CSPAN - Washington Journal Dr. David Shulkin

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April 21, 2025 13:10-14:00 - CSPAN

49:55

Washington Journal Dr. David Shulkin

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mimi geerges

cspan 06:09

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doug collins

01:24

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brian lamb

cspan 00:27

john taylor gatto

00:08

joseph delouise

00:03

louie gohmert

rep/r 00:14

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jim in michigan

callers 00:03

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brian lamb ▲ ● ▼		Connection between John F. Kennedy, Oliver Stone, Timothy McVeigh, QAnon, Alex Jones, and Donald Trump.
		In his introduction, author Tinline says the book is the true story of a hoax, a hoax that shocked the nation in the late 1960s and that once created seemed impossible to extinguish.
		Those involved in the hoax include Victor Navaski, E.L. Doctorow, John Kenneth Galbraith, and the author, the writer, Leonard Lewin.
unidentified		Author Phil Tinline with his book, Ghosts of Iron Mountain, The Hoax of the Century, Its Enduring Impact, and What It Reveals About America Today.
		On this episode of Book Notes Plus with our host, Brian Lamb.
		BookNotes Plus is available wherever you get your podcasts and on the C-SPAN Now app.
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		It's where debates unfold, decisions are made, and the nation's course is charted.
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		This is your government at work.
		This is C-SPAN, giving you your democracy unfiltered.
mimi geerges ▲ ● ▼		Welcome back to the program.
		We are joined now by Dr. David Shulkin.
		He's the former Veterans Affairs Secretary during the first Trump administration.
		Dr. Shulkin, welcome to the program.
unidentified		Glad to be here.
mimi geerges ▲ ● ▼		So I want to start with the news of a U.S. veteran, a U.S. Navy veteran, highly decorated.
		He shot and killed himself in front of a VA hospital in San Antonio last week.
		And his father says this on Facebook, quote, I lay the blame for my son's death on the VA system and the psychiatrist who drugged him instead of helping him.
		Your reaction to that.
unidentified		Well, first of all, it's always horrible to hear about these types of incidents.
		Unfortunately, veteran suicide is at an all-time high.
		Last year, the rate of veteran suicides rose by 11%, and there's been over 6,000 veterans who take their own life each year since 9-11 in 2001.
		So this is a real national crisis, and it's the reason why the VA has made veteran suicide the single highest priority.
		But too often we are failing our veterans the way that this father feels.
		And I can just imagine the grief in that family.
		And so we just need to be doing a lot more than we currently are.
		And we need to keep at this very, very stubborn problem until we can find a way to help these veterans that are suffering.
mimi geerges ▲ ● ▼		So this isn't a new issue.
mimi geerges ▲ ● ▼		Why hasn't it been addressed to the point that at least veteran suicides, you know, each one is tragic, but at least it would be not increasing year over year?
unidentified		It's a very complex issue in the fact that the majority of veterans who are taking their own life are not getting care.
		They're not in an ongoing therapeutic relationship.
		They're not even in the VA system.
		Now, this Navy veteran appears to have been treated at the VA, and certainly there are veterans that are being treated like this Navy veteran who do take their own life, but the majority of veterans are out in the community isolated, not seeking the right type of care.
		So this is a problem that needs to be addressed within the VA system, as this father points out, but also in the broader community by partnering with local governments, not-for-profit agencies, the churches, the mosques, the synagogues to be able to connect with veterans that are not getting the help that they need.
		We also need to be taking a look at new types of therapeutic interventions because the ones that we are currently using are not always effective.
		And so this is an area where we need more research and we need more effort being put into the problem to try to find the underlying causes why veterans are taking their own life.
mimi geerges ▲ ● ▼		This comes, of course, as current Secretary Collins of the VA is looking to cut about 80,000 jobs at the VA.
		It's part of an overall effort to reduce the federal workforce, as you're aware.
		What do you think of those cuts and the impact they could have on veterans care?
unidentified		You know, I certainly believe that the Secretary is coming in with a mandate to not keep things the way they are, to be able to figure out how to improve government, how to make it more efficient.
		But my belief is that you start with what you're trying to solve.
		You start with the problems that you're trying to address, how you're trying to make this system better for veterans.
		This issue of veteran suicide is just one example that we need to do better in.
		Unfortunately, where the administration has now started is in reducing the cost of care solely.
