Trump picked the wrong guy for the VA. Shulkin is a stooge and nothing but an apologist for the VA. This is truly a head scratcher.
I said this before: put Ivanka in charge and let Shulkin's dumb ass just be a mouth piece to Congress. If not Ivanka then someone else willing to break a foot off in the asses of the SES positions within the VA.
VA still cooks the books on wait times and all that as well. I can post numbers and parts of my own medical record to demonstrate this.
Unless an ass kicker like Jesse Ventura or Ivanka or someone like that takes over the VA, the best thing to do would be to shudder the whole system, give VA employees the option of a retirement package or severance, and just give Veterans an ID card and have the govt agree to cover 75% of standard costs for everything. Most Vets could afford the 25% left over for medication and many hospitals and doctors offices over charge to such a degree that getting 75% guaranteed would actually be a good deal for them and they likely wouldn't put any bill to the Vet at all.
As taxpayers we would save a bundle due to not having operating costs from the VA centers, and those savings would multiply after those that retire from the VA pass on to other careers or whatever. And Vets would be able to find doctors in their local areas. People don't understand how few VA's we have and if far enough away, the VA pays a portion of a Vet's travel back and forth. The VA is an insanely expensive enterprise.
The CBO has criticized the VA for not owning all of its facilities. This gives you an example of how stupid the VA is: they need a new facility, they design it, contract to build it, but do it all through a third party so in many instances the federal govt doesn't actually own the facility. So if in the future the place needs to be closed down it can't be sold off. So the VA subsidizes or covers all of the cost to build it, then maintain it, and then doesn't own a damn bit of it.
In Jacksonville, FL there was a Naval Air Station that shut down around 2000. It had a clinic like most military installations. The VA in Jacksonville needed another outpatient clinic. They started the process around 2002 or so. They could have negotiated a deal to just take over the clinic from the old Naval base. It was obviously already set up for medical care. They could have also taken over other structures on the base like the gym and turned it into a dental clinic or optometry clinic etc. But no, they couldn't do something logical like that. So, instead, they took the next 12 years trying to build one clinic and when it was complete it was already too small to handle the patient load. The way our govt operates is beyond frustrating.
The VA is our worst federal agency. And that says a lot considering how fucked up the EPA is.