By Mark Sumner / Daily Kos
The replacement of Secretary of Veterans Affairs David Shulkin has two narratives in the media—that Shulkin “embarrassed” Donald Trump with a trip to Europe that included days of sightseeing, and that Shulkin “clashed” with other officials at the VA.
Despite the amount of play the first item has received in the press, and despite some completely justified criticisms of Shulkin’s efforts both slip his wife’s travel costs onto the VA’s dime and indulgence in gifts he should never have accepted, the idea that he was pushed out over travel costs is clearly ludicrous. Scott Pruitt has engaged in far more lavish—and ridiculous—travel policies, hauling along a vast entourage on trips to Italy and Morocco, and the only thing his actions have earned from Trump is a suggestion that Pruitt may get a promotion to some other department ripe for wrecking. Besides, Trump isn’t capable of embarrassment.
And when the press reports that Shulkin butted heads with officials, what they really mean is that Shulkin was blocking appointees from Trump who were pushing to privatize the VA. Fast. The conflict was simple: Shulkin, the only hold-over in Trump’s cabinet from the Obama administration, was trying to maintain the VA as a viable system of health care for veterans. The Trump appointees that filled all the other VA slots, were actively working to do to the VA what Pruitt has done to the EPA—destroy it. This morning, hours after his firing, Shulkin makes the case for preserving in the VA in the New York Times.
During my tenure at the department, we have accomplished a tremendous amount. We passed critical legislation that improved the appeals process for veterans seeking disability benefits, enacted a new G.I. Bill and helped ensure that we hire the right people to work at the department. … We are now processing more disability claims and appeals than ever before and, for the first time, allowing veterans to see the status of their appeals by simply logging on to their accounts. …
It seems that these successes within the department have intensified the ambitions of people who want to put V.A. health care in the hands of the private sector.
To replace Shulkin, an experienced hospital administrator who previously oversaw Beth Israel Medical Center and was a pioneer in patient-centered care, Trump has selected … his personal physician. The one who says Trump is 6’3” and not obese.
The experience that the new head of the Department of Veterans Affairs has in running healthcare organizations appears to be limited to the running of himself. He finished medical school in 2004 and served a year in Iraq as an emergency physician. From there he was appointed a White House physician in 2006, and has been there ever since.
A biography released by the White House shows Jackson is credentialed and experienced in medicine but has no background in management. He nonetheless will be charged with delivering on one of Trump’s signature campaign promises: to fix the federal government’s second-largest bureaucracy.
His biggest achievement in the White House seems to be his pioneering work in patient-centered flattery.
“Some people have just great genes,” Jackson said. “I told the president that if he had a healthier diet over the last 20 years, he might live to be 200 years old . . . . He has incredibly good genes, and it’s just the way God made him.”
So when Trump begins a series of tweets against the Twenty-Second Amendment and planning his 2040 campaign, Jackson will be the person to blame.
But the biggest concern isn’t that Jackson has no management experience. It’s that he doesn’t plan to manage at all. Instead, he’s being put in place as a figurehead whose real purpose is to just stay out of the way of the forces that ultimately ran over Shulkin.
Until the past few months, veteran issues were dealt with in a largely bipartisan way. (My 100-0 Senate confirmation was perhaps the best evidence that the V.A. has been the exception to Washington’s political polarization). Unfortunately, the department has become entangled in a brutal power struggle, with some political appointees choosing to promote their agendas instead of what’s best for veterans. These individuals, who seek to privatize veteran health care as an alternative to government-run V.A. care, unfortunately, fail to engage in realistic plans regarding who will care for the more than 9 million veterans who rely on the department for life-sustaining care.
But at least there will be someone there with the experience to flatter them wildly.
“He’s very sharp, and he’s very articulate when he speaks to me, and I’ve never known him to repeat himself around me,” Jackson said. “I’ve found no reason whatsoever to think the president has any issues whatsoever with his thought process.”
Trump learning from Putin: When you privatize state assets like the VA Hospital system by selling them to cronies, you need the top official to be personally dependent on you for their position—total lack of qualifications is a bonus. C.f. Ben Carson.
— Tim Fernholz (@TimFernholz) March 29, 2018