Interview by Peyton Holston-Toth Summer 2005
Photographs by Brendan Mattingly
Sworn in February 1 as the fifth secretary of veterans affairs, Jim Nicholson knew that the war on terror in Iraq and Afghanistan was creating unprecedented challenges in the delivery of veterans’ health care. To meet those challenges, Nicholson, a West Point graduate and combat-decorated Vietnam veteran, knew he had to “bring VA fully into the 21st century.” That meant building on the positive changes the department had already undergone. Not an easy task, especially amid escalating medical costs and a severely tested budget. But the former U.S. ambassador to the Vatican remains convinced that VA can do exactly that—and meet the mandate it has to serve America’s veterans.
AMERICAN VETERAN: What is your top priority for the department?
My top priority for VA is for us to provide world-class healthcare services and benefits to our nation’s veterans.
AMERICAN VETERAN: Shortly after you were appointed, you mentioned that one of your top priorities is to make VA more visible in the eyes of the public. Now that you’ve been on the job for six months, what have you been able to do about that?
We’re working on that. It’s a work in progress. I gave a speech in Phoenix right after Easter season to the Rotary Club and got a letter afterwards from a veteran in the audience who said he had absolutely no idea concerning what I told them about their VA. He wrote, “VA is the greatest story never told.” And that confirmed in my mind the need we have to inform the American people about this great agency they have to take care of their veterans. They want our veterans well taken care of, and we’re their agents for doing that. That’s a great responsibility and also a great privilege.
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Another thing I’ve done to heighten awareness of VA is to make the department’s 75th anniversary a big event. The department started on July 21, 1930. And on July 21, 2005 of this year, we had an anniversary celebration at Constitution Hall, with 2,500 people in attendance. Vice President Cheney was also there, together with other notables and veterans. I think this big celebration went a long way toward helping people in America realize what they have and what a wonderful organization VA is, you know, providing health care to 5.2 million veterans, benefits to 3.5 million veterans, GI Bill education benefits to half-a-million veterans, home loan guarantees to millions of veterans since World War II. We also operate one of the largest life insurance companies in the United States, the SGLIC, Servicemen’s Group Life Insurance Company, with nearly a trillion dollars’ worth of insurance on our books.
AMERICAN VETERAN: To what extent will you seek input from the veterans service organizations on critical issues?
We consult the VSOs, all the time. I have breakfast with the leadership of the major ones and go to their meetings. They are a very important part of the stakeholder community of the VA.
AMERICAN VETERAN: What are your plans for women in leadership positions within the department?
We have a growing number of women who are veterans, so we have a growing number of women in leadership positions here. And I am continuing to find highly-qualified women and put them in important positions in the management of the agency and throughout.
AMERICAN VETERAN: You’ve been on Capitol Hill discussing changes to the budget all day. What do you hope happens next?
We requested a supplemental of $970 million for the remainder of FY05, which ends on September 30. Fiscal year 06 starts October 1, so we’re also working on seeking additional funds for that budget, because we’ve had a surge in the demand for services from our brave men and women returning from Operations Iraqi Freedom and Enduring Freedom, and from veterans across the board. And
I think because our hospitals are doing such a great job that more and more veterans are taking advantage of that benefit.
AMERICAN VETERAN: With a diverse military population funneling into the VA system for services, how is the department responding to their needs?
As I’ve said, our responsibility, our goal, our job is to provide world-class health care to all eligible veterans that we see. If we have the capability in our system, which we most often do, we’ll take care of them right there. If we don’t have it, we’ll contract for it with local providers, or go to where there is a specialist. We have a lot of acute-care specialties in most of our hospitals.
AMERICAN VETERAN: To what extent do returning female veterans present challenges to the VA healthcare system that are different from those of the past?
I’d like to think that returning women veterans are presenting us with opportunities—opportunities to serve them, to say thanks to them for their service. We know that women are being killed and wounded in Iraq right alongside men. So we’re treating them equally well. If there is a unique procedure or treatment that they need and we don’t have it because there aren’t enough female patients in a particular facility to keep, say, an OB/GYN doctor trained and sharp, then we’ll contract out the service.
AMERICAN VETERAN: Concerns exist among our women members that they’re not getting the care they need or that there’s a lack of trained doctors in the area of medical specialties unique to women. What is VA doing to address these concerns?
VA is in a transition as to women because we now have women combatants. We have a growing number of women in the active force and we have a new phenomenon, which is an activation of so many of the Reserve Components—the Reserves and the National Guard, which have an even higher percentage of women in them. And when they all come back from the theater, they’re eligible for VA healthcare. That represents a growing type of demand for our services, and we’ve responded by hiring OB/GYNs and people uniquely qualified to deal with breast cancer therapy and prevention, things indigenous to women’s health. Again, if we don’t have the critical mass yet at a certain center, we either send people to another of our health centers or we find doctors in the civilian market to handle these special needs.
AMERICAN VETERAN: Where do you see a need to improve the quality of claims adjudication and how will you eliminate the backlog of claims?
The adjudication and payment of claims is another of our major priorities and responsibilities. What we are attempting to do is to streamline the claims process. We also want to intensify our training of claims adjudicators and hire more of them in areas where claims are increasing. We want all of our adjudicators to be well trained so that claims are not only treated promptly and fairly but also consistently, regardless of where the claimant and the adjudicator are. The same applies to backlogs. The better trained our adjudicators are, and the better job we can do of informing our veterans what their rights are and what’s needed to make a claim, the more efficient we’re going to be in handling those claims.