What the Dept. of Veterans Affairs is doing to expand care and reduce veteran suicides
2019-07-11 00:00:00


JUDY WOODRUFF: Last month, the U.S. Departmentof Veterans Affairs launched its Community(1)
JUDY WOODRUFF:上个月,美国退伍军人事务部推出了社区

Care program, a major expansion designed togive veterans access to private doctors to(2)
护理计划,旨在让退伍军人获得私人医生的重大扩展

decrease wait times for health care.(3)
减少医疗保健的等待时间。

But veterans rights groups say the program'sgoals are unrealistic, and off-load the department's(4)
但退伍军人权利团体表示,该计划的目标是不切实际的,并且卸载了该部门的目标

responsibilities to the private sector.(5)
对私营部门的责任。

The $51 billion measure signed by PresidentTrump builds on legislation passed in 2014(6)
特朗普总统签署的510亿美元措施建立在2014年通过的立法之上

called Veterans Choice, which allowed veteransto seek private care.(7)
称为退伍军人选择,允许退伍军人寻求私人护理。

That came in response to a scandal at thePhoenix, Arizona, Medical Center, where at(8)
这是对亚利桑那州凤凰城医疗中心丑闻的回应

least 40 veterans died waiting months forappointments.(9)
至少有40名退伍军人在等待几个月的约会。

The Department of Veterans Affairs is thegovernment's second largest agency, with more(10)
退伍军人事务部是政府的第二大机构,拥有更多

than 300,000 employees and an annual budgetof $200 billion.(11)
超过300,000名员工,年度预算为2000亿美元。

Running it all is Robert Wilkie, the secretaryof veterans affairs.(12)
运行这一切的是退伍军人事务部长罗伯特威尔基。

And we welcome you to the program.(13)
我们欢迎您参加该计划。

ROBERT WILKIE, U.S. Secretary of VeteransAffairs: Thank you for having me, Judy.(14)
罗伯特威尔基,美国退伍军人事务部长:感谢你拥有我,朱迪。

JUDY WOODRUFF: So, you stepped into this job.(15)
JUDY WOODRUFF:所以,你进入了这个职位。

You were at the Pentagon in a high position.(16)
你在五角大楼处于高位。

ROBERT WILKIE: Yes.(17)
罗伯特威尔基:是的。

JUDY WOODRUFF: You moved over to the VA.(18)
JUDY WOODRUFF:你搬到了弗吉尼亚州。

You have been there now coming up on a year.(19)
你一直在那里出现一年。

ROBERT WILKIE: Most...(20)
罗伯特威尔基:大多数......

(CROSSTALK)
JUDY WOODRUFF: Have you been able to makesignificant progress?(21)
JUDY WOODRUFF:你有没有取得重大进展?

(CROSSTALK)
ROBERT WILKIE: I hope so.(22)
罗伯特威尔基:我希望如此。

I think what we have seen -- and I think validatingthose changes -- is that VA's been pretty(23)
我认为我们所看到的 - 我认为验证这些变化 - 就是VA非常漂亮

quiet.(24)
安静。

We have just finished embarking on the mosttransformative period in our history, at least(25)
我们刚刚完成了至少在历史上最具变革性的时期

going back to the G.I.(26)
回到地理标志

Bill.(27)
法案。

And I want to say something that our reformis not.(28)
我想说的是我们的改革不是。

It is not libertarian VA.(29)
它不是自由主义的VA。

It is not me giving a veteran a card and saying,go out in the private sector and prosper.(30)
这不是我给退伍军人一张卡片说,走出私营部门并繁荣昌盛。

What it does do is, it puts veterans on thesame plane as their neighbors.(31)
它的作用是,它将退伍军人与邻居放在同一平面上。

It allows them for the first time access tourgent care, to keep them out of emergency(32)
它允许他们第一次获得紧急护理,使他们免于紧急情况

rooms, and promote holistic health by doingthat.(33)
通过这样做,可以促进整体健康。

The other thing that it does is that it offersveterans the option of going into the private(34)
它做的另一件事是它为退伍军人提供进入私人的选择

sector, only when we can't provide them whatthey need.(35)
部门,只有当我们无法提供他们所需要的东西时。

