Veterans in America

Opening Remarks

MS. CORATTI: Hi. Good morning, everyone. Good morning, I love that. It's a good audience this morning. My name is Kris Coratti. I'm Vice President of communications at The Washington Post and General Manager of Washington Post Live. We're really thrilled to have you all here for our annual Veterans in American event.

I'd like to start by thanking our presenting sponsor for this event, Leidos Health Group, and our supporting sponsor, the University of Virginia. Their support today means a lot to us. We are also really honored today to host the only living Medal of Honor recipient from the Iraq War, Staff Sergeant David Bellavia. We'll hear about how his uncommon heroism saved the lives of countless American soldiers as he singlehandedly cleared a house of Iraqi insurgents during the Second Battle of Fallujah in 2004. He will also share his personal journey from active duty soldier to entrepreneur. His post-military career includes becoming a successful business owner, co-founding a veterans' advocacy group, and writing a book about his experience in Fallujah.

Staff Sergeant Bellavia is part of a new generation redefining what it means to be a military veteran. The experiences of those who served in post-9/11 wars are distinctly different from those who came before them. And according to Pew Research Center, today's veterans are more likely to have been deployed, more likely to have seen combat, and more than half say they have experienced emotional trauma related to their service. This, in addition to the many obstacles facing these veterans when they return home, from difficulty accessing quality healthcare, to the struggle reintegrating into civilian life.

Army veteran and Washington Post reporter Alex Horton will explore these issues with two military veterans who have written extensively about their experience. And we'll discuss the unexpected challenges of dealing with a public that doesn't understand what it's like to serve.

And we lead off the program today with two of Capitol Hill's most prominent advocates for veterans' healthcare. Senator Jerry Moran and Senator John Tester have proposed a new plan to improve veterans' access to quality mental healthcare. In response to the rising rates of suicide among U.S. military veterans. They will be out with my colleague Libby Casey in just a moment. Thank you.

[Pause]

Leading the Charge for Veterans

MS. CASEY: Good morning. I'm Libby Casey, the politics and accountable anchor here at The Washington Post, and we'd like to begin today's program Veterans in America with two key senators on veterans' issues from Capitol Hill. Thank you so much for taking time out of your schedule. You have a hearing in about an hour, so we're thrilled to have you here right now. Senator Jerry Moran of Kansas, of course Republican; and Senator John Tester of Montana. A bipartisan issue, both gentlemen have been advocating for veterans' healthcare for years, and they have pending bipartisan legislation that we'll be talking about this morning.

I invite our audience here in the room as well as those watching online to submit your questions to the senators. You can do that on Twitter by using the #PostLive.

So, gentlemen, as we just saw in the video, 20 veterans die by suicide each day in America. And the total number has gone up in four of the last five years, and that's despite more of a public recognition that this is a mental healthcare crisis. So, Senator Moran, what's happening?

SEN. MORAN: Well, there are a lack of professionals in mental healthcare across the country, in the public and private sector, at the VA and outside. There's a tremendous challenge in states like Senator Tester's and mine, rural America, in which those professionals, if they do exist, they don't exist close to where often a veteran lives. And I think the reality is that the wars that we face and the things that we ask soldiers, military men and women to do, they are dangerous, they have consequences, and those consequences include tremendous challenges.

There's a lot of issues, I mean scientifically, medically that we need to explore. One of them that we've appropriated money is to determine the connection between overmedication and suicide. Is there one? And that's an issue that we face within the VA and outside the VA, overmedication. So we have science. We needed medicine to help us figure out what to do. But we need a VA, a Department of Veterans Affairs, and Americans across the country who are looking after in every way possible those who served our country and have returned home.

I would say that a piece--and the legislation that Senator Tester and I have sponsored, one of the most important things we can do is pay attention to our military men and women as they depart active service and enter the veteran world. And so that transition between DOD and VA is a place that we ought to spend a lot of time, because I think that is where we perhaps can make the most difference in regard to suicides that may occur months or years after that transition.

MS. CASEY: Senator Tester.

SEN. TESTER: The statistics speak for themselves. What we're doing right now is not working to the level it needs to be working at. And Senator Moran is correct. There's all sorts of reasons for it. One of the reasons that we brought forward the John Scott Hannon Mental Health Bill is because I think that there's plenty of things we need to do outside of what we're doing now. And that's what this bill does, kind of thinks outside the box, offers alternate therapies like therapies in agriculture, in yoga, in animal therapy. If offers to address part of the problem. And it's not going to be the whole solution, but direct hiring authorities to the VA doesn't have to jump through a bunch of hoops to get mental health professionals on the ground.

And I think that one of the things-- and I'll speak for everybody on the Committee, and probably everybody in Congress--this is a problem. Mental health is a problem throughout our country. Montana, for example, leads the nation--not veterans, everybody--in suicide. That's not a category you want to be the leader in. But there are so many things that we have to approach it from. I think the John Scott Hannon bill that Jerry and I have is a step, but it's certainly not the final step. And we need to get more folks on the ground. We need to reduce the stigma. We need to make sure that when folks need help and they get in crisis, that they have a place to turn, whether it's either somebody on the other end of the phone or somebody in person they can go talk to.

MS. CASEY: I want to talk about the rural question, because that's something that you both want to address, but let's just talk about some numbers first for another moment. Of those 20 suicide victims every day, only about six of them were recent users of the Veterans Health Administration services.

SEN. TESTER: Yeah. Jerry, I don't know if you--look, it's outreach. We've got to do a better job of letting folks know that this is a different VA than it was when the Vietnam veterans came back home. We've got to let people know that this is a VA that's going to work for them. And if it doesn't, then it's up to folks like Senator Moran and myself to hold them accountable to make sure it does. And you know, the budget for the VA has increased in the last 12 years exponentially. We've been at war for a long time. It makes sense that this happens. But the bottom line is the VA has to deliver, too. And if they deliver, I think the word will get out. And we've got to do a better job in outreach. That's really the bottom line.

SEN. MORAN: Certainly, what John says is true. There are a lot of veterans who it surprises me on a regular basis that don't know what they are eligible for, entitled to, don't know how to apply, don't know who to go to. We have veteran service organizations across the country who are helpful in that regard, but there are still many veterans who slip through the cracks.

In addition, there are those who have been to the VA and suicide still occurs. And so it's another aspect of this. We need to make certain that every tool is available and the VA is open and available in every instance for somebody who's crying out. And it's not just the VA. We need neighbors, family members. The community needs to be educated and trained and have care and compassion in a way that when there's a symptom, there's a response, that somebody is taking care of us. And it's an example that we can't go through life just on our own if we're going to prevent a neighbor, a family member, a friend from committing suicide.

MS. CASEY: You're nodding your head.

SEN. TESTER: The other thing I would just like to add to that is that, you know, there's nothing to be ashamed of if you have depression or if you have mental health issues. The fact of the matter is, the only thing you need to be ashamed of is you don't ask for help. And we need to get that message out, that this is repairable just like a broken arm. And if we can get folks to understand that, that have the issues--and by the way, don't get penalized for it, whether they're in the military or out of the military--I think you'll get a lot more folks asking for help when they need it.

MS. CASEY: Some other numbers that are important. The Washington Post had a story just yesterday noting there are 49,000 vacant positions at the VA. Ninety-six percent of VA facilities report at least one severe occupational shortage. The inspector general has pointed out that these shortages are a real problem and a root cause for many of the issues in veterans' care.

SEN. MORAN: Our legislation does some things in that regard. A shortage of professionals means that we can utilize telemedicine, telehealth, tele mental health more. So with insufficient number of healthcare providers, we need to figure out how we utilize their services better, more efficiently.

But more importantly, there are educated and trained individuals that the VA doesn't, in my view, utilize sufficiently: marriage and family counselors, licensed mental health professionals. Again, there is a shortage everywhere, inside the VA, outside the VA, rural, urban. We need to use the other additional professionals that can help meet the needs. Our legislation requires the VA to utilize those additional types of trained individuals, educated individuals, to be helpful. And those professions are asking for the opportunity to be a part of the VA in helping those across the country who desperately need that help.

MS. CASEY: How do you make this a competitive job, though, something with adequate pay and also the reputation and the pride that could come with taking a job like this?

SEN. MORAN: The bill, again, puts additional resources. We both have been appropriators on the Committee that appropriates for the Department of Veterans Affairs. And as John indicated, we are increasing the funding at the Department of Veterans Affairs. It is one of the fastest-growing expenditures that we have. But you have to attract professionals. And this is a profession that doesn't adequately compensate to bring people to the profession. The challenges are great. The rewards, I think, could be tremendous. But more money is--you know, we say that often as kind of a trite expression, more money is not the answer to everything. That's true. But in this case, additional resources so that salaries and compensation can be improved for those professionals within the VA and to add to the number of professionals that qualify to work there.

SEN. TESTER: The thing about the VA Committee is that Jerry's talking points are the same as mine. There's nothing partisan about this. And the fact is, he's absolutely right. We have carried bills in the past and we have carried bills right now that makes it so the VA is competitive with the private sector. If they utilize those tools that Congress has given them--I'm talking about the VA--they can get folks in.

I just want to address one more issue that's pretty cool with our bill. And Philips just put a pod in Eureka, Montana, which is in the northeast corner. It is a remote part of the state. And it's a pod, so it's in an American Legion hall or a VFW hall. And if a veteran has got some issues, they can go in the pod. Don't know if they're checking their blood pressure or talking to a telehealth professional on the other end of the line with mental health. But I think this--

MS. CASEY: You say a pod. So it's a private space.

SEN. TESTER: Just a private space. In fact, it's no bigger than this stage, half of this stage. And quite frankly, it allows that veteran to go in and talk to a professional on the other end of the line, which I've talk to folks that have utilized it. They feel more comfortable in that condition than they do eyeball-to-eyeball with a psychiatrist, and hopefully get some of the things squared away that they're having problems with. And so I just think this could be a model. I don't know that it will be.

