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Linda Fletcher LTC (ret.)

Linda Fletcher LTC (ret.), Executive Director, A Matter of Honor

House Committee on Veterans’ Affairs
Congressman Dan Benishek
Subcommittee on Health
Oversight Field Hearing
Traverse City, MI 49684
August 27, 2014

Testimony  Of:

Linda L. Fletcher  LTC/ANC (ret)
Executive Director, A Matter Of Honor
1189 Dyer Lake Rd
Traverse City, MI 49685

I thank you, Congressman Benishek,  for the opportunity to address this group today.  I hope to provide an interesting perspective on the topics at hand.

The recent events surrounding the VA have been very disturbing to say the least.   But…it was Winston Churchill who said “Never fail to take advantage of a crisis”….and that is what we have in  the VA system today.  Now is the time for problem identification, for opening to the consideration of conventional and unconventional ideas and formulation of bold steps to institute carefully conjured solutions.  
Abraham Lincoln eloquently captured the mission of this organization that he created in 1865 with these words….”to care for him who shall have borne the battle and for his widow and his orphan”.  The structure and configuration of what we currently know as The Department of Veterans Affairs has changed through the centuries  and our many wars but the promise and the intent have not wavered and the mission statement has remained the same.   
This nation has lately been generous with funding for our veterans.   The FY 2014  budget is $152.7  billion.   Approximately  40% of that budget  ($61.1 billion) is directly related to provision of health care.   And, due to the recent findings regarding administrative issues,  an additional $17 billion is being added.  There can be little doubt that America wants to take care of our veterans and we are willing to pay whatever it takes to do so.  Unfortunately, sometimes  pumping in  money to patch a sag in the ceiling  isn’t the answer. Sometimes we have to start by fixing deeper foundational problems. I am in hopes  that reformation of the VA system  will  begin with  a review of the original  mission statement so we can proceed to  evaluate our  existing organization in accordance with that guiding light.   
According to the VA is currently the largest health care system in the nation.   In 2012 the VA provided health care for approximately 5.9 million Americans. … 2% of our entire population.   Interestingly, of that group some 1.6 million  (26%) qualified for care which the VA categorizes as not associated with war related illness or injury.
In view of these numbers perhaps the answer to the situation facing us is not what seems to be the foregone conclusion that we need to supersize the VA. Perhaps we need to consider streamlining the system in accordance with the mission statement by targeting caring only for war related illness or injury. A restructuring that focuses specifically on that population would decrease the workload by 26% and provide a more focused approach to care for the remaining group. The care required by that smaller  group could be provided in the local civilian sector by having the VA assume all costs associated with insurance provided by the Health Care Act.
This mechanism might also be considered as an option for our many veterans located in rural areas where accessibility to VA facilities is geographically challenging.  Perhaps we should consider allowing these veterans the option to receive equivalent local care funded by the VA through the HCA.  
From an administrative perspective I would also like to recommend that the VA revise  their practice of hiring from within.   The intellectual and cultural inbreeding that results from  selection  from  the same pool chokes the breath of new ideas, perspectives and leadership that comes of selecting from a diverse assortment of potential employees.   
Lastly, care to veterans is restricted by more than just geography There are some exciting concepts emerging and/or re-emerging regarding different psychotherapeutic techniques which target resolution of cause not just the current objective of mitigation of symptoms.  Additionally, there is a wide variety of treatment methodologies, from acupuncture to Zen meditation,  available in the alternative medicine communities that target stress reduction, a major component of PTSD care. In view of our less than successful results in managing PTSD to date we need to explore not restrict new possibilities in theory and treatment.
I am well aware that this is a superficial and limited overview of a very complex situation.   I hope that some of these thoughts will be helpful as this nation struggles to provide better care for those who gave so much for us.  And let it be remembered that the VA may be stumbling but with our help it can resume it’s revered and important position in our nation. They have a long and honorable history and they can regain their glory with our support which includes constructive, not destructive, criticism.  We are in crisis and it presents the chance to take great strides in an abbreviated length of time. Let’s take Winston Churchill’s advice and not fail to take advantage of this opportunity to advance our systems for the good of our veterans.
Thank you and God Bless America