While he ruled out privatization, David Shulkin did promise "major reform and a transformation of VA." | John Shinkle/POLITICO Veterans Affairs nominee rules out VA privatization

President Donald Trump's nominee to be secretary of Veterans Affairs pledged on Wednesday to resist privatization of the department while continuing a push for overhaul.

In a largely uncontroversial confirmation hearing before the Senate Veterans' Affairs Committee, David Shulkin faced early questions from Democrats about privatization. But the undersecretary of health, called VA "a unique national resource that is worth saving."


"There will be far greater accountability, dramatically improved access, responsiveness and expanded care options, but the Department of Veterans Affairs will not be privatized under my watch," Shulkin testified.

Democrats have warned that Trump's campaign promises to allow veterans to seek medical treatment outside the VA system would be a step toward privatizing the department. But Shulkin, a physician, told senators that in his discussions with Trump before his selection as VA secretary, he told Trump "I'm a strong advocate of the VA" when the topic of privatization came up.

"The fact is the president's talked about privatization," said Sen. Sherrod Brown (D-Ohio). "I think it's important that all the [veterans service organizations] ... that think the VA should remain a public system ... continue to speak out."

Republicans, however, pushed back on the notion that they would consent to privatization.

"We've made it clear there's no privatization of the VA," the panel's chairman, Sen. Johnny Isakson (R-Ga.) said.

During the hearing, Sen. Thom Tillis (R-N.C.) asked for a show of hands among veterans in the audience who support complete privatization of the VA. No hands went up.

"Anyone in this body who tells you that there's a movement afoot to privatize the VA has either been misled or is trying to mislead you," Tillis told Shulkin.

While he ruled out privatization, Shulkin did promise "major reform and a transformation of VA."

"If confirmed, I intend to build a system that puts veterans first and allows them to get the best possible health care wherever it may be — in VA or with community care," Shulkin testified.

Under questioning from Sen. Bernie Sanders (I-Vt.), Shulkin said the VA has just over 45,000 openings, mostly within the department's health care system. But when pressed by Sanders about how Trump's recent hiring freeze had affected the department, Shulkin said roughly 37,000 of those position were exempted due to public safety.

He also said the establishment of the Veterans Choice Program in 2014, aimed at cutting wait times for medical appointments, had added complexity for veterans trying to access care. The VA, he said, "needs to take back customer service and scheduling" from third-party administrators.

Shulkin also said the VA is in "desperate need" of an overhaul of the growing backlog of benefits claims appeals.

"It is a broken process," Shulkin told the panel's ranking Democrat, Sen. Jon Tester of Montana. "It will not get better without your help."

Shulkin acknowledged the VA's 2014 wait-times scandal had "eroded" veterans' confidence in the department — and vowed to regain it.

"One of the things that I think most people would tell you about me is I don't have a lot of patience, and I am going to be serious about making these changes and regaining that trust," Shulkin said. "And if I don't do that, I should be held accountable and you should replace me."

Darius Tahir contributed to this report.