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February 3, 2017

Shulkin pledges not to privatize VA health care

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David Shulkin, President Trump's nominee for Veterans Affairs (VA) secretary, during a Senate committee hearing Wednesday vowed that VA's health care system would not be privatized "under [his] watch."

The Senate Committee on Veterans' Affairs could vote on whether to advance Shulkin's nomination to the full Senate as early as next week. If the committee takes too long to vote on the nomination, the full Senate can vote to invoke cloture, which allows the full chamber to consider the nomination. Fifty-one votes in the full Senate are needed to confirm Shulkin's nomination.

Shulkin is expected to easily receive full Senate confirmation, USA Today reports. If confirmed, Shulkin would be the first non-veteran to head VA and the only former Obama administration official confirmed by the Senate to serve in Trump's cabinet.

Background on Shulkin

Shulkin, a physician, has been VA's undersecretary for health since June 2015. In the position, Shulkin directs the Veterans Health Administration (VHA), which oversees the care of about nine million veterans at nearly 1,000 VA clinics nationwide.

Shulkin took over VHA following a scandal that emerged in 2014 over long wait times for veterans seeking health care and subsequent cover-up efforts.

In the scandal's wake, many conservatives have pushed to privatize VA health care. Trump during his presidential campaign also called for greater privatization of VA's health care system. Officials on Trump's transition team last month said Trump was considering a "public-private option" for the VA.

Currently, VA only will cover private health care for veterans in certain circumstances under the VA Choice Program.

Hearing details

According to the Wall Street Journal, lawmakers largely questioned Shulkin about his history with VA and how he would continue to reform the department.

Shulkin told senators he would advance reform efforts, but said he would not privatize the system. "There should be no doubt that if confirmed as secretary, I will seek major reform and a transformation of VA. But [VA] will not be privatized under my watch," he said.

When asked whether Trump might try to pressure him into privatizing the system, Shulkin said Trump "knows I will follow my values." However, Shulkin added that he and Trump both "share a common vision that we have to do a lot better for veterans."

Lawmakers also questioned Shulkin about the VA Choice Program implemented under the Veterans, Access, Choice, and Accountability Act. According to the Washington Post's "PowerPost," the program's rollout was slow and few veterans are receiving care under the program.

Shulkin acknowledged that the program was in "disarray." VA currently contracts with a third party to administer it, which Shulkin said is "an additional layer of complexity we need to take out."

Shulkin also addressed the VA secretary's power to fire employees. He indicated that widespread firings are not necessary, saying, "VA has many dedicated employees across the country."

Calling VA workers the "best in health care," Shulkin added that attacks on the department's workforce are affecting its ability to fill vacancies. According to Shulkin, there are 45,300 vacancies across the department.

In addition, Shulkin said VA needs to address its "infrastructure issues."

Shulkin said he would look at closing and consolidating underused VA facilities and "explore expansion of public-private partnerships rather than continue building medical centers that have large cost overruns and take too long to build."

Shulkin also addressed problems that he has not dealt with directly during his tenure, such as reducing the VA's backlog of disability claims. "We have to continue our work to eliminate the disability claims backlog, and we need legislation that would allow us to reform the outdated appeals process," he said.

If confirmed, Shulkin said, "There will be far greater accountability, dramatically improved access, responsiveness, and expanded care options." He added, "VA is a unique national resource that is worth saving, and I am committed to doing just that" (Kesling, Wall Street Journal, 2/1; Rein, "PowerPost," Washington Post, 2/1; Philipps, New York Times, 2/1; Yen, AP/ABC News, 2/1; Slack, USA Today, 2/1).


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