MS. CASEY: So is that being done other places as well?

SEN. TESTER: Yeah. And it's in the bill, and it can be done in other places. This is kind of a pilot project that Philips had done to try to see how it works. Look, they've got grander ideas than this. We'll hopefully get it spread through the VA--if it works--and then hopefully throughout rural America. But the bottom online is that I think this is an opportunity to help some of the staffing shortages we have. And we don't have enough mental health providers in any area. Senator Moran is exactly correct. We ought to be using every tool that's out there, whether it's family and marriage counselors, or whatever, because the bottom line, when these folks get in crisis, somebody needs to help them. Otherwise they're going to do something bad, potentially.

MS. CASEY: Sure, go ahead, Senator.

SEN. MORAN: Could I make one more point on this? We may talk in this conversation about choice, about mission act, community care. There is a mental health component to the MISSION Act. There should be a greater mental health component to all community care. But for example, in the state of Kansas, we have community mental health centers where there are occasionally a psychiatrist but often a psychologist, social workers. They provide mental health services to Kansans, generally. For a decade I have been trying to convince the VA to contract with those community mental health centers to utilize those professionals to care for veterans who live a long distance. The congressional district when I was a House member that I represent, is about the same size as Illinois. There is no VA hospital. Can we use the community providers that already exist in rural America to meet the needs? And so while we talk about a shortage of professionals, no doubt about it. But we still have to convince the VA under their community care programs under what used to be CHOICE, what's now MISSION, to contract with, to allow in this sense the private sector in these, it's actually public agencies, public entities that are providing mental health services to Kansans, use them to meet veterans' needs as well.

MS. CASEY: So this is interesting, because this is a question of the public access, like getting something that's provided by the state or by a county. But when we talk about privatization, are you concerned, Senator Tester, about this fear of privatizing the VA and the more you pull out the resources from the VA itself, the more you could see it fall apart?

SEN. TESTER: I am. But the truth of the matter is, there's some areas that the VA can't economically provide the services, and many of those areas are in rural America. What I believe is, and what I do as a senator in Montana, is make sure that the veterans are driving the bus. I can count on this hand how many veterans have come up to me and said we don't like VA healthcare, once they get through the door, okay? And so if the veterans wants VA facilities--which if that's what I hear, that's what we'll do. But in cases like Eureka, Montana, where it's a couple hundred-mile drive to a VA facility, or longer, in wintertime, when the roads are bad, it makes much more sense, if that veteran so chooses, to go right there to the local hospital or local healthcare facility. And that's really where the MISSION Act kicks in and where we can, I think, not only save taxpayer dollars but let the veteran drive the bus. If they want to get it in the local area, they can.

Let me give you an example. This August, when we were home on break, I got a call from a guy in Havre [phonetic], Montana. He said I've had a heart condition for three years. I want to thank you because you fixed it. I didn't fix it. The MISSION Act was implemented and the MISSION Act fixed it because he got his heart fixed locally. The VA didn't have the people in Montana to be able to do the procedure. And so that's a victory, and that's a victory for the MISSION Act. And it talks about exactly what Jerry talked about, about people getting access. But as far as taking away from the VA, we need to build capacity within the VA, because I think the veterans like the VA and the veterans need to be the ones driving the bus.

MS. CASEY: So give us an update on where your mental healthcare bill is. Of course, the one that we learned about named for Commander Hannon, you guys got it out of Committee. Where is it?

SEN. TESTER: No, actually we're going to be taking it up in Committee after the first of the year.

MS. CASEY: Excuse me.

SEN. TESTER: If the Republican leadership does their job, Senator Moran will be the Chairman of the Committee after the first of the year. We are going to miss Johnny Isakson, but Jerry will do a great job in that capacity. And we will take that bill up hopefully at the chairman's request.

SEN. MORAN: This will be the last moment that John Tester pays me any deference. It will not last.

[Laughter]

But John is correct. First of all, I would say I'm filling in today for Johnny Isakson, and we appreciate his leadership in the Committee and his service to the United States Senate and to his constituents of Georgia.

MS. CASEY: He's of course retiring.

SEN. MORAN: He's retiring.

MS. CASEY: He's the chairman of the Committee.

SEN. MORAN: He's the chairman of the Committee.

MS. CASEY: You're the next in line.

SEN. MORAN: That is true.

MS. CASEY: So the expectation by many watchers is that you would be at the helm of that Committee.

SEN. MORAN: I've been on the Veterans Committee. I've served in Congress, 14 years in the House, eight years in the Senate. I've been a member of the Veterans Committee since I came to Congress. I chaired the Healthcare Subcommittee in the House for a long number of years. And I'm not a veteran. I care about these issues greatly. I'm a product of the end of the Vietnam War. I graduated from high school as Vietnam had come to a conclusion, if it ever came to a conclusion, but the war was presumably over. And I saw how, not my high school classmates but those I went to high school with that were a year or two older than me, how they were treated when they returned home. And I just made a commitment to myself as a 16-year-old kid that I'm going to do everything I can to respect those who served our country.

I never envisioned being a United States senator, and I think my responsibilities, I know my responsibilities have now grown to do more than just respect people. It's to make sure that we work together, Senator Tester and all of us, to make sure the promises that we made to those who served are kept, that they are cared for and respected and loved. And so we have an opportunity. This legislation will--certainly my interest in mental health and suicide prevention is huge. It will be a priority of the Committee. And we'll work to see that legislation occurs.

I would mention that in addition to the MISSION Act, which I think can be of help in regard to providing care--so an issue for us in Congress needs to be the implementation. How is the VA doing as it implements this major piece of legislation, the MISSION Act?

But a couple other things. One for example is 988. There's legislation pending for a national suicide hotline with a dedicated VA line that's included in that. Today you have to dial a 10-digit number to get the attention of somebody who will help prevent you from committing suicide. The legislation is requiring the FCC to dedicate, like we have 911, now a number 988 for those who are contemplating or know someone who's contemplating suicide. Again, the Veterans Committee I think will take a lead on these issues, but there's a number of other aspects within Congress that we can work to address suicide generally that would be of great help to veterans.

MS. CASEY: It sounds like you are ready for this gentleman to take the chairmanship once Senator Isakson retires.

SEN. TESTER: Look, there's great people on the Veterans Affairs Committee. And of course, Jerry's my choice. But, no, the truth is, is that I just want to step back. Johnny Isakson has really set the standard on the VA Committee. He has been an incredible friend and an incredible senator to work with. He has depoliticized every issue down the line. Jerry Moran has been a good friend since he got into the Senate, I look forward to Jerry. If the leadership chooses him as chairman, I look forward to working with him.

MS. CASEY: So I mean, this is an issue that you've been able to work across the aisle on.

SEN. TESTER: Yes.

MS. CASEY: And I want to point out that the bill that you're working on, the mental healthcare bill, has aspects that are sort of hallmarks of what a Democrat might like, what a Republican might like, and it all comes together in one bill. How do you get this now through its next paces? I mean, do you expectations that you'll be able to continue the bipartisan wave of this and the other legislation that President Trump signed into law last year to get bills like this in a time when so much is really fractured on Capitol Hill?

SEN. MORAN: I think this is the arena. I mean, the number of arenas, I remember we used to say when I was a House member, we talked about how the House Agriculture Committee, which I was a member of, is one of the last places in which things are still bipartisan. All those things are hard to keep--to remain true. We are, Veterans, is one of the places in which the partisanship has been significantly less. And I think that's true not just in the Committee but on the Senate floor. So as the Committee, we want to get--certainly Senator Tester has taken a lead in this Hannon Mental Health Act, but we want to make certain that our colleagues have input too. Almost every member of the Veterans Committee has indicated or has introduced bills or has talked about issues related to suicide, issues related to mental health. We want to make sure that while we think the bill that we've introduced is good, we want to make sure it's comprehensive, that we haven't missed anything. And we would welcome the input of our colleagues. And I think we can accomplish that. Once the Committee approves a bill, this bill--I would guess it's nearly unanimous in the Committee, if not totally--I think it's a bill that can work its way across the Senate floor despite all the challenges we have with other things that compete for Senate floor time.

MS. CASEY: You know, one thing I want to point out about this bill--and it was named obviously for Commander Hannon, who we learned a little bit about--it talks about investing in innovative and alternative treatments, something you mentioned, Senator Moran, at the beginning. And Commander Hannon was someone who loved nature. As he retired as a Navy SEAL and went to Montana, he got involved in getting veterans out to nature. He was involved in, like, raptor rescues and wildlife rescues. Senator Tester, how do you see that as a component here, and how do you convince members of Congress that this is for real and this isn't like wishy-washy feel-good stuff?

SEN. TESTER: There has been some stuff done, I'm sure around the country but certainly in Montana, on things that you wouldn't really think could be effective but is incredibly effective. Fly fishing for example. There's a number of groups out there that take veterans out fly fishing. I'm not a big fly fishermen because I don't have the skills to do it, but I went out with them one day. It was absolutely the most amazing peaceful experience that I've had in my lifetime. It was just amazing. So this stuff that's outside the box stuff, I think it works. I think working with horses works, equine therapy. I think that yoga therapy. As you can tell by my body, I'm not big into yoga. But the truth is, I think it can work.

[Laughter]

MS. CASEY: And is there a role for the federal government? I mean, I know groups that take hunters up to Alaska but they're like nonprofits. They fundraise.

SEN. TESTER: Well, the rule here is none of this stuff is free. It all costs money. And as Jerry talked about at the beginning, we have an obligation to our veterans. You put forth the statistics. What we've been doing hasn't been working to the point where it needs to work. So we need to think outside the box. And I think the Commander John Scott Hannon bill does exactly that. It gives other tools, more tools for the VA to utilize. And you know, if this bill saves one life, it's well worth it. And I think it's going to save far more than that.