		And when you focus on reducing the cost through job cuts, canceling contracts, and you're not focused on what you're trying to achieve, it's hard to understand how you're going to leave this system in a better place than it is.
		So what I think that we should be doing is stating the objectives, reducing veteran suicide, reducing the wait times so that veterans can get the care that they need when they need it, reducing veteran homelessness, making sure that we improve the health outcomes of our veterans, and then figure out how do we make the workflow better?
		How do we use technology to make the system more efficient?
		That will result in less cost.
		But most importantly, it will result in us honoring our commitment to serving our veterans, to making them delivering the type of care that we all think that our veterans deserve.
mimi geerges ▲ ● ▼		I want to play for you a portion of Secretary Collins on CNN last week.
mimi geerges ▲ ● ▼		He was asked where they are in the process of cutting staff at the VA, and then I'll get your reaction.
doug collins ▲ ● ▼		Well, the first thing is no jobs have been cut yet.
		We're still in the process of looking at that.
		And as I told you then, it was a goal that we're looking at to reduce force.
		But also, you have to understand, I think that everybody has to understand where we're at with the VA right now.
		And that is since 2015, we've added hundreds of billions of money in money, and we've also added hundreds of thousands of positions, but yet we still have what we've added to as a bureaucracy and not many times into the condition of handling patient care at the front end.
		So there's a lot of jobs that no one would even know is at the VA that has nothing to do with our patient care and nothing to do with disability claims that are frankly clogging up the system in many ways.
		The bureaucracy at the VA is a little bit more than just rampant.
		So there's many ways that you can look at this because if it was just simply adding people and adding money, Jake, I tell this story all the time.
		If I was to tell the VA leadership 10 years ago in the hospitals and benefits that there's what your budget would look like in 2025 and here's what your number of employees will look like, they would have all jumped up and down on the table thinking that we were going to be in some type of grand scenario where the VA would be able to solve everything.
		Well, guess what?
		We're 10 years later and still on the GAO, GAO high-risk list.
		So we've got to do better with what we've got and we've got to focus it.
		And one of the things we did, and since we talked our last time, is I was actually table to take some of the cuts from contracts, $360 million that we actually moved into our community care veteran health care outreach.
		So we are moving money back to where it's more on the target for our veterans.
mimi geerges ▲ ● ▼		Dr. Shulkin, the Secretary says that the bureaucracy itself is negatively impacting veterans' care.
mimi geerges ▲ ● ▼		Do you agree with that?
unidentified		I do agree with Secretary Collins.
		And I said when I was Secretary, that this is not a matter of that the VA doesn't get enough money.
		The VA budget is fairly generous.
		And I do believe that it is the responsibility of the head of the agency to look at doing things better, doing things more efficiently.
		But I don't agree with Secretary Collins that there haven't been reductions.
		There have been many VA employees that have been fired, and I hear from them every day.
		I've heard from hundreds of them.
		And this is beginning to affect care.
		And more importantly, this anxiety and uncertainty about the future is beginning to significantly affect the morale of the workforce.
		I've never seen the morale this bad in the VA.
		And I think that's natural when people are uncertain about the future of the agency.
		I do believe that the Secretary would be better off talking about how he's trying to make this system better for veterans.
		You do not cut your way to an excellent health care system.
		And prior to being in government, I ran many health care systems.
		So I understand that sometimes you do need to do a reduction in force or you do need to cut your budget, but you have to make sure that you're cutting it in a smart way.
		You're not letting your very, very best employees leave the organization.
		You're essentially replacing the things that you're cutting with better ways of doing it using technology or new ways of delivering the type of care.
		And so this is a very complex system that you can't just cut your way out of it and expect that there aren't going to be harmful results to our veterans.
mimi geerges ▲ ● ▼		If you'd like to join our conversation with Dr. David Shulkin, he was the Veterans Affairs Secretary in the first Trump administration.
		You can do so.
		Our lines are bipartisan.
		So if you're a Republican, you can call us on 202748-8001.
		Democrats are on 2028-8000.
		Independents are on 202-748-8000.
		And two, we also have a line set aside for veterans.
		So if you're a vet, please call us on 202748-8003.
		You can use that line as well for texting us.
		Dr. Shulkin, I want to ask you about the PACT Act.
		It was passed in the Biden administration in 2022.
		Remind us of what that does and the impact that that is having on the VA, on the budget, and on the staffing.
