything because it was after the Denver debacle of a $4 billion construction, you know, fiasco and I used to, you know, they used to say to me privately, VA should not be in the construction building process. We don't want to authorize anything for you. And so that's times are changing.

Leo Shane: 27:13

Well, that's also where the devils in the details here, because they again, we haven't explained everything yet. But if they're talking about outpatient clinics that are partnerships with with local, you know, civilian doctors, then is that building is that just sending some doctors over here are there are there ways to do partnerships that are lower impact, but have more reach, but also, fundamentally, just just make sure that veterans are being taken care of and veterans have have lower, lower drive times and more access.

Louis Celli: 27:43

And it was interesting to hear you talk about the IRS commission and what some of the groups were, were sharing with you that what they thought that the purpose was, and I can tell you I was in the room when that was being negotiated. And that was not the purpose of purpose was not by the group to push care out into the community. It was to take a responsible look at VA and find out where there is over capacity where there's under capacity with a with a bright knowledge of it could conceivably include building more facilities. And it's interesting now that that was that was a bit of a partisan wrangling when we were negotiating the mission act, actually. And now one of the very first announcements to come out was in as you said, South Dakota and you know, Senator Thune very powerful, you know, very powerful senators, one of the first ones come out and say, Well, no, you're not closing anything here. So, you know, what, what is it that you see coming out of this?

Leo Shane: 28:43

I see a very interesting year long discussion about what VAs role is and what VAs footprint should be. And to be honest, if that's all that comes out of it. That's that's probably good for the country there. I mean, that is at its heart. That was one of the issues here. As you said, a lot of this falls in the eye of the beholder. I remember plenty of folks saying, Look, we could build more facilities. I also remember plenty of folks in the Trump administration saying, Yeah, I guess we could build some more facilities. But really, this is about closing. So it's, it was what part of the sentence did you want to yell? And what part of the sentence did you want to whisper? So but look, this is eyes, as we've heard from from, I think the last four or five secretaries in a row now and I know I know, Secretary Shulkin, you were talking about this. VA has a has a aging infrastructure. There is there is no debate over that many of these facilities, there needs to be a hard look of, are we going to close them down? Are we going to demolish them and replace them? Are we going to upgrade them and if we don't upgrade them? How? How disrespectful is that to the needs of younger veterans, the needs of women veterans who there's not facilities in some of these places for them. How do we address that? So if this becomes a at its at its best, this is a year long. public conversation not just in the veterans community but with local communities about what's the importance of VA medical facilities? What role does it play in America right now? And where do they need to go? That's the best case scenario and its worst case scenario. It's a partisan fight over privatization and, and outsourcing, VA is mission and everyone just yells at each other. And we're back to square one. And we end up with a handful of VA facilities that are a year older and with no real plan for upgrading them.

Dr. David Shulkin: 30:31

So Leo, you know, these are these are complex issues come healthcare is complex alone. But when you interface the needs of veterans, the political aspects, you know, what the future of healthcare holds, and whether you need these facilities, it gets very complex. And it's even more complex when there hasn't been an undersecretary for health since February of 2000. The

Leo Shane: 31:00

last one of those, I'm trying to remember the last guy who had that job, who was Senate confirmed, I think he went on to some other jobs.

Dr. David Shulkin: 31:07

Yeah. But you know, Leo, it's been more than five years, and you haven't really covered that issue in terms of how can you have respect for our nation's veterans, and have the essentially the CEO of the health system position open for five years? And you know, who is going to make these complex decisions? Of course, there's the Secretary, but the Secretary has a lot of things on their plate. But, you know, so that now finally, yesterday, there's a nomination for a new undersecretary, which, of course, I think is great news for VA, they still have to get confirmed, of course. But that's what we need. We need somebody who's in that chair, who can help oversee and guide some of these decisions.

