Donald Trump won the White House pledging to use his business acumen to overhaul the Department of Veterans Affairs, the poster child for government mismanagement — even if he has to "pick up the phone and fix it myself."

But Trump’s leading candidates to run the troubled Cabinet department strike fear in many veteran's advocates, current and former agency officials and members of Congress, who worry that the new administration will aim to gut the VA and privatize many of its services.


Whether Trump chooses Sarah Palin, former Texas Gov. Rick Perry, conservative activist Peter Hegseth, outgoing Rep. Jeff Miller or former Massachusetts Sen. Scott Brown — all reported to be in the running — the advocates say they are bracing for an ideological assault on the $180 billion-a-year agency with 350,000 employees.

"The worst case scenario within the vets community is a total dismantling of everything they worked generations to create," said Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America, who has been critical of the VA. "There is a growing fear it is all going to get burned down."

"Privatization is an experiment," he added. "Is that an experiment we want to take in the middle of a war with demand about to skyrocket?"

The concerns played out Thursday in a "listening session" that Trump transition officials held with more than 30 veterans' groups at the headquarters of the American Legion in Washington.

The veterans' representatives "all talked about having a healthy VA," Verna Jones, executive director of the American Legion, which represents 2 million veterans and participated in the session, told POLITICO. "There were people who talked about making sure the VA was intact. Veterans deserve to go to the VA. We oppose privatization."

Trump has said his strategy for fixing the VA "doesn’t have to be privatization," although he has proposed allowing veterans to get government-funded health care outside the system — offering veterans an escape from long waits and providing an incentive for the agency to improve.

But the leading candidates for the post have gone much further. Hegseth, for example, helped found Concerned Veterans for America, a conservative group funded by the industrialist Koch brothers that last year proposed turning the VA into an “independent, government-chartered nonprofit corporation.” Hegseth met with Trump earlier this week.

Miller, a Florida Republican who chairs the House Committee on Veterans Affairs, wants to make it easier to fire poor-performing VA employees and supports expanding a pilot project allowing private health care for veterans who face unreasonable waits in the government-run system. Likewise, Perry said last year that "a lot of the solutions dealing with the VA are to be to privatize, to allow those veterans to be able to get that health care at their local clinics."

Opponents of privatization find all those choices alarming — Hegseth in particular.

Picking Hegseth "would signal a real intent to fundamentally change the agency," said Phillip Carter, a retired Army officer and director of the military, veterans and society program at the Center for a New American Security, who also advised President Barack Obama on veterans' issues.

“Personnel is policy,” Rep. Mark Takano of California, the acting ranking Democrat on the House Veterans Affairs Committee, told POLITICO. He added: "Radical change is really unnecessary and a misuse of what Donald Trump thinks is his mandate."

Hegseth declined to be interviewed, but Dan Caldwell, the Concerned Veterans for America's legislative director, said his critics are misrepresenting "what we are actually proposing."

“We have been disappointed with the rhetoric from these organizations, and we think it is pressure from the Obama administration and the current VA secretary not to work with us,” Caldwell said.

The VA was founded in 1930 by combining the Veterans' Bureau, the Bureau of Pensions and the National Homes for Disabled Volunteer Soldiers. It was elevated to the Cabinet-level Department of Veterans Affairs in 1988 and is now headed by Robert McDonald, the former CEO of Procter & Gamble.

Trump's transition team, on its website, is promising to "transform the Department of Veterans’ Affairs to bring it into the 21st Century."

That is music to the ears of many veterans who have experienced long wait times at VA hospitals and clinics around the country and a nightmare of red tape to get disability payments, subsidized home loans, education and other benefits.

But some of Trump's own statements — he called the VA “the most corrupt agency in the United States" — and those of his leading candidates to run the agency have signaled not just a desire for reform but a wholesale re-engineering.

