Let me introduce our two reporters who will be asking questions. A National Security and Veterans AffairsVeterans Affairs reporter for the wall street leo, you are asking the first question. I want to start with the issue of account ability. It he threeyear anniversary of the wait time scandals at the v. A. We got news because of problems at the v. A. Center, you demoted a medical director. You may accountability a big issue but i wonder has that in the missing piece with the Reform Efforts of recent years should we expect Real Progress on accountability sin . You are seeing a real difference with the v. A. And we are taking Decisive Actions. Issue at the washington dc v. A. Was an inspector generals report to my attention that i was concerned about asian safety. And you will see wherever there is a concern about safety we will take immediate and Decisive Action. Vastwant to say the vast, majority of our employees are the best in the country, serving with great dignity and mission. But where we find we are having people dont meet our standards, we are going to take Decisive Action to make sure they are not part of our organization and not leadership positions. You have endorsed a house bill that is floundering in the senate. And that is a way to more easily fire some of the bad actors, folks involved in incompetence or criminal activity. Is that that a matter of just finding scapegoats for that activity or do you really feel like if we get rid of these folks, there will be a change that folks on the top of the hill have asked for . David shulkin everything starts with leadership. It is important you have the right leaders in place if you want to make sure the organization is moving in the right direction and running the way it should be. I am grateful to the house and chairman row for his leadership to make sure we do have the accountability bill through the house. I wouldnt describe the bill as floundering in the senate. I think there is strong support and i think we will see action coming out of the senate. This is a bill that allows us to remove people that should be removed. And it allows them due process which i believe him strongly, to make sure that there are not very years to making the right decisions. It is a bill that helps us reach higher and recruit and retain the best. So it is an accountability bill that covers both ends of the spectrum. Hiring and removal. Reporter to followup on that for legislation. As the legislative priority for your predecessor was dealing with appeals reform. I wonder if that is a priority for you at this point and if you are pushing for the legislators in the house and the senate, which seem to be getting along with each other at this point, the democrats and the republicans, are you pushing to have appealed reform go through quickly . David shulkin it is one of my legislative priorities. This was last written in 1930 and we know that without legislative changes, our appeals process will remain broken and get worse. A veteran soon will wait six years to get a decision when they make an appeal. That is totally acceptable. We need legislative action and i am hopeful and optimistic that we will see that in this congress. Their support in the house and the senate side to get this legislation through. We have worked closely with the Veterans Service organizations to make sure we have the best legislation we could come up with. And now, there is the momentum to move that across the line. Reporter what you think stand right now with appeal backlogs . Over time, the claims backlog has started to take back up after it was tackled pretty well i your predecessors, it dropped by hundreds of thousands. At that number is starting to go up a little bit. And the appeals backlog is starting to go up for folks who may not understand it, when a veteran puts in a claim for disability, they could put in a claim and wait some time to improve the process. That is the initial background and after the appeal, it is a twotier system. Could you talk a little bit about where that stands . David shulkin we did talk about the appeals. Today, it stands at 450,000 cases. If we dont get legislation to fix the problem, that is going to continue to grow and that is totally unacceptable. Wiley legislation for appeals. On the disability claim, i think you are correct that we have seen a tiny bump up and it is something we are now addressing. You have to remember, 2. 5 years ago we had 611,000 disability claims above 125 days. Today, we are at about 100,000. So we have made significant progress from where we were. But 100,000 is good enough. And we are looking at a number of new strategies. Decision ready claims. Going paperless. Changing systems ultimate sure we can get the number down significantly. And that is one of my priorities, to get that number down to a much smaller number than where it is today. Host there is a federal hiring freeze and i wonder how it will affect you getting the kind of people in to the claims are view that you need . David shulkin the federal hiring freeze is over. As of april 12, we no longer have that hiring freeze. We are committed to filling the positions necessary. We are taking a close look at every position we felt to make sure that they are absolutely necessary, as you know, we are trying to do government more efficiently and smarter and making sure that we really are looking at every dollar the taxpayer pays to make sure it is necessary. In areas like getting the disability claims process, where we are at 100,000, we had a freeze on those positions. It is really important that we get the people in place so we can take that number down. Because veterans deserve better. They deserve faster decisions. Reporter i want to followup with one more thing. Our you saying the federal hiring freeze did affect the vas far as processing claims and that the decision to put a hold on hiring did negatively affect you and what you could do . David shulkin yes, the v. A. Has a germanic need to have positions filled. We have 45,000 