JUDY WOODRUFF: Well, as you are, I'm sure,well aware, a number of veterans advocacy(36)
JUDY WOODRUFF:嗯,就像你一样,我很确切地知道,一些退伍军人的倡导者

groups are saying the intention may be good,but what's happening is that veterans, many(37)
团体说这意图可能是好的,但正在发生的事情是退伍军人,很多人

of them may end up in the hands of privatehealth care providers, whose care is not as(38)
他们可能最终掌握在私人医疗保健提供者手中,而他们的关心并非如此

consistent, not as -- frankly, as competentas what they might get at the VA, that the(39)
一致的,而不是坦白地说,就像他们在弗吉尼亚州可以得到的那样,那就是

VA needs to do a better job of overseeingall of this.(40)
VA需要更好地监督所有这些。

ROBERT WILKIE: Well, I think we are.(41)
罗伯特威尔基:嗯,我想我们是。

We don't allow that people into our systemunless we have fully vetted them.(42)
除非我们对他们进行全面审查,否则我们不允许这些人进入我们的系统。

The other thing that...(43)
另一件事......

JUDY WOODRUFF: You mean in the private sector?(44)
JUDY WOODRUFF:你的意思是私营部门?

ROBERT WILKIE: In the private sector.(45)
罗伯特威尔基:在私营部门。

JUDY WOODRUFF: OK.(46)
JUDY WOODRUFF:好的。

ROBERT WILKIE: We have just certified 4,500urgent care facilities across the country.(47)
ROBERT WILKIE:我们刚刚在全国范围内认证了4,500个紧急护理设施。

My goal is to certify 7,000.(48)
我的目标是认证7,000。

But what we are seeing is, veterans are votingwith their feet.(49)
但我们所看到的是,退伍军人正在用脚投票。

I have seen the explosion in requests forurgent care.(50)
我看到紧急护理请求的爆炸式增长。

I haven't seen that in the explosion and requestsfor other medical care in the private sector.(51)
我没有在爆炸中看到这一点,并要求私营部门提供其他医疗服务。

Our statistics show us that our veteran satisfactionrate is at an all-time high.(52)
我们的统计数据显示,我们的退伍军人满意度处于历史最高水平。

It's about 89.7 percent.(53)
这个比例约为89.7%。

So they're voting with their feet to staywith us.(54)
所以他们用脚投票与我们在一起。

JUDY WOODRUFF: But, at the same time, youhave veterans groups, they're -- we talk to(55)
JUDY WOODRUFF:但是,与此同时,你有退伍军人团体,他们是 - 我们交谈

them.(56)
他们。

ROBERT WILKIE: Right.(57)
罗伯特威尔基:对。

JUDY WOODRUFF: A number of them are sayingthe responsibility here ultimately lies with(58)
JUDY WOODRUFF:其中一些人说这里的责任最终归于此

the VA, and they want to make sure the VAisn't trying to push this responsibility off(59)
弗吉尼亚州,他们希望确保弗吉尼亚州不会试图解除这一责任

on somebody else.(60)
在别人身上

ROBERT WILKIE: Well, it's an interesting argument,because it's a variation on the privatization(61)
罗伯特威尔基:嗯,这是一个有趣的论点,因为它是私有化的变种

argument, which was raised when MISSION wasbrought up in the Congress.(62)
在国会提出任务时提出的论点。

And this is an act that only had four negativevotes in the United States Senate.(63)
这是一项在美国参议院只有四票反对票的行为。

I just presented the largest budget in thehistory of this department to the Congress,(64)
我刚刚向国会提交了这个部门历史上最大的预算,

$220 billion, calling for 390,000 employees.(65)
2200亿美元,需要390,000名员工。

That's a very strange way to privatize care.(66)
这是一种非常奇怪的私有化护理方式。

I think we're expanding care, and we're expandingcare in a good way.(67)
我认为我们正在扩大护理,我们正在以一种好的方式扩大护理。

JUDY WOODRUFF: Mental health, a big part ofthis story that we're talking about.(68)
JUDY WOODRUFF:心理健康,这是我们谈论的这个故事的重要部分。

Mental health problems for veterans, we know,are still enormous in this country.(69)
我们知道,退伍军人的精神健康问题在这个国家仍然是巨大的。

Suicide rate among veterans has been -- hasstayed at a disturbing number, 20 a day.(70)
退伍军人的自杀率一直保持在令人不安的数字,每天20。

Why has that been so hard to tackle?(71)
为什么那么难以解决?