SEN. MORAN: A point that two of you that I'd like to highlight is that we need--perhaps the most effective--I'll be more cautious. One of the most effective tools is community programs, private organizations, veterans helping other veterans. We need to continue to encourage that.

MS. CASEY: Encourage how?

SEN. MORAN: Encourage in--for example, you mentioned agriculture. We have a--the appropriations process a couple years ago created a grant program at USDA, not at the VA, but at the Department of Agriculture. And we have a handful of programs across the country in which private organizations have teamed up to create a farm environment, to teach soldiers who have returned to the United States how to produce agriculture, how to produce livestock and crops. It's a combination because the average age of a farmer is increasingly dramatically. We need new farmers. At the same time, those who return from war need new careers. The combination of those two things can be very effective. And it's a private not-for-profit corporation who does that in Kansas, but they're accommodated by federal resources, taxpayer dollars. So it is a combination.

MS. CASEY: And one thing I want to make sure we talk about are women veterans, because there are concerns. They do have a higher suicide rate than the general populace of women. What are you two talking about in terms of mental health, as well as general healthcare for women veterans, of which we have so many more now?

SEN. TESTER: There's another bill called the Deborah Sampson bill that is going to do some positive things, I think, for women veterans, because their rate of suicide is rising incredibly high. But it talks about having women providers within clinics. It talks about privacy issues, because quite frankly, this is a different military than we had 30 years ago. And I think that we will continue to address the women veterans' needs. We need to get Deborah Sampson of course done. It's a bill that Senator Bozeman, the senator out of Arkansas, and myself have. And I think it's a good bill. And with the chairman's blessings, we can hopefully take that up next year, too.

MS. CASEY: You know, the two of you sent a letter in August to the VA secretary about an inspector general report focused on the improper rejection of payments. And this is a big concern that a lot of people have voiced, especially as we look to privatizing and how do you make sure that payments are going through and that veterans are getting the care they need. Have you gotten a response? Where are things at?

SEN. MORAN: We have not had a response. I would tell you that my focus in veterans' issues is driven by what we call casework, the person I meet on the street or calls my office or sends me a letter, an email that's had a problem at the Department of Veterans Affairs. And part of all of this--how do we reduce the number of suicides, how do we better take care of female veterans, each one of these issues, how do we provide greater care across the spectrum--each one of these issues requires a VA that is efficient, effective, dedicated, less bureaucratic. And so part of the Committee's opportunity and responsibility is to provide oversight to the Department of Veterans Affairs to encourage but also to make certain that fewer veterans fall through the cracks.

MS. CASEY: But I mean this is that issue though of you get private care somewhere and then you need to get reimbursed.

SEN. MORAN: The MISSION Act, its implementation is taking place. I think we will be in a better position with the VA's implementation. The law, the MISSION Act changed the way that healthcare providers in the private community were compensated by reducing--it used to be that third-party administrators were involved in the payment process. So now this is an issue between the VA and the provider, not the VA, the third-party administrator and the provider. So taking one piece of bureaucracy out of the path. We've increased the compensation, particularly for rural healthcare providers, under MISSION Act so that they get compensated in a way that covers their cost. We're moving in the right direction. We need to make sure that the VA in its implementation and in its bureaucratic payment system gets caught up with today's--and technology has a lot to do with that, but it also takes leadership that insists the right thing be done.

MS. CASEY: Let's get you in on this, Senator Tester.

SEN. TESTER: Look, I think the CHOICE Act was a train wreck, and it was for those very reasons you talked about: providers not getting payment. If they don't get paid, they're not going to provide the services. I think the MISSION Act, although not perfect, is a giant step forward. But one of the problems we're having in Montana, I think across the country, is the providers that had experience with the CHOICE program are going, geez, I don't know if we want to get involved with this MISSION program. It's a VA program. But the truth is, is we've got to break that down so they can do it. And the VA, we need to hold them accountable so that those payments are made through those third-party providers. And I think it's working much, much, much better than it ever was in the CHOICE Act. And I think part of it is, is we gave them a year to bring MISSION Act up to speed. I think they did a good job of doing it. It's not perfect. I've got plenty of complaints about the caregiver component. But the truth is, this one about the payments I think is exponentially better than it was. That doesn't mean that all the problems have gone away.

MS. CASEY: But you haven't gotten a response from the VA secretary.

SEN. TESTER: What's that now?

MS. CASEY: Have you gotten a response from the VA secretary?

SEN. TESTER: We have not gotten a response from the VA secretary. But I can tell you this. I get a response from the providers in the state of Montana, the same way Jerry talked about case work. Those complaints have gone down. Are there still some out there? There are. But they've gone down exponentially.

SEN. MORAN: We think about these issues in regard to veterans, which absolutely, I mean, that's who we're caring for. But in order to get that care delivered, the providers have to be bought into the system as well.

SEN. TESTER: That's right.

SEN. MORAN: And all the challenges, mostly bureaucratic and slow payment and low payment, healthcare providers in Kansas and Montana, particularly rural, but generally across the state, whatever location, suburban, urban or rural, most of them are hanging on by a thread. They are struggling for their own financial well-being. And if we don't do this right, I actually think that MISSION Act can be helpful to keeping hospital doors open in a rural community, because just like our small towns, their school needs every student, their hospital needs every patient. And again, I don't disagree with what John had to say about the value of the VA. And we want it as a hospital system, a healthcare delivery system to function well institutionally in red brick buildings in Wichita, in Leavenworth, and in Topeka. This is an aspect of taking care of veterans who aren't able easily to access that care. And in doing so, in providing care at home, we're also improving the ability for that hometown healthcare delivery system to have a better future.

MS. CASEY: We'll have to leave it there. Senator Moran, Senator Tester, thank you so much. And I'll now turn things over to my colleague Alex Horton. Thank you, gentlemen.

SEN. MORAN: Thanks.

SEN. TESTER: Thank you.

[Applause]

Bridging the Gap

MR. HORTON: Good morning. I'm Alex Horton. I'm a reporter here at The Washington Post.

I'm joined here by Kayla Williams. She is the Director of the Military Veterans in Society Program at the Center for a New American Security.

We also have Elliot Ackerman. He is an author and a Marine Corps infantry officer, a veteran.

And we have, I think, seven combat deployments between all three of us, though Elliot is really pulling it in with five, really raising the average.

So, we just checked out that video there and there was an interesting sort of discussion there about this divide, and it's something that we're going to talk about today.

What's really interesting with this dynamic, I think, is, you know, as veterans, we have been on these panels, we have watched these panels with a lot of consternation about why can't we bridge this gap. And I think there's a lot going on in that discussion, but it's also very closed to the veterans' community and we really don't have this out in the open, and therefore nothing gets done. And we also have lawmakers come in and say, "You know, we have to do something for veterans," and it just goes down the rabbit hole.

So, we're just going to get into some of the nitty-gritty of what we talk about in our community and some of the more counterintuitive ideas of how we talk about veterans in society, how we talk about our relationship with civil society.

And if you have any questions in the audience or online, you can go on Twitter and you can ask us questions with #PostLive, and we'll get to them.

So, first, Kayla and Elliot, I want to talk about what we saw in the video about this gulf or this divide or this bridge that we have between veterans, the military, and civil society.

What is that exactly? Can you kind of define what the feeling is amongst veterans and active-duty service members? And also, what is sort of missing from that discussion?

MS. WILLIAMS: I think we have seen some survey data that shows that service members and their families feel that civilians don't understand them. And there is some echo of that among civilians, as well.

And I'll be honest, when I first got back from Iraq and when I first left active duty and became a civilian again, like, I leaned into that. People would say, "Oh, I just can't imagine what you went through." And I was like, "You're right. If your boots weren't on the ground, you can't imagine." And it took me a long time to step back and say, "I’m exacerbating the problem by owning that."

And as one of the folks in the video said, like, people should feel free to ask and then we, as veterans, to the extent we're comfortable with it, have an obligation to meet them halfway and be willing to tell our stories and share our experiences.

Because if folks can imagine--you know, my kids love the movie Wall-E. If you can imagine sentient robots, like, surely you can imagine what troops are going through on this planet, right now.

MR. ACKERMAN: Really, I think that video kind of speaks to a desire for connection. And so, we talk about the civil/military gap, I don't think there should be any surprise that there's a gap. The gap was hardwired into these wars, meaning the 9/11 wars, by their very design.

And what I mean by that is, like, listen: If we look at the history of our nation and how we've gone to war, there has always been a construct in how we go to war.

And what I mean by that is you can look at the Civil War. The very first income tax in this country and the very first draft came out of the U.S. Civil War, and that was how we constructed that war.

The Second World War, right, national mobilization and war bond drives.

The Vietnam War, characterized by a very unpopular draft.

These wars have been characterized by two things: They've been funded through all deficit spending, so there's been no war tax on anyone; and they've been fought with an all-volunteer military. So, we outsourced the war to a very specific segment of our society.

So, why are we surprised there's this gap? By design, these wars were constructed to anesthetize American society to them, and we sort of scratch our heads and say, "Wow, isn't it amazing these wars have gone on for almost 20 years?" They've been designed to go on for 20 years.

The reason they've gone on for 20 years is not because we haven't been able to find the exact policy alchemy for how to defeat the Taliban necessarily or how to get rid of Islamic extremism in and around Iraq and Syria. They've gone on for 20 years because they've been fought by an all-volunteer military and funded by deficit spending. And one of the residuals is that we have this massive civil/military divide.

MR. HORTON: And so, I think what's interesting, too, is that since the active-duty military force and the Guard and Reserves, it's such a small segment of society, there is a large population that doesn't know anyone connected to the wars.

And you know, when I went to community college after I got out of the Army, like I was typically the only veteran in my classroom, and that led to a lot of interest, a lot of intrigue, but also a lot of sort of exotic kind of beliefs.

And I think what's interesting about it, too, is when we think about how we honor the military or veterans, it's usually in the span of halftime celebrations or flags on the field during the Super Bowl, and then, we kind of go back to it.