unidentified		The PACT Act is often referred to as the Burn Pit Act.
		It is the ability to recognize the harm that has been caused by a generation of veterans that have gone to defend our country overseas and have been exposed to toxins and then come back home and can't get the benefits and services that they've earned.
		And rather than fighting their own government, the PACT Act recognizes that many of these conditions were caused by toxins and give the veterans the health care and the benefits that they deserve.
		And so when this was passed by President Biden or signed by President Biden during his term, we saw the largest expansion of veterans' benefits since World War II.
		We've seen several hundreds of thousands, more than actually a million veterans enter the system and will continue to enter the system over the next decade to be able to get that type of care and benefits.
		And so it's a very positive legislation that allows veterans to get that care.
		What it's doing is it's putting a significant stress on the VA system because we're having so many new people enter the VA system, which is a good thing.
		But when you're doing these types of budget cuts that we've seen and you're reducing staff, you're not hiring new staff to come in.
		We're seeing these veterans that should be getting the care and benefits actually seeing a delay in receiving that care.
		And that, of course, is very concerning.
mimi geerges ▲ ● ▼		This is Govigzek writes this.
		The VA plans to lay off as many as 83,000 employees this year.
		And this is a leaked memo that calls for the VA to slash its workforce to 2019 levels that were in place before millions of veterans became newly eligible for care.
		That, of course, is talking about the PACT Act.
		So what happens to all those people coming into the system?
		You know, Secretary Collins is saying that he's not laying off people directly involved with patient care.
		These are all, you know, what he calls bureaucrats.
		What's your impression of what could happen as far as wait times or quality of care?
		And is there another way that those vets can be cared for that doesn't cost the government so much money?
unidentified		You know, I do have some concerns about labeling everyone who is being laid off as a bureaucrat.
		Look, I'm a physician, and not only that, but have run many health systems, including the VA.
		And what you know when you do that is that a clinician just can't show up and see a patient.
		The veterans have to be scheduled.
		There has to be people that are supplying the medical supplies.
		There has to be people that are cleaning the rooms.
		There have to be nurses and assistants and all sorts of other people that many are behind the scenes that result in the ability to care for these veterans.
		So it's a system of care.
		It's not individuals that can be labeled bureaucrats.
		And I do think that we are seeing an increase in wait times around the country as a result of this.
		And so that's concerning.
		Now, there is a system of care called the Community Care Network.
		When veterans aren't able to get care in the VA system, they should, by law, be able to go outside into the community.
		But we are still seeing barriers to veterans getting that type of access to the community care system.
		So something has to give here.
		We either have to adequately staff the VA system so that veterans can get good access to care without long wait times, or we have to open up the community care system as that outflow so that veterans can get care by private physicians and go to private hospitals if the VA is not going to be staffed at the levels that are required.
		But right now, we're in this middle land where I think the veterans are experiencing trouble in getting the care in a timely manner.
mimi geerges ▲ ● ▼		All right, let's talk to calls.
		Tom is in Pittsburgh, California on the line for Democrats.
		You're on with Dr. David Chulkin.
unidentified		Thank you.
		First of all, thank you for taking my call.
		Dr. Sir, I am a former or retired VA employee.
		I'm also a Vietnam veteran.
		And this has been an ongoing problem for decades.
		During the Vietnam War, we came home.
		We weren't getting the services that we needed.
		They cut back back then.
		They were cutting back on services.
		And that's the reason why a lot of Vietnam veterans committed suicide, became alcoholics, drugs.
		Now you have a whole new generation of veterans.
		And the issue is this.
		It's a two pro, it's a it's.
		The situation is this.
		You can expect when I was working for the VA, when you're paying the employees who work for the Veterans Administration, who are taking care of patients, that when you look at the outside, they're making more money than we are.
		Well, what's happening?
		A lot of qualified people are saying well, I can make more money this way, and they leave.
		So again, the situation is that not only is patient care, but the employees have to be paid the wages that meet the surrounding area.
		I lived in the Bay Area.
		We were way behind.
		The patient care isn't there.
		If they want, they don't come to us.
		The employees, the veterans.
		What can we do to?
		What can we do to help the veterans?
