National Press Club

I really am glad to be at Press Club today, for many reasons. First of all, for Veterans. The Press Club has a unique place in the annals of American’s service. The American Legion post—and it was established here, right after World War I—continues to this day, and amongst its members: General of the Armies Jack Pershing. And that is a testament, to the bravery, the frontline service of American journalists throughout the years.

I was privileged just a few minutes ago by your President to receive the collected words of Edward R. Murrow, and the autobiography of Walter Cronkite, a man who served as much time on the front line as many of those who were commissioned or who were enlisted in the fight against both Germany and Japan.

The other thing I will say, is that last night the President opened with a very optimistic theme about America’s comeback. For those of us who have served, and for those of us who serve Veterans to this day, I think the hallmark of yesterday evening was the presence of [Brigadier] General Charles McGee. I had the great privilege of hosting General McGee when he was a colonel, a few months ago, and he is a testament to the valor and the stick-to-it-ness of the American Nation, having served in combat in three great wars—World War II, Korea and Vietnam—and as an airman who has never had wings, I stand in awe of his accomplishments.

Before I tell you that the state of our VA is very strong and is in a position that we have not been in in many years, I will speak to you about the events that occurred on Monday. As many of you have covered, we’ve left, locked out, or had to part with the Deputy Secretary of Veterans Affairs. It is a simple business decision. There are times in any company, and in the military, and even in Congress, when there are some people in the organization that just don’t gel with the rest of the team. IBM just let go of their CEO of many years. The Chairman of the House Committee, Mr. Takano, just relieved a senior member of his staff, which he felt was in the best interest of his organization and Veterans. It was nothing personal, but we have so many things going on. It has been my mission, my goal, to ensure that everyone who works for us is performing to the utmost.

A few years ago we were accused—when it came to accountability—of only holding those at the lowest end of our workforce to account. I’ve read many stories that you’ve written about sterile-processing units and custodial workers bearing the burden of changes at VA. I have to tell you, in the time I’ve been with the VA, if people don’t live up to the performance standards that our Veterans expect, and some of that may be through no fault of their own, it just may be a bad fit, then I have taken action. We have removed medical network directors, we’ve removed hospital directors, we’ve removed custodial staff, and so I wish Jim Byrne well. He was a man of great distinction in terms of his service to the country. But I will say it was a simple business decision. The other thing I will say, and I will categorically emphasize this, that some of the reports that I read that this had to do with a disagreement over the handling of the DC VA and Andrea Goldstein are categorically not true. There was no disagreement there. I think what happened is that this just happened to occur when the story re-emerged again. We agreed on the policy from day one, and it had nothing to do with a process that began well over a week ago. So my goal is to make sure that we have an organization that hums along, that is integrated with not only our headquarters, but also with our people in the field and having learned this business from people with names like Rumsfeld, Gates, and Mattis, we do that from time to time. It is never easy, but I do believe that it was in the best interest of the organization and in the best interest of carrying on the reforms that have taken place.

Yesterday I was struck with an incredible statistic. When I became Secretary of VA, I was told that only 25 percent of women Veterans were part of the VA family. Well, last year, on December 31^st of 2019, the new statistics came in. And those statistics showed that 41 percent of all women Veterans in this country are now part of VA. [CLARIFICATION: In the past 20 years, the percentage of enrolled women Veterans using VA healthcare has risen from 20 percent to 25 percent, and in the past two years, enrollment of women Veterans has risen from 40 percent to 41 percent.] We are leading the change in the military culture. When my father was first commissioned, two months before President Kennedy was inaugurated, less than one half of 1 percent of those in uniform were women. As the Under Secretary of Defense under General Mattis, 19 percent of the force was female. For Veterans, that means right now 10 percent of all Veterans in the United States are America’s fighting women. And for us, to see those numbers rise so dramatically is an affirmation of how well we have advanced as a culture, how well we are caring for the needs of our women Veterans, and we expect that those numbers will increase in the next few years.

That also, is right in line with the actions that we took when the incident of DCVA took place late last year. We immediately referred it to the Justice Department. We took it out of the hands of VA police, and that is part of our commitment to ensure that everyone who walks into a VA is safe, and is taken care of, and then when anything happens we make sure that the highest authorities are informed. And I will also add what I have said to some of you, and it has been in some of your publications: I met with the Inspector General last night, and we are working to make sure that the House Veterans Committee and Ms. Goldstein receive all of the information available to make sure that their needs are taken care of, and we have a great concern in that regard. So, those issues will play out in the next few days. But I will also say that even though we have had a change in some of the leadership in our VA, not one appointment has been missed, not one operation has been canceled, and our Veterans are coming to us in numbers that are unprecedented in our history.

