What Would a Bunch of Vets Tell the Presidential Candidates If They Were Trapped on an Elevator Together?

Veterans, like the country they’ve defended and served, are an increasingly diverse group; they don’t march in lockstep when it comes to politics and policy. But there are a few areas that engender broad agreement among vets: Those who haven’t served can never truly understand their experiences, and by and large, they like the health care provided by the Veterans Affairs Department.

That was the take-away from a panel featuring several representatives from veterans’ groups, most of whom are vets, earlier this week at a Washington, D.C. conference co-hosted by the Roosevelt Institute and the Union Veterans Council, part of the AFL-CIO. Moderator Jackie Maffucci, research director of the Iraq and Afghanistan Veterans of America, asked the seven panelists what they would tell the presidential candidates about the VA from the vets’ perspective, if they found themselves alone in an elevator with the presumptive Republican and Democratic nominees.

The VA, which has more than 300,000 employees, has never been a streamlined, efficient operation. But the last few years have really laid bare the department’s seemingly intractable management problems, outdated technology systems, and poor decision-making on a range of issues. Those problems led to the 2014 Veterans Access, Choice, and Accountability Act, several pending legislative proposals, and calls for privatizing the VA’s massive health care system. The Commission on Care, created by the 2014 law, will issue its final recommendations June 30 on reforming the VA health care system, which some fear could lead to the massive outsourcing of veterans’ health care.

As for the presumptive presidential nominees, Democrat Hillary Clinton opposes the wholesale privatization of the VA’s health care system. Donald Trump and his campaign have made pro-privatization comments, but the candidate has not said he would eliminate the department, or even fully privatize VA health care.

Here are edited excerpts of what the seven panelists at Tuesday’s conference would say about vets and the VA if they got a little face time with the next commander-in-chief:

Lauren Augustine, legislative associate, Iraq and Afghanistan Veterans of America: “It’s critical that you understand that veterans are more than a political chew toy. They are more than the two dominating narratives that we hear in the media of heroic hero or PTSD [post-traumatic stress disorder] injured veteran. We need you as the national spokesperson to speak our voice, and speak our voice for the nation’s stage and the world’s stage to say these veterans served the country with honor, and we’re going to continue to honor them with the way we talk about them and treat them.”

Joshua Ulibarri, partner, Lake Research Partners: “Veterans like the VA. They appreciate the VA [and] they believe the VA does a good job. They believe that the VA nearer to them does a better job than VA [facilities] far away – of course that’s true of almost everything. That doesn’t mean that they don’t have criticism, or things that they would improve. They [vets] have real concerns about for-profit, private medical care. They do not want to be pushed into a system that is voucher-based. They don’t want to be pushed into a system that doesn’t adequately understand their struggles and their concerns, and hasn’t researched how to care for them.” (Lake Research Partners is a public opinion research firm founded by Democratic political strategist Celinda Lake. Ulibarri has done research and polling among vets on health care issues.)

Garry Augustine, executive director of Disabled American Veterans: “Ironically, I just had a conversation recently with a senior adviser for one of the presidential candidates. As I started to explain to him some concerns that our organization had with some comments that his candidate had made, he told me that I’m the first veteran he’s heard from that had anything good to say about the VA. It made me realize that the perception out there, the perception war, is being lost. I went on to explain to him that we do not think the VA is broken beyond repair as some have said, that many of the stories that are out there are dated stories, that the VA is doing very positive things. I gotta tell you, I don’t think I won that discussion with him. It makes me realize that we’re in a very nice environment here today, hearing very positive stories about the VA. I don’t know that those are resonating out there in America. The DAV, along with the major VSOs [Veterans Service Organizations] in the country think very differently about what’s going on in today’s VA than what is being perceived out there, or what is being pushed out there by the news.”

Ruth Browne, VA nurse practitioner in Gainesville, Fla., and American Federation of Government Employees member: “I was mobilized into Iraq in ‘08. I took care of an acute care clinic, and I was also the sexual response coordinator, which was a very difficult job because there are a lot of atrocities that go on with that. About eight months into my tour, my husband died suddenly at home. The Army was great -- [in] two hours I was on a plane heading home. But after I got home, that was it. And there I was very, very depressed, and whatever. I didn’t realize I was so depressed. I didn’t even realize I was sick. So I decided to go back to work because I didn’t know what to do with myself, and I got back to work taking care of the veterans. It was the veterans who came to see me, and it was the veterans who are providers there that told me and let me know just what I needed and directed me into place. And so, the veterans aren’t just there to get their basic care -- they network with other veterans. They find out what and where their resources are at the various places.”

Sherman Gillums Jr., executive director, Paralyzed Veterans of America: “Secretary Clinton, Mr. Trump, there are people in your inner circle who are going to tell you that privatizing the VA is the answer. And all I ask is that you ask them two questions: Have you ever received care, or recently received care in a VA medical center in the last five years? Or is your opinion informed by a second-hand perspective? Second question: Who will be responsible for monitoring health care access and quality in the private sector when it goes wrong without Title 38 protections to include investigation of wait lists and other access issues, medical malpractice cases, erroneous billing? Cause that’s going to happen with a fragmented system in instances where the care falls below the standard set by VA, particularly when we are talking about specialized care services. And lastly, I would like to take this issue out of the abstract for you by [having you accompany] me to a VA medical center of your choosing. Walk with me through the process of the experience. Then, I’ll take you through my experience of using TRICARE coverage, or being left to rely on the private sector for the exact same services. I’ll let that inform your decision.”

Dr. Tom Berger, chair of the Veterans Health Council with Vietnam Veterans of America: “The VA has been promoting the whole business of military history -- where did you serve, when did you serve, and what was your MOS [military occupational speciality]? If we had that information in our electronic health records, do you realize how much epidemiological information would be available to not only the VA, but to the research community and academia? Dr. [David] Shulkin [VA Undersecretary for Health] has indicated that they’ve started this at 10 or 11 institutes this summer, so as not to overwhelm the system. The involvement of the VA in the criminal justice system for our veterans who have lost their way, that’s really important…what’s known as the veterans’ treatment courts. We’re kicking ideas around with the White House for relative to when the vets get out, and how to work with them at that point. That’s what I would do if I were trapped on an elevator with one of the candidates, and hopefully one of them I would keep away from using my mental health credentials on.” (Berger also cited suicide prevention and Hepatitis C treatments as areas that should continue to get support and funding.)

Bill Rausch, executive director, Got Your 6: “All too often, especially in Washington, D.C., we spend an enormous amount of time having false arguments. And the VA, I think, is the subject of probably the biggest false argument I’ve ever heard which is, the answer is: privatization, or the VA. Both are wrong. It’s more nuanced than that. And most presidential candidates, frankly, don’t know that. Because ultimately what we need is a system that supports the veteran and their family, which involves both [VA and private health care]. And it [the system] already does. That would lead me to my second point: If you are the commander-in-chief, would you hold Congress accountable? Because ultimately in order for the VA to become the organization that we know it can be, Congress has to act, Congress has to fully fund VA, Congress has to get out of VA’s way, in many instances. I mean, right now, if you look at the VA omnibus, it’s gone nowhere. [Also] I’d ask them [the presidential candidates] to commit to keeping the current leadership team at VA into the next administration because in order for us to really make these strides and really transform the VA into the organization we know it can and should be, it’s going to take people. It’s not a process, it’s not a system. It’s leadership.”