Leo Shane: 31:59

It is it is astounding to me that we are two years into a global pandemic where VA was called on to implement its fourth mission to act as the backbone to America's health system, to reach out help vaccinate all sorts of federal workers on top of all the veterans and family members they had to do. And we did all of that without a Senate confirmed head of the Veterans Health Administration like I, again, you you were the last one to serve in this job as Senate confirmed, there have been folks who have have done admirable work and acting jobs in the interim. But but this is this is not just another throwaway Pentagon position where you're making you're pushing some stuff. This has been very key health care decisions, very key, you know, guidance for where what, what should be the priority for medical care for how things should operate for setting up vaccination priorities for all sorts of stuff, and it's all been done on on an interim basis. That is that is mind boggling. I cannot I cannot imagine the DoD getting away with this the same way the VA did. I cannot imagine there wouldn't be just a front page stories on major newspapers. I've written quite a lot about this. They've had candidates things have fallen apart, you probably know more behind the scenes on some of these than I do. But but it's been it's it's been a point of frustration for for the veterans groups been a point of frustration for for, frankly, the media to know, again, not to diminish the Secretary's vote at all. But you're you're supposed to have somebody who's your right hand man answering these medical questions for you, or right hand woman and there's been a right hand, nobody this whole time. So it's astounding. It's just astounding that that now so it would not surprise me if this is a record for one of the quickest confirmations and Senate history because I know lawmakers have been dying to get someone in there. So if if they if they call him up next week and say your confirmations on Thursday, and the votes on Friday, good stuff in here. I wouldn't I wouldn't shock me.

Louis Celli: 33:59

Well, let's let's talk a little bit about the pandemic. You mentioned it. And you know, the nation has essentially gone undercover for a couple of years. So have you know, so have many of the departments VA is no different. And now we're starting to see as we emerge out of the pandemic, what does the infrastructure of VA look like? I mean, with regard to employees, employees coming back to work, the amount that have stayed the amount, the the amount of left, you know, caregiver support caregivers now is, as you know, is starting to heat up and become an issue. There's a lot EHR modernization, there are just so many major projects that have kind of either gone to sleep, or we just haven't heard much about them. What are we looking at coming out of this? Yeah, it's

Leo Shane: 34:41

it's gonna be interesting, because on top of all those things you mentioned, there's just the the issue of the deferred care, too. I mean, it's not just that VA has to return to normal operations. You've got to return to super normal operations where all of those all those cancer screenings, all of those just routine appointments and those checkups never I think they all have to be made up for now. And there's going to be health complications that come in there. So there, again, it changes from administration to administration, this administration seems very focused on building up VA more. They're not talking about reducing folks, but they are talking about a more, I guess, a more pro worker environment. They're talking about more telework capabilities, talking about more telehealth capabilities to talking about maybe not the, the old established thing. And I think, you know, just a few years ago, these were these were kind of unthinkable actions, not just not just because of, you know, stodgy old policies, but because of the technology available, because what people know, I mean, you know, that the idea of doing major, major corporate meetings on Zoom was was unheard of three years ago. And now it's commonplace. So, you know, to get the multiplier of more telehealth to be able to say to benefits processors, hey, I don't know if I care if you come in every day, but just come in on Friday and get your work done. Maybe that creates more, maybe that creates more efficiency. Maybe it doesn't. And maybe we find a year from now that folks who could come back yeah, just wanted to stay home because they're feeling lazier, it gets back to that oversight. And as you know, VA is not an easy, not an easy department have oversight, we're talking 400,000 plus employees, we're talking about taking care of, of 9 million veterans, that's before we get into all the benefits and all the money that goes out the door. This is just a massive unappreciated agency, for most of the public, and I, you know, as much as we talk about it as much as the VSOs scream about it. I don't know what it's going to take for the public to start viewing VA the same way it views DoD the same way of views the Department of Education in terms of its importance to the core of America,

Louis Celli: 36:50

well, we're coming up, kind of on the end of our time, but I mean, there are so many issues that I want to make sure that we touch on real quick, like some of the big issues like, you know, burn pits and the expansion of community care, you know, where do you see these things? Is there going to be a huge fight over how much VA has spent historically now on community care, as opposed to even three, four or five years ago? And, you know, are we going to need legislation for burn pits? Or is VA just going to solve it with administrative, you know, decision making, How's that look?

