#187 Doug Collins - United States Secretary of Veterans Affairs

Doug Collins and Shawn Ryan voice concerns about the inefficiencies and lack of trust veterans have towards the Department of Veterans Affairs (VA), engaging in a poignant dialogue about the bureaucratic hurdles that may stand in the way of the care veterans need and deserve.

Veterans Find Va Ineffective and Untrustworthy

Podcast Host Shawn Ryan Criticizes Va Wait Times, Staff, and Care Quality

Veterans' dissatisfaction with the VA is palpable, as indicated by a high volume of calls to congressional offices related to the VA. This indicates that many veterans find the VA ineffective and do not trust it to deliver the required benefits. Shawn Ryan vocalizes this distrust, sharing his negative experiences with long wait times and inadequate care. He relays stories about doctors who were poorly informed about the Navy SEALs or combat operations, some appearing unprofessional.

Many Veterans, Especially in Special Operations, Forgo Va Care for Private Healthcare

Ryan reveals that because of his personal negative experiences with the VA, which included consultations with less than knowledgeable or professional staff, he and many of his friends from top war fighting units have stopped using VA services and prefer paying for private healthcare. Collins also implies that there's a tendency among veterans to seek help from nonprofits rather than the VA, further suggesting a lack of trust in its effectiveness.

Va Bloated and Bureaucratic, More Employees Than Army

Va Faces Long Waits, Backlogs, Poor Care Quality

Collins points out the VA's bloated nature, with 480,000 employees outnumbering the active-duty Army's 450,000. The disparity in numbers begs the question of the effectiveness of the VA's services and whether it can fulfill its mandate with such a large staff. By requiring what Collins refers to as a "VA whisperer" to access benefits, veterans face complexity and inefficiency that often prevent them from getting care via VA channels, indicating systemic backlogs and hindered quality.

Disconnect Between Va's Mission ...

Doug Collins details comprehensive strategies for reshaping the Veterans Affairs (VA) system into one that is more veteran-centric and efficient, emphasizing the need for significant reform to improve services for veterans.

Collins Aims to Make the VA More Veteran-Centric

Cut Bureaucracy to Redirect Funds To Frontline Services

Collins discusses making transformational changes to the VA by cutting bureaucracy to redirect funds directly to veteran healthcare and benefits. He reveals a plan to reduce the workforce that does not directly contribute to veterans' health services and to reallocate those resources to the veterans themselves. Specifically, over $500 million is already in the process of being redirected toward suicide prevention, homelessness, prosthetic care, and community care. This initiative involves examining organizational policies and statutory constraints that prevent funding for certain treatments.

Collins acknowledges some legal restrictions but believes in the potential for change and is engaging with groups to explore efficacious treatments. Emphasizing a shift in the VA's mindset, he directs his general counsel to find ways to say yes to solutions. He has also identified non-mission critical contracts that can be eliminated, thus freeing up funds for essential services.

Doug Collins criticizes the VA's previous focus on organizational structure over veteran-centered care. He aims to streamline and reallocate resources within the VA more efficiently, improving essential services rather than spending on non-essential procedures like gender reassignment surgeries which do not directly serve veterans' primary healthcare needs.

Collins Aims to Empower VA Employees For Innovation and Responsiveness to Veterans' Needs

Collins promises to support VA employees doing good work and aims to raise standards while refusing to accept the status quo. He expresses his intent to utilize his experience to make a positive impact and to ensure that veterans receive the care promised to them. This includes empowering VA employees, encouraging innovation, and being open to new approaches, including partnerships with nonprofits and organizations willing to assist.

Collins to Rebuild VA Trust Through Transparency and Accountability

Engage With Veterans On Improvements via Social Media and Outreach

Engagement with veterans is a cornerstone of Collins’ strategy to rebuild trust. He plans to use social media to inform veterans about VA developments, directly countering lies and misinformation by providing honest answers. Collins also aims to utilize modern platforms to reach broader audiences and engage in transparent communication.

He also speaks to the nee ...

Implementing changes at the Department of Veterans Affairs (VA) presents an array of barriers and challenges, as identified by Collins, who faces opposition from entrenched interests and finds the existing infrastructure inadequate for modern demands.

