Veterans Affairs Secretary Shinseki Says Job Is Opportunity for 'Do-Over'

Eight million of nation's 23 million veterans are part of agency's health care.

Nov. 14, 2010— -- Department of Veterans Affairs Secretary Eric Shinseki leads the second largest federal agency after the Pentagon. The VA is also the nation's largest health care system. Eight million of the nation's 23 million veterans are enrolled, including more than a million who served during the Iraq and Afghanistan wars.

Shinseki, 68, was confirmed as VA secretary Jan. 21, 2009. He is a former Army chief of staff and a twice wounded veteran of the Vietnam War, losing a portion of his right foot in an explosion. At VA, he increased access to disability compensation for Vietnam and Gulf War veterans, launched a study into the health effects of military burn pits in Iraq and implemented the new G.I. Bill.

He is also conducting pilot programs aimed at simplifying and automating disability claims.

Recently, he sat down with USA TODAY to discuss his job.

Nearly two years into this, how are you doing?

"Busy. There is lots to be done. But I will say none of this is the kind of work where I put my head in my hands at the end of the day and say, 'Gosh, I don't know what I'm doing.' … We have the opportunity to make some major changes."

You haven't granted many interviews. It's not clear how much Americans know about you. With Veterans Day approaching, can you talk about the wounds you suffered and how that has shaped your leadership of VA?

"Any time you've been carried off the battlefield on the backs of American soldiers, there's a relationship there that stays for a lifetime. And that's certainly true for me. It happened twice and both times they were quick and gallant, and I'm thankful for it. While I was in uniform there was the beginning of a long love affair with the American soldier. … I know what they've been through, what we've put them through. So I can mentally calibrate that and ensure that we're providing them the best care, the best services available."

Let's talk about the backlog in disability claims. There are more than 1 million claims pending, 30% of them delayed more than five months. When you took office, you said that no claim should take longer than four months to process. You said earlier this year that you would "break the back of the backlog this year." What went wrong?

"Last year we pushed 975,000 decisions out the door. We had a million new claims come in. We expect this year that will go up. We have a couple of challenges. One is to make sure that (the VA's 15,000 claims adjudicators) are trained. Two, that they have the right attitude — this is a little bit of a cultural change. Three, that we have skinned down the process to where it's more efficient, simplified. And then four, automated. So we're pursuing corrective actions on all of them."

When will you be automated?

"We think 2012."

Was it a mistake to promise to break the backlog this year?

"Breaking the back of the backlog is figuring out what causes it and then making sure that we're attacking those things. What happened here was that it was like building a grocery store, stocking the shelves with all the best stuff and putting no parking places out front. People can't get in. Can't advantage themselves. … We're (now) holding people accountable for delivery (of services). That's about putting parking spaces out front."

Nobel-prize-winning economist Joseph Stiglitz and Linda Bilmes of the Kennedy School of Government at Harvard recently estimated that the health care costs of the Iraq and Afghanistan wars over the next five years will be $315 billion. Does that sound correct?

"I don't know. I really don't have a way of validating those numbers. But he (Stiglitz) is an authority and I would accept that. I'll take a look at it. Estimates about (long-term cost) is a great question. There are two children of Civil War veterans still on our beneficiary lists. Abraham Lincoln's promises are (still) being delivered. A hundred years from now, the same will be said by some future (VA) secretary of President Obama's time in office. So when we talk about this estimate looking forward, I don't think anybody can anticipate the long reach of these obligations."

As a matter of national policy, should decision-making to commit military forces include an assessment of the projected costs to the nation of caring for the combat veterans of that contemplated war?

"The thought about that as being part of the discussion is probably reasonable. … Under this president, I would probably have that opportunity in the initial stages to do that."

What about this job keeps you up late at night?

"There's lots to be done. And always there's the (unexpected) pop-up that no one saw coming. A good example, I came in focused to work on the backlog in 2009. The pop-up was the G.I. Bill. Suddenly it's all hands on deck to make that happen. And working on the backlog had to take second place. It's that kind of environment. It's not that things are not solvable — maybe the back log is, I'm going to find out. (But) if I am up late at night thinking about what to do next, it's how to get momentum out of all the initiatives that we've put out there. … (It's) not enough hours in the day to get done what I think needs to be done."

You mentioned during your confirmation process that secretaries usually have a shelf life of three years. You've been on the job for two. Are you going to stay for the rest of Obama's term?

"I'll stay for as long as this good man or President will have me. I truly serve at his pleasure. This is a wonderful opportunity. Not often in life do you have do-overs. For me this is a do-over. I get to look after kids I went to war with 40 years ago. I get to care for kids I sent to war as (Army) chief, and then I get to care for veterans who raised me when I was a young pup from World War II and Korea. Everybody looks for that purpose-filled life. I've got one."