VA nominee David Shulkin vows faster improvement, more choices for veterans
WASHINGTON — David Shulkin, President Trump’s nominee to lead the beleaguered Department of Veterans Affairs, is pledging to accelerate improvements in the agency and provide veterans more care in the private sector.
At his confirmation hearing Wednesday, Shulkin said “there should be no doubt” that he will seek “major reform and transformation of the VA.”
Shulkin, as the only Obama appointee among Trump’s Cabinet nominees, is walking something of a tightrope, outlining what he will do differently under Trump, while at the same time assuaging the fears of Democrats and some veterans' groups that VA services will be privatized.
“There will be far greater accountability, dramatically improved access, responsiveness and expanded care options, but the Department of Veterans Affairs will not be privatized under my watch,” he said. “If confirmed, I intend to build a system that puts veterans first and allows them to get the best possible health care and services, wherever it may be — in VA or community care.”
Trump promised a major overhaul of the VA during the campaign, and his plan includes allowing veterans to get VA-paid care in the private sector if they choose. Currently, they can only do that if they can’t get a VA appointment within 30 days or live more than 40 miles from a VA facility. The plan also includes creating a 24-hour hotline for VA complaints, convening a commission to investigate misconduct and swiftly holding employees accountable for wrongdoing.
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Shulkin, whom Obama tapped to be VA undersecretary for health in 2015, said that during his tenure, the percentage of care provided in the private sector grew from 21% to 31%.
“Should I be confirmed, I intend to build an integrated system of care that would strengthen services within the VA that are essential for veteran well-being and use services in the community that can serve veterans with better outcomes and value to the taxpayer,” Shulkin said.
He has previously said he favors a hybrid model where the VA provides care that it specializes in — such as treatment for post-traumatic stress disorder, traumatic brain injuries and loss of limbs, for example — but potentially discontinues other services that the private sector may better provide, such as obstetrics and gynecology.
Shulkin said he would work with Congress to expand and overhaul the so-called choice program, which approves and funnels veterans into VA-sponsored private sector care. Congress passed a law authorizing the program in 2014 after the VA was rocked by revelations that schedulers at the Phoenix VA kept secret wait lists, masking how long veterans were waiting for care and at least 40 veterans died while they waited.
But the choice program has been rife with problems — an inspector general report released this week found it was hampered by “cumbersome authorization and scheduling procedures, and inadequate provider networks.” During the program's first year, it took 42 days on average for veterans to be seen in the private sector — 12 days longer than the reason for the program in the first place, which was to get veterans appointments within 30 days.
Shulkin said improvements have been made since the inspector general's review but more needs to be done. He did not detail exactly what fixes need to be made during the hearing, but said that in general, there is too much bureaucracy and he will present to Congress an alternative plan if he is confirmed.
He said he will need congressional help, whether through funding or legislation, to fix many of the problems still plaguing the VA, including for hiring and retaining good staff and firing substandard workers. Shulkin said information technology needs to be overhauled at the VA and the appeals process for benefits claims modernized.
"There's a lot of very, very good work that’s been done that we want to build upon, but as secretary, it would be my job to make sure that you allow me to have the tools and the resources and the authority to be able to get this work done and to make the progress that we need to make," he said. "And I expect to be held accountable if you give me that authority and I'm not getting the job done."
As one of the least controversial of Trump's Cabinet picks, Shulkin is expected to be easily confirmed. Senate VA Committee Chairman Sen. Johnny Isakson, R-Ga., said Wednesday that he hopes to vote on the nomination next week.
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