So, Elliot, you're saying that we shouldn't be surprised that there's sort of this consequence or there's a disconnect, but what are the things that civil society does that exacerbates that and makes them worse than if we just came home, went back to work, and didn't talk about our service?

MR. ACKERMAN: Well, I think, listen: Like, I have--ask the question, do you like when people say, "Thank you for your service"?

And my response is always like, "Absolutely." Listen, there's someone--that's someone just reaching out saying, "I don't know how to make a connection, but I want to connect with you." So, you know, I think that's fantastic. But I think one of the results of the construct of these wars has been the fetishization of the U.S. military. And then, people who are outside of the military feeling very uncomfortable about offering opinions and being overly deferential to the U.S. military, which has all sorts of negative consequences when it comes to making policy and, you know, our previous panel about how do we deal with veterans.

So, I think this is really a moment where we should be, as a nation, reflecting on how we got here. Is this the healthiest relationship for a republic to have with this military? And I would argue it's kind of not because we are operating in a sphere of real moral hazard where also it's become very easy for us in our minds to go to war.

You know, we look at the saber rattling in North Korea that we've seen recently, or even with Iran and it's sort of--it skewed our perception of what war is.

A war, that's a thing that happens over there and it's done by people who decide they want to go do it, but that doesn't affect me and my family. So, I think, you know, this is really a moment we should be asking ourselves, if we're going to go to war, do we need everyone to have skin in the game?

MS. WILLIAMS: And to reflect a bit the diversity of veteran opinions, I personally don't like being thanked for my service. It makes me a little uncomfortable. My passive-aggressive response is to, like, thank TSA agents at the airport for their part in trying to keep us safe.

But I think another tendency that complicates this and doesn't necessarily help is this assumption that veterans are inherently more ethical or moral. Like, we need more veterans in office because they're so ethical and they're going to be able to rise above. I'm like, that's not necessarily true. We do have service members in prison because they've committed crimes. Choosing to join the military doesn't inherently make you, like, a better human being across all fronts, throughout all time.

And we do need to really question this, as you call it, fetishization of the military.

MR. HORTON: Yeah, and sort of, like, this duality I see that we're sort of--you know, there's--the public and, you know, media, Hollywood, politicians, they sort of reach for two things of a way to describe us. You know, it's either the hero, like, the lone survivor, lionization of this epic hero. And then, once we take off the uniform it's the downtrodden veteran, the unstable one, and--

MS. WILLIAMS: You're broken.

MR. HORTON: --broken. And you know, that's sort of infused in, like, the video we saw, is this sort of, like, kind of undercurrent of this trauma that we carry. And maybe we don't even carry trauma at all, but that's what's supposed of us to do.

But Veterans do, once they navigate the world, when they go to college, you know, like, they wear, like, the camouflage backpack. They wear the veterans' hats and they drink the veteran coffee and wear the veterans' t-shirts.

So, you know, other generations, they have probably assumed this veteran identity. Maybe other generations seamlessly or a little bit more seamlessly plugged back into civil society.

What do you think this sort of concept of thanking veterans for their service and sort of congratulating this identity--what does it do for people to complicate that when they move on to the rest of their lives? How do they subsume that into their identity without it being such a problem?

MS. WILLIAMS: I think there's a huge amount of diversity in that.

And when we talk about prior generations, I don't think it's completely that seamless, right? I mean, we have VFW halls and American Legion halls all over the country where veterans would go and hang out with other veterans. And to the extent that that's not necessarily being as replicated now, I think it's complicated. And yeah, we have folks who completely own that identity, like you're describing. And then, there are folks who don't, who walk away entirely.

I know a number of women veterans who don't disclose that they were in the military at all because--

MR. HORTON: Why is that?

MS. WILLIAMS: It varies. Some because they had negative experiences; others, because they are concerned that it will complicate their ability to get jobs or reintegrate because they are violating gender norms, and that can make some people uncomfortable. For others, just because they've moved on. They have new identities that are more salient for them.

And it's not universal. I know plenty of women who are, like me, happy to wear a pin and show up and say this is one component of my identity.

I think the other thing that's really important to remember is it's not like transition happens once and then it's over, right? Like, your transition can last for many years and go through multiple iterations.

I left active duty, took a job that was about half private service; and then, have transition slowly into places where my veteran identity is somewhat less salient. It's less a component of what I do day-to-day.

MR. ACKERMAN: Yeah, and I would just add, I think, in years past if you look at our war--our major wars, they were generationally defining events, even for people who did not serve. You know, just look at the Vietnam War. I mean, everyone at that age can tell you about the draft, tell you what their draft number was.

I can't tell you how many book readings I've down where someone who was of the Vietnam--will come up to me and literally tell me, "Oh, my draft number was 362," you know, all these years later.

These wars have not been generationally defining. And as such, I think a little bit of the effect on the veterans--you know, I mean, I'm a writer. And at one point on a panel someone was asking a question about the lost generation of the First World War and the history of war writing. And it occurred to me, you know, I don't feel as though I'm a part of a lost generation. I actually sort of feel more like I'm the lost part of a generation, and that when I look at the people that I went to high school with and we all sit around, you know, I don't have that much in common with them, because I kind of went off and did this other thing.

And so, I think that has made the reintegration--it's kind of like you have to then, like--you took this detour from your generation. You have to re-plug in, and again, that's sort of been unique to these wars because of how they've been structured as sort of something that's been on the side of what's gone on with--within the larger American culture.

MR. HORTON: So, how does this work with you two, specifically?

Like, Kayla, you swam in academic and policy waters. Elliot, you swim in literature waters. So, how does your veteran identity both inform or distort what you try to do? Do you feel like it's a hindrance as well as benefit? Like, how well are you able to get ahead of it if you want to, or how much of it is just sort of back into your orbit?

MR. ACKERMAN: Well, you know, one way sort of comes--I mean, one interesting thing that has sort of come up in the books that I write is I think people have a tendency to immediately look at the books that I write and think of them as being directly informed by my war-time experience.

And having written the books, I sort of know what I'm plumbing from. A lot of it is not from my war-time experience. And if you look at kind of the history of American literature, there are many great novels that we have never looked at as war novels, but I would argue to you absolutely are war novels.

Like, I want to say--one is The Great Gatsby, right? Great Gatsby, great American--Great Gatsby is a war novel. The First World War is all over that book. It's how Gatsby meets Daisy Buchanan.

Another one I offer to you that no one considers a war novel, which certainly is, is The Catcher in the Rye. Cather in the Rye is a war novel. First of all, if you know anything about JD Salinger, he landed in the first waves on D-Day, liberated the concentration camps, carried that experience around for his entire life.

You know, if you go back--I encourage you, take a look at that book and read the voice of Holden Caulfield that's so famous, his voice of youthful disaffection. I read that voice now and I'm like, "I know that voice." Everybody is a phony, right? And he's walking around New York City, like, that is the voice of a veteran.

And if you read the last line of that book--the last line of The Catcher in the Rye is, "Don't tell anybody anything, or else you wind up missing everyone." You know, like, if that's not a guy dealing with some experiences, I don't know what is.

But when those books came out, that experience was so wide across the culture that you could understand those books as just American books, because America had been through those wars. But now, America has not been through these wars. This sort of group of people on the side, the veterans, have been through the wars. And so, the books and the culture is kind of experienced through that lens.

MS. WILLIAMS: For me, I have used my personal experiences to inform the research I've done and also, I hope, to be able to communicate the results more clearly.

So, I use my personal example to illustrate data that I'm talking about--mine and my husband's, who was severely injured in the war. And then, another way to look at it is that I am able to contextualize my personal experiences with the data. And I think that that's an important part of me being able to communicate, like, what policy changes I think are important and why they're important in a way that humanizes them, because most folks don't connect emotionally with data and charts and graphs and p-values, but when you tell it in terms of a story, like an individual story, like, "Oh, now I get it and I can connect with that."

So, in that sense, my experience as a vet, as a woman vet, in particular, as a spouse to a wounded warrior, like, that is a really essential part of the way that I work and the way that I communicate the results of my work.

MR. HORTON: And Elliot, you mentioned something about this sort of cultural understanding of, like, a veteran experience and how it's kind of shifted throughout the years. World War II, everyone sort of understood that, maybe more clearly than they did today.

So, what does it say about our society that the biggest war stories or the biggest impactful things come from blockbuster movies, where, you know, they sensationalize a lot of this stuff?

You know, at one point, American Sniper was the highest-grossing R-rated movie, every. And people couldn't get enough of that story. And when I watched it, it took place in a part of Iraq that I was close to at a time that I was almost there, and I didn't recognize any of it. It had this sort of portrayal of very tough things to do and the only decision was whether to do it or not.

But I thought the biggest problem was the sort of thing that defines our wars, partly, is of this sort of gray--this amorphous, should I pull this trigger in this car full of civilians, that maybe they have guns, or not. And that wasn't clearly defined in the movie, even though that's something Chris Kyle struggled with.

So, we don't get these cultural touchstones unless they're violent, loud, blockbuster moves. So, what is that doing to civil society's understanding and our empathy towards veterans in the military?

MR. ACKERMAN: I think you touched on it before, right? It's that we experience veterans with regards to two polarities, right?

MR. HORTON: Yeah.

MR. ACKERMAN: It's that we experience veterans with regards to two polarities, right? Either they are heroes, supermen, you know, Navy Seals--list the movie--or they're these completely broken people who have come back racked with demon and guilt--demons and guilt.

And I think we--I don't want to speak for you all. I would say the reality is probably somewhere in between. It's that muddy, nuanced middle that, at this moment, our culture doesn't seem to be doing a very good job grappling with.

