As I'm writing this, Donald Trump has still not named a nominee to head the Department of Veterans Affairs. Maybe he will have, shortly after this is published. But, even if he does, the struggle he has had to find anyone qualified willing to take the job, thus far, is demonstrative of a bigger issue: He can't find someone well-qualified who wants to execute his plan to turn VA Care into voucher-care.
The Cleveland Clinic's Toby Cosgrove (Trump's rumored favorite for the job) told Trump "thanks, but no thanks." Another top pick, Luis Quinonez turned down the job, after meeting with Trump. Thus far, Donald Trump doesn't seem to have found anyone qualified for the job. Maybe it's because of what Trump has told his potential nominees what he wants to do to the VA.
Donald Trump and his advisors could not have been more clear during the campaign. He was going to move veterans' health care to voucher-care. The Wall Street Journal detailed Trump's thinking way back during the summer:
Donald Trump Adviser Signals Plan to Change Veterans' Health Care
GOP front-runner would likely push VA toward privatization, shift to an insurance model
While the scandal that rocked the agency, regarding wait times, brought new attention to the agency's fixable shortcomings, the VA still enjoys tremendous favorability among veterans who use its services, according to independent surveys. Not only that, but the VA consistently delivers a higher level of care than private hospitals, according to the RAND Corporation. A bi-partisan poll found that a majority of veterans strongly opposes the privatization of the VA.
In short, the VA provides high-level care that veterans, overall, very much like. And there's a relatively simple way to address the issues that the VA does have. We should provide it with the funds it needs to hire more doctors and staff, retain good doctors by offering competitive pay, and building more VA centers to deal with the influx of veterans who have entered the system as a result of the wars in Iraq and Afghanistan. And while that is happening, programs like Veterans Choice should remain in place, which temporarily allow veterans who have waited the longest to get full reimbursement for private care.
But Trump has another idea. He's aligned himself with the Koch Brothers, and Concerned Veterans of America, which they fund, in seeking to slowly strangle guaranteed care for veterans, by privatizing the system.
That plan would do a few things.
First, much like school vouchers, VA insurance or care vouchers would be useful for those who could supplement them to get the kind of care they need. For those who couldn't, they'd be left behind in a dreadfully underfunded VA.
Second, it would put veterans in a system with a profit motive, not a care motive. For all the issues facing the VA, the one thing that cannot be said about it is that it looks to cut costs by denying care -- something that can be said about the private care system.
Third, it would bleed the system dry, forcing mass closures of VA hospitals and care centers. Those centers are specially qualified to handle the needs of veterans that many hospitals and doctors are not qualified to handle -- from prosthetics to traumatic brain injuries to exposure to Agent Orange and burning oil fields. Not every neighborhood hospital is able to handle those unique needs. And so, veterans would be left with a voucher and a message of "good luck finding someone who can care for your brain injury," from Donald Trump.
It's fairly likely that people like Mr. Cosgrove and Mr. Quinones realize that, and Trump's privatization plan was a factor in them turning down the job. And, it's likely the reason that, thus far, the only people who seem eager to be the veterans hatchet person are Koch-affiliated CVA Founder Pete Hegseth, failed former Senator Scott Brown, and half-term Governor Sarah Palin.
Maybe by the time this is published, Donald Trump will have reversed course, and given up VA privatization, so he can bring on someone qualified to lead the agency. One can only hope.
With just days until the new administration takes over, no transition to a new team at the VA has even started. Even before he takes the oath of office, veterans are already losing, under Donald Trump. Sad!