Isakson addresses VA reform, PTSD treatments and ISIS

U.S. Sen. Johnny Isakson, R-Ga., received The American Legion’s Distinguished Public Service Award during the organization’s Washington Conference earlier this year. A member of American Legion Post 233 in Loganville, Ga., Isakson served in the Georgia Air National Guard from 1966 to 1972.

Before beginning his first term in the U.S. Senate in 2005, Isakson represented Georgia's 6th Congressional District in the House of Representatives from 1999 to 2005.

Earlier during this session of Congress, Isakson sat down with American Legion Media & Communications staff to discuss his public service, efforts to improve the VA and other veterans issues. Here are excerpts from the interview:

American Legion: How does your military service help you as you continue in public service today?

Isakson: We wouldn't have a country and wouldn’t have our Congress if we didn't have our military that protected us. It was our point of the spear, so to speak, when times get tough. My job is talking, my job is convincing people, my job is trying to come up with the good ideas to help the American people, but all that goes for naught if you don't have a peaceful nation in which you can operate and work and you're not safe from the threats that are always out there. Our military's critical to the existence of our country and it's something I work on every day to try and make sure they get the treatment and the preferences that they need to continue to serve the country.

American Legion: You were at The American Legion's Washington Conference, and in your presentation you said, "We're going to fix VA's problems." How do we accomplish that?

Isakson: You ever try to get a hundred frogs in a barrel?

American Legion: Not recently.

Isakson: It's a challenge, but how you do it is you first of all make a commitment, which I've done as chairman. And then you try and bring everybody along on the things that need to be done. I think everybody understands that the first challenge of the VA is to change the whole attitude in terms of accountability.

We've had a terrible lapse with veterans not getting medical appointments in time, shredding of documents, etc. We've had problems with accountability in Philadelphia. We had two people fired for manipulating numbers in the Merits Systems Protection Board put them back in their jobs so there's no way to have accountability. We are working very hard to come up with a bipartisan reform of the accountability within the VA so there are consequences for failure, there are consequences for bad performance, and there are also rewards for good performance. I mean there are 314,000 people in the VA health system working every day to provide health care to our veterans. You go up to any veteran on the street and nine times out of 10, they like VA health care. But we all know there are problems and we've got to get to where it's 10 out of 10 and there are no problems.

We've also got to make sure the benefits available to our veterans are seamless from their service whether it was in Vietnam or whether it was post-9/11, we're working hard on that. We've got to address the contemporary problems today, the opioid use and the over prescription of opioids in private business and society but also in the military as well. We've got to do everything we can to make sure that access to mental health is timely and incident relevant, meaning if a person feels like they have a mental health challenge, they need somebody then, they don't need them in two weeks, they don't need to be sent to a clinic in a month. They need somebody on the phone right there to help stabilize them and get them to a VA facility as fast as possible or get them to a contract provider in VA's contract clinic. Now we're doing a much better job on suicide since August of 2014 when we had the real tragedy that happened again in Atlanta, unfortunately, where we had three suicides inside of six weeks. We've turned that around a good bit, but we got a ways to go. I could go on and on and on, these are the points we're working on right now to finalize major reforms in the VA.

American Legion: Do those major reforms include a move to privatization?

Isakson: Privatizing the VA would be the dumbest thing possible for us to do. Giving the VA a forced multiplier in terms of its providers would be a great thing for us to do, the Choice Act did that. Instead of having to go out and hire hundreds of doctors and hundreds of providers, the VA was able to allow a veteran to go to a private sector provider if they couldn't deliver the service in a timely fashion. The VA has proven it does some things well like provide health care. It doesn't do other things well like build hospitals. I give you Denver as the biggest challenge on that. We've dealt with it in my first act as chairman of the committee in the Senate was to go to Denver, analyze the problem, and get the thing fixed in terms of how it's organized, get the overage funded and get that behind them, but also put the VA permanently out of the business of building hospitals. They just had no business doing it. The Corps of Engineers should be doing that, they're more accountable on cost.

Privatization is not something that makes any sense to do first of all. Utilizing the private sector makes all the sense in the world when you don't have the facilities to meet the needs of the veterans whom you've promised services, whether it's in rural Montana, or rural Georgia, or rural Arizona.

American Legion: Let's talk about accountability a little bit more. Who should be held accountable when issues arise? Is it the senior management of VA, is it someone who's running that specific VA hospital? Who's accountable?

Isakson: I ran a company for 20 years and was in private business for 33 years. If you're the boss, you're accountable. You're the first line of offense and defense, and so senior executive leadership is the most accountable entity. If you have manipulation of numbers for wait times in a hospital, whomever is over that hospital and whoever is over that function at that hospital are the people who should be accountable. There may be someone under them that should be held accountable or even fired, but if you don't hold your leadership accountable, you don't have any accountability at all.

American Legion: What are the long-term solutions for ensuring quality and timely care for veterans? We've talked about accountability, but we have more and more veterans coming back from overseas now who are suffering PTSD and other ailments. What do we need to make VA the best health care that the next generation of veterans can use?

Isakson: We need the most seamless transfer from active duty DoD service to veterans service. We've had a lot of problems in the past over the veteran kind of falling through the cracks between active duty and veteran status. Both are doing a better job of that, but there's still work to be done. The Warrior Transition Units were one of the best things the active duty military did to identify where a soldier might have problems rather than look the other way. I've gone through those Warrior Transition Units in Ft. Stewart in Georgia and Ft. Benning in Georgia and other places. We're doing a better job of early identification in terms of PTSD and TBI. We got to do a better job of seeing to it that the transition is seamless.

