Mar-a-Lago, Privatization, and the Media

The VA’s Acting Under Secretary for Health made a speech to the American Legion. Here is one Legionnaire’s response.

By Suzanne Gordon
VHPI Steering Committee, Senior Analyst

On Saturday August 25th, VHPI steering committee member Paul Cox and I attended the 100th convention of the American Legion held in Minneapolis, Minnesota, as a convention delegate.

The committee meeting he attended concerned VA issues such as benefits, healthcare and the National Cemetery Administration. A number of VA leaders addressed the packed room. The first to speak was Richard Stone, MD, who is the Executive-in-Charge of the Veterans Health Administration (VHA) –i.e. the interim Under Secretary for Health who is slated to become the next official Under Secretary for Health if nominated and approved by Congress. Paul R. Lawrence, The Under Secretary for Benefits at the Veterans Benefits Administration also addressed the Legionnaires.

Stone began his remarks citing the Legion motto that the VHA is a “System Worth Saving.”  Under this title, I and VHPI advisory board member Phillip Longman, authored a long report explaining just why that is. Stone promised to save the system and “move it forward.” His three priorities for the VHA, he said were to restore trust in the VHA, turn the VHA into a learning organization, and modernize the agency.

In the program’s Q&A period, Cox asked Stone two questions:

  1. How will he deal with constant barrage of bad press to which the VA is subjected?  
  2. How will he deal with the chronic understaffing of the VHA?

Interestingly, Cox did not ask him about VA privatization, yet Stone launched into a series of assertions about his determination not to privatize the VHA.

Stone’s response to questions are worth publishing in their entirety, below:

“Let’s talk about the media. You just smile when you read it. I read a number of the publications, and I know where I’m at and nobody from Mar-a-Lago has called me. Okay. So  I met with those guys, actually before I took the job. You need to understand that I have no intention of privatizing the VA.

“When I was in uniform, after the last Iraq tour, I was deputy surgeon general of the Army and one of my assignments was to take down the Armed Forces Institute of Pathology. And I  can tell you I walked the hallways of what I considered to be a jewel of American medicine and I took it apart.

“And so when they began talking to me about taking this job, they asked me would I take it and I said I am not interested in privatizing. And I said I want to talk to these guys (from Mar-a-Lago) in a week and I went up and met with them in New York… And I had a great discussion.

“They were bright and they were opinionated but we agreed at the end of that discussion that I would have no further contact with them. And I never heard them say they want to privatize the VA.

“I’m not defending them. I’m not saying anything.  What I’m saying to you is that I came into this job with the absolute concept that this is a system worth saving and that there are more than 300,000 people some of them of sitting right in front of me, that I am really proud of and proud to work with and we’re going to get this going in the right direction.

“I don’t know how to fix the media in America.  My solution to that is the same thing [What] I’ve done with most of the National Football League is that I’ve turned it off.  

"Every morning we get these daily clips coming out and I sort of figure that if I’m in trouble the Secretary will call me and I’ll need to read at least that one.

“How do you staff the people?

“I was just with a senator who informed me that there are 200 openings in his state, and what was I going to do about it? I said well, if someone would say something nice about us maybe I would get applicants to jobs.

“People want to be proud of where they work. If the entire tenor is what a terrible place this is then people will not apply.  The major reason we don’t have people in jobs is that we don’t have applicants. If you sit down and very quietly talk to many of my employees, especially my newer employees, some of them have not even told their families that they work for the VHA.

“They know they work for the government but they don’t know what they are doing. How can that be?

“This is the most accessible healthcare system in America.  I don’t know how many of you use commercial healthcare but you can’t get in. You wait for weeks.  None of the providers talk to each other.

“This is the most accessible, the most integrated system in America.  It’s the one we ought to be celebrating as the model for the rest of American healthcare.  And that’s the message I leave. Now I came to the agreement with the senator that he would say at least one nice thing about us before he hammered me in testimony. And that’s a fair deal to say something nice. Go over to the Minneapolis VA and go to their hybrid OR [operating room]. There is nothing like that that exists, that allows interventional radiologists and surgeons to work side-by-side and shoulder–to-shoulder. There is nothing like that in America except at the VA.  It is a system worth saving.”

In rereading this transcript Paul had the following thoughts:

“Perhaps he was saying this in jest, but Stone basically said he doesn’t pay attention to the bad press unless the Secretary calls him.  In fact, the VHA suffers because it is not only the most accessible and integrated system in America but also the most accountable.

“Every wart and pimple gets headlines because it’s the VHA and must be transparent by law. Deficiencies that would never even make it to a journalist’s desk — much less into print if they came from a private sector institution — are treated like the end of the world when revealed about the VHA. Moreover,  the VHA is hamstrung because it does not have enough resources to effectively beat its own drum. I look at ads for hospitals like Marin General near where I live, and they call themselves “your healing place, ” and tell endlessly inspiring personal stories. To effectively counter these constraints, VA officials like Richard Stone have to go on the offensive and take the kind of stories he told to a small group Legionnaires out to a much broader public.

"A final point. Stone says he’s against privatization and I hope he is. Former VA Secretary David Shulkin also said he’s opposed to privatization and so has current Secretary Wilkie. Yet privatization is marching right along.  

“These administrators appear to have good intentions but they are not driving the bus. And they keep getting kicked off of it if they try to stick to their commitments.  At the American Legion meeting, Stone got the biggest applause when he said he was opposed to privatization.

“Legion members love their VA. This means that the  Legion needs to push much harder to ensure  that the VHA is fully funded and fully staffed — and that the VA MISSION Act, which the Legion supported, is funded in a way that doesn’t cannibalize the VA budget.”

Brett Copeland