Trump’s VA pick promises shake-up

Expanded medical options but no privatization, Wilkie tells lawmakers

WASHINGTON — President Donald Trump’s pick to lead Veterans Affairs promised Wednesday to “shake up complacency” at the struggling department by expanding private care to better meet the growing health needs of veterans, but he rejected a wholesale dismantling of VA.

Robert Wilkie, currently serving as a Pentagon undersecretary, stressed the VA must work faster and better to address a rapidly growing population of veterans. He said he will not tolerate continued problems of long waits and bureaucratic delays and will strive to quickly implement a newly signed law to ease access to private health care providers.

“There are no more excuses,” he told the Senate Veterans Affairs Committee. “You have infused VA with a $200 billion budget, you have passed the Accountability Act — to shake up complacency — and you have passed the Mission Act to bring the institutional VA, community care and caregivers closer together. The future is up to the department.”

Still, he said the government-run VA could never be fully replaced by the private sector and that the quality of VA care remains high. The new law easing restrictions on private care gives the VA secretary wide authority to decide when veterans can bypass the VA, based on whether they receive “quality” care.

At his confirmation hearing, senators grilled Wilkie on the future direction of VA and whether he could stand up to the White House. The department has been paralyzed by political infighting over the role of private care for veterans, an issue that former VA Secretary David Shulkin says led to his ouster. During the 2016 campaign, Trump promised to steer more patients to the private sector, saying last July that he would triple the number of veterans “seeing the doctor of their choice.” Currently more than 30 percent of VA appointments are made in the private sector.

Wilkie said he would oppose “privatization” and continue to bolster core VA medical centers.

When pressed by Sen. Jon Tester, the top Democrat on the panel, if he would be willing to disagree with Trump, Wilkie responded “yes.”

“I have been privileged to work for some of the most high-powered people in this town,” said Wilkie, who works for Defense Secretary James Mattis and previously served under Donald Rumsfeld, President George W. Bush’s defense secretary. “They pay me for their opinions, and I give those to them.”

Wilkie is expected to be easily confirmed by the Senate. After the hearing, Sen. Johnny Isakson, the Republican chairman of the committee, said he would back Wilkie’s nomination, as did Tester, who will be steering Democratic votes for Wilkie in the narrowly divided chamber.

Trump selected Wilkie for the post last month after firing Shulkin amid ethics charges and mounting internal rebellion at VA. Trump’s replacement choice, White House doctor Ronny Jackson, was forced to withdraw his nomination after allegations of workplace misconduct surfaced.

Wilkie, 55, served as acting VA secretary after Shulkin’s firing in March, before returning to his role as Pentagon undersecretary, a post to which he was confirmed unanimously last November.

He received mostly positive reviews from veterans’ organizations, although they stressed he had a tough job ahead in fixing VA. Some senators half-joked Wednesday that he should be prepared as a VA secretary for a “public flogging,” or something similar to it, if he doesn’t work quickly to get the job done.

“Mr. Wilkie will have to prove to millions of veterans nationwide that he is up to this mammoth, sacred leadership task,” said Paul Rieckhoff, founder and chief executive of Iraq and Afghanistan Veterans of America.

In his testimony, Wilkie said he would seek to outsource more routine care to private physicians to help trim wait times for medical appointments. But he stressed his view that VA medical centers can offer unique services in treating battlefield injury.