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VA leadership requires more than the Trump shuffle

White House physician and nominee for Veterans Affairs Secretary Ronny Jackson arrives at the annual White House Easter Egg Roll on the South Lawn of the White House on April 2.Associated Press/Andrew Harnik

By now, Donald Trump’s process of filling key jobs in his administration should be mind-blowingly familiar.

First, fire the incumbent by tweet — in this case, Veterans Affairs Secretary David Shulkin, a respected physician appointed by President Obama with overwhelming bipartisan support.

Next, apply beauty-pageant standards to the global search for a replacement. Affable and telegenic? Check. Has lavished praise for Trump’s intelligence, stamina, and robust health? Check. Military record with nary a bone spur deferment in sight? Check again.

But Ronny Jackson, the newest winner in Trump’s round-robin reality show, should face heightened scrutiny from Congress, which must approve his nomination as head of the second-largest federal department — one that oversees the benefits, health care, and well-being of more than 9 million veterans.


Jackson, a rear admiral in the Navy, has been White House physician for former presidents George W. Bush and Barack Obama. He has solid credentials in emergency medicine, and served as an emergency doctor during Operation Iraqi Freedom. While his background as a veteran may help him understand the struggles of the VA’s core constituency, his lack of experience as a manager is worrisome. Just as troubling, while Jackson awaits confirmation, the agency will be in the hands of acting secretary Robert Wilkie, a former aide to North Carolina Senator Thom Tillis, instead of Shulkin’s trusted deputy, Thomas Bowman.

If confirmed, Jackson would be jumping unarmed into an agency that is front and center in the complex and fractious debate over soaring health care costs, and a seeming target of small-government zealots like David and Charles Koch.

Already, more than 30 percent of VA medical appointments are provided by the private sector, primarily in regions where there is no nearby VA hospital. And Shulkin himself once called for more public-private partnerships to alleviate scandalous waiting times and access issues.


But any wider effort to push millions of vets who receive government-funded health care into the private sector risks creating chaos at a time when those who have served in Iraq and Afghanistan are flooding into the system. Proposals for more drastic free-market changes, like those advocated by the Koch-associated Concerned Veterans for America, need a full airing before Congress and a realistic assessment of economic impact.

By all accounts, Ronny Jackson served his country honorably, and is a respected personal physician. But lawmakers have a duty to assure good health care for the servicepeople who fight the nation’s wars and keep the peace. In the end, that’s what confirmation hearings must address.