Veterans Health System in Need of Triage

For his part, Shinseki promised to be "a forceful advocate for veterans", saying Obama "charged me to ensure that veterans receive the benefits and services they earned and that the nation expects".

Most observers agree the situation Shinseki inherits is dire.

The non-partisan Rand Corporation estimates 300,000 Iraq and Afghanistan veterans suffer from post-traumatic stress disorder or major depression, while another 320,000 have experienced a traumatic brain injury — physical brain damage often caused by roadside bombs.

Less than half, however, are getting help from the government that sent them to battle. Wounded veterans are being forced to wait six months to two years on average to learn if they qualify for disability payments, and many have been turned away when they seek medical care.

At his confirmation hearing, Shinseki vowed to "transform" the VA, to cut down on long delays, promising "timeliness and consistency" in processing disability claims, a more "transparent" bureaucratic process and increased use of new technologies.

Like the senators at the hearing, veterans’ advocates expressed optimism about Shinseki’s selection.

"As a wounded combat veteran, he has a firm understanding of the issues veterans face not only when they’re deployed and when they return home, but also just the everyday issues that a veteran has to deal with that most civilians wouldn’t understand," said Ernesto Estrada, an Iraq War veteran and policy associate at the organisation Swords to Plowshares.

Now Estrada and others are waiting to see the specifics of Shinseki’s proposals. His answers to most of the questions posed by senators were vague, and none of the lawmakers pressed him for specifics.

In his written answers to questions from Senator Akaka, for example, Shinseki spoke of the long wait times veterans face for disability payments "I have much to learn with respect to the specifics of the claims process, but it seems to me that timeliness and quality should be primary concerns in the decision-making process," he said.

Veterans hope Shinseki’s reputation for honesty will lead to a change in approach at the Department of Veterans Affairs.

Under Pres. Bush, high-ranking officials have tried to cover up these problems. In one infamous example, the head of the VA’s mental health division, Dr. Ira Katz, directed an agency spokesperson not to tell CBS News that 1,000 veterans receiving care from the VA attempt to kill themselves every month. The subject line of Katz’s e-mail read: "Shh!"

Those who did call attention to the crisis have been punished. In 2006, Dr. Frances Murphy was working as the undersecretary for health policy coordination at the VA when she told the medical journal Psychiatric News that waiting lists for mental health care were so long the care was "virtually inaccessible". Days later, Dr. Murphy was sent packing.

Indeed, General Shinseki had his own battles over facts with the Bush administration.

Announcing the appointment on NBC, President-elect Obama said he picked Shinseki to head the VA because he "was right" when he warned Congress and the Bush administration about the dangers of war in Iraq.

As secretary of Veterans Affairs, Shinseki advocates hope he will continue to tell the country inconvenient truths about the long-term effects of the wars in Iraq and Afghanistan.

IPS contributor Aaron Glantz is author of "The War Comes Home: Washington’s Battle Against America’s Veterans [1]" (University of California Press, 2009).