A novice in the VA OR
The 20 million-plus veterans of the U.S. Armed Forces served this country with the eminently deserved expectation that their country would serve them. Now even as the heart of that trust, the VA health care system, recovers from deadly delays in getting patients care, and after summarily dispatching his first head of the U.S. Department of Veterans Affairs, David Shulkin, President Trump inflicts risky experimental treatment, nominating as the new chief a doctor who has never come close to the operating room of managing a large organization — never mind one with nearly 378,800 employees.
The distinguished career of Rear Admiral Ronny Jackson, a medical doctor, has put him everywhere from the Iraq battlefield to the deep sea, demonstrating impressive courage and resourcefulness, starting from humble roots in Texas.
In recent years he has served as the White House physician, in which capacity he pronounced Donald J. Trump to be in excellent health. His team of 58 or so medical pros treats a few thousand executive employees, including cabinet members and senior staff.
No doubt Trump is fond of Jackson, and Jackson in no position to decline the demand of his commander-in-chief. So it must fall to the Senate to make full use of its confirmation powers to press Jackson on the hows, whys and wherefores of delivering complex services across more than 1,200 facilities.
This, after the VA’s inspector general laid at Shulkin’s feet alarming failures that ranged from inventory mismanagement to costly accounting laxity to misapplication of anesthesia. And Shulkin was an experienced hospital administrator who once ran New York City’s own Beth Israel.
If Jackson cannot prove himself poised to do any better, he should not get the job.
Congress must also stay alert to forces eager to meddle with VA’s core mission and services by putting vets’ health care in the hands of for-profit businesses, a possibility Shulkin warned of after his firing in an extraordinary New York Times Op-Ed.
“I am convinced that privatization is a political issue aimed at rewarding select people and companies with profits,” he wrote, “even if it undermines care for veterans.”
To the extent private players can deliver better services for less money, go for it. Indeed, greater freedom to visit private physicians was a breakthrough in solving the VA’s patient-care crisis.
But Shulkin’s dark prognosis casts doubt that improving the VA’s own services is part of the plan. A Department of Veterans Affairs that fails to put veterans first, middle and last will be unworthy of the name.