President Joe Biden's nominee for Veterans Affairs secretary pledged to measure all things put before him by two metrics: whether it will give greater access to services for veterans, and whether it will improve outcomes.
In his confirmation hearing before the Senate Veterans Affairs Committee Wednesday, Denis McDonough, nominated to helm the federal government's second largest department, laid out his priorities if he gets confirmed.
McDonough would be only the second non-veteran to serve as VA secretary, after David Shulkin, a medical doctor who served the department under the administrations of former Presidents Barack Obama and Donald Trump.
Citing a connection to troops that he forged during visits to Afghanistan and Iraq and time spent at military hospitals at home and abroad as Obama's chief of staff, McDonough pledged to "fight like hell" to ensure that veterans receive the benefits they have earned.
"I'm a fighter and I'm relentless, particularly about things I have a passion for. Having the professional experience of the last 20 years since Sept. 11, 2001, and having witnessed up close the experience and sacrifice of our veterans, I have a passion to treat them as well as they have treated us," McDonough said.
Covering the three primary functions of VA, McDonough said his top priorities will be to provide veterans with timely, "world-class" health care, timely access to benefits and honoring veterans in their final resting places.
He also said that Biden has asked him to ensure that veterans are receiving the best care and support through the COVID-19 pandemic; have opportunities for education and job training commensurate to their skills and talents; ensure that VA continues to broaden services for all veterans, including women and minorities; and strive to reduce homelessness and suicide among vets.
"The first and most important thing that I will do, if confirmed, is underscore that comprehensive health care for our veterans includes mental health," McDonough said.
To do this, he added, he would continue to increase access to mental health services, which include using grants and connections signed into law last year by Trump to access community organizations and programs that address veterans' mental health and wellness.
"The VA does a very, very good job and works really hard at this crisis. On the other hand, there are so many entities in communities [that are] also doing a very good job and are ready and willing," McDonough said.
A VA report published in November showed a slight uptick in suicides among young veterans in 2018 -- the last year the department has analyzed the numbers. The suicide rate among veterans was 17.6 per day in 2018, up from 17.5 a day in 2017.
Regarding health services, McDonough was quizzed repeatedly by senators about VA's community health care services -- first introduced by Obama as the VA Choice program in response to lengthy appointment wait times at VA medical centers nationwide and expanded under the Mission Act by the Trump administration.
In response to a question about community services from Sen. Bernie Sanders, I-Vermont, McDonough said he did not support "privatization" of health care and said community care would continue to be part of VA health services.
"At the same time, we have to ensure that this integrated health model continues to draw on the success and excellence that is obvious in [VA's] workforce," McDonough said.
In light of the riot at the U.S. Capitol on Jan. 6 -- an event in which roughly 20% of those arrested were veterans -- McDonough fielded questions on "cyber-hygiene," ensuring that veterans have the tools and awareness needed to deflect disinformation and propaganda, and he said VA may have the opportunity to highlight to vets the threats they may face online.
"It would be my intention to work with my interagency colleagues, the National Security Council and others to make sure that's receiving appropriate consideration," McDonough said.
McDonough served as deputy national security advisor and later as White House chief of staff during the Obama presidency. He played a pivotal role in advising Obama during the scandal over VA medical appointments and turmoil over VA Secretary Eric Shinseki's resignation. He was also key to helping develop the Veterans Choice Act in response.
Fraught with issues that included delays in care for veterans and payments to providers, the Veterans Choice Program eventually was allowed to expire and replaced with the VA Mission Act -- overarching legislation designed to improve access to community physicians and expand the eligibility pool of veterans.
Montana Democrat Sen. Jon Tester, chairman of the Senate Veterans Affairs Committee, and ranking member Sen. Jerry Moran, R-Kansas, pledged support for McDonough's nomination during the hearing, with Tester predicting he would "be successful" if he put veterans' "well being above all else."
"In the end, we all want you to succeed because veterans across this country need you to succeed," Tester said.
"I look forward to working with you and your commitment is evident to me," Moran said.
Tester said he expects the committee to vote on McDonough's nomination Tuesday, followed by the full Senate.
McDonough told lawmakers that if approved, he would 'fight like hell' to take care of veterans.
"I have seen and internalized [veterans'] excellence and know that a basic requirement of the VA secretary is to have their backs," McDonough said.