VA Secretary Robert Wilkie Talks Expanding Access To Care

The James A. Haley Veterans Hospital in Tampa is undergoing a $148 million dollar expansion to meet the growing demand for health care in Florida. 

WUSF's Stephanie Colombini recently spoke with Department of Veterans Affairs Secretary Robert Wilkie about the expansion and other ways the VA is trying to increase access to care.

What can patients expect from the expansion at the James A. Haley Veterans Hospital?

Well first let me tell you why it’s happening. Florida is number three in terms of total veteran population. It is the fastest growing state in the country for veterans. That is why Tampa needs 96 new rooms and 40 new ICU beds to just meet with the demand that is occurring across the state of Florida.

But it's not just the main hospital there right off the (University of South Florida) campus. It's four different clinics that we are improving, activating some as we speak. I do expect in 2022, the Tampa hospital to be finished and I'm very excited about that.

Tampa Bay is definitely in better shape than some other areas in that it has and will have more actual VA care.

There are satellite outpatient clinics being built in Lakeland, Sun City Center, Brooksville and New Port Richey. One opened earlier this year in Zephyrhills.

How will the VA allowing more private sector care expand access even more?

Well let me tell you what the move isn't and then I'll tell you what it is. It is not, as has been reported or argued by some, libertarian VA health care. It is not us giving a veteran a card and saying, “Thank you, go out into the private sector.”

The only time that our new access and availability standards kick in is when we at VA cannot provide that veteran with specialty care or primary care within a given frame of time and then and only then does the veteran have the option to choose to go in the private sector.

But I would argue our veterans going out in the community in the last year or so has actually gone down.

The access and availability issues that you've raised really apply to extreme rural America and places like metropolitan New York City or Los Angeles where traffic makes Tampa traffic look like a stroll in the park.

Moving to medical marijuana, you know it's expanding more and more across the country. Of course the VA still doesn't allow it because it's federally illegal.

Would you change your stance at all on reimbursement where, OK veterans can't get the medicine from a VA doctor but if they get it elsewhere the VA will still reimburse it?

No. It is against federal law. And as long as it is against federal law and Congress tells us it is against federal law then we are committed to following that law.

What would you tell patients who are frustrated by that? They don't want to take opioid painkillers.

Actually you've just hit on an area where the VA is really a revolutionary healthcare system. We have reduced the percentage of opioid prescriptions just in the last year by 51 percent.

If you had told my father, a Vietnam veteran terribly wounded in the invasion of Cambodia, he would go into VA and we would be providing him with Tai Chi and acupuncture my nose would have been flat against my face because that was not part of the warrior ethos. So what we're doing is changing the way our veterans think about pain.

We're changing our prescriptions from Tylenol 3 and opioids like that, that affect the brain and not the pain, to include combinations of Advil and aspirin. And we’re finding those combinations get to the pain quicker. So the answer to your question for me has nothing to do with marijuana. It has to do with the cultural change we are undertaking here at VA.

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