ROBERT WILKIE: Well, I think it's been hardto tackle because the majority of those veterans(72)
罗伯特威尔基:嗯,我认为这很难解决,因为大多数退伍军人

who are taking their lives are not part ofthe VA system.(73)
谁正在夺走他们的生命并不属于VA体系。

Now, some of them are on active duty.(74)
现在,其中一些人正在现役。

Some are in the Guard.(75)
有些人在警卫队。

A significant number come from the Vietnamera and have never had any contact with us(76)
相当多的人来自越南时代,从未与我们有任何联系

by their own volition.(77)
靠自己的意志。

Our job is to do a couple of things.(78)
我们的工作是做一些事情。

One, it is to begin a national conversation.(79)
一,是开始全国性的对话。

And if we just focus on the last tragic actin a veteran's life, we're never going to(80)
如果我们只关注老兵生命中最后的悲剧行为,我们永远不会去

get anywhere.(81)
到处都是。

We have to look at mental health.(82)
我们必须关注心理健康。

I have said that we're not even at the Sputnikstage in this country when it comes to talking(83)
我已经说过,在谈到这个问题时,我们甚至都没有进入这个国家的人造卫星阶段

about mental health.(84)
关于心理健康。

The other thing we need to do is take a hardlook at addiction and how we treat those who(85)
我们需要做的另一件事是仔细研究成瘾以及我们如何对待那些人

need care for pain, and make sure that they'renot addicted to the medicine that's supposed(86)
需要关心疼痛,并确保他们不会对所谓的药物上瘾

to help.(87)
帮助。

JUDY WOODRUFF: So, we know President Trumpsigned a proclamation made, moves with regard(88)
JUDY WOODRUFF:所以,我们知道特朗普总统签署了一份公告,并在此方面采取行动

to suicide among veterans last spring.(89)
去年春天退伍军人自杀。

ROBERT WILKIE: Yes.(90)
罗伯特威尔基:是的。

Yes.(91)
是。

JUDY WOODRUFF: But, still, this is an entrenchedproblem.(92)
JUDY WOODRUFF:但是,这仍然是一个根深蒂固的问题。

Should President Trump make a high-profilespeech, raise the level of visibility of this...(93)
特朗普总统是否应该高调发言,提高这一点的知名度......

(CROSSTALK)
ROBERT WILKIE: Well, I think he has.(94)
罗伯特威尔基:嗯,我认为他有。

And I think by calling attention and callingforth a whole-of-government approach to suicide(95)
我认为通过引起注意并呼吁采取整体政府的自杀方式

in a way that we have never had it, he israising the profile of this issue.(96)
他以一种我们从未拥有过的方式,提升了这个问题的形象。

I sit at the head of a task force that includesHHS, HUD, NIH, Indian Health, and the goal(97)
我坐在一个包括HHS,HUD,NIH,印度健康和目标的工作组的负责人

is to have this national conversation at theend of the process, open the aperture in terms(98)
就是在这个过程结束时进行这个全国性的对话,打开光圈

of financial and educational support to allelements in the country, tribes, states and(99)
对国家,部落,州和国家的所有成员提供财政和教育支持

localities, to help them help us address thisissue.(100)
各地,帮助他们帮助我们解决这个问题。

One thing we are doing, though, that has changed,we provide same-day mental health services.(101)
但是,我们正在做的一件事情已发生变化,我们提供当天的心理健康服务。

