As America pauses for Veterans Day this weekend, a leading advocate for improving the VA system that cares for those who have served this nation in uniform says the VA system has made made some important improvements in the first year of the Trump administration but she says some badly needed reforms are happening far too slowly.

Jessie Jane Duff served as a gunnery sergeant in the U.S. Marine Corps. She is now a senior fellow at the London Center for Policy Research. She gives the Trump administration a ‘B’ grade thus far in improving the health care system for veterans.

Duff says Veterans Affairs Secretary David Shulkin has made progress on some bureaucratic issues, including closing down 430 vacant buildings around the nation and another 284 that were underutilized.

“That can save $23 million a year. That money can now be going to health care or receiving mental health care for these veterans,” said Duff.

She says other efficiencies are also now in place.

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“They have improved same-day services for primary and mental health care at all of their medical centers. They’re making it easier for veterans to file online health care applications. They’re receiving eight times as many online applications this year. That’s good,” said Duff.

Duff also applauds collaborative efforts with the private marketplace to allow veterans to get minor health care needs, such as flu shots, taken care of outside of VA facilities. Veterans living in rural areas more than 40 miles from a VA hospital also have greater access to private sector health care.

She is also encouraged that Shulkin is informing the public of any disciplinary actions within the VA in real time.

Hear the interview:

“They also became the first agency to post information on employee disciplinary actions online. That’s a must. How many times did we hear about disciplinary actions after the fact, after they had either resigned from a position or transferred to a new job. They had covered up in the past,” said Duff.

But while those positives are making life easier for veterans, other major priorities are moving at a glacial pace. Duff says is taking entirely too long to implement a modern system to seamlessly transfer medical records from the Department of Defense to the VA.

“This ordeal, which should have been corrected ten years ago, has fallen on President Trump’s lap and on Secretary Shulkin’s lap, is apparently going to take another eight years,” said Duff.

Another major frustration is the slow turnaround on veterans’ health care claims. She says in a digital world, the kind of backlog we see at the VA is simply unacceptable.

“There should not be any kind of backlog. A backlog means you’ve been waiting over 125 days for your claim to be addressed. In my opinion, it should be no more than a 30 to 60, no more than a 90-day turnaround,” said Duff.

“We’re not sending anything by the Pony Express anymore. We’re not even sending anything by the Postal Service anymore. Everything is electronic. Everything should be expedited and that should immediately shave off 30 days,” said Duff.

While Duff is adamant about the turnaround times, she admits forcing standards on bureaucrats often leads to the scandals we saw just two years ago.

“The problem when you give these deadlines is you start having people fraudulently putting down numbers. That’s what created the basic backlog in the first place,” said Duff.

So while progress has been made at the VA in 2017, Duff says there are still great concerns.

“It’s just very dismaying to me to see that these things still are going to take long to happen. How many more veterans are going to die waiting? How many more veterans are not going to get adequate care?” asked Duff.

While she hopes to see rapid improvement on issues like claim turnarounds and record transfers, Duff warns that a federally-run health care program is always going to have problems.

“The fear I have is that government health care is always going to be muddied down with government bureaucracy,” said Duff, once again urging the VA to partner with outside health care providers.

“Let Blue Cross or whatever health care system that’s willing to take on veterans that are away from hospitals. Let’s get this moving,” she said.

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