Somewhere between honoring the memory of Martin Luther King Jr. and the inauguration of our 45th president, the future of the Department of Veterans Affairs is waiting to emerge from its present state of despair. As Dr. King famously stated in his “I have a dream” speech in Washington, D.C., over 50 years ago, “out of the mountain of despair, a stone of hope.”
For many veterans and their families, Dr. David Shulkin, recently nominated to President-elect Donald TrumpDonald TrumpPence: Supreme Court has chance to right 'historic wrong' with abortion ruling Prosecutor says during trial that actor Jussie Smollett staged 'fake hate crime' Overnight Defense & National Security — US, Iran return to negotiating table MORE to head the VA, is that stone of hope. Although some in the veterans community felt that Shulkin was a surprising pick to head the VA — after all, how could a political appointee from the Obama administration be considered “draining the swamp” — the general attitude toward his nomination is one of cautious optimism.
Shulkin has been praised as a “turnaround artist,” “a committed leader” who is “respected by the entire veterans community” and “authentic and ... unflinchingly candid.” However, he has also been criticized for being likely to keep numerous Senior Executive Service officials in place, some of whom are viewed as being responsible for the department’s current woes.
Trump Veterans Affairs nominee, David Shulkin, was confirmed unanimously in 2015 for his current VA post. https://t.co/lBo74JTvls— Post Politics (@postpolitics) January 11, 2017
At first glance, there are certainly a few things Shulkin gets right. A review of his stated priorities include better access to care, restoring the public’s trust in the department, better business practices and employee engagement. In addition, his clinical priorities of focusing on veterans' mental health, tele-health, and better oversight of opiate prescriptions are all areas requiring continued improvement at the VA. These, of course, are all good priorities for the VA to have.
However, Shulkin may lose some of his hopeful supporters if he ends up making the same mistakes that some of his predecessors have, by focusing too narrowly on certain subsets of the agency or trying to gloss over real issues with rosy statistics that are quickly and easily disproven.
First, Shulkin must be mindful of the president-elect’s priority of allowing veterans greater access to healthcare from non-VA providers, if that is their preference. The notion of expanded access to care was much discussed on the campaign trail, and was also a priority of the previous two Congresses, as evidenced by the Choice Act passed in 2014 and its subsequent revisions.Since that time, access to outside care has proven difficult to implement due to VA’s unwillingness to acknowledge some of its own shortcomings, as well as the associated red tape and bureaucracy that has unfortunately come to be expected when dealing with the federal government. Shulkin must show that he is willing to tackle this challenge head on, and show critics that greater access to outside care does not mean that the VA will be privatized or done away with entirely.
Second, Shulkin must quickly get up to speed on VA’s two other subsets: the Veterans Benefits Administration (VBA) and the National Cemetery Administration (NCA). Few have questioned Shulkin’s commitment to the Veterans Health Administration; however, both the VBA and NCA also require the leadership and guidance of a dedicated secretary. Shulkin must show a willingness to set priorities for these business lines he does not yet have firsthand experience with.
Corruption and a lack of accountability have plagued the VA for years—resulting in poor health care for veterans. https://t.co/4d1gJbVIDn— Heritage Foundation (@Heritage) January 17, 2017
Specifically, the Obama administration outlined appeals reform of disability benefits claims as a top priority, and despite efforts to pass such legislation, failed to do so before the end of the 114th Congress. Shulkin would be wise to note the continuing issues with the VA appeals process, but also to take note of why the reform package did not pass, and be open to new ideas for reform as opposed to simply rubber-stamping the appeals reform package of his predecessor.
Finally, although the NCA is generally regarded as the least controversial branch of the VA, it did experience several issues related to mismarked graves and prohibited procurement practices under the Obama administration.
Of course, some of Shulkin’s success in these areas is largely dependent on the other political appointees he is able to surround himself with — a process not entirely within his control.
As he recently noted with regard to the newly appointed director of the Phoenix VA Medical Center, “we don’t have a lot of people volunteering to go to Phoenix.” Similarly, and as evidenced by Trump’s lengthy search for a VA secretary, qualified folks aren’t lining up and volunteering to become political appointees to the troubled bureaucracy either. Nonetheless, as was also stated by Dr. King, “the ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.”
The VA is no stranger to times of challenge and controversy, and we must all remain hopeful that Shulkin is up for the task of truly reforming it.
Rory E. Riley-Topping has dedicated her career to ensuring accountability within the Department of Veteran’s Affairs (VA) to care for our nation’s veterans. She is principal at veterans advocate Riley-Topping Consulting and has served as in a legal capacity for the U.S. House of Representatives Comittee on Veterans Affairs and for the National Veterans Legal Services Program.
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