Commentary: If the guiding principle of modern-day conservative political philosophy is a smaller federal government, Donald Trump may be the most effective president ever to hold the office. For better or worse.
That gets lost, I think, in all the craziness and reality show schtick that constantly surrounds Trump.
The latest example is the firing of David Shulkin as Veterans Affairs secretary. Because of Trump, the focus has been on the crazy – the fact that Shulkin was fired by tweet hours after a phone conversation with the president that gave no indication the firing was coming. The fact that he was the third cabinet-level official, and the bazillionth high-ranking official to leave the White House. The fact that he was in trouble for taking a European vacation on the taxpayers’ dime. The fact that he was replaced by Trump’s physician, who is best known for the Saturday Night Live parody of his fawning press conference following the president’s annual physical examination.
All of that may be newsworthy, but it misses the bigger picture. And that is the ongoing debate as to whether we should even have a Veteran’s Administration at all. That is the debate Shulkin tried to draw attention to in his recent New York Times opinion piece.
“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,” he said. “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.
“Working with community providers to adequately ensure that veterans’ needs are met is a good practice. But privatization leading to the dismantling of the department’s extensive health care system is a terrible idea. The department’s understanding of service-related health problems, its groundbreaking research and its special ability to work with military veterans cannot be easily replicated in the private sector.”
All persuasive arguments if the goal is to meet our obligation to care for the men and women who risked their lives serving our country. If, however, the goal is to shrink the federal government, then you can’t find a more appealing target than the VA.
The Veterans Health Administration is the largest integrated health care system in the nation, with 1,240 health care facilities, including 170 medical centers and 1,061 outpatient clinics. All of this is to care for more than 9 million veterans enrolled in the program.
The VA is also responsible for administering all benefit and entitlement programs, for providing burial and memorial benefits and managing national cemeteries.
They have more than 377,000 employees and an annual budget of just under $200 billion.
Rear Admiral Ronny Jackson, the White House physician who has been picked by Trump to head the VA, is by all accounts an excellent doctor, a stellar Navy officer and an incredibly bright guy. But he’s never run a hospital, more less the nation’s largest health care system. He’s never managed anything close to the size of the VA. And, he would appear to be ill-suited for the political battles Shulkin describes in his column.
In short, he is over-matched. I don’t know if that was intentional or just crazy