On March 5, Secretary of Veterans Affairs Doug Collins announced that the Department of Veterans Affairs is conducting a department-wide review of its organization, operations and structure. Central to these efforts, the secretary said, is a pragmatic and disciplined approach to eliminating waste and bureaucracy at VA, increasing efficiency, and improving health care benefits and services to veterans.
As part of his review, he hopes to reduce the department’s work force by 15 percent and look at the 90,000 contracts VA administers to cancel those that are duplicative and not critical to the department’s mission of caring for veterans, their families, caregivers and survivors.
As a former secretary of Veterans Affairs, I agree changes are very much needed. The rising costs of health care; the changing face of health care delivery from inpatient to outpatient; the large number of unneeded facilities VA maintains throughout the nation; the failure to build stronger bonds between the VA and Department of Defense health care systems, the need to insure the compensation system for disabled veterans is focused on today’s economic and health care realities, and other issues should all be looked at.
Decisions to reduce inefficiencies in the nation’s second largest Cabinet department should be made so they do not impact the scope of the vital services provided by the VA. I am sure the secretary’s review will be carefully conducted so as to not negatively affect the care and services we provide America’s veterans and their families, but also the health and well-being of all Americans.
Our nation’s taxpayers have received a superb return for their unwavering support of those who have served us while in uniform. As we think about changes to VA’s workforce and services, we must keep those returns in mind.
One purpose of benefits for veterans is to ensure those who have served in our wars are treated equitably, so they will be satisfied citizens in peacetime. History is littered with governments destabilized by masses of veterans who believe they were taken for fools by a society that grew rich at the expense of their hardship and suffering.
A second purpose is to make the distribution of sacrifice and prosperity between those who serve and those who remain behind “fairer” — and to mitigate the actual wounds of war.
The Servicemen’s Readjustment Act of 1944, known as the original GI bill, was in part a response to the Bonus March of the Great Depression, when America learned those who had served in World War I could become a source of active unrest, even revolution.
Instead, the GI bill, combined with the talent of the 16 million Americans who served in the war, initiated a revolution of a different sort. Much of what we now think of as normal in middle class America is rooted in those servicemen and women, and the benefits they used to transform our nation.
Before World War II, a college education was available to relatively few Americans. The first GI bill ensured that every veteran, rich or poor, could attend the best school to which they could be admitted. The promise of higher education, limited only by ability and ambition, shaped who we are today, and who we will be tomorrow. A generation of leaders were born in industry, unions, agriculture, academia and government who propelled America to greatness in the 20th century.
Before the war, it was difficult to finance a home purchase on credit. A long-term, low down-payment home loan was unknown. For most Americans, homeownership was nothing but a dream. The GI bill’s loan guarantee provisions changed all that, and in doing so created suburban America.
And to properly care for those who returned with illnesses and injuries because of the war, VA’s health care system entered into a partnership with our nation’s medical schools. The fruits of that partnership revolutionized medical education and research. VA estimates that more than 70 percent of all physicians receive at least part of their training at its facilities.
VA medical research led the way to the first successful treatments for tuberculosis; established the lifesaving value of treating hypertension and the relationship between smoking and lung cancer; developed the first prototype of the CT scan and showed how a practical, implantable cardiac pacemaker could be built.
Today, there is concern over these programs, and for a health care system that provides care to 9.3 million veterans and was shown in two prestigious medical journals in 2023 to provide care consistently as good as, or better than, non-VA care in the areas of quality, safety, access, patient experience and comparisons of cost versus efficiency.
And at a time when there is significant anxiety over rising pharmaceutical costs, VA’s pharmaceutical benefits management program is the gold standard in every aspect of this area: in clinical pharmacy practice; drug formulary management; contracting; medication safety; supply chain management; automation; post-graduate pharmacist education; and patient satisfaction.
VA’s budget also provides for the maintenance of 155 national cemeteries throughout the nation as national shrines, providing honored rest to 150,000 veterans a year — nearly twice the number buried in VA cemeteries in 2001.
And every month, more than 6 million disabled veterans receive a compensation check for their service-related disabilities from VA. Nearly 4 million veterans participate in the VA Home Loan program; more than 900,000 veterans attend school on the current GI bill and more than 144,000 disabled veterans receive vocational rehabilitation training to prepare them for civilian careers.
All Americans have an interest in ensuring that the men and women whom we depend on in peace, and will rely on in future wars, see that our nation truly values their service. Our veterans have truly earned the benefits they receive.
Tomorrow’s servicemembers will know whether or not they have the means to create a civilian career when they put aside their uniforms. They must rest assured they and their families will be taken care of should their commitment to put their bodies and their lives on the line on our behalf result in their injury or death.
We should certainly ensure waste, fraud and abuse are eliminated from the funding VA receives — and must always look for ways to provide the benefits and services the department provides in a more economical and efficient manner. As President George W. Bush reminded me when I assumed office: “Every dollar you receive is a dollar an American took out of their pocket to send to you. Use those dollars wisely.”
We must also honor President Abraham Lincoln’s commitment to care for those who have borne the battle and their families, and take whatever steps are necessary to welcome servicemembers back to civilian life when they exchange their uniforms for civilian clothes and assume the honored title of “veteran.”
I am confident and support Secretary Collins when he says this review is going to make the department work better for the veterans, families, caregivers and survivors VA is charged with serving.
Anthony J. Principi was secretary of Veterans Affairs 2001-2005. He served as chairman of the Congressional Commission on Service Members and Veterans Transition Assistance and chairman of the 2005 military Base Realignment and Closure (BRAC) Commission.