So, this is the new VA. This is not the VA that existed in 2014. This is not the VA that existed in 2015. We are the Nation’s largest integrated healthcare system, and that means we still have ongoing challenges that any large organization will face, but we have seen improvement in three broad areas. We have redirected ourselves to doing a better job in customer service. That is our single mission, not dodging scandal after scandal. And the numbers show our success. Our wait times, according to organizations like the American Medical Association, are good or better than any in the private sector. We are seeing more Veterans than ever. We completed 1.7 million more appoints in FY 19 than we did in FY 18, for a record 59.9 million appointments. Ninety percent of our Veterans surveyed trust the care that they get at VA. The Veterans of Foreign Wars most recent survey showed that three-quarters of the respondents recommend, to those Veterans who are not part of our organization, to join us.

As I said earlier, we brought back accountability. More than 8,000 employees have been let go from employment for not meeting the performance standards that our Veterans expect. There is no record like that in the Federal Government.

But we have also shown that we can implement dramatic organizational change needed to provide modern services to America’s Veterans. The Mission Act gave Veterans real permanent choice. In the first six months, we approved nearly 2.8 million referrals to the private sector on behalf of 1.5 million Veterans. This year we will implement the provision of the Mission Act that will extend caregiver benefits to Veterans from my father’s era, Vietnam, and others who served before 1975. and we are about to launch the electronic health record, which promises to revolutionize the experience Veterans have at the VA.

Now, we are in the middle of a long overdue national conversation about Veteran suicide. This is the first time in our history that the President of the United States has focused the energies of his office and the Federal Government on an issue that has afflicted the armies of the United States for well over a century. The first statistics on Veteran suicide were compiled during the administration of Benjamin Harrison in the 1890’s. Those numbers have been steady throughout the years, they spiked right before World War II, and they spiked after Vietnam. But as I’ve said, when I present the results of our President’s Task Force to the President and to the Congress, if we simply look at the last tragic act in a Veteran’s life, we will be doing a disservice to the entire country, if we do not look at homelessness, addiction, and mental health.

To tell you how dramatically our country, as a whole, has changed, when I was in high school in Fayetteville, North Carolina, the leading cause of death for high school students in America was automobile accidents. Today, the leading cause of death for America’s high school students is suicide. I believe that Veterans can show the country the way on how to deal with this terrible problem. Because most Americans, at whatever level they are, understand what it means when someone puts on a uniform and sometimes takes that uniform off. In terms of never having a conversation about mental health we are, at VA, providing now same-day mental health service. We’ve launched now universal screenings for all of our Veterans to identify any Veteran who may be at risk, and more than 4 million Veterans have been screened in the last year and a half. Our Veteran Crisis Line takes 1,700 calls a day, and we physically act on 100 of those calls to get immediate help to Veterans and their families.

But we cannot address this issue alone. 60 percent of those 20 Veterans a day who take their lives have no contact with us. That is why the President’s Task Force is so important, and I will recommend to the President that we open up the aperture and the support to local governments and non-governmental organizations, and give them the financial resources that they need to help us find those Veterans that we do not see.

Now, the third part is that we are living up to our legacy of technological and medical innovation that is benefitting America’s largest healthcare system. These improvements are not just improvements for Veterans, they are improvements for the entire county—something that President Nixon predicted when my father’s war in Vietnam wound down. Nixon signed legislation to boost the profile of Veterans in our society. He said, by giving our Veterans the gratitude and opportunity they deserve, we are not only doing the right thing for them, we are also doing the right thing for all of us. Each returning Veteran is a human resource—a mature, highly motivated young citizen who has proven the capacity to serve and to achieve. These young men and women provide the strongest hope for America’s future.

Nixon was correct more than he could ever know. The VA had already invented the cardiac pacemaker by then. It was the first to perform a liver transplant. Developments that would benefit the entire Nation. The 1980’s VA invented the nicotine patch and, in the first decade of the new century, unveiled the first powered ankle/foot prosthetic, ushering in a new era of increased mobility for Veterans and other disabled Americans.