And that--but that's not just for veterans. And we have to, I think, understand we're one community, but we also reflect the broader undercurrents of all of American society. And I would argue that right now none of American society is doing a very good job of sort of understanding and clearly articulating kind of the reality, which is that we all sort of exist in this gray middle. And the gray middle is really the truth and the truth of experience, whereas I think so much of our culture and our debate is defined by, "Nope, there's just two polarities. You have to pick."

MS. WILLIAMS: And we also see in some of these films, it's this hyper focus on a really, like, masculinized military. It's these combat arms guys, Navy Seals, Snipers. And those are the stories that people are picking up on. Common arms are only about 15 percent of the total force. We're not telling the stories of the rest of the military.

We have a flourishing of books written by women who have served, but they're not getting, to date--they haven't, you know, hit that blockbuster status when it comes to films, yet.

So, again, we're only telling a small fraction of the diverse stories that actually exist.

MR. HORTON: So, and diversity is a great point, because I think when--if you looked at the mind's eye of someone--when you say a war veteran, they picture probably me and Elliot, you know, white guys, maybe with--

MS. WILLIAMS: He's got a lot more hair.

MR. HORTON: A lot more hair, but also maybe 50 years older, you know, wearing the old World War II hat and grizzled and, you know, melancholy.

But there's also, you know, more women serving than ever before. There's other points of diversity. So, can you go through some of the things that you--people may say is surprising about the military and veterans?

MS. WILLIAMS: I found a lot of misconceptions about the education level of those who serve, which is higher than of the typical civilian.

And also, folks don't necessarily realize that the military roughly represents the United States in terms of its racial ethnic make-up. Women obviously not; we're a huge minority, still, in the military, only about 16 percent of the total force, 17 percent of the total force.

And also, we now have LGBT folks serving openly in the military. They've been in the military all along, but now that's a little more open.

I think, though, that, yeah, the typical person, when they picture a vet, they don't picture me. They don't picture the full diversity of those who serve who really do come from American society, and then we go back to our communities.

MR. ACKERMAN: I would just add, too, and frequently when they look at the people who look like me, who--and I was a combat arms guy for many years--they will immediately jump to assumptions about who you are.

Like, for instance, one of my very best friends in the Marines who is still in special operations and has been deploying since 2003, was in the Iraq invasion--actually is in Afghanistan right now. You would look at him and all you would see is hard, grizzled, combat operator.

The reality was he was a creative writing major out of UVA, is still one of the best-read guys I know, and we hang out and catch up. First thing, he'll be like, "Hey, Elliot, did you read the new Meg Wolitzer novel? Like, what do you think? I don't know, she's kind of losing it."

Like, you know, these are people every bit as diverse as anyone else in terms of their interests, who they are, their passions. And oftentimes, what is sad is all people can see is sort of the monolith of, "Oh, veteran. I know what that is."

MS. WILLIAMS: And they make assumptions of our political leanings, too, for the same reasons.

MR. ACKERMAN: Right, but and I think also goes past the veteran experience. I mean, that's something the entire country is suffering from right now. We look at each other and we think we just know at a glance.

MR. HORTON: So, what is it like going into book publishers' offices and talking with agents and people in your community when they learn? Like, what are their assumptions about you when you walk through the door?

MR. ACKERMAN: I think it's been--listen, I think it's helped me that I've been a veteran. I think people want to know those stories. And most people, once you sit down, we're sitting down, are good people and they want to connect. I'm a huge optimist about the human condition and what they can do when they are actually engaging with one another. But I just think sometimes it takes a little bit more of that in-depth engagement and people just taking a moment or a beat just to be open.

MS. WILLIAMS: I felt like when I first met my publisher that, especially maybe because I'm from enlisted, they were surprised I could string two coherent sentences together.

I really did. I felt like they were, "Why would you"--I had a lot of people say, "But why would you join the military if you had a bachelor's degree? Like, why would you do that?" That total gap.

MR. ACKERMAN: What's funny is people will often ask me and say, "Isn't it interesting that you, you know, went from being a Marine special operator to being a writer. That seems so strange that someone who was a Marine special operator would become a novelist."

I say, "Actually, it's funny: The people who have known me the longest look at me and say, 'Isn't it so weird that you became a Marine? Because you had these interests that predated your time in the Marine Corps.'"

Listen, we all contain--all of us individually contain multitudes, and veterans are the same as anyone else in that regard.

MR. HORTON: So, when it comes veterans kind of figuring out what they want to do for the rest of their life, because you know, we--I mean, we both did one enlistment, right? How many enlistments did you do?

MR. ACKERMAN: Eight years, so, that was--

MR. HORTON: You're commissioned, so, I mean, a big chunk of our lives comes afterward.

MS. WILLIAMS: Yeah.

MR. HORTON: Right? And we have to figure out how we sort of plug this into our identity and who we become.

So, what can veterans do, based on your experiences, to smooth those edges out, because I think some people have a problem with this jump?

You know, a friend of mine pointed that, you know, integration is sort of like a space shuttle coming back into orbit. You know, if you hit it right, the tiles will get warm, but you'll be all right. But if you come in like this, you'll burn up. So, there's a lot riding on how you make those months and those years after your service count.

What can veterans do to make sure that they land right?

MS. WILLIAMS: I encourage veterans to not isolate. Like, go ahead and join organizations, civilian, veteran, military, blended. But just don't isolate yourself.

And also, don't hesitate to take advantage of the resources that are out there. Like, my husband got blown up in the war and when he left active duty, he was like, "Oh, well, I don't know if I should do this or that or the other because it's for guys who are really hurt. Right, I'm still--I still have all my limbs, so, like, I'm not hurt enough."

I'm like, no, go ahead and do the things, right? All these resources exist. Don't hesitate to take advantage of them to connect with people, to connect with yourself, and to smooth that reentry, as you put it, by having some supports available to you.

MR. ACKERMAN: And I think, you know, it's a process of redefinition. I think one of the things that's challenging is that the military so clearly gives you an identity. I mean, you put it on every day when you put your uniform on. Everyone knows who everybody else is and their jobs and all of that, and you leave that all behind and go into something where your identity and who you are is far murkier.

But trying to proactively think about and craft that identity for yourself and think about your purpose and where you're going to derive that purpose from. Because I think we derive our happiness from our sense of purpose in this world. And when someone is reintegrating or coming in, you're basically--you're repurposing yourself and trying to substitute the meaning maybe you got in the military with a new sense of meaning in your life. And proactively thinking about that, I think, can be very useful.

MR. HORTON: Great. I think we could talk about this all day, but we're just out of time. So, I would like to thank Kayla and Elliot for this discussion.

And I would like to turn things over now to our sponsor.

Sponsor Segment

MR. SCHOLL: Good morning, everybody. My name is Jon Scholl. I am the Executive Vice President for Health Care at Leidos Health Group. I'm also a veteran of the Submarine Service.

And before I introduce our guest today, I wanted to give a little bit of background of what we're here to talk about.

In March of 1865, President Lincoln gave his second inaugural address not too far from here. It was a time when the Civil War was coming to an end, and he said some words that matter so much to our nation and to our nation's veterans.

What he said was that it's the nation's responsibility to heal, quote, "To care for him who shall have borne the battle and for his widow and his orphan."

And of course, today, it's much more inclusive than that. We have women service members. And what the message was, was to care for our veterans and their families. And so, caring is what we're here today to talk about, making people whole. And health is not just the absence of disease or infirmity. It is the presence of so many things that we've heard about this morning: the presence of mental and behavioral health, the presence of financial stability, the presence of social connection.

I'm joined today with Bill Tinston, who is leading the effort to deploy the military's new health record. It's a bold and important move to install a modern electronic health record to help our veterans who start their careers in the military and transition all the way through--you know, into their veteran service and need the continuity of the information that is contained in their records.

This new system is being developed by the Leidos Partnership for Defense Health. It connects in-patient and out-patient records. It connects the service members all the way out into their service units and back into their homes, ultimately, when they are veterans.

So, Leidos and our partners, Accenture, Cerner, Henry Schein One, and numerous large and small businesses are so proud to have the privilege to work with Bill and his team to accomplish this great mission.

Bill, I can go to my home today and walk to the place where I have my paper medical record and my DD214, and I don't think anybody will ever pry it out of my hands. And I know a lot of our veterans--

MR. TINSTON: I have one of those, too. I was a dependent.

MR. SCHOLL: You were a dependent? So, you have--and you know where it is, in your home, right?

MR. TINSTON: Right, it's in my basement.

MR. SCHOLL: What is MHS Genesis? How is it going to change that world?

MR. TINSTON: So, MHS Genesis is about transforming the way we capture the information about patients, right? So, we're creating a record about the patient, not where the care was delivered or who delivered the care.

And as you described, it ties together that basic record about the patient, which is available, whatever military treatment facility you go to, all the way out to deployed care and things that may have happened with a military member while they're deployed. And then, it ties it back, because we're working very closely with the VA--that same record transitions with them--well, it doesn't really "transition," because it's a single record--to any care provided by the VA. And then, it continues on if there's a Veterans' Benefit Administration thing--decisions that need to be made based on something that might have happened during military service or, earlier as a veteran, it carries forward to the Veterans' Benefit Administration. It deals with patient transport. And then, in the end, we have that single longitudinal record about that patient so we can--the VA and the DoD can look at characteristics of patients, common outcomes. There is a population and data analytics capability that ties all this together so we can gain more insight into the population and into the veterans and what might have caused what and what relationships we can find between outcomes and prior experience in the service.

MR. SCHOLL: Fantastic. And where are we in the journey?

MR. TINSTON: So, we have delivered--we have deployed two--we delivered the record. It's in use at eight military treatment facilities right now. We did four about two years ago. Our initial sites, we learned a lot from those.

Most recently, in September, we did what we call Wave Travis, which was four sites: It was Travis Airforce Base, Lemoore, Monterey, California, and Mountain Home, Idaho. And it was an outstanding experience and it was four times the number of sites we had done before. And it went exponentially better than what we had experienced before. We had the right people in the right place to get this done.

