During a Senate Veterans' Affairs Committee hearing last week, Sen. Kevin Cramer (R-ND) spoke about the hirings at the Department of Veterans Affairs during the Biden administration.
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00:00Thank you, Senator Sanders and Mr. Secretary, and welcome, Mr. Secretary.
00:06It's a good thing I haven't been here all day, or that I'd have way too many things to talk about.
00:10But right now, I want to raise an issue related to the discussion you just said.
00:14You know, we just passed, under the first Trump administration, we passed the pilot program for Solid Start Act,
00:22and then under the Biden administration, we made it a law specifically to get at the issue that I think Senator Sanders was raising,
00:28about how do you attract or inform veterans more about the opportunities and the benefits that they have at the VA.
00:35And so I would just encourage you to look at that and make sure we're managing that well.
00:41The other thing I would raise with regard to the workforce, which I think Senator Sanders is right about,
00:47and it is true, we have a shortage of people in health care everywhere.
00:52And to the degree we can incentivize it, I think we ought to.
00:56At the same time, and I'm just going to give a little North Dakota example,
01:02and Senator Blackburn spoke to it briefly toward the end of her questioning.
01:07In North Dakota, in this rectangular spot in the middle of the North American continent
01:11that's about 350 miles across and about 200 miles up and down,
01:16there are 36 critical access hospitals in rural communities.
01:21Now, Fortuna, North Dakota, to Fargo, North Dakota, where the only VA hospital is,
01:27is 412 miles.
01:29It takes roughly six hours and 19 minutes if you don't stop to go to the bathroom
01:33to go from one to the other.
01:37But there are these 36 critical access hospitals that have 20 hospital beds each,
01:42and maybe two or three of them are being used at any given time.
01:49Senator Blackburn talked about community care.
01:51We've talked about the shortage of facilities, shortage of workers and opportunities.
01:56And yet, there's all of this infrastructure not being used.
02:01There's got to be a way to utilize existing infrastructure
02:05and actually save money both for the VA and then create opportunity
02:10for these struggling hospitals in rural America.
02:13I don't disagree with you at all.
02:15And I think it's actually, Senator Duckworth and I actually had this conversation
02:18a long time ago about actually co-locating CBOX and stuff,
02:22that we can actually do that.
02:23I think that's a great idea as we look at it.
02:26But I think one of the things is how we, you know,
02:29utilize the Mission Act possibilities that we have.
02:32You make sure that we're getting people there.
02:33The other problem we have, and this is found not only in some of our facilities,
02:37but mainly some in DOD facilities, but also community facilities,
02:40it's also an issue of quality care.
02:42It's an issue of our doctors seeing enough patients to keep their clinical skills up,
02:46or nurses seeing enough to keep their clinical skills up.
02:49That's why I've already been looking at several options,
02:52and we're doing this in certain cities now where we can.
02:54I'm encouraging every one of our facilities to have, you know,
02:59understanding agreements with local hospitals, with community hospitals,
03:02where they can go back and forth.
03:05We can also look at DOD facilities, which is also a big issue.
03:08We have underutilized DOD hospitals, underutilized DOD facilities,
03:12in which we could be one of those actually we're looking at right now in Jacksonville, Florida,
03:15in which we could actually save our community care costs,
03:18because we could actually have a DOD facility there.
03:21So it's a lot of things we can work on here,
03:22but I think it's just a matter of using all the resources that we have.
03:26Right, and that starts with knowing what they all are.
03:29That's a great illustration of the one you just made.
03:31One of Kramer's convictions is I reject the notion that every transaction requires a loser.
03:35We should look for opportunities for winners and winners,
03:39and I think that would be one of them.
03:41Congratulations.
03:41Thanks for doing that.
03:42I want to get back to the $80,000 thing,
03:45because you've been being battered about it, I think,
03:50without acknowledging the other issue.
03:53I'm going to stick with the lower number.
03:56Correct me if I'm wrong,
03:57but I believe there were 52,000 new positions added between 2021 and 2024.
04:04Does that sound about right, 52,000 during the Biden administration?
04:09Yes.
04:09Okay.
04:11And how has that improved the health care offerings for veterans?
04:14Are we seeing a lot more veterans?
04:16Is it better care?
04:19Is that 52,000, has that really been,
04:22has that saved the day for our veterans?
04:24Yeah, I don't think so,
04:26because I think if you also,
04:27I use it in a different way.
04:28If you go back to 2015,
04:31when the GAO put us under the high risk,
04:33and again, I've been here all of,
04:34you know, barely 90 days at this point,
04:37you know, looking at this,
04:39I'm using the numbers that we are given,
04:41and, you know,
04:41we can talk about whether the numbers change or anything.
04:43I'm using the numbers that we currently have at VA
04:45to wait times have increased,
04:47primary care, mental health, specialty care,
04:49all roads, disability backlogs.
04:50It's not a secret.
04:52It was at 260,000 when I came in.
04:54It's about 220,000 now.
04:56These are just honest numbers,
04:58but I want to go back to something at 10 years ago.
05:01At 10 years ago,
05:02if I had told this committee,
05:04and I had told,
05:05and I did this at our senior staff,
05:07and I told,
05:08this is careers and politicals,
05:09I said,
05:09if I told you that in 2025,
05:12you're going to have a budget of almost $400 billion,
05:15and you're going to have a workforce of 470,000,
05:17you would have thrown a party.
05:18Everything would have been great,
05:20because that would have been an answer to everything.
05:21Well, we're 10 years later,
05:22and we're still experiencing the same problems.
05:24Well, I appreciate that.
05:26Servicing the same amount of veterans.
05:27Yeah, that's the important point.
05:29I appreciate all of that.
05:30I do think there are,
05:31I think everybody on this committee
05:33wants to have an honest discussion
05:34about how to do better for our veterans,
05:38and that kind of,
05:40real data can help us,
05:42because there's plenty of data there
05:44to tell us where we've been okay,
05:46where we haven't been so good,
05:47and where we've been awful or great.
05:49Thank you, Mr. Chairman.
05:49Senator Kramer, thank you.
05:50Senator Duckworth.
05:52Thank you, Mr. Chairman.
05:53I do think it's important to...