Does Trump's VA pick have what it takes to turn around troubled agency?

Campaigning for the White House, Donald Trump repeatedly pledged to improve veterans' care. But President Donald Trum...

Posted: Mar 30, 2018 9:49 AM
Updated: Mar 30, 2018 9:49 AM

Campaigning for the White House, Donald Trump repeatedly pledged to improve veterans' care. But President Donald Trump's choice of White House physician Ronny Jackson to serve as the next secretary of veterans affairs has been met with concern among Washington lawmakers and veterans' advocates who worry that Jackson lacks the experience to lead the government's second largest bureaucracy.

If Jackson is confirmed, he will inherit a Department of Veterans Affairs that has been faced with challenges that have spanned years. The department, which has 370,000 employees and serves more than 20 million veterans, has struggled to modernize with its inefficient health care system ensnared in crisis.

David Shulkin, fired by the President on Wednesday, departs at a critical moment with big decisions about the future of veterans' health care and its health records systems waiting in the wings.

Jackson has served for the last three administrations as a White House physician and is an active duty rear admiral in the Navy, but has little management experience.

That's led to a muted public response on Capitol Hill and private concerns that Trump's pick of Jackson, a man who has the President's affection and has been at the White House since 2006, is the right person for the job.

The top senators on the Senate Veterans Affairs Committee, chairman Johnny Isakson of Georgia, and ranking member Jon Tester of Montana, had little to say publicly about the President's choice. In separate statements, Isakson said he looks forward "to learning more about him," and Tester saying he wants to find out if Jackson is "up for the job."

Chris Lu, who served as the liaison to former President Barack Obama's Cabinet, told CNN, "VA is not only the largest health care system in the nation, but it also provides benefits for millions of veterans and their family members. Running this department is a massive management task. As accomplished a physician as Ronny Jackson might be, he brings less management experience to this job than any previous VA secretary."

A spokesperson for the former president declined to comment on Trump's decision to nominate Jackson.

Jackson's views on some of the most pressing issues at the department remain unknown, particularly on the debate over allowing veterans more access to private doctors outside of the VA's health care system. Roughly one third of veterans already see private doctors, but the President and his allies are pushing for more private care, particularly the group Concerned Veterans for America, which is backed by the billionaire Koch brothers.

The group did not include a mention of Jackson in a press release after his nomination was announced. It said Shulkin had made "significant headway in reforming the department but ultimately became a distraction."

Asked how Jackson is qualified to oversee medical care for US veterans, a White House official told CNN Wednesday that Jackson would bring with him both a medical and military background to the department as well as past praise for his work in previous administrations.

Corey Lewandowski, Trump's former campaign manager, said on CNN's "New Day" that former VA administrators with more experience weren't getting the job done.

"I think if you look back and you look at the previous VA secretaries, those who supposedly had management experience who have come in, we have seen disasters under their regimes," Lewandowski.

Nevertheless, one of Shulkin's toughest critics on Capitol Hill says Jackson could face a bumpy ride.

Republican Rep. Mike Coffman of Colorado, one of the lawmakers who had called for Shulkin's removal, told CNN's "New Day" that to succeed at VA, Jackson would need to "clean house."

"This is an organization that's over half the size of the United States Army," Coffman said. "Unless he's going be tough, nothing's going to change."

Asked whether he believed Jackson needed management experience, he said, "it certainly helps," but added that Shulkin was an experienced manager and failed at the job.

"It's gonna be tough," he added. "I'll be frank with you, the odds are not with him."

Jackson's performance during an extended, at times testy, press conference over the President's health and cognitive fitness played a part in his nomination for secretary of Veterans Affairs, a White House official told CNN.

The official said Trump liked the way Jackson handled himself with reporters during the briefing in January.

Aside from his experience, it's the fight over privatization that may define Jackson's potential term.

In a fiery New York Times op-ed, Shulkin pointed to the policy fight as factor in his ouster, saying his successes at the agency "intensified the ambitions of people who want to put VA health care in the hands of the private sector."

"The private sector, already struggling to provide adequate access to care in many communities, is ill-prepared to handle the number and complexity of patients that would come from closing or downsizing VA hospitals and clinics, particularly when it involves the mental health needs of people scarred by the horrors of war," Shulkin wrote.

The leaders of veterans' groups sounded alarm on the pick, and said they weren't consulted with the White House. Many of them, in fact, had been pushing the White House to allow Shulkin to stay in the job, even as the President's attitude on Shulkin soured.

"I have no idea what to expect from him, quite frankly," Vietnam Veterans of America President John Rowan told CNN, adding that he was disappointed that the President had removed Shulkin, but he also expressed some relief at the pick -- it could have been worse.

"We were hoping that we prevailed, but at least he isn't appointing one of those rabid privatization people, so that's a plus," he said.

At AMVETS, executive director Joe Chenelly said that Trump's decision to oust Shulkin and replace him with Jackson had brought efforts to reform and modernize VA "to a screeching halt."