		I'm a veteran and I can tell you, the problem is this, is that when you've got a veteran that's waiting six months six months for someone to see there's something wrong and this has to be addressed, and this problem is still going on today.
		How are we going to fix this problem?
joseph delouise ▲ ● ▼		And you're talking about cuts.
unidentified		Yeah well, first of all, thank you for your service, not only in Vietnam, but also for your service to veterans after you came back and working at the VA, and you're certainly right.
		These problems have existed for decades.
		Fortunately, I think that there have been uh changes to the system that, if used properly, are addressing those issues.
		We've seen increases in pay to our employees in the veteran health care system so that they can begin to keep up with the private sector not that they're equivalent, but you know my experience putting on a white coat and taking care of veterans myself is that some of the very, very finest health care professionals that I've ever worked with are working in the VA and are very dedicated.
		For the same reason you went back to work at the VA, because they're continuing their commitment to our to our veterans and to their fellow brothers and sisters, as many of them, like you, did serve in the military.
mimi geerges ▲ ● ▼		How much, what's the percentage of vets that are working for the VA?
mimi geerges ▲ ● ▼		Do you happen to know that?
unidentified		Yeah, it's been reported recently in the press as 25%.
		It's not 25%.
		It's much closer to 40%.
		And we see it in the people that are applying to the VA.
		And of course, there's a veteran preference in hiring employees that many people, when they transition out of the military, $250,000 a year, many of them choose to want to continue that service and preferentially seek employment at the VA.
		The VA actually has not had problems in general in bringing on new employees.
		Last year, the VA hired much more than actually they had originally planned to do.
		So now, of course, it's different in seeing budget cuts and reductions.
		But the VA is a very good place to work, and employees know that.
mimi geerges ▲ ● ▼		Mark is in Stittville, New York, a Marine vet.
mimi geerges ▲ ● ▼		Good morning.
unidentified		Good morning.
		I'm a Marine Corps combat vet from Beirut.
		I also am afflicted by the water contamination on Camp Blajeon.
		I was wondering why we only got letters for the last so many years.
		I think the first letter went out in 97 telling us we were contaminated.
		But go away, you don't have cancer.
		Here recently, I was diagnosed with cancer.
		I'm starting the VA process.
		But how come our government finds more need to support illegal aliens instead of us veterans with all the health care expenditures that they've wasted on these people that don't even belong here is ridiculous.
		And, you know, we all serve for the Constitution, and Article 4, Section 4, Clause 2 of the Constitution calls for the federal government to use all means of resources necessary to repeal foreign invaders.
		That's what these people that have come here for.
		I've worked my entire life working against these people at my detriment.
		When do we get support for our health needs from the government?
		When do we get our rights actually respected?
		Well, first of all, I do think that, as we talked about before, you are one of those veterans that is eligible for care and services because of the PACT Act, and that did involve Camp Lejeune.
		For those of us who fought to get the PACT Act for years and years, it is exactly for the reason that you talked about.
		People come back, were exposed.
		In this case, this was actually domestic exposure, Camp Lejeune, and yet have to prove their case to the government and have to wait often decades for the science to be able to show that there was harm.
		And of course, we saw this all the way back to World War II with mustard gas in Vietnam with Agent Orange in the Gulf War with Gulf War syndrome, and certainly, you know, in every generation of men and women that have served.
		And so, what the PACT Act is saying is we don't need to wait anymore.
		We need to get the care and services right away for people just like you and make it an easier process.
		Now, I think you're going through that process right now, and it's not always that easy, but stick with it because the system should work to be able to get you that care that you need and the benefits that you have already earned.
mimi geerges ▲ ● ▼		Dr. Shulkin, can you remind us what happened at Camp Lejeune?
mimi geerges ▲ ● ▼		This would be in North Carolina, right?
unidentified		Yes, that's right.
		An exposure to the water, toxins that leaked into the water supply, so that people that were there over decades long, including not only those that served, but their families and their children who lived on base, were exposed to unsafe water supplies.
		And that is recognized in the PAT Act.
mimi geerges ▲ ● ▼		Here's Will, a Vietnam vet in Massachusetts.
mimi geerges ▲ ● ▼		Good morning.
unidentified		Good morning.
unidentified		How are you this morning?
mimi geerges ▲ ● ▼		Good.
unidentified		I'm glad to hear that.
		Okay, I'm a permanently entotted disabled vet, but I'm calling about my girlfriend.
		She was a whack.
		She was in service in 1971.
