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The Deeper Challenges Facing The VA

With Meghna Chakrabarti

Rear Adm. Ronny Jackson, President Trump’s pick to lead the Department of Veterans Affairs, has withdrawn from consideration. Fixing the VA won’t be easy for whoever ends up running it. There’s a political battle going on, but we’ll look at the deeper systemic challenges still facing the VA.


Leo Shane III, deputy editor for the Military Times, where he covers veterans affairs, Congress and the White House. (@LeoShane)

Paul Rieckhoff, founder and CEO of Iraq and Afghanistan Veterans of America (IAVA), the country’s largest organization for Iraq and Afghanistan veterans. He served as an Army First Lieutenant and infantry rifle platoon leader in Iraq from 2003-2004. (@PaulRieckhoff)

Nancy M. Schlichting, former chair of the Department of Veteran Affairs’ Commission on Care and retired CEO of Henry Ford Health System.

Highlights From The Hour

On the allegations against Rear Adm. Ronny Jackson

Leo Shane III: “A lot of allegations here. Nothing proven, but a lot of questions from senators about accusations that he was drunk on the job, that he was mishandling medication, that he was an abusive boss in a lot of cases. And frankly, the allegations were one set of problems, and the fact that senators were blindsided by them were another set of problems.

“There were questions on both sides of the aisle about how much of this might be true, how much might not be true. Sen. [Jon] Tester, you know, sort of pushing back on these White House accusations that this was just obstructionist Democrats, said that they’ve talked to 23 current and former service members about this, and not just one or two anonymous attacks, but really what they are seeing as a pattern of potential problems that just haven’t been answered by the White House yet.”

On the challenges that the VA secretary will face

LS: “This whole controversy with Adm. Jackson is not really about VA. This is about the White House and his background and the vetting process. But unlike some of the other problems we’ve seen with VA, this isn’t talking about veterans’ care or veterans’ benefits or the services they deliver. But that has been the issue for the last four years, really since VA Secretary Eric Shinseki was forced to resign following a bit wait time scandal and doctoring of medical records back in spring of that year. And we’ve seen just about every top level VA person since then have a dual role of working to reform the agency, but also working to do some PR, working to sort of burnish the public image of the agency, convince people that it’s a system worth saving and not a system that’s so broken that it can’t move forward.”

On how to get past the political chaos

Paul Rieckhoff: “You mention the turnover at VA secretary, really, over the last 15 years, and it’s important. I mean, roughly every two years or so, Leo and I are on the radio and TV talking about a new VA secretary nominee. There have been four since I got home from my tour in Iraq, so instability is the norm now. And the Veterans Affairs team and workforce and atmosphere has been overwhelmed by chaos and starts and stops and increasing levels of politics. So our veterans are caught in the middle.

“And I think it’s important to note that this doesn’t just impact the veterans who use VA, and there are millions of them. This impacts our national image — how we are viewed by the public, how we are viewed by corporate partners. This person is not just an administrator, they’re also the leading veterans advocate. So when there’s a shooting, or there’s an employment push, this is the face of our community. So having this kind of constant twisting and turning and changeover is bad for veterans, it’s bad for our country and I think it’s important to note, too, it’s bad for our national security. This impacts recruiting, this impacts retention.”

On surveying veterans, and what they want

PR: “They want to focus on combating suicide, they want to see reform for women’s care, but most of all they want leadership. That’s what they expect in the military, that’s what we expect at the VA and in Washington.”

On what we need from a VA secretary

PR: “We really need a multi-sport athlete. We need someone who can do a lot of different things well in the middle of a pressure cooker. … They wanna know that they’ve got somebody in charge that gets it. And I think for our members — you know, their average age is in their early 30s, they’re more diverse than the previous generations, they’re 20 percent women — they want someone who’s served since 9/11, someone who’s been in Iraq and Afghanistan, who understands our health needs, who understands the dynamics of the integration of the National Guard and reserve. And I think there’s another really important point: We need someone who understand the media. Because a big part of the job as VA secretary is kind of constant crisis communication.”

