Dr. David Shulkin, President Trump’s nominee for Secretary of Veterans Affairs, was unanimously confirmed by the Senate on Monday.  Shulkin was previously the undersecretary for health services under the Obama administration.  During his nomination hearings, Shulkin indicated a flexibility regarding care options between the private sector and what he referred to as core VA services, which he seeks to strengthen and improve.  Work is needed on access, accountability, responsiveness, and widening of care options, but Shulkin shied away from any notion that privatization of VA medical care would be a possibility.

Trump articulated a ten-point plan for VA reform during the campaign, citing the following as steps he would take as President to bring about change to the bureaucratic juggernaut that is the modern Veterans Administration:

1. Appoint a VA Secretary whose sole purpose will be to serve veterans. Under a Trump Administration, the needs of D.C. bureaucrats will no longer be placed above those of our veterans.

2. Use the powers of the presidency to remove and discipline the federal employees and managers who have violated the public’s trust and failed to carry out the duties on behalf of our veterans.

3. Ask that Congress pass legislation that empowers the Secretary of the VA to discipline or terminate any employee who has jeopardized the health, safety or well-being of a veteran.

4. Create a commission to investigate all the fraud, cover-ups, and wrong-doing that has taken place in the VA, and present these findings to Congress to spur legislative reform.

5. Protect and promote honest employees at the VA who highlight wrongdoing, and guarantee their jobs will be protected.

6. Create a private White House hotline, which will be active 24 hours a day answered by a real person. It will be devoted to answering veteran’s complaints of wrongdoing at the VA and ensure no complaints fall through the cracks.

7. Stop giving bonuses to any VA employees who are wasting money, and start rewarding employees who seek to improve the VA’s service, cut waste, and save lives.

8. Reform the visa system to ensure veterans are at the front of the line for health services, not the back.

9. Increase the number of mental health care professionals, and allow veteran’s to be able to seek mental health care outside of the VA.

10. Ensure every veteran has the choice to seek care at the VA or at a private service provider of their own choice. Under a Trump Administration, no veteran will die waiting for service.

Shulkin indicated that he is ready and willing to work as Secretary to accomplish these goals.  Time will tell how successful he (and the President) will be in making these changes, some of which are fundamental differences that may be difficult to effectuate with the often glacial pace of change in the VA.