"We don't see anything in his bio that makes him fit to lead," Chenelly told CNN, adding that his group is "a long way to supporting the nominee."

Veterans of Foreign Wars echoed that point in a statement Thursday, saying Jackson's background does not show any experience working with the Department of Veterans Affairs or with veterans or managing any organization of the size of the agency, "so the VFW will be closely monitoring his Senate confirmation process."

The group also praised Shulkin for his helming of a department rocked by a crisis the year before he took over, saying that under his tenure, the agency saw successes ranging from "increased accountability and transparency to a beefed-up education package and increases in overall funding and patient satisfaction."

Paul Rieckhoff, the chief executive of the Iraq and Afghanistan Veterans of America, told CNN's "New Day" that the move to replace Shulkin would only add to the instability that already plagues VA, noting that since he returned from Iraq in 2004, three VA secretaries have either resigned in scandal or been fired.

"The VA's a monster for any leader to try to manage effectively. And when the changeover happens, it's very disruptive to the front line personnel at the VA, it's very disruptive to the veterans that depend on it for care," he said.

Of Jackson, Rieckhoff added, "he's going to have a very hard row to hoe to try to convince people that he's qualified."

Minnesota Coronavirus Cases

Data is updated nightly.

Cases: 483790

Reported Deaths: 6543
CountyCasesDeaths
Hennepin1003791583
Ramsey42945800
Dakota36091387
Anoka33200384
Washington21986254
Stearns18703200
St. Louis14746262
Scott13209107
Wright12489115
Olmsted1176188
Sherburne869772
Carver765240
Clay688887
Rice667191
Blue Earth591035
Kandiyohi578474
Crow Wing518381
Chisago496844
Otter Tail481370
Benton444890
Winona416649
Mower402731
Douglas392268
Nobles386547
Goodhue384468
Polk342262
McLeod338349
Beltrami336751
Morrison323547
Lyon312444
Itasca311646
Becker309941
Isanti305354
Carlton299848
Steele299211
Pine281916
Freeborn279823
Nicollet256041
Todd246330
Brown243537
Le Sueur233920
Mille Lacs226747
Cass219124
Waseca208617
Meeker206934
Martin188228
Wabasha18613
Roseau179617
Hubbard160640
Houston157114
Dodge15154
Renville149040
Redwood146527
Fillmore13708
Chippewa135935
Cottonwood134520
Pennington131816
Wadena130220
Faribault122716
Aitkin118733
Sibley117110
Watonwan11708
Rock115614
Kanabec107319
Pipestone101424
Yellow Medicine97617
Murray9438
Jackson93310
Swift87918
Pope8025
Marshall77615
Stevens7398
Lake73518
Clearwater71914
Lac qui Parle68216
Wilkin66910
Koochiching61711
Big Stone5163
Lincoln5052
Grant4908
Norman4768
Unassigned44568
Mahnomen4417
Kittson40821
Red Lake3625
Traverse3025
Lake of the Woods2161
Cook1180

Iowa Coronavirus Cases

Data is updated nightly.

Cases: 361499

Reported Deaths: 5412
CountyCasesDeaths
Polk58007549
Linn20606312
Scott18279207
Black Hawk16223290
Woodbury14924211
Johnson1380473
Dubuque13522194
Dallas1132690
Pottawattamie10762143
Story1018945
Warren553474
Clinton542484
Cerro Gordo532781
Webster517687
Marshall495572
Sioux493469
Buena Vista472736
Des Moines457061
Muscatine450691
Wapello4314108
Jasper416266
Plymouth394277
Lee374752
Marion358469
Jones294354
Henry293037
Carroll285348
Bremer279154
Crawford273435
Boone259130
Washington253747
Benton252054
Mahaska223846
Jackson221138
Dickinson217238
Tama212965
Kossuth208154
Clay193125
Hamilton191942
Delaware188639
Winneshiek188427
Buchanan184629
Fayette184335
Page182619
Hardin180839
Wright179531
Harrison179469
Cedar177023
Clayton168053
Butler165831
Mills162820
Floyd162740
Madison154018
Poweshiek153630
Cherokee153535
Hancock146729
Lyon145941
Allamakee144946
Iowa144223
Grundy138830
Appanoose138647
Jefferson138232
Winnebago137730
Calhoun133311
Cass133351
Mitchell130640
Louisa128341
Union126331
Chickasaw124813
Sac124218
Emmet120940
Shelby120433
Franklin118419
Humboldt117225
Guthrie116228
Palo Alto104921
Montgomery103936
Howard102821
Clarke100320
Unassigned9850
Keokuk97829
Monroe93128
Adair91928
Ida90832
Pocahontas85219
Davis82523
Monona81527
Greene76910
Lucas73221
Osceola70314
Worth6947
Taylor66312
Fremont5869
Decatur5749
Van Buren56018
Ringgold51820
Wayne48721
Audubon4869
Adams3264
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