The Defense Health Agency has a Health and Informatics Organization that really brought the military treatment facility commanders together and made them part of the team, delivering this rollout to their facilities.

So, while some of the early sites, it felt a little more like something we were doing to the facilities and the commanders, in this case, they were an integral part of delivering this to the military treatment facilities, and we had commensurate improvements and success in delivering to these sites.

So, when we went live, we didn't have--experience any patient safety issues. We saw trouble problems--or reported problems dramatically lower than what we had seen in previous go-lives. And it was a profound experience to watch. It went very, very well.

MR. SCHOLL: Yeah, good. That's fantastic. I've done a number of these installations out of my current role, in a prior life, and I know they're hard.

There are a lot of things to learn as you go through time and deploying these. Do you have any insights about the lessons that have been learned that we carry forward?

MR. TINSTON: So, our initial sites gave us the insight and the opportunity to improve the training, because we made the typical IT people mistake of trying to train IT instead of training the job that people are going to do. As you're transforming the clinical workflows, you need to train people to be ready to do their job when the new capability comes into play.

So, we didn't get that right the first time. We spent a lot of time getting it right this time, and the results showed that.

We saw some--because this is all delivered from a common data center. There are not multiple instantiations of this record and the set of capabilities. Getting all the infrastructure to deliver that capability right up front, and we actually have a target for ourselves of six months in advance of any MTF, or military treatment facility, that we're going to, that we have all that infrastructure in place.

And we got that done this time, as well as just the organizational change. And this is where really the Health Informatics Organization at the Defense Health Agency really, really transformed this go-live and this rollout, is they were there and they were engaged with the clinics and the hospitals to make sure that they understood why we were doing it, what impacts it was going to have on them, and how it would improve care going forward.

MR. SCHOLL: Great. At the top of the segment, we talked about the VA a little bit, which of course, as I mentioned, this is really the beginning of a veteran's journey that ends years or decades later.

The VA and the Coast Guard are going to start to implement the electronic health record. How are you working with other agencies to get all that done?

MR. TINSTON: So, we're engaged with the VA on a daily, continuous basis, because they're not deploying something different; they're joining the common record.

So, they participate in our activities, our go-live activities. We had a command center when we were doing the Wave Travis implementation; we had people locally here in Washington, actually, out at your building is where we did it; we had command center downrange to Travis Airforce Base and each of the other locations.

The VA had people engaged in that, so they understood what we were doing. But there's a lot of talk about what is the VA learning from the DoD so that when they go live at their sites--their initial sites, which I think are scheduled for March of next year.

But it's actually--it's a two-way street, because we have DoD people engaged in clinical workshops that the VA is doing. And we are learning things from the work that the VA is doing and influencing the already-deployed record and improving and improving workflows for the DoD facilities as we go through the work with the VA. So, it's a two-way street. We're both learning at the same time, and we're improving this process as we move forward.

It's also a well-protected record. The VA and the DoD are engaged in a common cyber protection of the patient data and the record and the workflows and the system so that it's an extremely well-protected record.

MR. SCHOLL: Yeah, I think that's one of the really interesting parts about the whole system is how the attention to cyber, cyber protections, of course needed for--

MR. TINSTON: Right.

MR. SCHOLL: --for the kind of thing that you're doing.

MR. TINSTON: Right.

MR. SCHOLL: So, at the very top of this segment, the two Senators talked about mental health, behavioral health. And if you expand that into the more broad topic of population health, right, how is the military health system thinking about population health and the readiness of the troops, and how does MHS Genesis help that?

MR. TINSTON: So, what MHS Genesis allows us to do or allows the defense health agencies and the military health system to do, and the VA, as well, is to bring all of this data together, beginning, like I said, from when a member joins the military all the way through their veteran experience, all of the medical data, including anything that is done through community care, because we have interoperability standards, and we are able to share the appropriate data out to the community care system and bring the appropriate data back into the record.

So, we have a complete record of what's happened with an individual patient, but we have that across every single patient that is being seen by the military health system or the VA health system, so that researchers or physicians can gain insights across the population. They can look at outcomes, see if there are characteristics of other patients that had the same outcomes and that they can make decisions and gain insights as to why that might be, and just improve individual outcomes for patients based on that.

MR. SCHOLL: Yeah, it's a really special part of what's emerging in U.S. health care today.

MR. TINSTON: It is. And I read an article, and it was actually in the summer, oddly, about Willis Carrier, who invented air conditioning. And it was odd, because he didn't try and invent air conditioning to change the way that we all worked and how comfortable we were in the buildings and when we could work.

He invented air conditioning because he ran a print shop and he couldn't get the ink to stick to the paper because the humidity was too high. And so, he knew why he created air conditioning, but he had no idea what the outcome was going to be.

I think we know why we're creating and implementing MHS Genesis and a common record across the Coast Guard, the VA, and the DoD, but I don't think we have any idea where it may take us and how it might transform how we deliver care in the future.

MR. SCHOLL: Yeah, I think you're right. Thank you.

Well, maybe one more question given the time.

MR. TINSTON: Okay.

MR. SCHOLL: What's the future look like? What's the deployment schedule look like? And how does this, you know, come to fruition and then ultimately transform where we're going?

MR. TINSTON: So, we did four initial locations a couple years ago, and that gave us the insight and opportunity to improve the process.

We have just done Wave Travis, where we had four additional sites; so, four times what we had done at once in the past.

Come next summer or late spring, we're going to do what we call Wave Nellis, which is clearly Nellis and several other sites in California and Nevada, and that's a much bigger wave. It's more than four. I think it's ten.

And then, beyond that--and that will be another opportunity for us to refine our deployment process. And after that, we start doing two waves at a time. And on the DoD side, we complete our deployments in 2023. So, we will have the entire military health system using the common record in 2023.

And the VA begins in March, and I won't speak to their full timetable, but they begin in March. So, we will both be using the same record and integrating workflows to provide health care to the military and veteran communities we go forward.

MR. SCHOLL: So, many years of overlap between the DA and the DoD as this gets rolled out.

MR. TINSTON: There's many years of overlap, but it is, in the end, we are all using the same record about the patient, not where the care is delivered or who delivered the care, be it community care, be it care that's delivered in a deployed environment, or delivered through a VA or a military health facility.

MR. SCHOLL: Good. Well, on behalf of Leidos and the Leidos Partnership for Defense Health, I can just say thank you for allowing us the privilege to participate in serving our nation's heroes.

It's really deeply felt on my team, and your team is just phenomenal to work with. Thank you.

MR. TINSTON: Well, it's a privilege for me, as well. I'm the son of a veteran and the brother of a veteran. So, I appreciate doing this.

MR. SCHOLL: Yeah, so, with that I will turn the stage back over to The Washington Post.

Thank you.

[Applause]

Medal of Honor: A Hero’s Story

MS. CASEY: I'm Libby Casey with The Washington Post. Hello, again, and I am pleased to introduce David Bellavia, the first and only living Medal of Honor recipient who served in the Iraq War.

Thank you so much for being here.

MR. BELLAVIA: Thank you for having me. I appreciate it.

MS. CASEY: Yeah. I want to talk about that day, November 10th, 2004, but first, let's go back to the basics.

Why did you enlist in the Army?

MR. BELLAVIA: I mean, I think there's--everyone has 15 reasons why they joined the Army.

For me, I was home from college. I had a home invasion. These two guys, they got, for whatever reason--they found my parents' house. My mom just had some neck surgery so she was convalescing. My dad was taking care of her and these guys just busted through the house. And I just remember, I held a shotgun and I couldn't--I was afraid. I was scared of--you know, I just didn't know what I was doing. I was naïve and thankfully no one was hurt. They took their stuff, they went away, they went to jail, everything worked out great. But I remember my dad looking at me and just thinking, "Uh oh, this one needs to cook a little longer. He's not quite ready."

And so, I went to the Army and said, "I want to be that person that is able to, you know, be able to look at the people in his family and say, 'I got you.'"

MS. CASEY: How old were you when that happened?

MR. BELLAVIA: I was far too old. I think I was, like, 22-23, yeah.

MS. CASEY: Wow.

MR. BELLAVIA: But it's one of those things where you just--you think to yourself, "Why?" You know, what is it going to take for me to be able to, you know, get to that next level and become a man?

MS. CASEY: So, you enlisted and you saw a lot. I mean, you were in Kosovo before you were deployed to Iraq, a very tight turnaround, too.

MR. BELLAVIA: A very tight turnaround. I'll tell you, Kosovo was actually a worse--to me, that deployment, because there's really not a lot of anything going on, just a lot of opportunity to get into accidents, a lot of opportunity to, you know, just get complacent.

My leadership in the 1st Infantry Division took that opportunity to get us ready for combat in Kosovo. So, we're doing 12-hour patrols, making sure everyone is safe, and training for combat at the same time. That's really the reason why we were so effective in the war.

MS. CASEY: I want to remind you, if you have questions for Mr. Bellavia, you can send them to us on Twitter. You can use the hashtag, #PostLive, whether you're here in the room or watching online and we can hack it into you and you can answer them.

You know, we--set the scene for us: It's 2004, it's fall of 2004. This is often thought of as the second battle of Fallujah, that's how people talk about it. I want you to remind us what it was like at that time, because it's been described as some of the worse urban combat since the Vietnam War.

What was it like, there?

MR. BELLAVIA: Having never served in Vietnam, I had served in Diyala Province before that. We did some time in Najaf. We had elements of our taskforce go out to Mosul.

So, we were--because of our Bradley fighting vehicles, basically tanks with infantry in the back of them, we--this is really conducive to that urban fight in Iraq at the time.

The wheels were coming off the cart. The insurgency was really getting strong. Fallujah in April, the Marines handled their business, but the civilian population was there. And it was just--it was an information operations war. And if the Middle East was looking at pictures of injured or, you know, killed civilians, it wasn't helping the mission at all.

