least 236,000 veterans were waiting six months more for first appointments or initial followup. clear indication of lack of sufficient capacity or at a minimum a lack of adequate to provide required care.

admitted v.a. needed an dditional $975 million for 2005 and $2 billion more for 2006. even when v.a. accurately indicates its needs, omb passed back a lower number in the final budget. that's why dav and our partners have testified over the past decade that v.a.'s medical care and construction budgets were inadequate. in the prior 10 years the funding provided for medical care was more than $7.8 billion less than what they recommended. for next year we project it will be $2 billion less than needed. here's what the congressional budget office said in a recent report. and current law for 2015 cbo's base line projections for 2016 v.a.'s appropriations for

health care are not projected to keep pace with growth in the patient population or growth in per capita spending for health care. meaning that waiting times will tend to increase. in addition, over the 10 years of funding appropriated for construction has been about $9 billion less than what was needed. and that's based on v.a.'s own internal analysis. mr. chairman, in 1905 american philosopher george santiana famously wrote that "those who cannot remember the past are condemned to repeat it. ." the question is will we learn from the mistakes of the past? in our view, the debate over whether there is a mismatch between demand for v.a. health care and the resources provided

is a settled issue. why else would the house vote 42 6-0 and the senate vote 93-3 for legislation to expand veterans access to health care hat cbo estimated could cost $30 billion for two years of coverage and up to $54 billion annually after that if there was already enough money? acting secretary gibson testified about the progress made over the past two months adding more clinic hours, filling physician vacancies, and using temporary staffing resources. secretary gibson also testified in order to continue this expanded access initiative for this year and the next 3 years, v.a. will need supplemental resources totalling $17.6 billion. unlike the proposals in the

conference can he, v.a.'s proposal would have an immediate impact by continuing v.a.'s expanded access initiative and its purchase care while building up internal capacity for the future for these reason wes support the supplement nal request approach. dav has for decades said the inadequate. ded is sadly history has proven us correct. it is up to asking and the administration to take steps necessary to end the mismatch provide v.a. the resources it needs and work with vso's to strengthen the health care system so enrolled veterans receive high quality timely and convenient medical care.

>> there needs to be true accountability. if people lie they get fired. i totally agree with that decision. you can't run an outfit where people systemically do not tell the truth. the first thing is they have adequate resources and i have to agree that we have been saying for a long time they don't have adequate resources addressing consequence which hasn't been done for any generation. it wasn't done for those

exposed to ineniesing radiation , it wasn't true for vietnam vets with agent orange, not true of vets exposed to serin gas. thie these do have long term health consequences. it's something that needs to hange in a system in the way that the v.a. approaches their vision of veterans health care. it is not a general health care system that happens to be for vets. it has got to be a system based on military exposures whether that be all the things that people talked about earlier today, spinal cord injuries, visual and impaired and life services, prosthetics, and on and on.

that's why we have such high rates. i notice somebody, it wasn't us, put it on the table, a card from the american academy of veterans. they are disseminating it to their members. why? because v.a. is not talking to private sector medicines. these conditions that stem from military services based on bratch of service, when did you serve, where, and what was your occupational specialty. and it should be. ecause 70% or 60 to 70% of veterans don't go near a hospital and have more wounds today. but we still don't have adequate resources. and most importantly we don't service. ight kind of

the mentality, what they need. how about asking the vets what do you need? what do you all think? here's the problem. can we solve it together? not just at the national level level. he veteran people have an example the white house mandate that everybody do a summit of mental health so they did it and supposed to be involving the community and set the agenda and work together. well that's not what happened. they had a predetermined message. they invited a couple people and told us what we ought to think. that's not a summit. that's not a partnership. and once we change this at the local level then we will start

to turn it around. we will say that under the acting secretary there is a wind of fresh thought. it hasn't gotten out to the field yet but it's wafting through. so people are doing what they should have been doing all along not just from v.s.o.'s. as an example, the scheduling system. some people asked our opinion and the acting secretary ecause we know what it's like. if you want to change a v.a. you change that particular part of it. forcing v.a. to listen to the stake holders and really do patient centered care or veterans cent rick care, to do that you have to respect the individual veteran and the veterans organizations that -- and other stake holders.

i want to just touch on resources here just for a second. have said frot the outset that it's a civilian formula for pfmentpfmentofment's an middle class formulas. hat's not using v.a. veterans coming into v.a. vets ls today among the it's 14 presentations. but the formula figures one to three presentations. it doesn't take a rocket scientists, even i can figure out that you're going to fall further behind if you use that to estimate what the need is going to be. we need to go through a more realistic funding.

the last thing, people have been saying where are we going to find the medical professionals? and a number of people inside, ve been working on a program for physician assistants but why not a school to go to medical school and they get back two years for every year they're in school? then you're growing your own. it's veterans who have served and who are committed to the and will m the system have enough people for the future. i thank you for the opportunity to appear here today and thank you for your insudgeance. >> thank you for your testimony sir.

>> while it is true that many of our members have expressed general satisfaction with the quality and delivery of health care they receive many have also expressed serious frustration with general access to and direct communication with the v.a. system. we are pleased to see some recent changes within the vha and we are eager to see more

pursued in the areas of accountability, adoption of best technologies and increased capacity to deal with future needs. congress has acted swiftly in the area of accountability in response to the scheduling scandal by passing the v.a. management accountability act. we are pleased to see this move forward we want to make sure the secretary actually uses it once signed into law. we would welcome an extension and application to similar authority within the v.a. with the appropriate due process protections as a part of that. we would like to see v.a. adopt more friendly technologically platforms. we believe the organization needs to begin a shift in the way it looks at its needs and how it goes about acquiring and designing those systems. compared to the private sector interphases the platforms and

portals are frankly a joke to many veterans. finally our members want to see an increase in v.a.'s capacity to deliver critical services to veterans especially in the realm of mental health care. the shortage of counselors, social workers and other mental health professionals must be quickly recommendied. some of these and many other reforms and are actions that v.a. could have pursued. unfortunately the v.a. ds level of communication cooperation and collaboration with new generation organizations over the past five years has been severely lacking. prior to the outbreak of the scandal the former secretary of veterans affairs had only met with us directly on one occasion during his entire tenure as secretary. much like the attitude towards this can he it is the prior regime within the varmint did not like what they were hearing

