Kevin Cramer Asks VA Sec. If 52,000 Staff Hired During Biden Admin. Has Improved Quality Of Care

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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.

Transcript

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...

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