So, when the Marines pulled back, we basically said, "We're coming." We gave those--the people of Fallujah six months to clear out.

Really, we were waiting--15 years ago today, this was the time that this happened, we were waiting on the presidential election. It was Bush/Kerry, and we did not want--the leadership did not want the invasion before the election. So, essentially between Halloween and the day we kicked off the battle of Fallujah, it was just sitting around waiting to get the word.

But we were well prepared for close quarter combat. This was going to be, you know, 10-meter shots. You're opening a door, it's the OK Corral. And it's psychologically debilitating, and you have to get into those young people's heads and remind them, "I got you. We're going to do this together." And I was just blessed to have incredible soldiers of 22 Infantry in the Army.

And this was a Marine Corps fight. We were just there to help. It was not an Army-led mission. The Marines in Anbar did incredible things.

MS. CASEY: This is Operation Phantom Fury.

MR. BELLAVIA: Yes, ma'am.

MS. CASEY: So, November 10th, it's your birthday. Tell us about that day.

MR. BELLAVIA: It was--what had happened at the breach on the day that Fallujah started, we got through with no problem.

It was a big berm that we--it was a railroad berm and we busted through it. Marines had trouble getting through, so they all used our breach. And what ended up happening was it set the battle plan off. So, while we punched in, expecting everyone to be to our right going into the fight, it took a couple days for them to catch up.

We found ourselves in Fallujah and pretty much surrounded and having to fight to where we were--you know, to our--you know, our mission was to get to Highway 10 and then come back and start over. And we did that day after day after day until everyone got on the same side.

We found ourselves in a house. They had locked in about 10 bad guys in a block. They squared them off with tanks and said, "You know, we got to get these bad guys." You're going room to room, door to door.

It's so weird, the senses in a house fight, it's not about what you see, because you're tired and you're hungry. It's often not what you hear, because your ears are shot out. It's smell. It's like, I smell that a person has slept here. I smell a person who hasn't bathed and I smell--we haven't bathed, either. But you can tell the senses that you use to--you know, I remember going in. Fallujah had been bombarded. Dust was everywhere. The food was rotted. Families just left. You could just see that they took their belongings and just got out. And then, you would see, like, an orange cup on the table. Everything else was dust and debris and just a fresh, orange cup. And it just--everything in your body just is like, "Someone's here," right?

A piece of cheese where everything else is rotted and smells horrible, and there's this, like--a plate with a piece of cheese and bread and you're just like, you know, here it is. It just changes everything. You're in a primal state of evaluating threat. Where could a person hide? Where can a person be? And how do I get to them before they get to us?

MS. CASEY: How do you prepare for that? You were talking about getting ready even back in Kosovo, really getting ready, and you talked about how you get in the psychological preparation mode, but how did you prepare for this?

MR. BELLAVIA: My whole thing was I never had been to war before. I didn't know how to do it. I read everything I could. I talked to as many Vietnam guys as I possibly could.

You really have to make yourself uncomfortable every day. You have--to get ready for war, you just have to--physically, it's the one thing to just be excruciatingly tired and just bone-weary.

People forget that when you've got bodies that have been out for a while, there's a ton of bacteria. Everyone is sick. You can't spend three days in a city where you're fighting thousands of bad guys and not get some sort of, you know, virus. So, you've got head colds and sore throats and temperatures and diarrhea and--you name it. And you're tired and you're hungry.

And the other thing I realized is when you exchange fire in closed quarter, in that region of the world there's no drywall; it's all concrete. And those rounds are just ricocheting everywhere. No one is unhurt in a house fight. Everyone's got a scrape, a graze, whatever. So, it just shows that if someone leaves the battle, they can't fight anymore.

And that's just--to me, it just shows the spirit of the men and women that we had over there in Fallujah.

MS. CASEY: You were squad leader.

MR. BELLAVIA: Yeah.

MS. CASEY: So, what does that mean in a situation like that? What's your role to protect and to help and to lead?

MR. BELLAVIA: So, I was--I joined after college. I was older. I had a son. I was married. To me, they were my surrogate children, right? I looked at them, they were 18, I was--

MS. CASEY: And you were old, you were 29.

MR. BELLAVIA: I was a 29--yeah, a grizzled veteran. I would check my stocks in the morning and drink like a--no, but these were 18-year-old kids.

And I never--I learned many, many lessons in Fallujah. I hated journalists. I couldn't stand them. I met an embedded reporter who completely changed my view as to the importance of--nobody knows what's happening in the war unless you tell them. So, nobody knows our experience unless there's a vessel, a filter there to let them know what is happening.

The other thing, I never thought--well, what is the chaplain doing? You know, you want to go pray, go pray. I got stuff to do. You know, I don't need that. I found love on the battlefield and it blew me away. War is horrible. All the clichés--you know, you've all seen the movies or have experienced it yourself. That's obvious. But there's love and people do what they do--we're all different, we all vote different, we love different, we worship different. We don't agree on anything. We're like every other cross-section of America. But we put all of our differences aside. And if you're willing to be there with me, I don't care anything about where you're from or who you are. You are my blood, I'm going to bring you home. And when you see people bleed for each other, sacrifice for each other, it is impossible to be victimized by that experience.

I hope nobody sees combat ever in their life, but I hope everyone has a moment in their life when they realize, "My God, this is so much more worthy than me. And this guy over here that I don't even know or get along with is as important as my whole family." It's beautiful.

MS. CASEY: You've been telling this story a lot because you just received the Medal of Honor in June. And you've been on the road--it sounds like constantly since then.

MR. BELLAVIA: Yeah.

MS. CASEY: But can you tell us a little more about--and we'll hear about what's going on with you right now in a few moments, but can you tell us more about that moment and that house that you went in and why that was such a pivotal moment for your squad?

MR. BELLAVIA: It's so confusing. You know, you think about just the noise of just bullets going. You know, we're shooting at people who have essentially rigged a house with kerosene and plastic explosives.

The back of your mind, you're thinking, shouldn't we just all--I mean, if we run, we're going to get shot; if we stay, we're going to blow up. What's the point, here? And it just seems like there's a clock that goes off in your head. And you know, the littlest things can--when it's that close quarter, it's that personal and you're making eye contact and you have a--literally screaming at the other side and they're screaming back, you realize that the littlest things can affect that battle, and it's confidence. You go from, "I'm Thor, no one can defeat me," to, "I should have gone to dental school. This was a horrible choice."

[Laughter]

MR. BELLAVIA: "What am I doing? You know, I have no business doing this."

And you just are constantly vacillating between the ebbs, the lows of high--and with machine guns firing back, you just--was that a bullet?

At one point I thought I was hit and I was like, "I can handle this. It's not that bad. I thought being shot was going to be horrible and I can do it. Oh, my God, I have so much confidence." And then, I saw it was, like, a piece of wood in my arm.

And I was like, "Oh, no. If I can't handle a splinter"--you know what I mean? This is going to be a long day. You're constantly--you don't--you're just trying to prepare yourself for what's going to go down.

And the thing is that, you know, this was just one day. My guys were incredible the day before and the day after. And every one of those guys--I would not be here today if it wasn't for Alpha Company 22 and Third Platoon and loss--and we lost Sean Sims and Steven Faulkenburg and Ed Iwan. That's your company commander, executive officer, and Sergeant Major, okay? Think about, you know, the leadership, young lieutenants that have to go and do their job two levels up. That's traumatic loss, that's sudden loss, and it's close quarter.

It just--I love those men and I really appreciate having them in my life.

MS. CASEY: How did you escape injury, major injury? I mean, we heard a little bit about your story, but firefight, hand-to-hand combat, even.

MR. BELLAVIA: I mean, there were injuries, but I don't consider--you know, I've been hanging out with guys that have lost limbs and, you know, have--those Purple Hearts, they earn every single day.

Now, this is one day of my life, but the Purple Heart is something that these guys live with all the time, and I have a world of respect.

I have no idea. That's the awkwardness of this whole thing. You know, it just--why me? What do I--what am I supposed to do with this now? You get this gift; you get this lightning strike that you're just alive. All I wanted to do was just come home and just be a dad, and everything else, to me, was--you know, we don't fight for awards. You know what I mean? It's impossible to make that a goal.

But you know, now that I'm old, I look back and I think, you know, maybe there are injuries that we just didn't identify at the time and they come up over time.

Without the Vietnam generation, we would be all lost in the forest. The Vietnam men and women have treated us so amazing, and they didn't get that at all. They've loved us and protected us from a lot of what they went through themselves, and they're beautiful.

Please clap for Vietnam vets, yeah.

[Applause]

MR. BELLAVIA: Without that Vietnam generation putting their arm around us saying, "You going to be all right?" I don't know if we would be all right. So, we're very appreciative of those guys.

MS. CASEY: So, this evaluation process that happened, it's sort of under Ash Carter, under the Obama administration. There was, like, a let's open the books and let's evaluate award recipients and figure out, first of all, why there have been no Medal of Honor recipients prior to you from the Iraq War.

And there have been some elevations. Yours was chosen, as well. You are the only living recipient of this from the Iraq War.

MR. BELLAVIA: I'm actually--I probably, right now, could name you seven people that are worthy of the Medal of Honor from Fallujah alone; seven, right there.

I don't know what the--this award is so cloak-and-dagger, secret. You don't even know--I found out that I was nominated from a journalist. But you know, it's--for a while, you feel like Susan Lucci. You know, you're nominated for 27 years, and then you're just kind of like, "It's an honor to be nominated." You know, that's what the deal is.

I didn't know anything about the award. I didn't know what it was. Out of the blue I get a phone call that someone wants to talk about the war. And honestly, you know, I called an attorney, because I was like, "What do you want to know? What are you asking about?" You know, I'm not comfortable talking to a complete stranger. Where is this going?