, they were shut out from top level access entirely. the interim leadership has been much more commune cative with us and other vso's and advocacy groups and the new liaison brought on immediately prior to the access crisis has done a phenomenal job in working to repair the relationships between v.a. and the nation's largest organization of iraq and afghanistan veterans to the families. in addition to the above we want to take the opportunity to let members of the can he know that today right now the national press club is releasing the results of its 2014 member survey. the policies positions and priorities are driven every year by our survey and the data this year overwhelmingly revealed the suicide and mental health care access are the top challenges facing this generation of veterans. more information about the results of our member servay are available today and our

staff and research team led by the doctor in our zs office will be happy to brief you on our findings in the very near future. this portion of his confn

hearing is about an hour. appreciate the

confidence of president obama in this nomination and i am fully committed to for filling this me, for filling president lincoln's promise to care for him who show up to battle and for his widows and orphans. and by serving and honoring the men and women who are america's veterans. organizationate an that lives by install use. over the next several weeks, i have had an opportunity to meet you individually, and i deeply commit -- appreciate the committee's concern and unwavering support for our veterans and for the mission of the dependent of veterans affairs. i've listened carefully to your concerns and advice and i benefited from your counsel. as explained by senators brown and portman, my life's purpose has been to improve the lives of others. my time at west point and as an

airborne ranger captain in the 82nd airborne division instilled in me a lifelong sense of duty to country. my values are steeped in my experience at west point and in the military. those values have allowed me to be an effective leader at the procter & gamble company and those values are what i will bring to the management of v.a. i am still guided by that west point prayer which encourages us to choose the harder right rather than the easier wrong. for me, taking care of veterans is very personal. i come from and care deeply for military families. my father served in the army air corps after world war ii. my wife's father was shot down over europe and survived harsh treatment as a pow. her uncle was exposed to agent orange in vietnam and still receives care from the v.a. and my nephew right now is in

the air force flying missions over the middle east. my 33 years with proctor and gamble taught me the importance of effective management, strong leadership and being responsive , to the needs of customers. when i joined the company, we recorded $10 billion in sales. today that businesses over eight times larger with $84 billion with almost double the number of employees and the brands are present in nearly every country of the world. i helped lead this transformation. i am a forward-looking leader who spent my business career expanding p&g to serve new and underserved customers. that is the experience needed to modernize the v.a. as i met with members of this committee in the past few weeks. you told me the depth of crisis of that the department of veterans affairs. while there is much that is going well, there have been systematic failures that suggests that some in the

organization have lost track of the mission and core values. the department's problems with access, transparency, and accountability are all well documented. there is a lot of work to do to transform the department. it will not be easy but it is essential and it can be achieved. the seriousness of this moment demands action. and if confirmed, i pledge to the committee and to our nation's veterans to take a series of immediate actions over the first 90 days to deliver the needed reforms our veterans deserve. i will put the veteran at the center of everything that we do consistent with our mission. if confirmed, on day one, i will lay out my leadership vision to all employees. my charge will be to provide veterans the care they have earned in the most effective way possible. i will ask v.a. employees to join me in reconfirming our commitment to v.a.'s mission and

core values. i also plan to ask all employees to bring forward any information, any concerns, any problems that exist so that i, as a leader, will know the whole picture of what is going wrong and what we can improve. if confirmed, it will be important to incentivize this process and reward those that constructively come forward to solve problems. i am looking forward to gaining valuable input and insights from its employees as well as veterans and other stakeholders. if confirmed, i will also renew the department's strategic plan and ensure it is properly deployed so that every individual in the organization knows how their work every single day ties back to the strategic plan and to the mission of caring for veterans. by getting out in the field and talking with veterans and employees, i will learn much about the organization as possible. i will be able to determine the

processes that will need to be reorganized or streamlined. in order to regain the trust of the american people and most importantly veterans, we must ensure every employee has an action plan in their annual performance review that rolls up to the strategic plan and the mission for the department. the majority of the employees of the v.a. are dedicated to the mission and the values of the organization. but those employees who have violated the trust of the nation and of veterans must be and will be held accountable. if confirmed, i plan to improve the communication between the field structure and the central office, between the employees and the leadership. i also plan to travel extensively over the first several months to hear directly from employees, veterans, and other stakeholders. i plan to establish a board of physicians to advise the secretary on best practices for delivering timely and quality health care. if confirmed, i will focus on

reorganizing the department to more efficiently and more effectively use our resources to get care that the veterans deserve and have earned. the department must improve his forecasting and develop a strategy for meeting increased demands. at the same time i believe the , department will need to expand the use of digital technology to free human resources that can be applied more to the care of veterans. i plan to take advantage of the scale to improve productivity and the flow of more people to the work. it is clear the v.a. must be more efficient and productive. the department needs to demonstrate they can manage a complex facilities portfolio, it can create with the department of defense an integrated record system, it can regularly and accurately produce key data for decision makers and oversight entities. most importantly, provide the veterans the highest-quality and

cost-effective benefits possible. all of these things are possible. they are possible through some of the steps i have outlined. if confirmed, i will work to transform the department of veterans affairs. i will continue to partner with you and all the department stakeholders. v.a. has made great strides in serving veterans thanks to the commitment of many dedicated employees and the hard work with our partners and advocates in the community. but, the v.a. is in crisis. the veterans are in need. there is much to do. i can think of no higher calling, no higher calling than to serve our veterans who have so selflessly served all of us. with your support, i am confident we will succeed at the department of veterans affairs. thank you and i look forward to your questions.

>> thank you very much for your testimony. in a sense i think you have , answered my first question. but i am going to ask it again. you don't need this job. i don't think you're at the age in your career where you need to move up the ladder. you don't need anything more to your resume. you have done pretty well. in the midst of all of these problems and a dysfunction u.s. congress and bitter partisanship, why do you want this job? >> thank you, chairman sanders. i think it is a good question. it is a question my family and i have talked a lot about. i desperately want this job because i think i can make a difference. i think my entire career, whether it was starting at west point, being in the 82nd airborne division, being at the procter & gamble company, one of the most admired companies in the world for 33 years has prepared me.

i think there is no higher calling and this is an opportunity for me to make a difference in the lives of veterans, who i care so deeply about. if not me, who? >> thank you for that response. one of the issues we are struggling with is v.a. health care. i look at this different than some of my colleagues who think health care is just fantastic and it is just the v.a. that is having problems. the other point i want to make is not just the size of the v.a. 6.5 million come in every year. inevitable problems are going to occur. the fact that because the v.a.

is a public entity and, appropriately so, there is a lot more public attention to the problems facing the v.a. in the paper today, johns hopkins university hospital paid $190 million to more than 7,000 women for inappropriate behavior on the part of a physician. that was in the "washington post." if that happened at the v.a., there would be dozens hearings, articles for months to come all , kinds of investigations. john hopkins university is a great hospital. problems happen. a couple of weeks ago, in montana, there is a lacking of 20 physicians. just in the small state of antenna. i know that in vermont, we lack them. in phoenix, god knows how many they lacked. in a nation in which 40 million people have no health insurance, in a nation where we spent almost twice as much per capita

on health care than any other nation, in a nation where 45,000 people died because they don't get health care, how are you going to help us get the physicians that we need, the nurses we need so that when people attempt to get into the v.a., they get in in a timely manner and they get high-quality health care? how do you do that within a dysfunctional health care system nationally? >> chairman sanders, first of all, we will start with us giving you very transparent projections as to what we think the demand is and how many resources we will need. we will have to build those from the bottom up and i promise you i will be, if confirmed, open, transparent with you as to what we think the need is. we will have to restore the reputation of the v.a. if anything, this crisis may

have damaged the reputation of a great organization. we will have to restore that and we do that by acting quickly to make sure every veteran in need gets the care they deserve. they can tell our positive stories for us. we will have to do recruiting. third, at proctor and gamble, we talked about this, we promote from within. i left the army as a captain. i went to the proctor and gamble company. bottom i started at the and i worked my way up. we spent a lot of time on college campuses recruiting. last year, we had over a million applicants for fewer than 5,000 jobs because people want those jobs. it is a company they want to work for. v.a. is a health care system that people want to work for. what i need to do is help recruit the very best people for that system. >> will you go to the medical schools of this country and the nursing schools in order to bring bright young people into that system so that our veterans get quality health care?