We have spent tens of millions of dollarson outreach.(102)
我们花了数千万美元进行外展活动。

We are taking it seriously.(103)
我们正在认真对待它。

It is our number one clinical priority.(104)
这是我们的首要临床优先事项。

JUDY WOODRUFF: A piece of this, as you know,is homelessness.(105)
JUDY WOODRUFF:正如你所知,其中一部分是无家可归者。

ROBERT WILKIE: Yes.(106)
罗伯特威尔基:是的。

JUDY WOODRUFF: It's one of the ways thosewith mental illness deal with what they're(107)
JUDY WOODRUFF:这是精神病患者应对的原因之一

going through.(108)
经历。

And President Trump made a comment not longago.(109)
特朗普总统不久前发表了评论。

Wasn't just talking about veterans.(110)
不仅仅是在谈论退伍军人。

He was talking about homelessness broadlywhen he described it as a new phenomenon.(111)
当他把它描述为一种新现象时,他大致谈论无家可归。

He said it's only been around for two years.(112)
他说它只存在了两年。

He described it as something almost politicallyaimed at him.(113)
他把它描述为几乎在政治上针对他的东西。

Do you agree with his interpretation?(114)
你同意他的解释吗?

ROBERT WILKIE: Well, I agree that homelessnessis part of this continuum that we have to(115)
罗伯特威尔基:嗯,我同意无家可归是我们必须要做的这个连续统一体的一部分

deal with when it comes to not only takingcare of our veterans, but also in addressing(116)
处理不仅要照顾我们的退伍军人,还要处理

suicide.(117)
自杀。

I will say...(118)
我会说...

JUDY WOODRUFF: But that it's new?(119)
JUDY WOODRUFF:但这是新的吗?

ROBERT WILKIE: Well, no, I wouldn't say thatit's new.(120)
罗伯特威尔基:嗯,不,我不会说这是新的。

But I will say that the numbers have gonedown.(121)
但我会说数字已经下降了。

Several years ago, we were looking at hundredsof thousands on the street.(122)
几年前,我们在街上看到成千上万的人。

Today, we're looking, tragically, at about40,000.(123)
今天,我们悲惨地看着大约40,000。

But cities that you know very well, Atlanta,Houston, New Orleans, have eliminated veterans(124)
但是你熟悉的城市,亚特兰大,休斯顿,新奥尔良,已经淘汰了退伍军人

homelessness by getting in partnership notonly with the VA, but with charities and non-governmental(125)
无家可归者不仅与弗吉尼亚州合作,而且与慈善机构和非政府组织建立伙伴关系

organizations.(126)
组织。

Most of our homelessness is concentrated inone area of the country.(127)
我们大多数无家可归者集中在该国的一个地区。

And that's the West Coast.(128)
这就是西海岸。

JUDY WOODRUFF: And -- but do you -- and youfeel progress?(129)
JUDY WOODRUFF:而且 - 但是你 - 你觉得有进步吗?

ROBERT WILKIE: Oh, I -- much progress -- 40,000compared to the hundreds of thousands a few(130)
罗伯特威尔基:噢,我 - 取得了很大的进步 - 相比之下,成千上万的人只有40,000人

years ago is progress.(131)
几年前是进步。

But we still have to work on it.(132)
但我们仍然需要努力。

JUDY WOODRUFF: Women, they are the fastestgrowing demographic in the U.S. military,(133)
JUDY WOODRUFF:女性,她们是美国军队中增长最快的人口,

more women serving in combat than ever before.(134)
在战斗中服役的女性比以往任何时候都多

ROBERT WILKIE: Absolutely.(135)
罗伯特威尔基:绝对。

JUDY WOODRUFF: That means more women becomingveterans, coming under the purview of the(136)
JUDY WOODRUFF:这意味着更多的女性成为退伍军人,属于女性的职权范围

VA.(137)
VA。

ROBERT WILKIE: Yes.(138)
罗伯特威尔基:是的。

JUDY WOODRUFF: Again, what we're hearing fromsome of these veterans groups is, women veterans(139)
JUDY WOODRUFF:同样,我们从这些退伍军人团体中听到的是,女退伍军人

tell them, when they go into a treatment center,they often feel disrespected.(140)
告诉他们,当他们进入治疗中心时,他们常常感到不尊重。

They even feel hostility toward them.(141)
他们甚至对他们充满敌意。

At the same time ,a month ago, there was astudy done by an internal government watchdog(142)
与此同时,一个月前,内部政府监管机构进行了一项研究

group that found more harassment of womenand men at the VA over a recent two-year period(143)
最近两年内在弗吉尼亚州发现更多女性和男性骚扰的群体

than any other government agency.(144)
比任何其他政府机构。

ROBERT WILKIE: Well...(145)
罗伯特威尔基:嗯......

