In combat, he explained, commanders never have perfect knowledge, never have enough time, never enough resources. “Sometimes you just gotta launch, and fight your way through the unknowns,” he said.
That approach — setting high goals, announcing them to the public, and then challenging and enabling people to reach them, marks Shinseki’s tenure as VA secretary on this Veterans Day, nearly four years after he was drafted out of retirement by then President-elect Barack Obama. It may be that despite his many critics, the VA under Shinseki is nailing down reforms and expansion of services that have eluded previous VA chiefs for years.
But daunting challenges lie ahead as the VA struggles to serve two vastly different generations: the aging veterans of World War II, Korea and Vietnam, whose need for geriatric care is dramatically driving up the VA’s health care costs, and the younger Americans surging off the battlefields of Iraq and Afghanistan.
While the older generation is filling the VA’s 152 hospitals with patients needing nursing care for diabetes, Alzheimer’s disease and congestive heart failure, the new generation of combat veterans is demanding more community clinics, mental health services, advice and assistance on college and jobs.