		She served at Fort McClellan, Alabama.
		And this poor little sweetheart was exposed to Agent orange, white, blue, the entire rainbow of herbicides.
		She was exposed to mustard gas.
		She was exposed to plutonium.
		Anybody who was at that time, whoever went to Fort McClellan, was exposed.
		They were exposed to all these things.
		And at one time, they had a sign up over the water supply: do not eat the fish caught here.
		Monsanto Chemicals, they stocked one of these streams that the Fort and Anderson, Alabama used jointly for water supply.
		And they stocked the stream with game fish.
		Within 30 seconds, the game fish were all disoriented.
		Within five minutes, the last one died.
		I'm just giving a heads up to anybody who went to the chemical school, the MP school, the WACS, anybody who served there, anybody, even people who live there as dependents, civilian workers.
		I'm just giving them a heads up.
		You have been exposed.
		I want you to know.
		Thank you.
mimi geerges ▲ ● ▼		Dr. Shulkin.
unidentified		I do think that there are many people that do not recognize that they were exposed.
		And so thank you for getting that word out.
		The VA does work hard to bring that message out to people that have served to let them know that this is something that they should be aware about.
		And if they are concerned, to reach out to the VA and to enter that process.
		So I think the caller is absolutely right.
		Many, many people are unaware of these exposures and, frankly, do need to look into this to make sure that they're getting the type of help that they need.
mimi geerges ▲ ● ▼		Dr. Shulkin, I want to ask you about an opinion piece that you wrote for Military Times about the budget shortfall at the VA at $15 billion and your ideas to address that.
unidentified		Yeah.
		Well, the VA did during the last fiscal year experience a significant budget deficit.
		And one of the reasons for that was the PACT Act, that so many new veterans were seeking care and coming into the system.
		And of course, any health care system would need to staff up for that level of new services being in demand.
		And so the VA has had a significant increase in budget deficit.
		But like Secretary Collins had said, there are ways of getting this system more efficient.
		The VA budget is large, and one does need, rather than to always seek more and more funding, to look for more efficient ways of doing things.
		And that's the job, whether you're running a healthcare system for the government or running a healthcare system in the private sector.
		And so I have suggested a number of ways that the system could be far more efficient.
		But these are ways that, frankly, would not result in significant job losses.
		These are building the facilities, the VA facilities, much more efficiently rather than doing it through government contractors.
		These are sharing facilities with the Department of Defense that has many underutilized facilities.
		This is standardizing the supplies and services across the VA system and putting in a standard electronic health record across the system.
		So there are many more efficient ways of running this system, and I applaud the Secretary for looking for those.
		I just don't think the way you do this is by cutting your way out of this problem, but you have to do this in a smart way in improving the way that care can be delivered.
		And frankly, a lot of that is by replacing old government technology and putting in new technology that's now available, including artificial intelligence.
mimi geerges ▲ ● ▼		Let's talk to a vet in Riva, Maryland.
mimi geerges ▲ ● ▼		Jim, you're next.
unidentified		Hi.
		I'm just called in to mention about the community care that I heard him speak about, about when the VA cannot handle it, they'd send you out to community care.
		I'm waiting to try to get a hip replacement.
		A year ago, I was in need of one.
		They had me come back and take more x-rays.
		I took the x-rays.
		I went down to orthopaedics to schedule an appointment.
		And then you wait and you wait for them to call you.
		And if you miss the call, you're out of luck.
		So you basically got to sit by the telephone hoping that they're going to call you in a reasonable time.
		It interrupts your whole life.
		And this is what you go through with the VA.
john taylor gatto ▲ ● ▼		And I'll say this about the VA: they're probably one of the finest medical outfits out there.
unidentified		And they deal with a lot of different issues.
		I heard them speak about the Agent Orange, the Gulf War syndromes.
		You have to prove these cases.
		And when you're fighting for mental health issues, you have to prove that you have these mental health issues.
		And the way you have to do that is by proving your stressors.
		And this opens up more wounds to people.
		But I'm very proud of the VA.
		I think they do a wonderful job.
		They are compassionate.
		But when you're going to cut their funds, you're cutting the throats of these veterans that have already suffered a great deal.
		And it's just not right.
mimi geerges ▲ ● ▼		All right, Jim.
mimi geerges ▲ ● ▼		Go ahead, Dr. Shulkin.
unidentified		I think you're hearing what I hear on a regular basis from so many veterans, which is that the VA is an incredible resource and very important that we have a VA to be there because of that compassion and care and understanding of veterans' issues.