We've got to make sure once they get into veterans care, access for mental health service is timely and instantaneous, at least by phone if not in the first visit and to make sure that happens. We got to make sure we got the kind of treatments for the veterans to help them get through the difficulty of PTSD and TBI, and to that end, we had some real breakthroughs in terms of some of those treatments that were helping people actually deal with PTSD and TBI and beginning to turn the corner and medically handling that situation.

American Legion: I want to move on to some other topics now. We've witnessed the rapid growth of the Islamic State in recent years. What do you think of the U.S. strategy? Are we implementing the correct strategy to defeat ISIS? If not, what do you recommend?

Isakson: We've had a president whose commitment has been to contain it, and we've tried to contain it through the use of our Air Force through air power, and we haven't been willing to make the commitments to defeat it. I've said on national television that if somebody's going to cut off your head, burn you in a cage in the town square, or kill themselves to kill you, the only way you can defeat that enemy is to kill them first. We need to make the commitment to do that. We need a coalition of the willing with a stated goal to wipe out ISIL. Put them on the ground in the Middle East to do exactly that. I don't know if you're talking about the number of troops you'd have in a surge like we had in Iraq. We had 130,000, but I do think you're talking about special operations forces from NATO countries, from Middle Eastern countries, and from the United States.

Half our bombers come back without having dropped their bombs because we don't have the ground visual intelligence to make sure they're hitting the right target or where that target is. We need to have those eyes on the ground so we can do that. It takes a commitment not of a containment but of eradication, and until you do that, you're never going to put that genie back in the bottle in terms terrorism. But if you make it untenable to even try, you do a better job of putting most of it to an end, and that's what we need to do.

American Legion: From your answer about Islamic State, what I hear between the lines is using ground troops as part of an offensive?

Isakson: That was more than between the lines. You've got to have a coalition of the willing that we have to lead. The United States in modern history has been the leader in terms of world joint efforts against terror, against evil, whether it was World War II or World War I, or whether it was in Grenada, or whether it was in Panama, or whether it was in Vietnam. I think we need a coalition of the willing, and have a coalition of the willing in Afghanistan, Scandinavian countries, European countries, etc. We need a coalition of the willing to go in and try to wipe out ISIL wherever they are, whether it's the Maghreb or the Levant or wherever.

American Legion: What would be the end game? That was the criticism in Iraq after we left — there wasn't an end game. What would be the end game for defeating Islamic State if we send ground troops there?

Isakson: First of all, every military operation has a goal. The goal of ISIL is to establish a religious caliphate, which is their form of government under Islam. Our goal should be to stop the ability for them to establish a religious caliphate. It's that simple. They're trying to do it in the Maghreb, in the Levant. The Maghreb being the North Africa, the Levant being the Eastern Mediterranean countries. Sixteen of them all together and in fact they have in framework a caliphate established now. We've got to make sure it's wiped out.

American Legion: You've called for tightened border security. How do we achieve that goal? More security agents, patrols, building a wall? What's the solution?

Isakson: I've said for a long time that we're sitting on a ham sandwich starving to death. We have a perfect example, the US-VISIT program that's working. You go to any international airport in the United States today and watch those foreign nationals coming into our country. They go through a separate line to get into the United States other than a U.S. citizen. Their passport has an embedded fingerprint, biometrically secure identification. We have these little things that looks like a birdhouse on the desk of each custom agent where you stick your index finger into the hole, and it shows you whether the fingerprint that you've got on your finger matches the fingerprint in the passport. And if it doesn't, there are jail cells in every international airport today. We've got three of them in Atlanta where you're arrested and you're sent back from wherever you came. We don't have a biometrically secure identification for any visa we issue in America.

Everybody that's here illegally and working here illegally and avoiding capture because they have a forged document whether it's a H2A, an H-1B, whatever it may be, it's forged because it's not biometrically secure. So the very first way you end the problem is to have a seamless identification system that cannot be duplicated and cannot be forged. If you do that, all of a sudden those that are here illegally or are coming, say wait a minute, I lose my documentation, I get stopped for a traffic ticket, I'm gone. Right now that's not the case so that's the first step.

Walls are important. We proved that Smuggler's Gulch in San Diego works. You take a geographic area where you can funnel everybody into one place, where the throughput coming into the country is kind of corralled so to speak. You can control that, but much of the Southwest is flat as a pancake. It's an expanse of 2,000 miles. Walls help, but what you need is the manpower, you need a drone system. I've been to Ft. Huachuca in Yuma, stayed up all night with a bunch of guys flying Predator drones back and forth on the U.S.-Mexico border, identifying through body heat identifiers and sensors, people coming across the border and deploying troops to stop them. Those are the types of techniques you do. People have to realize there's a consequence for bad behavior, whether it's somebody not being held accountable in the VA for something they did that's wrong, whether it's somebody trying to come into America illegally or the wrong way. They have to be held accountable. We have to see to it that they're thwarted, but the best way on those entering the country illegally is to have a biometrically secure identification.

Last point, the 19 hijackers on 9/11 all had U.S. driver's licenses. All of which they got by getting into the country with forged student documentation, which was a fraud. But we had no way once they got here of going after them. That's what you need to be able to do.

American Legion: A few years ago you were diagnosed with Parkinson's. First, how are you doing now? Secondly, how has that impacted you in your role as a United States senator?

Isakson: I'm doing great. I'm in better shape. Managing Parkinson's is all about doing the exercises that you need to do to strengthen the parts of your body that aren't working as good as they did a long time ago. Parkinson's is not a terminal disease. It may contribute though to somebody dying because they slip and fall because they're not agile enough or because something had happened. I spend every morning, like I did this morning, getting up at five or six o'clock and doing an hour of exercises that are designed to make my muscle tone good, make my responses good, make my reflexes good, and I'm just doing great. I think the staff will tell you I'm probably in better shape than I was a year ago.