>> we talked about the important role of leadership and changing culture. the fastest way for a leader to change the culture is through their own behavior. if recruiting is important, which i believe it is because we have a shortage. we also have a time where the v.a. is in crisis. i think the leader has to play a role in recruiting those doctors and nurses. >> my last question deals with technology. there is no question or debate that the v.a. has very outdated technology in terms of scheduling appointments and other areas. what can you do to utilize the best technology to make the v.a. a more efficient and cost-effective entity? >> i think technology is a real enabler.

it is a high-leverage activity. it would allow us to release some people and some resources and flow them to the mission which is to care for veterans. my undergraduate degree is in engineering. i studied computer science at west point, both hardware and software. i wrote an assembly program for the honeywell computer at west point. at procter & gamble, i committed that we would become the most digitized company in the world. creating molecules digitally and shipping to our customers using digital technology. i think the same thing needs to be true for v.a. we need to use technology to free up people and take care of veterans. i plan to do that. >> thank you. >> welcome, mr. mcdonald. we are truly grateful to you and your family for this.

i want to start with a couple of housekeeping questions. as ranking member, part of my role is to conduct oversight with regard to v.a. activities. this often leads me or my staff to request information, statistics, or other materials from the v.a. if confirmed will you ensure , that my staff and i will be provided with the requested information in a timely fashion? >> senator burr, you and i talked when we were together, you will have my cell phone number. every member of the committee will have my number. i would expect if we are not in -- if we are not meeting your needs, you will call me. when you run a large corporation globally, you have a cell phone that is on 24 hours a day, seven days a week. it gets called. if you have concerns, i want to know about them and react to them. >> i thank you for that. if confirmed will you be , proactive in alerting this committee, including both sides of the aisle, about significant issues involving the v.a.? >> yes, sir.

i believe no leader can do a job this big by themselves. i need your help if confirmed. >> he has deep concerns that the veterans needs are not being met. i think he chairs the new york hospital. he told me this morning the medical staff is the same medical staff that we use at the v.a. facility. that we actually leverage the hospital staff to staff the v.a. is that a model we could expand around the country and leverage for any shortages that exist? is that a possibility? >> from what i know, that is relatively common. i know that -- i think from what i read, two thirds of health care professionals in the united states have at least trained in the v.a. that would certainly be something we would want to look

at, particularly in a case where capacity is constrained and we need help. >> i have been told that in 2011, v.a. began an initiative called the harmony project. this was to explore the pros and cons of further integrating emerging operations of the v.a. and the department of defense health care systems. i believe this effort resulted in a report suggesting the agencies could improve access and continuity of care while saving billions of dollars annually, but it is unclear to me whether the v.a. ever discussed the findings of that project with the department of defense and whether any action was ever taken on that report. i do not expect you to know anything about the harmony project. can i get your commitment that you will go back and ask was there a harmony project, that you will review it, and then you

will provide the committee with a copy of the conclusions of that project? >> yes, sir, i was certainly like to learn about. demonstrating my own commitment to the importance of the department of defense and veterans affairs working together, i had the opportunity to meet with secretary hagel. we had a great meeting. we both committed to a partnership, a partnership that acting secretary gibson had also had it with secretary hagel. we both agree that it should not be the veterans fault or the service members fault that there was a scene in the united states government between the department of veterans affairs and department of defense. that should be absolutely seamless for those who have taken the oath and became veterans. i pledge and i know secretary hagel does the same to make that as seamless as possible. >> if i could get your commitment, excuse me, to report back to congress or the

committee if what or any interactions taking place between the v.a. and the department of defense about the concepts highlighted in the harmony project. >> i am not familiar with the project, but we will take a look at it and get back to you on what we think about the different items in the harmony report. >> i appreciate that. i look forward to expediting your nomination. i thank the chair. >> thank you senator burr. >> thank you mr. chairman. mr. mcdonald, i was really troubled to hear secretary shinseki say he felt like he was misled by directors and other senior leaders. the department, they cannot function at the secretary is not given honest information from the field and taking appropriate action. if you are confirmed how are you , going to create a better team and build trust and transparency?

>> i think that is an excellent question. on day one, what i have to do is meet as many employees as i can. i have to understand how they think about their role in the department. one of the things i pointed out is i think we have a pretty good strategic plan. when i looked at the strategic plan on the internet -- i am only looking at publicly available information. the behavior of every employee in the department is not consistent with that strategic plan. we have to develop a way to make sure the department -- the behavior of every employee and their expectations and their performance each year ties back to the strategic plan. >> do think that was happening? >> i do not want to judge but at the procter & gamble company, what we work hard to do is to take the strategic plan and make sure every blow ranking and

every employee in the entire company, if you roll up their behavior, it will be based on the strategic plan. >> i agree with that, too. what secretary shinseki was saying he was misled about people that were not telling him the truth. how do you build that trust so to give you the information that you can -- >> i have to be out there with the people in the field and we have to have the leaders who are vigilant, making sure that trust is real. it is unconscionable to me that you have an organization where one of the stated values, one of the stated values -- the first stated value is integrity, yet you have people lying. you have people tolerating it. the west point honor code says we do not lie, cheat, steal and we do not tolerate people who do.

you don't want people in your community lying. we have to get into this and understand it. >> i appreciate that commitment. i have talked with prior v.a. leaders about concerns with some of the facilities. the v.a.'s access, many of those facilities for some further investigation. the most recent wait time and quality data released shows shortcomings at washington medical facilities. i have raised real concerns about what is happening with the spokane medical center, including whether staffing and budget shortfalls are hurting health care for veterans. if you are confirmed, how were you going to confirm oversight of these facilities and make sure the resources are getting to the places where it is needed? >> i think that is part of the forecasting and projecting that i was talking about in

conjunction with the strategic plan. what i heard from secretary gibson last week during his testimony was that the v.a. had not done a bottoms up forecast before. he was having some trouble getting that done. we got to do a better job of that. we got to be very open and transparent with all of you and all of our constituents as to what we are forecasting. we have to put the systems in place that can make sure our veterans are getting the appropriate care. we have to be able to have doctors and nurses and physicians on the ground to be able to do that. i think digital technology will play a role because it will help us -- i know we have at the v.a. -- the v.a. is known for a very good electronic medical records. if we can get a scheduling system that is equally world class, there is no reason we can't, i think we can use that to help better care for the veterans. >> you talk a lot about health care.

i did want to ask you about the veterans transition into civilian life. many of them are using their g.i. education benefit. back in 2012, i passed legislation to make sure they had something available to them so they can have resources available to them. schools may provide inaccurate or incomplete information to prospective student veterans and that veterans themselves want independent, objective advice when it came to making their education decisions. i know you are not in there yet but one of the things i hope you focus on is making sure the veterans make good choices when they use those education dollars. >> i will certainly focus on that. i myself am a beneficiary of the g.i. bill. i did my graduate degree using the g.i. bill.

my father was a g.i. bill user as well. it is a very important part of this country. we need to make sure it is robust. >> thank you very much. my time is up. >> thank you, senator murray. senator isaacson. >> in your 90-day plan, you're going to travel the v.a. system and meet with providers within the v.a. and veterans and stakeholders. when that is over, will you report back to was what you found and what you were going to do to correct what is wrong? >> i would love to do that because my ideas are laid out in my opening statement are based out on publicly available information. as i learn more, that will be modified. i would love to report back to you as to what i saw and he -- and how i would modify the indicated actions going forward.