Bureaucracy, Unions, and Politics Resist Change

Change at the VA meets significant resistance, and Collins delineates the sources of this opposition, emphasizing the difficulties he encounters when attempting to reform.

Opposition to VA Cuts or Restructuring From Congress, Media, and Veteran Groups

Collins is facing opposition from various parties, including media, union bosses, and members of Congress and the Senate. He notes that these groups are invested in a failing system and struggle to accept that changes are necessary. The fear of backlash from Congress or complaints from unions hampers the introduction of new ideas within the VA. Bureaucrats and politicians are seen as barriers to veterans' access to assistance, with decisions often being made by those who have not experienced combat.

Collins has received criticism from some Veterans' Service Organizations and members of Congress over proposed changes to the VA that might affect wait times and quality of care. Despite discharging 2,400 workers, there were accusations in the media and from The Hill, senators, and union members that healthcare services were being gutted at the VA, even though the layoffs did not pertain to medical roles.

Collins is fully aware of the criticism and opposition these changes might invite from Congress, the media, and unions. He understands the difference between internal policies and laws that require congressional action and is ready to navigate these challenges.

He recognizes that groups who are not focused on solving problems may be perpetuating them to justify their existence. Moreover, misconceptions and opposition from various stakeholders—such as nonprofits and VSOs—pose additional challenges. Collins also faces political and fiscal barriers, such as insufficient funding, which hinders necessary changes within the VA system.

Challenges In Modernizing VA's Systems and Data Infrastructure

Collins highlights a stark contrast between the VA's current systems and the modern functionality expected by consumers.

VA Lacks Effective Tools For HR and Resource Tracking

Collins voices dissatisfaction with the VA's current HR systems, comparing them unfavorably to the military's efficiency in tracking personnel. He indicates that the VA struggles with referral processes due to reliance on third-part ...

Collins lays out his plans and objectives to advance veterans' healthcare, emphasizing the necessity of reforming the current system to provide better access, choices, and innovative treatments.

Expanding Healthcare Access and Choice For Veterans

Collins expresses a clear intention to reform the VA system to enable veterans to readily access the care they need.

Collins Seeks to Improve Veterans' Access to Private Providers via Va's Community Care Program

Collins highlights the importance of the Mission Act, which is intended to allow veterans to receive care in the community with the VA footing the bill. He indicates that the trend of de-incentivizing veterans from this care and making them wait longer is a problem he plans to tackle. He talks about legislation in the House and the Senate aimed at strengthening access to private providers through easing some limitations and making the VA's Community Care Program more accessible. Collins is committed to making sure veterans can see local doctors they are comfortable with, funded by the VA.

Hybrid Va and Private Care Model Needed For Veterans

Without specifying details, Collins suggests a hybrid system combining VA and private care elements through the Community Care Program. Citing generational differences among veterans, Collins argues for the necessity of such a hybrid model, especially for those who struggle to reach VA facilities or prefer local healthcare options. He outlines a healthcare model that doesn't restrict veterans to exclusively VA or private care but allows for the best available care tailored to their needs, involving private groups for treatments that are showing progress.

Exploring Alternative Treatments Like Psychedelics and Telehealth

While offering no specifics, Collins indicates a readiness to explore innovative therapies and partnerships that could help veterans’ health outcomes.

Collins Seeks Private Sector and Nonprofit Partnerships For New Therapy Research and Implementation

Collins is interested in expanding the use of alternative treatments like psychedelics and mentions a collaboration with Bobby Kennedy for this. He recognizes legal and policy hurdles but is looking for ways to work through these challenges with Congress and other agencies such as HHS and the President. He is examining how alternative treatments can be part of what the VA offers, and he's discussing with relevant groups the implementation of potential new therapies.

Legal and Policy Hurdles In Expanding Access to Non-va Approved Treatments

Though Collins acknowledges legal and regulatory barriers, no precise details about his initiatives in this area are given. He does express an interest in tackling these issues to improve veterans’ access to potentially beneficial treatments not currently approved by the VA.

Improving Mental Health Support and S ...