Leo Shane: 37:21

Now we're gonna need legislation on burn pits. I mean, that's, that seems clear, just just looking at the past, VA will, will take some steps, but there's some stuff they're going to have to be forced into uncomfortably. And, frankly, there's cover and legislation and decisions that have to be made this burn pits is going to be the big issue this year. And that's largely thanks to President Biden putting it in the State of the Union address. This is something that Military Times was writing about as far back as 2008. Before my time with company, we've all known it's a problem. We all know, the health issues, the country is finally going to have I believe the country is finally going to have a good reckoning on this this year. And we'll see if that means legislation on community care. That's going to be wrapped up a lot. I think in the the commission, I think that we'll have some really interesting conversations about what does it mean to co locate VA doctors with private doctors? How does this relationship work? How is the money actually being spent? You know, there's, there's a very big conversation to be had about what are the standards to it's not just enough to say, well, we need VA doctors to do this. But if you go to a private doctor, they can do whatever. So Congress and VA have to come to terms with how are they going to set standards for what care is available? What are the access standards, one of the wait times for private care so so they're ones and the other one that you didn't mention, but I know you're thinking of his caregivers, that's that's going to be a nasty fight this year. There's a lot of caregivers that are being dropped off the VAs program this fall, or actually, they won't be dropped off till next year. But as we talk about the burn pits issue, as we talk about military families, I expect there to be a lot of conversation about caregivers to expect Congress to get involved at some point and try and rein in some of the changes that are being made to that program.

Dr. David Shulkin: 39:01

Hey, I think Leo, your predictions, your thoughts, your your understanding these issues are really helpful. We really appreciate you being with us. I'm gonna just wrap up with one final question. And that is this invasion of Russia into Ukraine, I think has the potential for changing everything in American politics and issues. Do you see coming out of this, that the American public is going to have a renewed interest in the military, the US military and veterans and that this will help galvanize some of that interest that you've talked about in treating our veterans the right way? Understanding that America can't retreat from the world stage.

Leo Shane: 39:48

Yeah, let me let me put my my veterans community hat on and say, Yes, I believe that that country will and will, you know, there there'll be the you know, this is obviously this is this is a Conflict, like we haven't seen in quite some time. And there is, you know, it's it's so connected to what the world could be. And people are seeing horrible images for Ukraine. So this, of course, is going to be something that gets people more invested more involved in the military and more aware of the veterans community. Let me take off my veterans community hat and put my reporter hat on and say no, I mean, I, you know, we've seen this before we've seen it's, it's so like, I, the thing I always come back to with with veterans issues is I know, they don't affect a lot of folks outside the veterans community. But there's veterans living on your street right now and affects them that, you know, people this affects, and there is a there is an empathy in there. So I, you know, if if US troops aren't directly involved in Ukraine, I wonder if it will amplify any message for the US military, I actually think that the burn pits issue may be bigger in terms of people refocusing on what the military has done, what the sacrifice has been, then Ukraine, that's, of course, being very hopeful that US troops aren't pulled into the situation Ukraine, and with Russia acting as erratically as it is. That's the fear, right? That's the fear. There's a there's 100,000 US troops in Europe, there's very sensitive areas, there's some folks that are very close to the frontlines of the fighting. Now, without actually being in Ukraine. It doesn't take a lot of mistakes for us all of a sudden to slide into a world war. And God forbid, I don't, as much as I love covering veterans, I don't want to be creating more combat veterans with more wounds to cover I want to be talking about how to fix all the ones that we haven't dealt with yet and hopefully, lead to a future where we're just dealing with, with old issues and folks coming out of a peacetime military where I can talk about those education and those job training programs that I'd like to write about

Louis Celli: 41:49

Leo, as you drop the mic there. That's a perfect place to end and I just, I can't thank you enough for taking the time to join us. This is really this has been one of our one of our greater podcasts, and we appreciate having you on. And that really is all the time that we have for this week. So listen, join us next week. We've got a great podcast coming up. We've got Kelly McKeague, the director of the defense pow Mia accounting agency DPAA you're not gonna want to miss this. We'll see you next week.

Charlie Malone: 42:24

Thanks for listening to the policy. That's podcasts. For more information about projects and other podcasts. Go to policy. That's dot org.