>> your answer is really perfect because all the discoveries we have made beginning with phoenix and other facilities in the country have been information that is not publicly available. we had to dig it out. it took whistleblowers to bring it forward to us which reflects the culture within the v.a. system right now which is a insular protective culture. , you have to open up. there are only two motivators in running a business -- one is fear and the other is reward. the reward is not necessarily compensation. it is the fact you are doing a good job. i hope you will give us a game plan and make it public and make it is the fact you are doing a good job. i hope you will give us a game plan and make it public and make the employees know you are not just passing through. we are going to insist on accountability. >> i cannot agree with you more. for in organization to succeed, it has to learn. for an organization to learn, people have to admit when things go wrong. we try to do the same thing at procter & gamble company. if something goes wrong or right, you need to learn from it

and share it through the organization so it does not happen again. in this culture, you're not getting bad news, you are not correcting mistakes. everything becomes a one-off. that is why we are seeing so many reports and it seems like there was a bit from a different location somewhere in the country. we have to create a learning organization. >> in your testimony, you mentioned creating a position advisory board. did you contemplate those physician becoming only the a physicians or do you have outside physicians? >> my initial thought was to get the very best medical talent in the world. and i have been very heartened by the number of people who come forward to me and said they would like to participate and like to help.

i think the greatest thing about this nomination at this moment in time is the original question about the mission about caring for veterans. there is an unusual coming together of everyone in this country to take care of those veterans. i have got a lot of offers already. i will like to the very best medical minds we could find inside the v.a. and outside. >> i think you have discovered what i have found in my travels over the past six months dealing with this issue and that is a lot of people want help. there is a lot of help out there. there is an example in atlanta today and one of the finest centers in the world and recognizing. they tried to get the v.a. to cooperate. they finally cracked into it last year and now they are taking voluntarily in raising the money to do it. taking spinal cord injury patients.

i think the more we open the door and make the v.a. accessible to the private sector providers, those people -- many of them are veterans -- the better the v.a. will be because there is support from the outside. >> it is a great institution. it is lead innovation in so many areas and does so many unique things that i do not think can be done as well by the private sector. nevertheless, any organization like the v.a. needs the benchmark itself consistently against activities elsewhere to become better. the procter & gamble company, we benchmark ourselves against the very best companies in the world in order to make ourselves better. i think we would need to do that as well if i am confirmed. >> thank you for your service to the country and thank you for the willingness to take this job. >> thank you, mr. chairman. i want to thank you, bob, for willing to take this job.

i don't know what you thought about what you will do on your first day. you mention your testimony about the 90 days. what is on the very top of your list? >> the very top of my list is getting the leadership and the entire organization together and sharing with them what i plan to do. and how important to me the mission and the values of the organization are and how on acceptable it is to behave in a way that is inconsistent with the mission and the values. that is what i will do on day one. >> i know you talked about leading by example. is there anything you can do to restore trust by the veterans to the v.a. again? >> i have already made calls to

the veterans service organizations. i have talked to other veterans. what i would like to do as i travel is to get together with the veteran service organizations and veterans around the country and listen to their concerns. i want to do that as a veteran. i want to do that as one of them. i do not want to do that as a secretary with an entourage. >> good. i want to talk about perception. you said you have gone health care from the v.a. in the past, is that correct? >> my family has, i have not personally. >> it still applies. has your perception of ea changed over the last 30 some years? >> my father-in-law before he passed away suffered tremendous treatment as a pow. he loved the v.a. he loved going to meet with his

fellow pows. he very much benefited from that. my uncle who suffered from agent orange and still is under the care of the v.a. speaks very highly of the v.a. his personal experiences have been all been positive. >> since you became a nominee, has anything changed from your perception of the v.a. in the last month or three weeks? >> when you run a large organization, there are always things that go wrong. the people i have met seem very dedicated to the mission and the core values. what we have to do is figure out who was not. >> right. the big issue that most people are talking about is access because once it goes to the

door, 90% of them think -- there is another issue and that is mental health. the injuries coming out of iraq and afghanistan deal with -- the majority deal with ptsd. we have a shortage of providers. there is also a big shortage in the private sector. how are you going to solve that problem because it is a problem that will not go away. you will have a better success rate if you get to them early. >> i agree with your comment. it is a great comment which is we do have an issue on mental health, not just in the v.a., but in the country. we have to find ways to meet this need. it is one of the most pressing needs that we have within the v.a. and one of the most pressing needs within the country. i think partnerships may be one way to look at it. certainly, talking -- this is a longer-term solution -- talking

to people interested in careers. this is a great career for someone to be able to make a difference in the life of another person through effective mental health is fantastic. we do need more. we do need more. >> last question -- we have a conference committee going on right now. and major cost to those bills deals with outsourcing health care to the private sector. it costs more money. sloan gibson says it costs more to give the private sector than what the v.a. can provide. it is an emergent situation, i believe. that aside, what is your number one priority coming out of that conference committee? >> again, i am dealing with publicly available information. having known sloan gibson for over 40 years, having gone to west point together and serve

together and in the military, i trust what he has to say. i think he has talked about the resourcing needs that we have. that is all about access. >> thank you. i appreciate your time. >> thank you. senator heller. >> thank you. mr. mcdonald, thank you for being here. i don't think there was any secret to my priorities on this committee. the backlog. especially in light of the fact that i has the worst backlog in the country. the v.a. continues to provide is a very rosy picture of how it has reduced the claims backlog. i want to assure you that this depiction is false. last monday, a report was

released about how the claims initiative led to inaccurate processing in part of them feeling pressure to complete claims. i want to go nationwide and then a little locally. nationwide, 32% of the claims reviewed had errors. some claims were denied without waiting for evidence needed to decide. some claims were filed without a final decision. some claims without a final decision were counted as closed. my question is -- do you think is responsible for the v.a. to count as progress in light of this report? >> i think we need to improve the claims backlog. i read the report which you shared with me. i am thankful for that but i am also embarrassed for the organization that you had to go to that. we have to get ahead of this

claims backlog and we have to find a way to get it down and get it down quickly so that the veterans are getting the care they deserve. >> if i can get a commitment from you that you will review the entire claims process, whether management has tried to manipulate these numbers. >> absolutely. one of the things i am trained in is total quality where it is a technique taught by a doctor where you take a look at a work process and you work to find out where the constraints are and you streamline that process. given the challenges with the claims process and the backlog, that will be one of my first jobs is to take a look at that. >> there was an ig report recently of the va hospital in reno. that inspection found that 51% of the claims reviewed were

inaccurate and that management had contributed to inaccuracies and other problems. many months ago, i was promised by your predecessor or would be predecessor that there would be changes. i personally have called for new leadership. would you review the management of each regional offices including that of reno? >> certainly, i will. one of the first tasks of the leader, i think i wrote this in my submission, is to get the right people on the bus and get them on the right seat on the bus. i do not care for the fortune 500 ceo you talk to, it took them too long. it always tasted too long to get the right leadership team in place but it is the first priority. >> i think you just answered my question. you are willing to make leadership changes when they are necessary?