And it's just such a secret process. I don't get it, but it's exhausting and they go into every nook and cranny and every detail. And honestly, I was lucky enough to have a journalist there that filmed it, and had, you know--I'm not sure what process that played in it, but it was--you know, Michael Ware from Time Magazine was a part of that story. He didn't cover the story; he was in the house. He did that with Scott Lawson and myself. So, it was pretty crazy.

MS. CASEY: So, initially, you were awarded the Silver Star.

MR. BELLAVIA: Yes.

MS. CASEY: And of course, President Trump gave you the medal this past summer.

In Afghanistan, there are 13 honorees from that conflict, and I--I'm just wondering if you have a sense of why there are 13 living honorees from Afghanistan and only one yet from Iraq.

Do you think there should still be a continued evaluation process?

MR. BELLAVIA: I think it's--I mean, we're being frank, here, right? Just you and me talking?

MS. CASEY: Just you and me.

[Laughter]

MR. BELLAVIA: All right. We made a huge mistake when we made good wars and bad wars, and a lot of Iraq veterans wear this chip on our shoulder that we don't deserve.

I wouldn't know a weapon of mass destruction if it hit me in the head, okay? I didn't choose to go to war. If you gave me a choice and a vote, I would have stayed home and I would have been with people that I care about for the rest of my life. My country asked me to serve, I served. That's what I did.

When we came home and everyone started--I remember going up to someone when I came back and I said, "Where did you serve?" And Afghanistan was like, "Thank you very much for your service." When I said Iraq, they were like, "I'm so sorry that you had to go through that."

That's garbage. That's garbage. That's shameful. We don't put policy above the valor of a generation. And I believe that there are a lot of people that wanted to forget Iraq and just put it away. Put it in a jar and let's say, "Never again. Let's be slow to war"--which we should be--"but let's never speak of this again."

And I think a lot of people, especially folks that lost their lives, are not able to--you know, their families, because of the conflict they served in, I believe, for whatever reason that came into the process, and that--

MS. CASEY: What do you think should be done to change that?

MR. BELLAVIA: Hey, listen, I don't know what power--I don't know what I can do with this thing, right, but if--I'll make the coffee right now. Let's get the guys back in the room.

Because I mean, how can you tell me that Rafael Peralta, who jumps on a grenade, is not worthy of the Medal of Honor.

How can you tell me that Brad Kasal, a First Sergeant, who is shot repeatedly, is not--so many Marines, soldiers--it's awkward.

But I'm proud to have served with the men and women I served in Iraq. I'm proud of my fight and I'm proud of who we are when we come home.

Judge us on the battlefield, but judge us when we come home, the fathers, the wives, the partners, the educators, what we're doing here is far more important than what we did in the war.

MS. CASEY: David, who did you have at the ceremony at the White House this summer? We heard that big cheer go up after President Trump placed the medal on you.

MR. BELLAVIA: Right. Okay, so, this is the coolest part of the entire thing, right? You're nervous, you're freaking out.

I made the mistake of putting a tobacco product in my mouth during the ceremony, and I was told that that is a no-no.

[Laughter]

MS. CASEY: I mean, it's kind of a big moment.

MR. BELLAVIA: I believe the President was like, "Just don't spit on the floor." And I was like, "All right, I won't do it."

So, when everyone's looking at you, they're like, "Were you getting emotional?" I was actually trying not to swallow dip juice is what I was trying not to do. That was happening.

[Laughter]

MR. BELLAVIA: But I brought 32 of my guys, my family, and Gold Star families that we lost, my interpreter that just became an American citizen was there.

And the coolest part of that entire--I don't remember a thing about the ceremony--when I asked the President, "Can I bring my guys up?" And I was allowed to bring--and it was--I don't know--I don't think he knew there was 32 of them, because it was like a clown car opened up and these guys just started falling out. The whole stage fills up with my guys and in that moment, we were young again, we were together again. And it was the most beautiful experience of my life. I really--I appreciate having that opportunity and having those guys there and, you know, bringing them into the White House. It was pretty awesome.

MS. CASEY: So, you've only had this around your neck now since June and it sounds like you've been traveling nonstop. Like, what do you see as your role right now?

Because--and how do you see this as, like--because when I was talking to you before we came on, you were sort of very humble about it, but you seem to recognize that there is a larger symbol--

MR. BELLAVIA: Yeah.

MS. CASEY: --that you now literally wear.

MR. BELLAVIA: When most of these Vietnam guys that I talk to all the time--you know, Audie Murphy was alive. There were 370 recipient when they received their awards during the Vietnam War.

We have 71. You know, just by looking at time and statistics, in 15 years, we're going to have under 20 recipients out there.

Are we really going to be--with technology and drones, are we going to have sustained combat in the future? Are we going to have, you know, tens of thousands of troops invading cities and doing--I'm not sure America really has the stomach for another 18-year conflict.

So, this is a war--going to go away? And ultimately, that's the goal, that we don't have war. So, it would be a positive thing. I just think that, when you get something like this, people tend to want to say, "What are you going to do with it? You going to go become a spokesman for a company? Are you going to go, you know"--

MS. CASEY: You've run for Congress before--

MR. BELLAVIA: I did.

MS. CASEY: --so, like, would you run for office before--right, right--

MR. BELLAVIA: I'm not go--so, now, the idea is, well, now that you have the award, now you really understand trade, you know what I mean? And that's just not the case.

I don't--I want people to experience the service. I don't care if it's in uniform, if it's out of uniform. I come out from the White House, I go to New York and I enter gay pride week in New York. And I'm literally standing in my uniform in the middle of gay pride week, and I'm thinking, "I don't know what's going to happen, here." Everyone said thank you. Everyone hugged me, shook my hand. And everyone said, "Go kick ISIS's ass," right? That's America.

We are so divided and everyone wants to talk about what separates us. What brings us together is this country, what it stands for, and the defense of it. And I want to go to every aspect of this country and tell young people, "You want to go to college? You want to better yourself? Do it in the United States Army. Make your country better, make your community better, and we'll fix this thing." You know, it's not going to be done in Washington or in your state house. It's going to be done in your neighborhood and in your community.

MS. CASEY: You are working for the Army now essentially doing just that.

MR. BELLAVIA: That's right. I'm going everywhere, rodeos--you know, I just had a BMX biker jump over my head, yesterday.

[Laughter]

MR. BELLAVIA: So, hopefully, we raise some awareness for the Army doing that, you know?

MS. CASEY: What's your message to young people? I mean, how do you talk to them? Because I'm sure they want to hear your story.

And I guess I have two questions: How do you talk to them about such a graphic story, first of all?

MR. BELLAVIA: We don't.

MS. CASEY: You don't?

MR. BELLAVIA: We don't. First of all, I want them to touch this. I want as many people to see this thing as possible so that it's not foreign.

And the other thing is we're just trying to normalize service and say, "We do this because you're worth it and we do this because we love." Americans have taught the world how to dream and we've taught the world how to fight, and we do both of those things because we love. We, you know, are surrounded by brothers and sisters that we care about, but more importantly we care about our citizens, we care about our country.

And when we come home, we just want the opportunity to continue to serve.

MS. CASEY: Yeah, but that dedication that you went to an incredibly dangerous, terrifying situation where some of your friends were killed. I mean, the second battle of Fallujah was such an intense fight.

And you are an exemplary soldier of someone who survived it, fought it, lived it. Is it hard to look a young kid in the eye and say, "Yeah, you might want to sign up for this, too"?

MR. BELLAVIA: You know, no, because what I--when I saw the--when I see these young people, a lot of these guys and girls, you know, they didn't have the home life that I had. They don't have two parents. They don't--what they're screaming for is, you know--our colleges right now, there's a mindset that we're trying to breed perpetual adolescence, right? Everyone wants to stay as young as you possibly can forever.

You want an adult coloring book? Let's do it, right? Keep the band--you're 42, you want the band? Get it back together, keep playing. Be Peter Pan.

And the world is run by adults, and the military crushes adolescence and we make adults and we make responsible people and we make people that have very broad shoulders that can handle the world.

And when I see these young people, I want them to enjoy their youth as long as they can, but when they're ready to make a difference in the world, the United States Army is going to open the door to all of those opportunities where they can use those God-given gifts, be around different people, be around different folks of all different backgrounds and find a way to get things done.

We are missing that in this society and the military breeds that.

MS. CASEY: So, you don't plan to run for office anytime soon, again?

MR. BELLAVIA: I don't--

MS. CASEY: So, you ran as a Republican in New York.

MR. BELLAVIA: Right. And I just--to me, what are you voting for? You're voting for the award.

MS. CASEY: So, you think it's really different now. Like, you think that--

MR. BELLAVIA: It's totally different.

MS. CASEY: --now that you've got it around your chest--

MR. BELLAVIA: Well, we have to be accountable. I can't just say one thing and do another. That's what people do in this town, right? I don't want to do that. I don't want to be that. I don't want to be that. I want to be accountable. I want to be--I'm a soldier--

MS. CASEY: So, it sounds like you view yourself differently now that you've received the Medal of Honor, like, you have a different level of responsibility.

MR. BELLAVIA: I owe it to 37 men who gave their lives for me. They are the reason why I'm here. They took a spot that I very easily could have taken. And that's holy to me, that sacrifice is holy. The men that I served with on that stage that I love, I want more people to understand that there is something more important in this world than ourselves.

And if we all could look at our brothers and sisters and communities and realize that, if we all pulled on the same side, what America could do, it would be incredible, and I'd like to see America return to that.

MS. CASEY: David Bellavia, thank you so much for being here. I really appreciate your service and the time you spent with us today.

[Applause]

MS. CASEY: And we know you'll have a very busy Veterans' Day, veterans' month, but happy early birthday to you, as well.

MR. BELLAVIA: Thank you.

MS. CASEY: Thank you so much to all of you for being here. If you’d like to see a full recap of this, you can go to our website, WashingtonPostLive.com.

You can also find out information about upcoming programs. Thank you very much. Thank you.

[Applause]

[End recorded session]