VA privatization debate could derail new secretary's confirmation

When Donald Trump fired his secretary of Veterans Affairs, David Shulkin, and named his personal physician, Rear Admiral Ronny Jackson, to replace him, red flags went up on Capitol Hill and among some veterans groups who oppose privatizing the V.A.

Indeed, in a parting shot to his detractors within the administration, Shulkin wrote an op-ed in the New York Times warning against forces inside the White House that want to privatize the entire agency.

The Hill:

In an op-ed published in the New York Times just hours after he was removed, Shulkin blamed his ouster on forces within the administration that he said are pushing hard for privatization[.]

"The advocates within the administration for privatizing V.A. health services ... saw me as an obstacle to privatization who had to be removed," Shulkin wrote. 

Dismantling the department's health care system "is a terrible idea," Shulkin wrote, adding that the private sector "is ill-prepared to handle the number and complexity of patients that would come from closing or downsizing V.A. hospitals and clinics."

Groups like the Koch brothers-backed Concerned Veterans for America (CVA) are pushing to loosen current restrictions on veterans receiving private sector care.

Very few veterans groups want to eliminate the V.A. or downsize it.  But it's a convenient red herring for liberal groups and Democrats in Congress to bash Trump:

"There is no effort underway to privatize VA, and to suggest otherwise is completely false and a red herring designed to distract and avoid honest debate on the real issues surrounding veterans' health care," the agency said in a statement.

Democrats and veterans' advocacy groups have been wary of Republican efforts to privatize the VA since before Trump took office.

In a 2016 campaign rally in Virginia Beach, Trump called the VA corrupt and inefficient.

"Veterans should be guaranteed the right to choose their doctor and clinics, whether at a VA facility or at a private medical center," Trump said.  "We must extend this right to all veterans."

Senate Democrats and veterans groups have not yet drawn any hard lines in the side [sic – a line in the sand...? –DJB] against Jackson, partly because they said they don't know what his positions are.

Verna Jones, the executive director of the American Legion, said she would have to sit down and speak with Jackson before passing judgment on his nomination.

"It seems like people are putting the cart before the horse. Jackson hasn't had a confirmation and none of us know his views," Jones said.  "To be clear, the Legion opposes privatization.  How all this ties into Jackson – we owe it to him to wait and see." 

That's a rare sentiment in these partisan times.  But Democrats will also look to diminish Jackson by claiming he is unqualified to lead such a large agency:

Jackson is an active-duty Navy admiral who has worked as the White House physician for three presidents.  Lawmakers have expressed skepticism over whether Jackson, who doesn't have experience working with the VA or managing a health care organization, has the qualifications to run the agency.

Senate Democrats on the Veterans' Affairs Committee said they also don't know where Jackson stands on privatization.  Still, they don't trust the administration's motives and are gearing up for a fight. 

AT contributor Ed Timperlake, a former V.A. assistant secretary, weighed in on Jackson's qualifications:

The selection of Admiral Jackson is being attacked on the issue of his lack of significant command qualifications.  In fact, Jackson's immediate experience will ultimately prove to be a boon for the VA.  Navy doctors are trained professionals for big-deal thinking.  I would never typecast a Navy doctor with the rank of Admiral as someone who doesn't understand how to take command of an organization the size of the VA.

As for privatization of the V.A., it's not going to happen.  Every major veterans group is opposed to privatizing the agency, and most Republicans oppose it, too.  But the scandals in recent years involving unacceptable wait times for veterans who need care have begun the process of much needed reforms that include some care being supplied in certain circumstances by the private health care industry.  As Mr. Timperlake points out, there may be issues with timely payments by the government to private providers, which he recommends an agency-wide audit to discover.  But with so many returning veterans from Iraq, Afghanistan, and other combat zones who have serious health issues, it seems that an expansion of choices for veterans is logical and necessary.

How this impacts Jackson's confirmation isn't clear, except that Democrats will seek any opportunity to damage the president, and the Jackson nomination is setting up to give them exactly what they want.

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