WASHINGTON — President Barack Obama on Monday intends to nominate Robert A. McDonald, a former chief executive of Procter & Gamble, to be the next secretary of Veterans Affairs, a White House official said Sunday, betting that a global corporate officer can turn around a government health system that has been rocked by allegations of mismanagement and cover-ups of long patient waiting times.
The president last month accepted the resignation of Eric Shinseki, the retired four-star Army general he tapped in 2009 to lead the agency. By appointing McDonald, 61, Obama is turning to an outsider to overcome deep bureaucratic problems and the mismanagement that stemmed, in part, from a surge in the number of veterans needing care.
In the weeks since Shinseki’s departure, White House officials had explored three kinds of potential replacements: someone with deep management experience, someone with a military background similar to the department’s former leader or someone with a track record running a sprawling hospital system.
By picking McDonald, Obama signaled that he views the problems at the department as primarily a management concern, although his nominee is a graduate of the U.S. Military Academy at West Point with a military service record. A report issued on Friday by Obama’s deputy chief of staff, Rob Nabors, described a “corrosive” management culture and “a lack of responsiveness and an inability to effectively manage or communicate” at the agency.
The choice is markedly different from one Obama made five years ago, suggesting that he no longer believes that a military commander can fix the substantial problems at the country’s largest integrated health care network, with over 1,700 facilities that serves more than 8 million veterans a year.
“This is definitely a surprising pick,” said Paul Rieckhoff, the CEO and founder of Iraq and Afghanistan Veterans of America. “McDonald is not a name that was on anyone’s radar over the last few weeks. His branding background may prove helpful because there are few organizations in America with a worse reputation toward customers than the VA right now.”
But Rieckhoff added that because McDonald had “been away from the military for quite a while, he’ll have to move quickly to show he is committed to and understands the post-9/11 generation of veterans.”
From 2009 to 2013 at Procter & Gamble, McDonald oversaw more than 120,000 employees as he directed a company that had operations around the globe. Officials noted Sunday that McDonald’s former company served more than 5 billion customers.
The president’s plans to nominate McDonald were first reported Sunday by The Washington Post.
If he is confirmed, McDonald will face a beleaguered $154 billion-a-year department whose major functions are stricken with a combination of operational and technological dysfunction; serious morale problems exacerbated by what administration officials now acknowledge is a corrosive management culture and hostility to whistle-blowers; and a lack of trust among many veterans.
The most severe problem is the scandal over falsified waiting lists that last month led to the ouster of the department’s top two officials, including Shinseki. He had characterized the lack of honesty and proper behavior at some of the department’s facilities as a “systemic, totally unacceptable lack of integrity” that he could not explain.
The waiting-list controversy revealed that veterans in many places faced long delays for appointments — delays that were hidden by administrators and scheduling employees who were under pressure to convince their bosses that waits were typically no longer than 14 days.
Results of investigations and audits in recent weeks have suggested that the cover-ups of the delays were spurred in many places by administrators whose performance ratings were tied to measurements of how long it took veterans to see doctors.
VA officials have already taken steps to eliminate what they now acknowledge were potentially perverse incentives to manipulate waiting-time data, such as eliminating performance bonuses this year for senior health care executives and deleting the 14-day goal from employee contracts.
But the underlying cause of the delays will be harder to address: The department’s medical centers and clinics have seen a sharp increase in visits scheduled by patients, particularly for primary care appointments, but the number of doctors and nurse practitioners available to see them has in many places barely grown.
Much of the demand has come from younger veterans of Iraq and Afghanistan with profound and complex injuries that require close monitoring and many follow-up visits. But most veterans seeking treatment at department clinics, though, are Vietnam veterans, many with chronic illnesses like diabetes that require long-term care, or with cancer or cardiovascular disease, which require complicated and expensive treatments.
In addition, if confirmed, McDonald will be confronted with the continuing problem of how to make sure veterans returning from the battlefield, some of them seriously injured or battling psychological problems, receive their disability compensation in a timely manner. In his 2008 campaign, Obama criticized delays in providing benefits to veterans and promised to make fixing the agency a top priority. But while the White House has bragged about making progress the timely distribution of benefits, the revelations this spring about delays in seeing patients has raised the agency’s profile to a new political level.
To win confirmation, McDonald will have to win over lawmakers in both parties. Records show that McDonald has made political contributions only to Republicans, giving $5,000 to Mitt Romney, the Republican presidential nominee in 2012, and $11,000 to the Romney Victory Committee. He also has made several contributions to House Speaker John A. Boehner and Sen. Rob Portman, R-Ohio.
Sen. Bernie Sanders, I-Vt., the chairman of the Veterans Affairs Committee, offered a neutral reaction Sunday to the president’s pick.
“The VA needs significantly improved transparency and accountability, and it needs an increased number of doctors, nurses and other medical staff so that all eligible veterans get high-quality health care in a timely manner,” Sanders said.
Boehner released a statement complimenting McDonald as “a good man, a veteran and a strong leader.” But he also said any Veterans Affairs secretary could succeed only “if his boss, the president, first commits to doing whatever it takes to give our veterans the world-class health care system they deserve by articulating a vision for sweeping reform.”
Correction: An earlier version of this story misspelled Procter & Gamble.