August 9, 2009 - If anybody is up to the job of making a sluggish bureaucracy into a "provider of choice" for veterans seeking medical care, it's Eric Shinseki.  The former general, best known for being defenestrated by then-Defense Secretary Donald Rumseld, has been assigned an enormous job by President Barack Obama.

But in Portland Wednesday morning, he gave every indication of being equal to the job. In his prepared remarks before the Blinded Veterans Association and in a more informal discussion at Portland State University, he showed himself to be a leader who understands the issues veterans face and who cares deeply about making his agency more responsive to them.

Unlike like some who ascend to cabinet-level posts through political channels, Shinseki doesn't shy away from describing the huge issues his agency has failed to manage very well. Something is wrong, he notes, when only about one-third of all the veterans in America are even enrolled in the VA system. About 15 million of them live entirely outside it, and many of them, no doubt would benefit if they had access to VA services.

And VA services get generally high marks. The medical care is well-regarded by vets who get it, and the benefits can be generous. The problem is that the system is so clunky and bureaucratic that it frustrates many who try to access it. They tell stories about nightmarishly long waits just to get an appointment, about the heavy burden the system places on veterans to document their health issues as service-related, about how quickly their benefits are docked by paper-pushers who watch to make sure all the T's are crossed and I's dotted. And the backlogs are notorious.

A big problem is the lousy handoff from the active-duty military medical system to the veterans medical system. For years, the systems haven't communicated well with one another, forcing veterans to go back and forth to collect paperwork to satisfy intake officials. Obama and Shinseki vow to create a system that gives every new enlistee an electronic medical file that will follow him the rest of his life, from doctors in the military to doctors at a VA outpatient clinic half a world and half a lifetime away.

It's a huge undertaking, but as Shinseki noted Wednesday, it could light the way for the rest of the country, which, as you may have heard, is in the midst of a big debate over health care.

And then there's homelessness, a problem that previous VA secretaries didn't like to talk much about. Shinseki frankly acknowledges that 131,000 veterans are sleeping outside in a rich country that they once served in uniform. This is, he said, "a blot on our consciences." That number apparently has declined from some 195,000 six years ago, so Shinseki thinks things are moving in the right direction. He promised Wednesday that "we are going to take 131,000 veterans off the streets in the next five years."

Homelessness among veterans, he said, is the final stage of a series of the country's lost opportunities to take care of them. Access to medical care, housing and jobs are all part of the formula for keeping vets off the streets. His department, he says, is in a "full-court press" in all those areas.

It takes a strong leader to acknowledge such big problems and set such ambitious goals. And people who watched Shinseki in person on Wednesday could see that's what the Veterans Affairs Department has got.

It was an inspiring morning. Good luck, Mr. Secretary.

The Oregonian