		But it's not a great place if you can't get in there and if you can't get care scheduled or if you're waiting a year for that care.
		So I think a couple things.
		One is under President Trump, when I was secretary, the law was passed called the Mission Act, where it is put into legislation that veterans should not be waiting for specialty care like orthopedics more than 28 days.
		And if they are waiting more than 28 days to get into the VA, then that should allow them access to the community care network.
		Also, if a veteran lives more than 60 minutes from a VA, that should allow them access to the community care network.
		So the intent of the VA system is veterans should not be stuck waiting for care in what we're hearing on a regular basis.
		And, you know, we're hearing that directly from this veteran.
		The other thing that we're hearing from the caller is that they feel like they have to fight their own government just to get the services that they've already earned and that they deserve.
		And again, that's not a system that is intended or that we want.
		And we know that our veterans deserve much better.
		So this is what I mean.
		Rather than focusing solely on the cuts, we need to focus on what is the system that we're designing and how do we get there to be more efficient.
		And look, I do believe we can probably get there with a smaller budget, but it's going to take the fortitude to design the new system and to put in the support tools to allow us to get there to be more efficient.
mimi geerges ▲ ● ▼		We have a question for you on X: who says, Is it the expectations of veterans that everything is covered and free?
mimi geerges ▲ ● ▼		Should some co-payment be required?
unidentified		The VA does have co-payments.
		The way that the VA system works is there are eight priority groups for veterans.
		When they leave the military, they get an examination.
		And if you are in priority group one, which is severely 100% disabled, think about veterans who came back from Iraq and Afghanistan, missing legs and arms or in wheelchairs.
		Those veterans don't pay co-pays.
		Those veterans get the highest level of service and don't have to pay for it.
		But if, on the other end, you're in priority group seven or eight, which means that you're not service disabled and you have a higher income, you actually don't even get access to VA health care services.
		Those that are in between have some level of co-payment depending upon their service connectedness or their service disability.
		So the system does take into account whether you can afford to pay your level of service disability, and there are co-pays associated with those that don't meet the requirements.
mimi geerges ▲ ● ▼		Let's talk to Myron, a Vietnam vet in Hancock, Wisconsin.
mimi geerges ▲ ● ▼		Hi, Myron.
unidentified		Good morning.
mimi geerges ▲ ● ▼		Morning.
mimi geerges ▲ ● ▼		Go right ahead.
unidentified		How are you doing?
mimi geerges ▲ ● ▼		Good.
unidentified		Well, I appreciate the VA.
		I just can't say enough about the health care.
		I think it's some of the best in the United States, maybe the best.
		My wife does not go to the VA.
		She has terrible health care.
		And when I compare my health care to hers, it's unbelievable.
		I have taken advantage of community care and got great community care.
		I can see today because of community care.
		I am very appreciative.
		Yeah.
		And, you know, this is so common.
		It's one of the reasons why when I got to VA, I became a strong advocate to support the VA and to make it a better system because of exactly what I hear from veterans, which is this is the best care or some of the best care that they've ever received.
		And, you know, when I would put on my white coat and stethoscope, even though I was secretary, I would see that personally, the type of care and caring that occurs in the VA.
		And that's why I fought for that system and why I continue to fight for the system.
		There are efforts underway to privatize the VA to essentially reduce its importance and scope.
		And I'm not in favor of that.
		I actually wrote a book called It Shouldn't Be This Hard to Serve Your Country about all of the reasons why this system is an incredible system and important for our national security and why I think it's important that we all stand up for the VA.
		But, you know, there are people who I think don't share that belief and don't want to see the VA succeed.
mimi geerges ▲ ● ▼		Here's Ed in Jacksonville, Florida, lying for independence.
unidentified		Yes, good morning.
unidentified		I'm Iraq and Afghanistan and also Vietnam veteran.
louie gohmert ▲ ● ▼		And I would like people to know that, you know, especially the military people when they get out, unless they're service connected, that they are going to get a bill, which you already addressed.
unidentified		But also, you don't address that if you're a veteran that served and got a retirement from the military system, you got under the TRICARE system, you file for that for your insured for the VA bill, that they will not take TRICARE.
		Yes.
		We have a very siloed system of care.