positions throughout the country that were open on usa jobs. We requested an exemption for 41,000 of the 45,000 that we determined were in the interest of Public Health and safety. We need to hire doctors, nurses, pharmacists and physical therapist to keep our veterans safe. We did have an administrative freeze on 4000 positions. Many of them disproportionately were in administratively type positions. Many of them in the veterans benefit organizations. So we did have a negative impact on the ability to process claims as people left jobs and we didnt fill them. Im not pleased that we are going back and making sure we can fill those positions that are necessary. As we have to get those claims down. Reporter i want to take a step back on this whole issue because you will hear 100,000 claims and a sixyear wait these are not new issues . Is it something you have been dealing with for years, even before you got there as the director of health. So what do you see has changed now . Or is it the key motive effect of improvements made that we will eventually see things . Basically, why optimistic that you will see changes on the appeals and backlog . I said i dont expect a change in the appeals without legislation. And that is why it is absolutely critical. One of my priorities that im working with the house and senate on is to make sure we get appeals legislations done in this congress. I am optimistic that we will continue to make improvements on the disability claims for a couple of reasons. Number one is that we are now seeing the benefits of our investing in the modernization of our technology and i. T. Systems. We are announcing a campaign to go paperless on all disability claims. We have six offices that are now completely paperless and we will be rolling that out across the country. And we are continuing to look at how we can refine and improve the processes. Decision ready claims is an example where veterans will be able to opt for a system where they could get faster decisions on their disability claims. It is their option to do that. So changing processes and investing in technology at the modernization of our systems area i do expect that we will see continued improvement. Reporter from legislative hope to legislative victory, you did have the Choice Program extension passed by congress. And you had said that was critical to make sure that the program didnt expire. You have promised that we will see major changes to the program. Could you talk about when we will see them . And what the timeline is for when Congress Might have something to vote on . David shulkin i think you got it right. It was absolutely critical that the house and congress extended the current Choice Program because veterans were beginning to be extended negatively. And because of the leadership that we have with the full congress, we did get that. The president is looking for to sign that on april 19. But that is just the beginning. We need to make sure that this Choice Program not only continues but it works for veterans. We are working harder now with congress to redesign a better, improved way of accessing care in the community. We will be working with them in the next several weeks to get what the package looks like. And we do hope to be able to bring that to legislative decision in the early fall. As we do need a Replacement Program by the end of this calendar year. If you bring it to congress in early fall, is there enough time to get it through if the money runs out at the end of the year . David shulkin that is only need new legislation. I am confident that when it comes to protecting and honoring our commitment to our veterans, that congress and the president is committed to doing whatever it needs to do to make sure that we meet that timeframe. Reporter that choice legislation, whatever it may be, one of the reasons it seems that you stayed on was because of what you did at the Veterans Health administration, the health care arm of the v. A. Some say it allows more choice and others say it pushes the organization towards privatization. Could you talk about what the difference between choice and privatization is . Is it just semantics . Is there a difference between those two terms . David shulkin im not in favor of privatization of the v. A. I came in from the private sector not knowing what the best decision was. And when i began to see what is happening in the system and whether that care would be available in the private sector and i began to practice and see patients in the Veterans Association, i came to the conclusion that we had to maintain a strong Veterans Association. The care that we deliver cant be and wouldnt be replaced in the private sector. At that doesnt mean that we shouldnt be working closely with the private sector. And i believe the way we should fulfill our commitment to veterans is to keep a strong v. A. But integrated with what the private sector is doing. So i am looking to design a single system that is seamless. So veterans can get the best of what the v. A. Offers and what the private sector offers with integrated care. Reporter at the end of the day, it is a Government Run Health Care system and quasiinsurance program. In what way does comparing that to the private sector, using the metrics, in what way is that the wrong way to look at it . In what way can you import private sector . Is it comparing apples to oranges . Is looking at it through the private sector lens bad for veterans . David shulkin no, it is one of the clear directions you will see under my direction. We will make it so we are doing correct comparisons to the private sector. Because that is how veterans can make the choices for their wellbeing. By understanding what the v. A. Has to offer and where the private sector has to offer. I want veterans going to the private sector that i also want people to recognize that the v. A. Is doing some extraordinary things better than the private sector. Like the Behavioral Health care and many things dedicated to what people suffer