“One thing is for sure in Washington is, no matter how tight or tough times are, veterans are a class to themselves; they are an issue to themselves. Partisanship rarely ever creeps into the VA.”
Senator Johnny Isakson (R-Ga.) has served in the United States Senate since 2005 and currently chairs the United States Senate Committee on Veterans’ Affairs. During his time in office, he has prioritized issues affecting veterans, including sponsoring the VA MISSION Act of 2018, which aims to improve access to healthcare for veterans. In this interview, he re-joins Merion West editor Erich Prince to follow-up on their conversation from a year ago about the work the Senate is doing on behalf of veterans. They discuss the degree to which veterans’ issues are an area of bipartisan agreement, physician shortages in the VA system, new telemedicine provisions, and the upcoming anniversary of D-Day.
Senator Isakson, happy to touch base with you again. I’d like to begin by discussing the recent bipartisan trip that you took to Iraq with Senator Duckworth and Senator King. And I remember speaking to Senator Lieberman one time, and he was talking about how he became friends with Senator McCain on one of these bipartisan trips. With the overwhelming bipartisan support on things like the VA MISSION Act and trips such as these, to what degree can veterans’ issues be a model for bipartisan agreement in these rather polarized times?
They are the only place a lot of times that you can find that first step forward towards bipartisanship; one thing is for sure in Washington is, no matter how tight or tough times are, veterans are a class to themselves; they are an issue to themselves. Partisanship rarely ever creeps into the VA. I’ll give you a good example: a few years ago we were having shutdown, if you remember that. We passed a law to keep us from shutting down the VA. The first time somebody tried to do a shutdown, we thought about it, and it would result in having actually to shut down the VA health services, and we can’t do that. So we passed a law to keep us from doing it. We funded them for two years rather than one year. So the veteran is special. They obviously are special for what they’ve sacrificed for us. All members of Congress, Republican or Democrat, believe that they should be dealt with and ensure that they get their benefits, no matter what we disagree on otherwise.
I think that was reflected in the vote counts for the VA MISSION Act of 2018, something like 92-5 in the Senate. And I was looking at that Act, and I was particularly struck—I know a lot of other media folks have talked about this—by this telemedicine provision. Can you talk more about the telemedicine provision, how it came about and what your hopes are for that part of the effort?
It came about as a part of an overall effort that the [Veterans’] Committees have made, both in the House and the Senate, to reach out and find the very best solutions for our most difficult problems. And one, access for rural veterans to healthcare is a tough hurdle for the VA; there aren’t that many physicians and facilities in rural America. It’s been the reason so many things have passed the last few years. The number one thing about the veterans’ bills that are unique about breeding cooperation is that that’s where we have the least resources available, so we have to put our most effort to get those resources to the veterans.
And I recall that when we spoke last year, veteran suicide was a big emphasis for you. And I was sorry to learn that recently two veterans had died by suicide in your home state of Georgia. And I know that the nominee Byrne for deputy secretary has also pledged to prioritize that veteran suicide issue. How has that effort been going since we last spoke?
Well, we continue to have the problem, and we will continue to have the problem. It’s not a problem that you’re ever going to totally solve. It’s a problem that we’ve got to stay ahead all the time and win a little victories along the way. The good news is we’re not getting a growth rate in the number of suicides in our veterans, though we are continuing to see the same level as we saw when we first addressed the problem three or four years ago. The more care available to our veterans in the least difficult circumstances, the better off we’re going to be. And that means having contractors in [areas] where we don’t have doctors. It means having telephone services work—we talked about telemedicine a minute ago. We put in three call centers in the United States over the past few years—the third went into operation about this time last year. They have all been a huge success. One of them is in Atlanta; they have trained people on the telephone. You don’t get a busy signal when you call; you don’t get a voicemail when you call; every single call is answered by a live, trained responder at the VA or by an outside call center.
We have almost seamless, one-hundred-percent touch to the veterans’ needs within just minutes. And unique also to the suicide problem is that most suicides are preventable if people get the help in time. It takes a long time to get them to ask for it. That’s part of the stigma of suicide. We’ve found the call centers to help with that stigma; it’s easier to talk to a telephone in a quiet room with nobody else but you than it is to talk in a room with five or ten people and a doctor listening. And we have some very good people and some great stories that would just make you cry about vets who finally got into contact and finally had somebody that could listen, finally had somebody they can talk to. And you can finally talk to them and coach them into the right type of care that’s available by the VA. So if the MISSION Act was designed to breed every bit of access we could and every bit of ease that we could for a veteran to have direct access to a physician or clinician immediately.
