During preparation for my confirmation as secretary of Veterans Affairs (VA), I was repeatedly asked, “Why doesn’t VA just hand out vouchers allowing veterans to get care wherever they want?” For a department recovering from serious issues involving health care access and scheduling of appointments, that was a legitimate question.
After nine weeks at VA, travel to 31 VA facilities in 15 cities, discussions with hundreds of veterans and VA clinicians, meetings with 75 Members of Congress, two hearings before the Senate and House Veterans’ Affairs committees and dozens of meetings with Veterans Service Organizations and other stakeholders, I can answer that question.
Veterans need VA, and many more Americans benefit from VA.
Almost 9 million veterans are enrolled to receive health care from VA a unique, fully-integrated health care system, the largest in the nation. The VA stands atop a critical triad of support three pillars that enable holistic health care for our patients: research, leading to advances in medical care; training that’s essential to build and maintain proficiency of care; and delivery of clinical care to help those in need.
VA’s accomplishments on all three pillars and contributions to the practice of medicine are as broad, historically significant and profound as they are generally unrecognized.
VA is affiliated with over 1,800 educational institutions providing powerful teaching and research opportunities. And our research initiatives, outcomes and honors are tremendous. Few understand that VA medical professionals:
Pioneered and developed modern electronic medical records;
Developed the implantable cardiac pacemaker;
Conducted the first successful liver transplants;
Created the nicotine patch to help smokers quit;
Crafted artificial limbs that move naturally when stimulated by electrical brain impulses;
Demonstrated that patients with total paralysis could control robotic arms using only their thoughts a revolutionary system called “Braingate”;
Identified genetic risk factors for schizophrenia, Alzheimer’s and Werner’s syndrome, among others;
Applied bar-code software for administering medications to patients the initiative of a VA nurse;
Proved that one aspirin a day reduced by half the rate of death and nonfatal heart attacks in patients with unstable angina;
Received three Nobel Prizes in medicine or physiology; seven prestigious Lasker Awards, presented to people who make major contributions to medical science or public service on behalf of medicine; and two of the eight 2014 Samuel J. Heyman Service to America medals.
No single institution trains more doctors or nurses than VA. More than 70 percent of all U.S. doctors have received training at VA. Each year, VA trains, educates and provides practical experience for 62,000 medical students and residents, 23,000 nurses and 33,000 trainees in other health fields people who go on to provide health care not just to veterans but to most Americans.
The 278,000 employees of the Veterans Health Administration work in a system spanning all 50 states and beyond, providing from Maine to Manila a high volume of quality, clinical care. Our 150 flagship VA Medical Centers are connected to 819 Community-Based Outpatient Clinics, 300 Vet Centers providing readjustment counseling, 135 Community Living Centers, 104 Residential Rehabilitation Treatment Centers, and to mobile medical clinics, mobile Vet Centers and telehealth programs providing care to the most remote veterans.
That network of facilities allows VA to deliver care to veterans from the greatest generation of World War II to the latest generation from Afghanistan and Iraq. In 2013, VA provided over 90 million episodes of care; that’s an average of over 240,000 each day. And since 2004, the American Customer Satisfaction Index survey has consistently shown that veterans receiving inpatient and outpatient care from VA hospitals and clinics give a higher customer satisfaction score, on average, than patients at private sector hospitals.
Finally, VA is uniquely positioned to contribute to the care of veterans with traumatic brain injury (TBI), prosthetics, PTSD and other mental health conditions, and the treatment of chronic diseases such as diabetes and hepatitis. The work we do in these areas, as well as many others, produces results and life changing improvements in care for veterans and for all Americans and people around the world who suffer from these conditions.
Fixing access to VA care is important; we have a plan to do that and are dedicated to implementing it. That process will take time but it must be done, and we will be successful. Those who fully understand the value of the department in research, training, and clinical care understand that veterans and all Americans need and deserve their VA to continue providing exceptional care to those we serve.
Robert A. McDonald is secretary of Veterans Affairs. His email is Bob.mcdonald@va.gov.