when they come back from some of our complex. So we are making it much easier. In fact, we released yesterday a website that allows veterans to actually see and understand what the wait times are for care because it is a big issue for us. There is nobody in the private sector that is publishing wait times. So i am encouraging the private sector to adopt our metric so that veterans could actually see what the wait times are in the private sector. Reporter with that website, do you have concerns about making that data public . I understand the issue of transparency but it is the threeyear anniversary of the wait time scandal and at the heart of that was some issues with transparency and issues of artificial deadlines that were being placed on medical centers. Does it worry you at all that you could have a competition between the medical centers where they say hey, we need to push the wait time numbers down, maybe we budget over here so we look better . David shulkin one thing i have learned in government is that there are no easy decisions. This is a fundamental belief of mine. That the way to fix the Veterans Association is by making information transparent and understandable. And that is where we are, particularly when it comes to peoples health. You should not be hiding data from people. This is too important for that. So by releasing the data, the most accurate comprehensives we have, we are allowing veterans to ask questions and to understand what is happening. I also fundamentally believe that the way you change organizations is not through internal change. But you drive it through external change. And we have learned this with almost every industry outside the government. Products change. And improvements happen because consumers demand it. So i am relying upon the American Public and among our veterans to say whether what we are doing now is meeting their needs. There are going to be unintended consequences of this. And we are very careful to make sure that we dont have disincentives to reporting Accurate Information but we will be learning a lot. This will be a system where we have where will be learning a lot but i releasing this information. I fundamentally believe this is the single most important thing we will do to fix the system in the foreseeable future. Reporter a quick follow up. You have been involved in this and last year and a half. Our you confident that the wait time data has integrity now . And that there isnt a way to manipulate or doctorate like what happened three years ago . David Shulkin David shulkin i think we have made clear to our leadership that we are not going to tolerate any data manipulation that his essential and is part of what leadership must commit to. The integrity of our data. And now that we are reporting it publicly the way that we are, it takes on even greater importance. The data that we are releasing is average wait time data. So my concern is that somebody could look at the website and say, there is a fiveday wait and they called the phone and somebody may say, you could get in in three days or eight days. That is how you get averages. So it wont be everybodys experience. But we are talking about 58 million appoints a year that we are reporting on. So i do believe that this is the right direction. I do believe that the organization understands that if we are going to regain the confidence and trust of the American Public that this data must be accurate. And that it has to have in crediting and it has to have integrity. Host six minutes left. Reporter i want to ask about your past experience and how it relates to your job now. You were in charge of the health care arm of the Veterans Association. There are the health care side and the benefits side and decide that runs the cemeteries. Coming in with just the vha experience, did you find and are you still finding that the learning curve for dealing with the rest of this Massive Organization is steep for you . Along with that, has the slowness with which the administration has acted in appointing insistence appointing assistance for you with appointees, has it affected the way you are managing the department . David shulkin well, i think i actually had an advantage in that for me, when i entered government from the private sector, that was my learning curve, almost two years ago, trying to understand how things work in government. When i was appointed secretary, that was behind me. So i didnt feel that the learning curve was that steep. Even though i was running the health part of the v. A. , i was part of the department. I was part of the decisionmaking for really all of the issues in the department. I havent found the learning curve to be that steep and i feel i have been able to accelerate the momentum of change happening in the v. A. In terms of my Leadership Team getting in place, of course i wish we could do this faster. We are working hard and we are working well with the white house to make sure we are doing it. But part of the process when you bring in political appointees, it is important to that them. To make sure that they have the right background and that there will be problems going forward. So we are in that process and i feel very comfortable that we are making Good Progress to getting the right people in place. Reporter does the process move more slowly than you would like and is it affecting the way the v. A. Is running . David shulkin whenever you are in an organization like the v. A. Which feels a strong imperative in improvements and change, of course it is slower then you would like. Of course, i wish it were faster. But i believe it is on course. I have fairy good Senior Leaders in place. Many of them are acting in return positions and we are making terrific progress. And i feel very comfortable with where we are today. Reporter a final followup on your experience. As secretary of the department of Veterans Affairs, an organization that is touted as knowing how to deal with specific needs of veterans, what does it mean for you to hav