The secretary of Veterans Affairs, David Shulkin, is not a radical by nature. Yet, as he steers the VA — a huge ship that nearly sank in scandal three years ago — he acknowledges that major changes were needed and are underway.
In an exclusive interview with i24 News, previewing a set of reforms that he and President Donald Trump will outline Thursday, Shulkin insists he is not “maintaining the status quo.” He will unveil new systems aimed at combining what the VA does well with what private medicine does best.
We have to hope that it is not only an aspiration, but is reality. The men and women who volunteer to defend this nation, and who later need health care, should be treated efficiently and with dignity, almost always at VA medical centers, but supplemented by private providers where necessary.
In addition, if for-profit clinics and hospitals have the expert doctors and staff with top equipment that veterans need, then it should be easier for veterans to secure permission to get that care.
Shulkin, who was chief executive of Beth Israel Medical Center in Manhattan before joining the VA as a senior administrator in 2015, this year decided to risk his department’s reputation by publishing measures of quality, such as waiting times, on a website: www.accesstocare.va.gov.
He is still a believer in hospitals run by federal bureaucrats. He rejects proposals he heard from men and women with vast experience in property investments and turning around businesses: that the VA would do best by closing many of its medical centers and selling the land.
It wasn’t an idle idea. Shortly after his election victory in November, Trump asked a group of his friends — people with vast fortunes, health care expertise or both — to propose solutions for the VA. Insisting on remaining behind the scenes, Trump’s informal advisers debated how best to leverage the resources of the nation’s largest health care organization. The VA has 360,000 employees at 1,200 sites, yet it is overburdened and it failed to modernize in recent decades.
A faction of the advisers favored selling the hospitals. But most of the experts consulted by Trump’s friends insisted that the VA was a valuable core for focusing efforts on treatments that veterans require, whether they be wounded, sick or elderly.
Shulkin, who started working for the VA after the scandal of long waiting times and inferior treatment erupted in 2014, says he’s confident that progress has been made.
At their news conference Thursday, he and the president will announce procedures to make it much easier to fire employees who underperform. They also aim to let more veterans be treated by private providers if a VA hospital is far away or treatments are not promptly available. Congressional approval will be required, but the Trump administration feels confident after Shulkin became the only cabinet nominee to win 100-0 confirmation by the Senate.
“We have 22 million veterans,” Shulkin says. “The country is united on this issue. The country is waiting to hear how we’re going to go about fixing this situation.”
I asked whether the White House had asked him to unveil new reforms and review what has been done in time for Trump’s 100th day as president on Saturday.
“Of course,” Shulkin responded. “What we’re trying to do is demonstrate to the American public objective evidence of the president’s commitments that he made before coming into office — and since being president.”
When it comes to trumpeting claims that the Trump presidency has been effective, Shulkin said, “We weren’t going to be left out. The VA is the second-largest government organization and is extremely important.”
Dan Raviv is senior Washington correspondent for i24 News TV.