Among all the various things Donald Trump promised on the trail, few will be more central to the argument that his Administration has succeeded or failed than whether he can say, four years from now, that he made meaningful improvements in our system of veterans’ healthcare. The VA healthcare system has been a scandalous failure under President Obama, a failure that is mostly not Obama’s doing (most of its causes predate him) but against which he’s made little headway. A thorough housecleaning is long overdue at the VA, as both parties on Capitol Hill have recognized. And unlike many other issues, providing healthcare for military veterans is fundamentally the responsibility the Executive Branch of the federal government. That’s true even if you think a component of any fix should be some kind of quasi-privatization like a voucher system. The VA hospitals aren’t going to disappear overnight. The next VA Secretary doesn’t even need to be much of a conservative, as long as it’s someone who is open to introducing some free-market principles and insights into the system. It absolutely needs to be someone who knows how to manage and get results.
Trump made fixing the VA a major theme on the stump, and the nation’s veterans responded with more enthusiasm to his campaign than almost any other group. Exit polls showed that Trump won military veterans by a smashing 60-34 margin. Trump’s sincerity on any given issue is less than a certainty, but this is one of the handful of causes he really did act as if he cared about.
Which brings us to the Secretary of Veterans Affairs, one of the remaining appointments (along with higher-profile jobs like State and Defense) that Trump has yet to fill. Characteristically, there have been a number of names floated – Sarah Palin, Scott Brown, retiring Florida Congressman Jeff Miller (presently the chairman of the House Committee on Veterans’ Affairs). Interestingly, Brown (who spent 32 years in the National Guard) is the only military veteran.
Personally, I’ve been arguing for some time now – since before we knew who the nominee would be – that the next VA Secretary should be someone meeting one or both of two criteria. One, a heavy hitter, with a much higher profile than is usual for this job – a Mitt Romney, a Jeb Bush, a Rick Perry (Perry is an Air Force veteran himself). Somebody who can walk into the disaster area of the VA with the public credibility and backing of the President to say “things are going to change around here.” And two, someone with serious executive and/or healthcare management experience in order to follow through, hold people accountable, and get things done. Someone like Romney or Bobby Jindal or even Mike Bloomberg would have the needed work ethic and expertise to pull this off, although Romney seems to be mainly under consideration for the State job. Rudy Giuliani would have been a good fit twenty years ago.
Trump doesn’t seem to be drafting off the “A” list, unfortunately, but Miller – having been involved in legislative oversight of the VA – would be a vastly better choice than Palin or Brown. Palin was a hardworking, hands-on executive as Alaska Governor, and veterans’ healthcare is an issue she’s undeniably passionate about, but nothing we have seen from her in the past five years or so suggests that she still has the work ethic and attention to detail for a task like this. Her performances on the campaign trail in 2016 were so rambling and incoherent that even the Trump campaign – which fielded some of the worst surrogates in the history of presidential politics – shunted her offstage in an apparent fit of embarrassment. Even leaving aside the potential three-ring circus of a Sarah Palin confirmation hearing, it’s very hard to picture her being effective at bringing an intransigent and entrenched bureaucracy to heel. She’d be a terrible choice, and that’s coming from someone who once thought highly of her. Brown’s post-Senate career has not been as embarrassing, but he’s had no real executive experience and did not exactly distinguish himself as a Senator.
Miller, at least, brings recent subject-matter expertise to the job. But Trump should think bigger. The VA doesn’t need a chief legislator or a reality-TV star, it needs a turnaround expert.