Kaine Asks Experts: Can We ‘Equip Our Civilian System’ For Backup Medical Support To The Military?

2 hours ago

During a Senate Armed Services Committee hearing held before the Congressional recess, Sen. Tim Kaine (D-VA) questioned experts about civilian support to the military health system.

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Transcript

00:00Senator Cain. Thank you Mr. Chair and thank you to the witnesses. I want to

00:03particularly recognize Dr. Cannon. I know you're very well prepared for this

00:07hearing today because one of the leaders that's with you, Kristen Malloy, used to

00:11be on my staff and she made sure I seemed a lot smarter than I was at any

00:14hearing that I attended. You know I think I want to focus all of your attention on

00:19the the workforce issues because I'm on the health education labor pension too

00:24and if I go to my hospitals and health care providers they're singing the blues

00:28about workforce, tight labor market, difficulty hiring and retaining folks. I

00:34went to the grand opening of a new VA clinic in the Fredericksburg area two

00:38Fridays ago and we built it to the tune of about 350 million dollars and we

00:43built this state-of-the-art clinic with one step down from a hospital because

00:48there were multiple clinics in the area and veterans were having to go from

00:51pillar to post to get care rather than a single place. But when we opened it and I

00:55was there for the opening I had staff say we're we're on a skeleton crew. The

00:59the three VA hospitals in Virginia, Salem, Richmond and Hampton are laying people

01:05off, there's hiring freezes, there's plans for even more layoffs and so the

01:10estimates I was getting at that grand opening is they're probably 20 to 50

01:14percent staffed. There's another sizable clinic similar that's going to open in

01:18Chesapeake supposed to on April 11th. If it does open on time I'm suspecting that

01:24it will be a similar thing and you saw the announcements about more cuts coming

01:28in the VA. What is your vision for how we, you've talked a little bit about the

01:35need to be more integrated between DOD facilities and VA facilities but then

01:39also on the civilian side, what is your vision for how we equip our civilian

01:46system to provide a surge capacity or backup capacity when we when we need it

01:51to perform well in combat situations? Please, Dr. Cannon. Senator, thank you for

01:59your very insightful comments and questions. I am a veteran. I get my care

02:06at our VA in Philadelphia. My wife is a primary care physician and takes care of

02:11veterans so I can speak to your comments about the VA from that perspective. I do

02:17have a role at Penn Medicine as the Assistant Dean for Veteran Affairs for

02:22Penn Medicine but I'm quite new in that role and still learning the ropes so

02:26I'll speak more from my end-user experience. I would say that certainly

02:31there are opportunities for synergy. The partnerships between VA facilities and

02:39academic medical centers I think have been partially realized but in this

02:44sort of urgent situation we find ourselves in, we need truly a whole-of-

02:50society approach and where there can be market synergy, where there can be

02:54economies of scale, we should aggressively pursue that. I know that our

02:58CEO Kevin Mahoney has made overtures to the VA and there have been agreements

03:04signed between the VA. I don't have detailed knowledge about that and where

03:08that stands but I think there is an opportunity and we should push for that

03:12and as a veteran who receives my care I hope that we can continue to deliver

03:17excellent care through better synergy. How about Dr. Friedrichs and Dr. Robb?

03:21Thank You Senator Cain and that is a beautiful facility and it'll be tragic

03:26if it sits there empty while veterans are unable to access care because of

03:29shortages of medical professionals in the VA, in the DoD, and in the civilian

03:34sector. We're in a less than zero-sum game right now and that is both a health

03:39security issue but also a national security issue. The first recommendation

03:43I would make to this committee, direct that the Department of Defense does not

03:47close any more of our military training programs. For decades the military

03:51training programs have been one of the pipelines that when people eventually

03:55left the military, which all of us do, they go to the civilian sector. We cannot

03:59afford to close any more training programs when we have so many shortages

04:03of doctors and nurses and dentists and other things. The second, I implore this

04:08committee in the NDA, direct the DoD and in partnership with the appropriate VA

04:13oversight committees, the Veterans Administration, to come back with a plan

04:16starting with the DC market to integrate the two systems. We've talked about this

04:21since I was a major. I moved here in 1997 and we were talking about this. It's time

04:27to stop talking and start doing it. We can't afford to keep talking about this

04:32problem. That hospital in the VA here is ancient. It's got to be replaced. We just

04:38finished a billion dollar upgrade at Walter Reed. Why in the world are you not

04:42demanding that we come back with a plan to do that? It is more efficient and it

04:47helps to pool the resources. The third point and the most important one in your

04:51health committee role is we must address these pipelines as both a health

04:56security and an economic security and a national security concern. As long as

05:02the pipelines continue to be insufficient to need, there's no way that

05:06any of these problems are going to get fixed. I think you have a unique

05:10opportunity to help bring that into both committees. Thank you, Senator. Thank you.

05:14Dr. Rob, I'll ask that question for the record because I'm now out of time. I

05:17yield back to the chair. All right. Actually, these witnesses will not

05:28be taking questions for the record, but I'll let you follow up for 45 seconds.

05:41Dr. Rob, then could you approach that workforce integration question too?

05:46Thanks. Yes, and I'll go back to where we can share resources and I will

05:53footstomp. We have very many successful joint DOD and VA partnerships. Travis

06:01Air Force Base is a great example where the actual VA is inside of David Grant

06:07Medical Center, share staffs, but more importantly, share patients. We have other

06:11where we're co-located community-based outpatient centers that feed patients

06:15into like Anchorage, Alaska. We see that down there at Naval Pensacola. So

06:21those opportunities, because usually what happens is we want access to critical

06:26care patients for our proficiency and the VA wants access to resources, which

06:32is either excess capacity on space or in staff. And so I think that

06:36continued movement forward, not always one-size-fits-all, but that is very, very

06:42important. Much like the VA is at all the academic health centers, I think the

06:46Department of Defense, especially in our six or eight strategic places, need to

06:50have strategic VA and strategic mil-siv partnerships, sharing staff. And I will

06:55quickly say, not only do we learn from the military, I mean the military learned

07:00from the civilian opportunities, during OIF and OEF, actually the American

07:05College of Surgeons made sure that they were with us so they could learn

07:09firsthand, real-time, on how we were treating. So it is a mutually synergistic

07:14relationship. Thank you, Dr. Rudd.

Kaine Asks Experts: Can We ‘Equip Our Civilian System’ For Backup Medical Support To The Military?

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