		What this caller is talking about is two different systems that are essentially treating the same population, which are people who have served our country.
		Some are covered under the TRICARE system.
		Those tend to be those that have put in a lot of years and have retired with a pension through the military and also their families, where the VA system is a broader system.
		But both are systems designed to treat populations who have served our country.
		And one of the ways that I think that we can become more efficient as a country and serve our veterans and those retirees better is to actually look at ways of bringing some of these systems together because there's duplication.
		And so those are things that I think are worth exploring and seeing whether we can design a better, more efficient system of care.
mimi geerges ▲ ● ▼		We've got a question for you on X from Ajika, who says homeless veterans in Los Angeles are still waiting for 1,800 units of permanent housing per court rulings.
mimi geerges ▲ ● ▼		Why is the VA appealing this decision?
unidentified		Yeah, veterans homelessness, when President Obama first set out to eliminate it more than 10 years ago now, is still a major problem.
		About 40,000 homeless veterans, you know, each night do not have a safe place to sleep or to call home.
		And California, especially Los Angeles, Santa Monica area, tends to be the area where we see the single highest level of veteran homelessness.
		The VA has been involved in many legal struggles, largely related to the Westwood campus in Los Angeles, which is about 300 acres of property in Westwood, right?
		Right, some of the most expensive property in that region where there is veteran homes for homelessness people being built.
		And the issue is whether there should be more built there.
		And I'm not exactly aware of this current legislation that's going on.
		I know that this has been an ongoing issue all along.
		Of course, many of us, Secretary McDonald and myself and others, have supported using that campus to house homeless veterans and to build that type of housing.
		And we obviously have a shortage, particularly in California, where landlords will not take the vouchers for veterans that are given to them to provide them homes.
		So more homes do need to be built in that area.
		And I certainly hope that VA is on the right side of that issue.
mimi geerges ▲ ● ▼		Tom is a vet in Arkansas.
		Hi, Tom.
		You're next.
unidentified		Oh, good morning, and thanks for taking my call.
		And thanks, Dr. Chulkin, for your service and your advocacy.
		I'd just like to say that I absolutely agree with the caller from Wisconsin.
		I think the VA health care system is the equal of the private system, if not better, in many cases.
		I've never waited for an appointment for over two weeks or three weeks or something like that.
		I'm a Vietnam-era service connected veteran, and I think the healthcare is excellent.
		I do compliment the VA on changing their engineering support to the Corps of Engineers, which used to be done by the VA.
		I think that was a good move and probably will overall improve the facilities.
		Kudos to the VA.
		That's all I've got.
		Thank you.
		Yeah, thank you.
		And thanks for that.
		I'm particularly fond of the care in Wisconsin.
		My grandfather, who was a World War I veteran, was the first full-time pharmacist at the Madison, Wisconsin VA.
		And when I grew up, I remember how proud he was of being able to provide pharmacy services for our veterans.
		And when I visited the Madison VA, they actually showed me the mortar and pestle that my grandfather used to compound medication.
		So that is a great VA.
		And I couldn't agree with you more that having the Army Corps of Engineers help oversee construction projects in the VA is certainly going to be helpful.
mimi geerges ▲ ● ▼		Jerry is in Long Beach, Washington, a Vietnam vet.
mimi geerges ▲ ● ▼		Hi, Jerry.
unidentified		Hey, good morning.
		I can say nothing but great things about the VA.
		I've had great service from them.
		I'm part of the system where I'm two hours away from any facility.
		And so I use what they call TriWest.
		It's right here next to us to me in Astoria.
		I've had no problem whatsoever.
		Here's my only issue that I think should be changed.
		I have a veterans card.
		And my wife and I are retired.
		And so we travel quite a bit and we'd be gone for five or six months.
jim in michigan ▲ ● ▼		Well, I got real, real sick here a year ago with COVID.
unidentified		And I went down to San Antonio, Texas to the VA Center.
		They wouldn't service me because I wasn't directly connected to them.
		And so I went over to, believe it or not, lo and behold, I hid into an emergency room thing.
		And guess what?
		These services and the vet administration pay for it.
		I can have no complaints about that.
		I mean, I thought that was strange.
		The other thing I thought was strange is I can't get my medications from anywhere other than the Portland VA clinic.
		That seems strange to me.
		I should be able to get that no matter where I go, but the systems aren't connected at all.
		And that just seems really strange to me in this world.
		By the way, I also think there's a bit of a red herring about timing because my wife just recently got an appointment.
		Guess when it is?
		It's in September.
		She couldn't get it into a facility.
