USA TODAY International Edition
Our view: Can Trump’s doctor cure what ails the VA?
Easily lost amid the latest Twitter announced firing within the Trump administration — the dismissal of VA Secretary David Shulkin — is what is best for the millions of veterans he was serving.
Ethical missteps by Shulkin, the only Trump nominee confirmed 100-0 last year by the Senate, left him exposed to ouster. But the underlying issue is whether the Department of Veterans Affairs’ health care system should be largely privatized. Shulkin, rightly in our view, made clear that would never happen on his watch.
Now he’s gone, slated to be replaced by President Trump’s telegenic personal physician, Ronny Jackson. Jackson, a Navy officer and Iraq War veteran, is best known for his fulsome assessment of Trump’s health.
He isn’t, however, known for having management experience, which raises serious doubts about his ability to tame one of the government’s largest and most intractable bureaucracies.
Second only to the Pentagon, the VA has a $186 billion budget and 360,000 people who provide benefits and health care to nearly half the nation’s 20 million veterans at 145 hospitals and more than 1,200 outpatient clinics.
Shulkin, a former hospital administrator brought in under President Obama to run the VA health care program in the wake of a delay-in-care scandal, stopped short on Sunday of endorsing Jackson to be his successor.
As administrator, Shulkin imposed a slate of improvements. He modernized the sclerotic appeals process for benefits, boosted patient satisfaction, increased transparency, decreased wait times and improved mental health care. Large veterans’ groups such as the American Legion wanted him to stay.
But significant problems remain, and Shulkin gave his enemies an opening by using taxpayer funds to bring his wife on a business trip to Europe and accepting free Wimbledon tickets — “serious derelictions” according to an internal investigation.
Major forces at work within and outside the administration — such as billionaire industrialists Charles and David Koch, key financial supporters for the group writing the opposing view to this editorial — prefer leadership willing to embrace reimbursed private care for veterans, with an eye toward potentially and eventually dismantling much of the VA health care system.
That ought to be a non-starter. For all of its faults, VA health care remains singularly capable of treating the complex consequences of war and service, including post-traumatic stress disorder, traumatic brain injury, prosthetics, spinal injuries and rehabilitation.
A recent RAND study of private care resources in New York state concluded that private-sector physicians are unprepared to treat the chorus of ailments veterans suffer. The VA knows how to do that, and Shulkin was moving it in the right direction. Now it’s up to the Senate, as part of the confirmation process, to ensure that the next VA leader is someone with the inclination and ability to continue that progress.