How to choose a chief of the Veterans Administration

The United States Veterans Administration is a huge, sprawling organization that has defied easy management.  In fact, mismanagement of some of its hospitals was a source of minor scandal -- practically the only scandal -- during the Obama administration.

President Trump has just replaced the holdover Obama head of the VA, David Shulkin.   It may be a good choice -- or not.   It's the way he went about making the choice that I'm critical of.

As usual, he was given a list of qualified people as suggestions, along with their credentials.   But instead he chose the White House physician, Admiral Ronny Jackson, who made quite a splash in January in reporting to the media about the president's annual physical exam.

He reported on the president's pysical and mental health in glowing terms, even saying playfully that, if the president had eaten a better diet for the past 20 years, he would probably live to be 200.  Asked to what he attributed such good health, given his diet and weight, he replied that "it's in the genes." 

And he specifically mentioned that the president had passed the cognitive mental status exam with  a perfect score.   (That's so Trumpy.)   And misleading.   Unimpaired cognition is an important factor in mental health -- but only one small aspect.   It says nothing about depression, stability, resilience, judgment, good relationships, etc. that we usually think of as signs of mental health.

But that's beyond what I want to go into here.  The point is that Dr Jackson performed well on TV, and he further praised the president's mental health based  on the almost daily hours he spends with him, given that he routinely travels with the president.  The president likes him.

Now to the point.   I have no reason to question Dr.  Jackson's medical expertise nor his credentials.  He could be the best in the world at that.  He's an experienced combat surgeon as well, and he has served as White House physician under three presidents before Trump.

But what are his qualifications as an administrator to take over one of the largest, most difficult administrative jobs in the government?  The Veterans Administration is the second largest bureaucray in the federal system, with 231 hospitals, 350,000 employees, and a budget of  $200 billion.  For all his medical and battlefront experience, has he ever been in charge of a large organization?   Trump doesn't seem to think that's important.

Here's the point.   Dr. Jackson's #1 quality that got him this appointment as head of the VA may very well be that he knows how to flatter the boss by praising him in Trumpian language.   And his #2 quality is likely being good enough on TV -- but not too good.   It's not good to be too good -- not good enough to overshadow the boss, anyway.

I hope that Dr, Jackson actually does have hidden talents as an administrator.   But I worry that Trump's "gut" decision is based on hearing what he wants to hear, not considering his administrative qualifications.

The other worry is that Dr. Shulkin was let go because he does not favor privatization of VA health care.   At least he's been very vocal about that since his days were numbered.    What's Jackson's position on that?  My guess is that he at least has not said he opposes it.

Ralph

PS:  After writing the above, I saw an interview with Dr. Shulkin on "All In With Chris Hayes."   He is very open and frank in saying that he was systematically undermined by political appointees installed in his department who wanted him out because he opposes privatization.   He's says the Koch brothers are behind it, as they are pushing to privatize Medicare, Medicaid, and Social Security -- solely in order to make money out of it for themselves.    All the criticism about his spending on a trip to Europe was trumped up and distorted in order to smear him.

I found him quite credible, and Chris was astonished at some of the blatant abuses he related.   According to his story, this was pure and simple a political effort to  get rid of him because of his stance against going private.  He says that, overwhelmingly, the veterans want the VA to be improved, not  dismantled.