So in the MISSION Act, I noticed that there was an effort to address some of these physician shortages that have been documented, such as this provision for a, “new loan repayment program for medical or osteopathic student education,”for some of these recent graduate coming in areas that the VA has shortages in that speciality. Are you optimistic that that might help to remedy some of these physician shortages?
In my personal sense, it has already helped because we [told] our business directors and regional responsibility people that we need to go beyond the pay schedule for certain professionals and certain experts, in brain surgery for example. And because of that, we are getting better people in the VA coming to work because the pay is competitive with the private sector. In fact, most private-sector physicians got their training, in part or whole, under the veterans administration. It’s our training ground where we train a lot of people. So we are trying to make sure that we get to use as many physicians as possible. We are trying to do well. Anything to get the best trained doctors to veterans is our goal.
I was chatting with a few veterans yesterday, and they were talking about something very similar to that in Philadelphia: that a lot of doctors were coming and training in the VA space there. So it’s interesting to hear you say that.
When you’re talking to these vets, do you think there are complaints I’m not aware of?
I would say overall they’ve generally expressed being happy with care. A couple of people, including a Navy veteran in Tennessee named Charles that I know, expressed that he’s experienced a high turnover rate of his [primary care] doctor. But overall, I think they’ve been pretty pleased with the care. One veteran said that he feels that the Trump administration has been particularly committed [to veterans’ issues]—he’s noticed a difference he thinks.
I will say this: the attitude of the Trump administration and Donald Trump himself has been very healthy and very good to the veterans. And it’s doing a lot of things faster than we thought we could. And with the backing of the president, it’s helped a lot.
So you think that perhaps some of these initiatives you were just mentioning might account for some of these salary discrepancies that were reported. Last summer The Washington Post had out a piece basically giving a case study of a certain cardiac surgeon who was making $395,000 in the VA system and then could go and make $700,000 in private practice. Do you think that maybe that could be changing?
It can. We have actually authorized some deviation from the schedule to raise [the pay] for some of those people and be more specific and more flexible and allowing them to do that. A lot of these people are working out of a love for the veterans, and love for the United States, and their salaries are important, but it’s not the most important. But you have to respect the fact that men or women who’ve done a lifetime of training to become a neurosurgeon or a heart surgeon—or whatever specialty they might be—they can’t turn a shoulder entirely to compensation. And if we don’t turn our heart to compensation and realize we’re paying a little more to get a lot, then we’re going be in trouble. I think we’re starting to see that materialize in residencies and hospitals around the country.
So for our last question, I recall that last year you mentioned this effort to visit a lot of veteran cemeteries. And, along those lines, the 75th anniversary of D-Day is coming up, and I know there are some plans to commemorate that. Do you have any reflections on the overall importance of military service with that anniversary in mind?
First of all, I’ll say that I’m very proud that we’re taking the almost-largest ever delegation to Normandy next week to celebrate the June 6th invasion of Europe to free Europe from Hitler and the Nazis. Now that, of course, is probably the biggest battle in the history of America. It and 9/11 are the two biggest things that have happened [along those lines]. Interesting enough, about the same number of people died on 9/11 in the towers in New York that died on the Omaha Beach in Normandy. In terms of life loss, those two days; they’re about the same. So it’s a significant battle and turning point in Europe in history.
So it looks like we have several Senators going, plus a number of members of the U.S. House. So there’ll be a big delegation to Normandy. It’s the last year that there’s going to be a veteran who can celebrate the 75th anniversary and had served in Normandy on that day because there’s nobody alive at that time now. Our veterans are dying at a rapid rate, and our 75-year veterans are about all gone. And they’ll continue to decline rapidly in the years to come. We owe them everything; they are America’s greatest generation, as Tom Brokaw called them. We make sure we remember them. And we should. To answer your question that you said in the beginning, I’ll never forget doing this, not because I’ve planned it, not because they might have told me to do it, but I got a book, an American history book and read chapters on WWII, in particular on D-Day to my children and my grandchildren. [My children] are in their forties, and they’ve got kids that are elementary school-aged. It’s so important that you all realize and recognize what these people did, so we can be here today. I think all we can do is, as Americans, to pass on the legacy and the history of the American victories in Europe and in World War II that led to the expulsion of Hitler.
That’s right I remember in President Reagan’s farewell address; he was reading from a letter of a woman to her late father who served at Normandy. He said that, “We can never forget what the boys in Normandy did.”
That’s exactly right, exactly right.
Thank you for your time, Senator. Always nice to touch base and to hear about the work you are doing for the veterans. So next time I’m chatting with them, I’ll mention some of the things you shared today.
Thank you. Anytime.