But, our work isn’t done. Our innovative staff is already making a difference in people’s lives on other fronts. Cancer usually means surgery. We’re administering poison to kill the cancer that severely weakens the patient. With precision oncology, we are now designing treatments that attack the cancer and not the patient. We have already built targeted therapies to attack leukemia. These therapies are already making that cancer lessening. One researcher called VA’s precision oncology program the future of America’s cancer care. That means earlier detection, less guesswork about treatment, and more comfortable patients.

VA will now have the first 5G hospital in America. President Trump, last year, challenged America to be the first 5G wireless service, and VA met that challenge. As I speak, a hospital in Palo Alto is about to become the first 5G-enabled health facility in the world and should be operational this week. Some might ask, ‘Why is 5G important to Veterans?’ What 5G will deliver is richer, more detailed 3-dimensional images of a patient’s anatomy. The resolution is so clear and consistent that it will give us reliable means of delivering tele-surgery services to Veterans across the Nation. That means we will have the capacity to allow VA’s best physicians to consult during surgery, even if they are not in the same room and are halfway across the country. It will also be a breakthrough for surgeons in the operating room. Imagine a doctor being able to see layers beneath the skin before the first incision is ever made. The FDA was never able to approve these sorts of practices and surgeries because 4G technology simply could not carry that much information. But we are on the cutting edge and moving forward in ways that just a few years ago were unimaginable.

The VA’s expertise in treating Veterans has led to a new branch of research and to exoskeletons that change people’s lives daily. Traditionally, exoskeletons do the work of moving patients who can’t move on their own. But we’ve launched a pilot to develop exoskeletons that simulate the spinal cord, and we’re seeing promising results. Instead of the exoskeleton moving the patient around, the patient can increasingly control the exoskeleton as their own muscles are reactivated. With further research at the VA, we are hoping to turn the exoskeleton from the mobility device into something that trains injured people to walk again under their own power.

Virtual reality is not a technology that VA developed, but we partnered with the University of Southern California and a non-profit called Soldier Strong and applied VR to help Veterans with PTSD and pain management. Veterans with PTSD are often not able to process the emotions related to a traumatic experience in the field. Virtual reality allows them to relive, re-imagine those traumatic events and control the setting under the care of clinicians. We found that giving Veterans the chance to process those emotions can be an effective treatment for PTSD. Virtual reality can also help block pain signals from reaching the brain and thus is a drug-free supplement to traditional brain therapies.

Telehealth: Telehealth is a tool VA is already using to consult with rural patients. Rural Americans to this day provide more Soldiers, Sailors, Airmen, and Marines than any other part of the country. We’ve partnered with Walmart to reach Veterans this way, even when they don’t live anywhere near a VA clinic. Telehealth is also being used to diagnose patients remotely. Many Veterans develop diabetes, for example, which makes it harder for the body to deliver blood to the extremities, and that can lead to foot ulcers. These ulcers developed, and as they develop they cause temperature variations in the foot. Today, VA can monitor those temperature variations by using floor mats embedded with thermographic sensors that Veterans can use at home. VA doctors can detect these variations remotely with the telehealth connections. These foot ulcers cost VA $3.2 billion a year. Now we can get ahead of this problem by detecting them earlier and directing.

So that is the state of President Trump’s VA. We are once again fulfilling the sacred promise to aid America’s Veteran. When Washington delivered his farewell orders to the Continental Army in 1783, he said it was now America’s duty to welcome those soldiers back to civilian life. As he put it, “And shall not the brave men who have contributed so essentially to these inestimable acquisitions, retiring victorious from the field of war to the field of agriculture, participate in all the blessings which have been obtained? In such a republic, who will exclude them from the rights of citizens and the fruits of their labor?” I am proud to be part of this historic effort to write the VA ship and to serve Veterans.

I will finish with a story that was particularly important to my father and a Veteran to the 82^nd Airborne Division. The greatest of all airborne warriors was Matthew Bunker Ridgway. He led the All American Division to victory in Sicily, North Africa, and planned the allied airborne assault on Hitler’s Fortress Europe. The night before the invasion, he actually fell out of his cot, and he reached for the Old Testament and he pulled down the Book of Joshua. He looked at Joshua’s promise from the Almighty that “I will not fail thee, nor forsake thee.” [Joshua 1:5]

In 1986, President Regan awarded General Ridgway the Presidential Medal of Freedom, where he said that “heroes come when they are needed; great Americans step forward when courage seems in short supply.” That is our duty at the VA. To serve those great Americans who stepped forward when their country needed them and step forward when courage seems in short supply. So I thank you very much for being here and I look forward to your questions.