>> i have done that throughout my careers, beginning in the u.s. army. >> ok. thank you, mr. chairman. >> senator brown. >> we have heard of my colleagues refer to me around the country. very critical of the v.a. we have seen some of this criticism directed at v.a. employees generally. i think it is important -- i know you will be dealing with very serious morale issues. we had terrible morality shoes at the dayton v.a. i just want to always point out that 30% of the v.a. employees are veterans and close to 100% of the employees chose to serve veterans. how important morale is and how important it is that we recognize most of the employees are doing a good job.let me ask

a couple of questions. your predecessor, he did three things that he was working on that want to ask if you plan to continue. he identified an self-imposed a plan for ending the backlog. we have seen major improvements. he worked hard in reducing veterans homelessness, and highlighting one of the v.a's that were considered some of the best in the country in meeting unique needs of women's veterans. want to ask you of what you know if you plan to continue his efforts on those three broad issues. >> i do, senator brown. in fact, i was reviewing the strategic plan. i noticed the agency priority

goals are two of the three things you mentioned. i know that one of the chronic groups of homelessness is women. absolutely, we will continue work on those three areas you targeted. >> the v.a. conducts of appointment each year. 6.5 million veterans, 80 million appointments. some of those are conducted by private providers. i hear it from these groups about delays and payments for the services. sometimes they go for as long as a year. i want to ask you to commit to dealing with payment and working on this issue on behalf of veterans affecting those health-care people and institutions outside of the v.a. >> yes.

prompt payment. >> last is one is on a further field we talked about in my office on your first visit. that is legislation that i have worked on called the significant event tracker where a number of soldiers in combat will get head injuries -- the marine or ranger may say he got his bell rung. it is not recorded anywhere. a soldier gets four or five of these and a space of a year or a space of two or three years of duty. six years later, his behavior changes. his kids notice it. he has no documentation of it. it makes it hard to diagnose it because they do not have the records. it makes it more difficult for the v.a. when this soldier or veteran filed for disability. often times, it is difficult to put together what happened. therefore, increasing the backlog, delaying it when the v.a. does have the information.

whether this legislation passes or not, would you commit to working with the department of defense so they keep that her records on these so-called invisible minor injuries, injuries that have a long-term effect on that soldier? >> i think that is a really important idea. secretary hagel and i discussed that. i think if anything this really shows why we need a v.a. because the v.a. and the dod working together can do this and they are going to be on the forefront of innovation on mental health as it deals with these significant events that occur. we have to do that but we have to find a way to do it. it will be all new and innovative. it'll be something that has never been done before but it has to be done. >> the burden rests with dod more.

you urging dod to do it just like trying to eliminate what you call a wall between the soldier and the v.a. and how that is so important to smooth that over. >> we will own the outcome. understanding that outcome and being able to trace that back to the significant events that occurred that created the head injury is going to be critical. i think it is very important that we work hard on that. >> thank you. >> thank you. again, thank you so much for being here, mr. mcdonald. is a pretty extensive interview with whatever the subject from the press. at the end of the interview, is there anything that i left out, is there any question i have not asked.

i usually reply not. i think you are at that point right now. i just want to say i am very impressed with the answers you have given. i do not think it is feared to get to specific since you're in the position that you were just getting your feet wet. you talked about process, your approach to how he will solve problems -- i think it is excellent. i want to mention a couple of things that i think is important. just mention a couple of things that are on my mind. one of them is the fact that right now when a better and goes to his medicare doctor, he gets a prescription and in order to get that filled at the v.a. which is a pretty good deal for the veteran, he has to go see a

va doctor which makes no sense. i would like you to think about that in the future. scheduling is a huge problem. you mentioned getting some of the providers, getting the best providers and visiting with them. certainly, the administrative people would be good to do along the same lines. that really is the backbone of health care and whatever you are looking at. suicide, prescription drug prescribing -- i think there is too much of that. not prescription drug that the schedule drugs. we put tremendous pressure on the v.a. to get rid of their backlogs and specifically, these things. in treating our veterans that have issues. there has been a lot of pressure to get that solved and eliminate the backlog.

the easiest thing is to prescribe a drug rather than working on the problem. again, the prescription drug abuse. there is so much of the stuff on the street that when i am visiting with my sheriffs, i talk about veterans regarding that and selling that to supplement their income. the other thing that i would like a commitment from you is one of the things that really frustrates the committee and as you are seeing -- the committee is a bipartisan entity when it comes to the veterans, congress works very well together whether it is in the senate or the house. republicans and democrats. one of the most frustrating things is trying to get information and not being able to get that information in a timely way, to be stonewalled. i think you find the committee

really does want to help you as we go forward. i would like you to commit that when we do ask for things that that is honored. this is -- we have oversight, recognizing that fact. and that you will try -- i know you would try to have a good relationship between the committees, but i think that is probably one of the most important things and most frustrating things we had. >> it is certainly my intention to be responsive to whatever questions or demand you may have. i realize the role you have an oversight and are realize that you have people in your state who have needs. it is going to be our responsibility to try to help you meet those needs. i will plan to, if confirmed, to give every member of the committee my cell phone number. i will expect you to use it and call me when you have a concern. we will try to do that together.

>> thank you, mr. chairman. >> thank you. i think you were probably the first person to give all of us your cell phone number so i hope this is not a situation where it is be careful what you ask for. >> i mean it. >> we appreciate it. senator brown brought up the question of the significant events of that occurred to our enlisted people, our soldiers that never get into the records as i have heard of veterans as they are trying to make their claims, they are not able to get the information to back up those claims. it leads me to ask you when general gates and secretary shinseki were leading the dod and the v.a. respectively, they talked about seamless records so that the records follow the

person, the individual. here we are. we still do not have the compatible systems. is this something you would pursue so that when our people leave active service and become veterans as their records are with them, it follows them. apparently this require some kind of a huge computer change now we have not been able to achieve even if a lot of money has been spent. would you pursue this course? >> yes, senator. i really think it is important that the dod and the v.a. operate seamlessly. it is not the veterans fault there is a boundary between those two organizations. we need to operate seamlessly. i think when i met with

secretary hagel, he had the exact same interest that i do. in fact, he asked for the meeting which i thought was incredibly gracious for him to do since i am only a nominee. i think that recognizes how well we can work together to get these things done. i know progress has been made on the record. interoperability between the two organizations but more progress needs to be made. >> apparently, there is some tremendous difficulties of getting this done because six years later, we are going to follow up with you. i intend to see how you're getting along with that. you mentioned in your testimony that the v.a. operates as loosely connected individual administrations so various decisions are being made at the local and state level perhaps. there is not compatibility or

procedures that are being utilized that would enable you to decide or prepare -- compare what is going on with the v.a. and one state versus another state. in a situation like that, how would you address the fact that across the v.a. system systemic problems will be difficult to address when there are multiple organizational management structures in place? >> i think your question is insightful because any large organization needs to operate with one team and one dream. you cannot have separate organizations going different directions. a lot of thought is put to how do you break down boundaries in organizations? my experience over the last 40 years has been if there is a problem in the organization,

typically a curse as a boundary. how do you make those boundaries permeable so that resources, information can flow between those boundaries? one of the ways we have to do that is by putting in place systems that will work so that we get predictably good results every time something happens. scheduling system is an example. the other thing is that allows you to flow resources across the boundaries so that each individual entity is not asking for more resources when in fact the resources may exist somewhere else and we need to flow them there. a good example of that is migration that is a currently happening with the veterans. they are migrating to different places than you may have expected. we are going to have to be flexible enough to make sure we follow that migration. >> when you're dealing with the huge system like the v.a. system, you are going to get a lot of pushback from people who are used to being left alone in