		And she's not a veteran, but she's in the regular system.
		She couldn't get an appointment until September.
		Anyway, beyond that, I love the VA and thank you for taking care of us.
		Yeah, I think what we're seeing is a consistent theme that veterans do care a lot about the VA because they know the quality of care that they're getting.
		That example of not being able to get your care in Texas, though, is not a good thing.
		You should have been able to go to any VA to get that care.
		And that is some of the bureaucracy that we're seeing that prevents it.
		So you went to an emergency room.
		The VA, the federal government, wound up paying a lot, lot more money because they wouldn't have seen you in that clinic because they're going to pay the emergency room a hefty fee for going to the emergency room.
		But that is part of the benefits: that if a veteran can't get care and they go to an emergency room, that is a covered service.
		But that's the fastest-growing area that the government's spending money on, which is veterans going to emergency rooms because they can't get care.
		So that clearly needs to be fixed.
		The other point about your wife in the community, you know, people who say, well, let's shut down the VA and just give veterans care in the community solely, you know, that the government would pay for, don't understand that it's not always easy for people to get care in the community, that they often have to wait months like September before they can even get an appointment with a primary care doctor or with mental health specialists.
		So the VA system is an important system to be able to maintain, but not if the VA is not willing to see you like you experienced in Texas.
mimi geerges ▲ ● ▼		We got a text from Richard in Minneapolis who's asking, does the PACT Act give you a disability check?
unidentified		Yes.
unidentified		If you go through the process and you are approved, that would include disability benefits.
mimi geerges ▲ ● ▼		Here's James in Kansas, also a vet.
mimi geerges ▲ ● ▼		Good morning, James.
unidentified		Good morning.
mimi geerges ▲ ● ▼		Go right ahead.
mimi geerges ▲ ● ▼		You're on with David Chulkin.
unidentified		My question to you, sir, and I thank you for your service.
		And I have a question for you.
		My question is: why doesn't more landlords take the vouchers?
		Landlords, and I've met with many of them, often say that the voucher is not enough for the specific locality.
		So that in Los Angeles, where housing prices are very high, the landlords often say that they would need to have a higher amount to accept the voucher.
		Other landlords are concerned about housing homeless people, even if they're veterans, that they often are difficult tenants.
		I don't think that either of those issues are particularly valid.
		I think the VA has worked with the Department of Housing and Urban Development to increase the check size of vouchers, particularly in areas where real estate costs are high, like California, and that veterans, particularly when put into housing that have supported services, are very good tenants.
		We do not see higher levels of problems than we do with other types of housing projects.
		And so we try to find landlords that are willing to work with the VA, landlords that are committed to helping our veterans.
		Unfortunately, in areas with housing shortages, there just aren't enough of those landlords.
mimi geerges ▲ ● ▼		It's Dr. David Shulkin.
		He was the Veterans Affairs Secretary during the first Trump administration between 2017 and 2018.
		Dr. Shulkin, thanks so much for being on the program.
unidentified		Glad to be here.
		Anyway, guys.
		Well, it's been about three years since the U.S. military withdrew from Afghanistan.
		And in just a moment, we'll take you live to a discussion on the current situation in that country.
		It's being hosted by the Hudson Institute.
		Live coverage when it gets underway shortly here on C-SPAN.
mimi geerges ▲ ● ▼		Here to talk about trade tensions between the U.S. and China is Scott Kennedy.
		He's Center for Strategic and International Studies Senior Advisor and Chinese Business and Economics Trustee Chair.
		Scott Kennedy, welcome to the program.
unidentified		Thanks for having me.
mimi geerges ▲ ● ▼		So Trump has raised the tariffs on Chinese imports to 145%.
		The Chinese have responded with applying a 125% tariff on U.S. goods.
		How big of a deal is this to the economies of both nations?
unidentified		This is huge for both the U.S. and Chinese economies and for the global economy.
		Exports from China to the United States are about 14% of Chinese exports.
		U.S. exports to China, probably about 8% to 9% of American exports.
		But they're also connected to investment in both countries, to global supply chains.
		There are geostrategic elements to this.
		Levels of uncertainty are higher than they've been in a long, long time as a result of the tariffs.
		There's still a lot more that can be done to escalate.
		An off-ramp is hard to see.
		And so this could have major ramifications for us, for the Chinese, for everybody.
mimi geerges ▲ ● ▼		Let's talk about the Chinese economy.
mimi geerges ▲ ● ▼		What's the status right now of the strength of their economy?

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