WASHINGTON — Something unusual happened inside the U.S. Capitol this week.

A cabinet officer was nominated by a divisive president to head a troubled government agency that has created politically embarrassing problems all over the country. Then he was approved by a Senate vote of 100-0.

The candidate was David Shulkin, a holdover from the Obama administration who joined the Department of Veterans Affairs in 2015 as undersecretary of health. A physician who was formerly a health care administrator, Shulkin was sworn in as secretary of Veterans Affairs on Tuesday.

“We know that we have a lot of work to do,” Shulkin said following the ceremony in the office of Vice President Mike Pence.

David Shulkin is sworn in to testify at his confirmation hearing before the Senate Veterans’ Affairs Committee.

Department of Veterans Affairs

Shulkin is taking over administration of the nation’s largest single health care network, which employs 314,000 workers and serves some 6.5 million veterans at more than 1,700 hospitals and clinics.

Its role is particularly important in Hawaii, which is home to some 120,000 veterans, and many of them rely on Veterans Affairs for their medical care.

Shulkin sailed to confirmation Monday after being approved by the Senate Veterans’ Affairs Committee on Feb. 7 on a 17-0 vote, winning the approval of the nine Republicans eight Democrats.

Why the sudden burst of bipartisanship?

Before the vote on the Senate floor, Sen. Johnny Isakson, a Republican from Georgia, implored his colleagues to show solidarity in supporting Shulkin.

“I want to make a statement not heard on this floor in several years,” Isakson said. “Let’s do this as a unanimous body. This is one thing we agree upon. They are not Republican veterans, not Democratic veterans, they are American veterans. They went on the battlefield and fought for us, and it’s time we fought for them.”

The top Democrat on the Veterans’ Affairs Committee, Jon Tester of Montana, spoke next: “Dr. Shulkin is the perfect person for that position.”

“They are not Republican veterans, not Democratic veterans, they are American veterans. They went on the battlefield and fought for us, and it’s time we fought for them.” — Sen. Johnny Isakson

Republicans and Democrats said part of the reason they supported Shulkin was because he has promised to fight efforts to privatize the department, something that has been urged by fiscal conservatives, including some within the Trump administration.

Shulkin has taken control of an agency that has grabbed headlines in the past several years, mainly for its bad performance. In 2014, reports surfaced that veterans in many parts of the country had been kept waiting for months for essential health care, with some dying before they could be seen by doctors.

Bureaucrats at the department were accused of concealing this information by creating false schedules that suggested that patients were being seen promptly.

The first allegations surfaced in Phoenix. Not long after, Hawaii residents learned that conditions in the islands were among the worst in the nation. Some veterans in the state had been forced to wait an average of 185 days to see primary care physicians.

Amid expressions of outrage, Congress passed overhaul legislation that provided more than $15 billion in additional funding, including provisions that allow veterans to obtain medical service outside the department through a program called Veterans Choice.

Secretary of Veteran Affairs Robert McDonald greets former homeless veteran Calvin Munies after 'Heroes Housing Heroes', Mayor Caldwell's initiative to house 100 U.S. veterans by the end of 2015. 9 july 2015. photograph Cory Lum/Civil Beat

Former U.S. Secretary of Veteran Affairs Robert McDonald, left, greeted veteran Calvin Munies in July 2015 during the secretary’s visit to Hawaii to talk about health service for veterans.

Cory Lum/Civil Beat

Since then, many other changes have been made. Wait times for appointments have been sharply reduced, and veterans in Hawaii have told Civil Beat they have seen real improvement in the quality of health care. A report by the department’s Office of the Inspector General in October said patients in Hawaii were receiving better and faster care.

But overall, the department continues to be rocked by allegations of misconduct.

In December, four health workers at a Veterans Affairs facility in Oklahoma resigned after maggots were found in the wound of a 73-year-old veteran. The patient had come to a health center near Tulsa with an infection and subsequently died of sepsis, according to news reports.

On Jan. 17, a former department physician in Kansas City pleaded guilty to health care fraud, allegedly continuing to perform disability examinations after surrendering his medical license due to accusations of conspiracy to distribute narcotics.

On Feb. 8, three Veterans Affairs employees in Little Rock, Arkansas, were indicted for allegedly conspiring to steal and sell prescription drugs. The investigation began, according to the U.S. attorney for the Eastern District of Arkansas, after the Office of Inspector General received reports that large quantities of opioids had been improperly acquired by the employees, allegedly for the purpose of selling them.

During his confirmation hearing, Shulkin acknowledged that the agency has problems, but said that most of the staff is performing well. He said that the agency was making steady improvements. He also said that the Veterans Choice Program had problems in its inception that were being resolved.

Hawaii Sen. Mazie Hirono asked Shulkin about services for Hawaii veterans during his confirmation hearing.

Anthony Quintano/Civil Beat

Sen. Mazie Hirono of Hawaii, who serves on the Veterans’ Affairs Committee, peppered Shulkin with questions. She asked him to do his best to promote telemedicine, which allows patients to get electronic care remotely and would make it easier for veterans on the outer islands to get care without traveling to Oahu.

She asked if veterans’ medical care could be provided by urgent care clinics in pharmacies and pressed to learn whether the agency planned to move ahead with an outpatient medical center on the Leeward side of Oahu and a state veterans’ home, also on Oahu.

Shulkin indicated he would pursue everything she asked him to investigate.

Hirono told Civil Beat that she decided to vote for Shulkin because he provides stability within the department and had promised to work with her on the issues she thinks are most important to Hawaii.

Other Democrats on the committee said part of the reason they voted to confirm Shulkin was that he had given them pledges that he would defend the department against conservatives in the Trump administration, including the president.

They asked pointedly about whether Shulkin had pushed back against the federal employee hiring freeze ordered by President Trump. Shulkin said that he had gone immediately to the president to ask for an exception for Veterans Affairs.

He said that of the department’s 43,000 positions waiting to be filled, he got 37,000 exempted from the White House order.

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