their regions or wherever. i wish you the best in making sure that we really are working with the system that responds to the way it should. >> thank you, senator. senator moran. >> thank you very much for your presence today. thank you for earlier willingness to serve as the secretary of veterans affairs. i hope you'll consider me and other members of this committee allies as you try to develop a strategy and implement that strategy that benefits those that serve our country. i want to talk broadly for a moment and bring kansas into the topic of conversation. first of all, in the hearing that was held in may, most of the veterans service organizations testified. i think without exception, those organizations that have consistently requested

additional resources from congress to support the activities of the department. my summary of the testimony was that each and every organization, those seven esos all caps the five that while in the past there is additional money going to the department, the president indicated earlier this year that during his time in office, the department of veterans affairs and more resourced than any other agency or department in his administration. madee point that v theso's is that we can probably use additional resources in the in thebut the -- veterans affairs, but the money is going to the wrong place. it results in more paperwork, bureaucracy

as we have conversations about we need to make sure this is about not expanding the number of people. i am told in the 1990's, there were 800 people who work here. nownumbers now 11,000 -- is 11,000. the focus has to be on the patient care, not the folks who get anyway of it. i indicated that what i am looking for is somebody who can rebuild the trust that i have -- want to have in the department. more importantly, what our veterans deserve. i look forward to working with you to a compass that. >> let me turn specifically to kansas. i want to highlight for you how rural our state is.

i served representing a congressional district larger than the state of illinois. no va hospital in the district. we need to continue to work to provide services to folks who do not have any place to live close to where there is a hospital. over my time in congress, working with the department, nine secretaries, we have had a outpatient clinics. that has helped. if you live for-five hours from va -- 4-5 hours from a hosptial, if you live 2.5 hours from a clinic, it doesn't make that much difference you are two hours closer to a facility if you cannot get there anywhere -- anyway. one of things i am pleased about any legislation, -- in the legislation, is the idea that if

you live long distances from the facility, the v.a. will provide that care for you. the v.a. has the ability to do that. they have the ability to pay for outside services. they are seemingly reluctant and often unwilling to do so. provide v.a. fails to the fee for services to the veterans, most likely what happens of the veteran gets no service at all. 23 miles away -- is hayes. we were successful in opening an outpatient clinic. is 1100 who are making it their way tog wichita. the end result is 2200. the other 1100, the doubling amount occurred because the veterans were receiving no care. i look forward to my

opportunity, in the time i am a member of the committee, to explain the challenges any real state.- in a rural we have a clinic in kansas that has not had a physician for more than three years. well i have raised this issue -- the problem i have, i understand it is difficult to recruit and retain physicians, but there is no plan to fix the problem. i want to be an advocate for all veterans. i want to bring home to you the unique nature of places like my home state. as you said, it is all about the mission. care for the veterans. we have to

>> congress passed a bill just before the august recess. it includes funding for veterans to get treat outside the v.a. if they live 40 miles away from a facility or are facing long wait times. $5 billion for more v.a. doctors and nurses. the bill makes it easier to fire senior v.a. executives. president obama signed the bill into law august 7. >> the headline at "military times.com," obama signs military reform that changes will take time. the writer of this article is leo shane. how fast will changes happened with the v.a. health system?

>> it will take a little time. time to develop rules and to implement. the expansion of private care options for veterans come that will take a while for the v.a. to figure out how to administer that, make it easier for .eterans to see private doctors we are looking at something that may take six months to a year until they have a real, new system. the veterans groups i have talked to said it is a really good first step. we also do not want veterans to think that we are finished. the joke at the bill signing behind-the-scenes was saying "we are all done, everything is fixed." it is going to take time before these provisions can be implemented. >> what about the first steps of

the new v.a. secretary, robert mcdonald? >> he set out a 90 day plan that volves getting out of d.c., talking to employees, hearing from veterans. last friday, he was in phoenix. the center of the wait time problems and the scandal. he was out there talking to some of the employees. talking to some of the veterans out there and he has already been to the disabled american veterans convention. the next couple weeks it will be more of the same, talking to some of the v.s.o's. a listening tour. exactly what the department's policies and procedures are for wait times and scheduling issues.

there is still public faith in that. outside review of the scheduling practices, behind the, give the veteran to have a lot of concerns about how the -- about the scandal. the numbers are on the up and up. veterans groups i have spoken to have said they are excited about what you have laid out and they will take a step back for the next two months or three months. and get back with more pressure after that. stay on the issue and make sure he is making the changes he promised. >> as the investigations continue on phoenix and other locations, what sort of disciplinary actions are possible resulting from these? >> at this point we have not seen many firings. just a few mid-level ones in one case. we're looking at possible dismissal.

is conducting a separate investigation into possible criminal charges. we have not heard any details about how likely it is that these folks can face that. is an assumption among lawmakers and veterans groups and even among many in the department of veterans affairs that we will see firings and we will see folks, especially in phoenix who were involved in gaming the system, lose their jobs or reassigned to less senior positions. we're getting to the end of the summer and we still have not heard much from the ig on individual cases. until we hear from them, we do not know what could happen. >> congress passed a new law. they have a new v.a. secretary. is congress likely to revisit problems with the v.a. health issue in the coming months? >> i think so. whether or not they will be able to pass legislation or not will

depend on politics on the hill. they will be holding more oversight hearings. you heard the chairman of the house veterans affairs committee promising as this got signed that the work was not done. there will be hearings and they expect to hold a number of v.a. folks up before his committee to talk about long-term fixes and long-term headaches they have seen. senator bernie sanders said the same thing. like to go he would further. the v.a. has asked for additional money to hire clinicians down the road. this will be part of next year's appropriations process. more hearings in the fall and maybe even a handful in september when they're back for the short session. veterans thatsure they do not think their work is done. >> a reminder that you can see many of the hearings we have covered on the v.a. at c-span.org. you can read the reporting at leo shane at militarytimes.com.

he's also on twitter, @leo shane. >> the center for strategic and international studies ho tradediscussion on the relationships between south korea, japan, and the u.s.. live at 12:30 p.m. eastern on c-span. next tuesday, c-span in primetime focuses on the general motors recall. we hear from gm ceo mary barra, who testified several times this year. and kenneth feinberg, manager of the victims condensation program. 8:00 pm eastern next tuesday on -span. of the highlights for this weekend. eastern, a:00 p.m.

history tour looking at the civil war. saturday at 6:30 p.m. eastern visit the technology fair on capitol hill. sunday on q&a, pat buchanan on c-span. friday at 8:00 hillary books on clinton, barack obama, and edward snowden. saturday at 10:00 p.m., daniel halper. at 8:00n3 friday night eastern, kansas city monarchs. sunday on railamerica at 4:00 p.m., an interview with herbert hoover. 626-3400.t 202- comments@cspan.org. lycos on facebook, follow us on twitter. >> highlights from congressional

hearings on veterans health care. theegin with members of house veterans affairs committee questioning officials about an investigation of the phoenix aaa the phoenix. -- v.a. health system, accused of keeping a secret way list of veterans who needed health care. this is about 25 minutes. institution has been accused of keeping a secret week list. -- wait list. >> what is the a doing to make sure it does not engage in prohibited practices? >> i'm not sure i understand the question. i did not see the allegations. i believe they will probably give us a complete report. it would be my expectation that if there was inappropriate

retaliation, it will be addressed. >> what was the name of the doctor that was the whistleblower? how was your meeting with him? >> i did not meet with him. >> did you ask for a meeting with dr. foot? >> i did not. that clearlyody was at the center of the storm. you are there to understand the process. you did not request a meeting. mightas concerned it interfere with the investigation. >> i think you're concern was it might interfere with the truth. >> you are not being forthright in your testimony.

there are a lot of good men and women of all ages that work for the veterans administration, the rank and file. some of them are the whistleblowers. without them, we would have no idea what is going on. because the leadership of the v.a. simply is not there. the tragedy is that the impression that you give, all aree of you, is that you here to serve yourselves and not the men and women who have made extraordinary sacrifices to -- defending this country. nothing will change in the veterans administration until we leadership and not just from the very top, general shinseki. all of you have got to find somebody to do.