And that would almost certainly set off a brawl both on Capitol Hill and with the nonprofit, nonpartisan advocacy groups known as veterans services organizations, which want better care and more choices but are almost unanimous that the VA system must remain the primary caregiver and supporter of the nation’s more than 20 million veterans. Of those vets, 9 million are enrolled in the VA health system.

The fears of radical change have ebbed and flowed since the Republican presidential primary, when candidate Dr. Ben Carson proposed eliminating the federal health care system for veterans altogether.

Leading veterans organizations called that idea "dangerous," and in an open letter to the presidential candidate asked: "Dr. Carson, do you really think that veterans would be better off today had VA not existed, or that they would be better cared for in the future in a world without a national VA system dedicated to their unique and often complex needs?"

Trump has insisted that what he wants is not to hand the veterans’ support mission entirely to the private sector. "No, it doesn’t have to be privatization," he said in May. "What it has to be is when somebody is on line and they say it’s a seven-day wait, that person’s going to walk across the street to a private doctor, be taken care of, we’re gonna pay the bill."

He has also proposed that all veterans be able to use their veterans' IDs to get care at any hospital or doctor's office that accepts Medicare. "The power to choose will stop the wait time backlogs and force the VA to improve and compete if the department wants to keep receiving veterans’ health care dollars," his campaign website said.

But veterans’ groups see that as a major step toward privatization because it would allow veterans to opt out of the VA health care system. That is different from the recommendations of a recent federal Commission on Care, which pushed for the VA to oversee a network of qualified private health care providers to supplement VA-run hospitals and clinics.

Veterans’ leaders see it as positive that Trump insists he does not want privatization. But they say several of his leading candidates for the VA post are not encouraging.

Rieckhoff, of Iraq and Afghanistan Veterans of America, was especially critical of Hegseth. "If that guy is in charge there is going to be an ideological war with just about every major veterans service organization," he said.

He was equally critical of Miller, who has been a close ally of Hegseth and one of the agency's fiercest critics. "Jeff Miller is in with CVA," Rieckhoff said. "He pushed their talking points, he pushes their bills."

In calling for new authority to fire agency employees who don't perform, Miller told Fox News: “You can’t have a World Series-winning team if you are not willing to get rid of those who can’t or won’t play their positions.”

In a recent interview with POLITICO, Miller also highlighted the need for more private care for veterans. That includes expanding a pilot project known as the Choice Program for people in the veterans’ health care system who have to wait 30 or more days for an appointment.

"Mr. Trump is committed to changing the way the department does business," Miller said, "and looking at avenues to resource and to expand the Choice Program."

He added: "Donald Trump comes with a totally clean slate, not bound by any preconceived notions as to what works, what doesn't work."

Others potential contenders for the VA post are Brown and Palin, who have both also called for more private health care options for troops but have views that are less fleshed out.

The veterans’ groups clearly don't want radical change.

"I think the transition team will be learning as we go forward," said Bob Wallace, adjutant general of the Veterans of Foreign Wars who was on hand for Thursday's session. "There are a lot of good things that have happened in the VA in the past few years to improve things. Bob McDonald has done a great job of moving the VA forward."

Sherman Gillums, executive director of Paralyzed Veterans of America, who also participated in the session with the Trump team, said finding the right mix between public and private care is "one of the most critical and confounding issues that the administration will likely face where veterans are concerned."

"How do we expand private sector healthcare for the majority of veterans who need timely access to care without diminishing the access to and quality of specialized care services for the most vulnerable veterans who rely on VA for lifelong care?" he asked.

Jim Wright, a former president of Dartmouth University and historian on the veterans’ movement, points to recent independent studies showing that the VA provides health care that is as good or better than in the private sector. Where the agency has failed is providing better access to that care.

"There needs to be more choice but I think the private sector should not be the first choice," he said. "We have to attach a priority to looking after the veteran. They need a dedicated agency and that agency needs to rededicate itself. There is a lot of focus on the recent veterans but the older veterans who are served most by the VA have a different set of needs. Some are quite pressing."

Connor O'Brien contributed to this report.