Nominee Outlines Changes in VA Health System



“I understand health care systems and I know the VA system very well,” Petzel, now VA’s acting deputy undersecretary for health, said Wednesday in testimony before the Senate Veterans’ Affairs Committee. “I know its strengths, its weaknesses and its challenges.”

Strengths include a clear mission, dedicated work force, and good reputation for quality and safety; a working electronic medical records system; a broad array of programs; and a high degree of integration, Petzel said.

Weaknesses include the need for a vision of the future veterans health care system; significant regional variations in programs and medical centers because of decentralized management; and an inability to reach all of its potential patients.

“We have the largest integrated mental health system in the country, but we still do not reach many veterans who need these services,” he said.

The veterans’ committee, chaired by Sen. Daniel Akaka, D-Hawaii, seems completely aligned in favor of having Petzel take VA’s top medical post. Committee members made it clear they have high expectations that Petzel will fight for adequate funding of health programs and smooth over the many speed bumps that raise complaints, such as long waits for appointments and continued problems getting treatment for veterans in rural areas.

Akaka said Petzel will be in charge of what appears to be a top-heavy organization. In the mid-1990s, when VA set its current health care structure, each network was expected to have less than a dozen employees overseeing programs, Akaka said.

“Today, VA’s networks employ at least 1,000 individuals, many in positions without any direct responsibility for the delivery of health care services,” he said.

And, while VA budgets have been increasing, Akaka predicted that money will be tight and that VA will have to fight within the administration and with Congress to get enough money.

Sen. Patty Murray, D-Wash., said Congress needs Petzel “to be candid” if he believes VA’s health care budgets are inadequate.

“I have a reputation for candor,” Petzel replied, promising to speak up within the administration if he felt medical budgets were too low and also be blunt with Congress about his personal assessment of funding


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