>> you are recognize for five minutes. >> so many of my colleagues have a alluded to the issue of trust. and for the nature veterans. working in concert together. a cautiousness that may be the nature of any bureaucracy. a bunkermoved toward mentality. the thealking about audit that was being done. he asked the deputy if we were going to get the list. i know your hearts are in the right place. bureaucracy is holding you back. i cannot imagine a scenario where we would let some of the

bureaucracy get some of that information. what you would not have said, i will get it and if they don't like it, too bad. that gets where we are today. what we're trying to do is solve everybody gets that. the problem is no competent formulate aing to course of action with all .ertinent data impression this is what this would look like. i thought there would have been interns taking stacks of e-mails. those would be here.

this committee would decide what was important. i was mistaken. i ready know the answer. be -- isr is going to there a team of lawyers saying, is thereoing to go something putting something in executive privilege is there an executive privilege of these anybody know the answer? >> i have met with this committee and staff the chairman. on a number of occasions to vare what i know about health. i'm looking for a collaborative relationship. >> we have known each other for quite some time. impressioner the that this relationship has been strained for a while? the between congress and the

v.a.? our intent.ot that we work closely with you. many of you talked to us about youes and we work to get information as quickly as we can. we understand the constraints we work for two and a half weeks. to provide the committee with a response. >> i expected you would send a pile of stuff at any staffers would sort through and decide what needed to be done. was that a naïve assertion? say that not leading or passive aggressively.

>> i was not part of that process. >> many have proved what we want to do. i can't help but feel something has not been given to me. the impression was there. , overd have loved to see my dead body. >> i have no doubt they will get this report and do not have responsibility for it irks the person who is here is not -- responsible is not here. job -- who do we talk to? should we just get over you and go directly to general counsel? >> in a subpoena, that is a

legal matter. we try to do without a subpoena. >> thank you very much. you are recognized. and aa veteran, physician, i have serious concerns like the rest the committee. let me ask you a few questions. >> they were canceled in an effort to reschedule. >> were they all new patients? in phoenix, as, i understand it, the administration and management model whereed a they had not employed the list.

they had scheduled patients when there was an appointment. it could have been six months out or seven months out. with the new team, there was a desire to identify appointment slots. they identified the patients who 3, 4, fiveheduled months in advance. canceled the appointments. brought them into a new appointment. in on theors weigh meeting see? do they say, that patient is very sick? areor any reason we rescheduling someone, it is rare that we are moving him up. -- them up. we would discuss on a patient by patient basis, this patient needs to be seen right away. they cannot wait to read that that ever happen? tell you whether the

doctors were involved in the rescheduling process. >> we don't know if doctors in the va are able to weigh in on the risk of patients waiting longer for the procedure. we are talking about people waiting for colonoscopies. they were delayed. to weigh in and say, this patient needs to be in here right now? >> i believe it does happen. physicians -- >> can or do? >> i hope to have access to the patients records. >> the hospital or clinic is not going to let patients set on a waitlist. r existence depends on that. doesthe doctor alluded to,

the drive to get to care derived from problems that have arisen? are thosequestion is, receiving bonuses penalized if they send the more patients in? >> i do not believe they are penalized if they send more patients to feed basis care. we have been putting in place the tools that have allowed the use of feed basis care. access of performance is and productivity as well as results. when it comes to the general nothing to you have be concerned about, you should be upset. you should be screaming and of reciting that you do for your review should

fire them stand up for them. any comments on that on a personal level? people are asking where is the information. you said you turned it over. >> i't that bother you? have turned over the information. they have old my e-mail files. it bother you they have ?ot submitted it to us it doesn't bother you. >> we are committed to being .ollaborative and responsible >> veterans responded to needs immediately. i hope you would do the same. >> thank you.

per committee rules, we will continue with never ship. , you are recognized for five minutes. this whole issue is disturbing. it is ironic that this is memorial day. this was the number one issue when we would talk to the military. they wanted to know what was going on. mentioned omar bradley. i was a second lieutenant in vietnam that met him. .e got shot up said, he wanted to

talk about the m-16. i said it does not fire right. was 1967. he was 80 something years old suddenly, after that, there were all kinds of investigations. would die because of . weapons failure what if general bradley were here right now? it is ironic that next week, the normandy invasion, sixth of june, i don't feel there is a chain of command or a sense of urgency.

my feeling is, who is going to go down and correct these things? i know you had a busy weekend. people are dying. you have to work through the weekend. it is a 24-hour day. there has to be a sense of urgency. i'm coming away from the hearing that the lawyers run everything. there has to be certain toisions made right away change some of these policies. whether certain people have to be fired or they don't get bonuses, a lot of great people out there. most of them are military. they are probably frustrated. what i am getting up to his i think right now, we are going to talk about this in the

committee. i was going to ask you, the chain of command and who is going to do this, i come away from the hearing and get the bea is in one in the a position to do anything. there is no trust or confidence. they want action. they want it now. didain people, if i something wrong and people died, i would be died, and probably court-martialed. we owe that to the veterans and the military. all the people working so hard. we had to straighten out the problem right now. we can have subpoenas and everything else. i haven't heard that. i would like to see the president to go down to the va hospital and meet with the veterans.

if it were possible to go down there right now and talk to them, investigate and take statements of everybody. we have all done it before. i am very frustrated. i am frustrated that i am a position to make a difference, and i cannot do anything. itan't get across to you -- is a feeling of frustration. if i was smarter than most people here, i would say, you have to do this and this. right now, you need to discipline -- the discipline to go down there. certain people have to be relieved or fired. the policies have got to be changed overnight.

excuses for the fact that the lawyers are handling it. but thatask questions, is something that has been bugging me. thank you. i yield back. colonel, thank you for your service to this country. we are honored to have you. >> there are 700 attorneys at the department of veterans affairs. mrs. walorski, you are recognized. >> i sit here and i don't think there is a word in the english language that can describe how frustrated i am. i have sat here for 18 months and listened to the same kind of answers i have heard tonight. and we have sat over 2:15 and 22 people questioned the three of you. and i know now 2 1/2 hours later what you don't know.