On what the next VA secretary should take on first

Nancy M. Schlichting: “Obviously this is a very complex task, and the work of the [Department of Veteran Affairs’ Commission on Care] put together, basically, a strategic plan for the next 20 years. And we focused on all of these issues, and particularly tried to find the balance around privatization. Because today about a quarter of the care provided to veterans is provided in the private sector because the veterans system can’t do it all. But we wanted to create a more integrated model, basically to have the private sector working hand in glove with the VA in each marketplace to make sure that the best care is available for our veterans. And that’s a complex thing to actually design and to figure out how to do.”

On how we transform all of this talk into action

PR: “In every single community there’s something you can do. Find a local veterans group. Go volunteer. Donate right now. Learn more about these issues. Do research. I mean, people in this country, generally, philanthropically, support their faith-based initiatives, education, where they went to school. The veterans philanthropy world is basically non-existent. Most Americans assume that the government’s got it covered, and nonprofits like ours are overwhelmed with demand.”

NS: “I think when it comes to things that we can do in every community, particularly for health care — I mean I was embarrassed, running the Henry Ford Health System, that I had never met the director of the VA medical center in Detroit. And, in this process, I realized that kind of collaboration would be very helpful on both sides, figuring out ways the private sector can do a better job treating the veterans that they care for and working to include and engage the leaders of the various medical centers and clinics across the country. There’s a lot we can do together to improve the community support for veterans.”

On the quality of VA health care

Our caller, Joel from Charlotte, North Carolina: “My father was a World War II vet, and he suffered a brain tumor that basically eventually made him require to live in a nursing home. And he went to the sixth floor of the veterans administration hospital in Syracuse, New York, and he was cared for, for six months in skilled nursing. And he passed away on Christmas Eve with zero bedsores. I mean, the people that were there that took care of him were the kindest, most generous and gentlest people we’ve ever known. And the VA has people like this. We should definitely celebrate that.”

From The Reading List

Washington Post: “Ronny Jackson withdraws as nominee to lead Veterans Affairs after wave of misconduct allegations” — “White House physician Ronny L. Jackson has withdrawn himself from consideration to lead the Department of Veterans Affairs following numerous allegations of professional misconduct, including that he had wrecked a government vehicle after getting drunk at a Secret Service going-away party. In a statement, Jackson called the allegations against him ‘completely false and fabricated.’ ”

Military Times: Latest allegations against VA nominee Jackson: Drunken driving, fake prescriptions, abusive leadership” — “Hours after White House officials asserted that their pick for Veterans Affairs secretary has undergone “more vetting than most nominees,” Senate Democrats released a list of 20 unresolved allegations against the would-be Cabinet official they say must be answered before a confirmation hearing.

“The charges include accusations that White House physician Ronny Jackson, an active-duty Navy rear admiral, wrote false prescription orders for himself and others, undermined superiors and subordinates to cover his mistakes, and frequently drank while on duty, one time crashing a government vehicle while intoxicated.”

Washington Post: “We can fix veterans’ health care without privatizing it. Here’s how.” — “The idea of doing away with the entire system and turning it over to the private sector is not only frightening, it’s morally reprehensible. And yet, if some high-level VA officials in the Trump administration get their way , that’s what would happen.”

Rear Adm. Ronny Jackson has withdrawn from consideration to lead the Department of Veterans Affairs. He was an embattled nominee to say the least, with allegations of improper behavior as the White House’s top doctor. President Trump blames what he calls “obstructionist” Democrats. But beyond the politics, there’s still the VA. Huge. Troubled. Serving 9 million veterans and in need of stability, modernization, vision. Those challenges face anyone who’ll lead the VA.

This hour, On Point: who and what it will take to fix the VA.

— Meghna Chakrabarti

Copyright 2021 NPR. To see more, visit https://www.npr.org.

U.S. Navy Rear Adm. Ronny Jackson, M.D., left, sits with Sen. Johnny Isakson, R-Ga., chairman of the Veteran's Affairs Committee, before their meeting on Capitol Hill, Monday, April 16, 2018 in Washington. Jackson is President Donald Trump's nominee to be the next Secretary of Veterans Affairs. (Alex Brandon/AP)
U.S. Navy Rear Adm. Ronny Jackson, M.D., left, sits with Sen. Johnny Isakson, R-Ga., chairman of the Veteran's Affairs Committee, before their meeting on Capitol Hill, Monday, April 16, 2018 in Washington. Jackson is President Donald Trump's nominee to be the next Secretary of Veterans Affairs. (Alex Brandon/AP)