JUDY WOODRUFF: Pull that together.(146)
JUDY WOODRUFF:把它拉到一起。

ROBERT WILKIE: Right.(147)
罗伯特威尔基:对。

Well, if you look at that study, that harassmentis not coming from VA employees.(148)
好吧,如果你看一下这项研究,那骚扰不是来自VA员工。

I can't -- I can't change the perception ofolder veterans who are not used to seeing(149)
我不能 - 我不能改变那些不习惯看的老年人的看法

women in uniform.(150)
穿制服的女性。

What I can say is that, in this budget, $9.5billion is set aside for women's care.(151)
我可以说的是,在这个预算中,95亿美元用于妇女的护理。

Each one of our hospitals has a women's clinic.(152)
我们每家医院都有一家女性诊所。

The culture is changing rapidly.(153)
文化正在迅速变化。

The notion that I, as a youngster, would haveever seen women wearing the red beret of my(154)
我作为一个年轻人,曾经见过女人穿着我的红色贝雷帽的想法

father's division, the 82nd Airborne Division,would have been -- that would have been unheard(155)
第82空降师的父亲部门本来是 - 这本来是闻所未闻的

of.(156)
的。

Today, they are.(157)
今天,他们是。

And I think the military as a whole is changingwith that culture.(158)
我认为整个军队正在改变这种文化。

And VA now, with 10 percent of those we servebeing veterans, and having those clinics in(159)
现在,弗吉尼亚州,我们服务的人中有10%是退伍军人,并拥有这些诊所

all of our hospitals, is changing with thosetimes.(160)
我们所有的医院都在随着时代而变化。

JUDY WOODRUFF: But how do you change thoseattitudes?(161)
JUDY WOODRUFF:但你如何改变这些态度?

ROBERT WILKIE: Well, you change that by -- it'sa cultural change.(162)
罗伯特威尔基:嗯,你改变了 - 这是一种文化变革。

And you also change it by confronting thosewho engage in that kind of behavior.(163)
你也可以通过面对那些参与这种行为的人来改变它。

Again, it's not our employees.(164)
同样,这不是我们的员工。

It's people who come in.(165)
这是进来的人。

And there are still elements in this countrywho refuse to accept that the times have changed,(166)
这个国家仍有一些人拒绝接受时代的变化,

that women are warriors on the front linein numbers that we have never experienced(167)
女人们是我们从未体验过的前线战士

before.(168)
之前。

JUDY WOODRUFF: And what about the harassmentinside the Veterans Administration?(169)
JUDY WOODRUFF:退伍军人管理局内部的骚扰怎么样?

ROBERT WILKIE: Well, that's one -- if we seeit, we act on it.(170)
罗伯特威尔基:嗯,那是一个 - 如果我们看到它,我们会采取行动。

And I read that report.(171)
我读了那份报告。

And, again, it is an instance of people whohave not caught up with the times.(172)
而且,这是一个没有赶上时代的人的例子。

But it's certainly not a part of our employeemakeup.(173)
但它肯定不是我们员工构成的一部分。

JUDY WOODRUFF: Robert Wilkie, who is now comingup on one year as secretary of veterans affairs,(174)
JUDY WOODRUFF:罗伯特威尔基,他现在担任退伍军人事务秘书一年,

thank you very much.(175)
非常感谢你。

ROBERT WILKIE: Thank you, Judy.(176)
罗伯特威尔基:谢谢你,朱迪。

Thank you very much.(177)
非常感谢你。


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