you actually traveled to arizona and didn't meet with anybody that had anything to do with weekend. we understand that plan, you didn't meet with anybody who was directly from all the testimony in these 20 people right here. if i was in your shoes. i would describe this as a five-alarm fire and rushing to the scene and bringing mutual aid because the house is on fire and nobody's going to survive and i listen to the three of you and the question i leave with tonight, what do you know? what we know is that people died . i guess the question i want to ask is on behalf of the families that probably aren't in this room tonight, but we have heard from some of them and i heard from barry that had a death warrant that was no fault of his wn because he couldn't get a

colonoscopy. we are asking all the same questions. if you have the opportunity, i'm going to give you the opportunity and this is carried live, what do you want to say, mr. lynch, to the families of these people that lost veterans, what do you want to say on behalf of the v.a. >> congresswoman, on behalf of myself, first of all, i take personally any time that a veteran has been harmed because of something the v.a. has done wrong. >> does the buck stop with you on these deaths? do you accept the bulk of the responsibility for what's happened? are you responsible? >> congresswoman -- >> yes or no, does the buck stop with you? >> i don't know whether it does but i consider myself. >> does the buck with you, do you feel responsible can you look in the eyes of these families and say i accept this

responsibility? >> i am the daughter of an atomic veteran. >> yes or no, are you responsible >> i'm responsible that ensuring and i'm sorry, mr. cook, that we didn't make this clear to you, our focus remains on caring for our veterans. >> this is my time that i have, limited time, i have sat here 18 months as a freshman and ever question i posed to you or anybody else, i'm still waiting on questions about the. mr. huff. does the buck start with you? yes or no. >> i'm a officer who is a civil veer vant and veteran. i'm not a supervisor but a stf-level federal employee. >> does the responsibility with secretary shinseki, do you believe in his leadership

ability? where in the world is the urgency? i can sense the urgency of this committee because our nation has totally lost its trust and it's our responsibility to sit here and maintain oversight and we can't find out where the buck starts. i asked for secretary shinseki's resignation when the america legion report came out. you heard several different people ask questions, do you accept responsibility? are you ready to accept this responsibility and look in the eyes of the american people and our veterans and say what? what do you say tonight? i know what you don't know. what do you know that you can tell the american people that they can learn in 2.5 hours. >> our focus remains on carring r caring for this.

>> can i finish? >> no. i have five minutes. how could dr. lynch go to arizona and not talk to anybody involved, that had anything directly to do with this and 40 unexplained deaths and i.g. reports that have facts and you all have turned the facts to a general counsel and we know less tonight -- i have more questions tonight than i have had when i walked in here because we learned what you don't know. my question is, what do you know? >> we know the facts of that report are utterly republic rens i believe, that is what we know. and we owe a debt to all of our veterans who served. every one of them. >> are you responsible? do you accept that responsibility? what are you going to do? are you going to stay in your position? >> i'm going to stay in my position and fight for veterans

and fight for this congress that i love, working together and really meaning it. working together for the good of our veterans. that's what the public expects and that what i'm committed to do. >> and 40 veterans died. this is what the public got. >> and we understand that and we review that report as the facts of that report as theonight, c-span looks at cdc's "disease detectives." here is a preview -- >> one of the researchers -- one looke reasons researchers at animals for emerging diseases, people are often

traced back to animals. one of these situations occurred in 2003. the first hint we had that something had gone wrong, you can see in this picture. this is a three year old girl and wisconsin. she developed these very odd, very disturbing skin lesions. i am too young to have been vaccinated for smallpox, i was the first generation of kids who did not get a smallpox vaccine. many researchers at the cdc dedicated their careers to eradicating this disease from the world. they took one look at this and said that is smallpox. we were worried, especially when a second case was reported a few ofs later from another part wisconsin. the two patients did not know each other. one is a three-year-old girl, one is a businessman. they had both been bitten by sick pet prairie dogs. cdc's "disease

detectives" at 8:00 eastern on c-span. >> here are some of the highlights for this weekend. friday at 8:00 p.m. eastern, the civil war. 30, the at six communicators. sunday, pat buchanan. on c-span2 friday night at eight hillary books on clinton, barack obama, and edward snowden. saturday on afterwards, daniel halper. tour the literary size of casper, wyoming. kansas city monarchs. eastern,at 6:00 p.m. slavery in movies. at 4:00 p.m., an interview with president herbert hoover. let us know what you think -- call us at 202-626-3400.

email us. the conversation, like is on facebook and follow us on twitter. up next, former house speaker and presidential candidate newt gingrich on using smartphones to help veterans. and then, "washington journal" looks at the women's rights movement, immigration, and the forty-year war on cancer. now, former house speaker and presidential candidate newt ways that technology and smartphones can be used for veterans health care. his remarks came at an event hosted by the american enterprises to. this is one hour. brooksnt to thank arthur for giving me this opportunity to propose a very large bold

rethinking of both the health system and the bureaucracy in the context of the veterans administration crisis. a decade as the aei family. it is always great to be back discussing ideas. i want to thank the cnn investigative team who stayed on the scandals until they broke through and became a national crisis. early on the stories were dismissed as isolated small problems. the teams continued effort grew the facts until they had to be dealt with. our thinking on the future of the veterans administration has been deeply influenced by the hard work of chairman jeff miller and there find many staffs. we are further down the road because of their help. they have worked tirelessly and against a lot of opposition to help americans veterans find a

better future. i want to thank our chief researcher on the v.a. and who developed the interactive map you will see. i want to thank ross worthington for helping think through these proposals. let me say this is going to be a standardsshington radical speech. i'm going to use terms that are not common in washington circles. let me share a few of these new ideas ahead of time. smartphone. smartphone apps. ipad. facebook. google. khan academy. duolingo.

this is not your typical washington policy speech. you know that these words are now part of everyday life. in 2004.was founded 10 years later it has 1.3 billion monthly users. there is no government subsidy for joining facebook and no government training program for how to be on facebook. google was founded in 1998. it has grown into a worldwide index of knowledge with well over a billion searches a day and a host of other capabilities. date to 1994. today, 3-4 americans owns a smartphone. you can get a smartphone for free with a service contract or for as little as $50 online. many people in the developing

world revealed they will invest in a smartphone the four indoor plumbing. when i ask all of you, take out your smartphone if you have one. to get a sense of the audience. you are holding the entry point for a massive information system. i think it is important to understand that. every time you think the proposals in this speech are unrealistic, i want you to look at your own smartphone and the apps you already have installed. more presented of our future? the current failing bureaucracy or the smartphone in your hand? we have the opportunity to create a 21st-century veterans service system, empowering veterans to use their smartphones to re-center

services on their lives, at their convenience, and with the veteran rather than bureaucrat in charge. this vision of a dramatically more effective, more modern, more responsive veterans is part of aem much larger opportunity to think about the transition from late 19th century bureaucracy to 21st-century citizen centered government. the three major regions to have a national dialogue at the future of veterans health care, we owe it to our veterans to get them the best possible health outcomes with the greatest convenience at the lowest cost. it isn't enough to eliminate the worst aspects of the current bureaucratic mass. theave to be able to answer question, is this the best we can do for veterans?

anything less should be unacceptable. improved bureaucracy fails that test. secondly, the lessons we learned in thinking through a 21st-century veterans health astem will teach us a lot bout the characteristics of our future health system for all. the same technologies that will improve veterans health will help improve everyone's health. third, replacing this obsolete bureaucracy with a new 21st-century system will teach us a lot about how to replace every other bureaucracy. the v.a. could be deferral runner to a generation of profound transformation in government. the changes we have seen in information technology are so indoor mist that the next few decades will be the most creative in rethinking