President Donald Trump nominated Adm. Ronny Jackson, the White House physician who has no experience administering a large organization, to be secretary of Veterans Affairs, a department with a 360,000 employees and a US$186 billion annual budget.
Jackson is best known for his fulsome report on Trump’s health following an annual physical in January 2018.
Now, Jackson’s nomination is in trouble after allegations that he abused subordinates, created a hostile work environment, was drunk on the job, and freely passed out prescription pills including Ambien, Provigil and Percocet. The allegations come from various sources, including a summary prepared by Democratic Senate staff.
It is too early to determine if the allegations are true, and whether or not Jackson will be confirmed as Secretary of Veterans Affairs.
But whoever gets that position will have the task of trying to manage an agency that has long been in crisis. Nevertheless, the VA has pioneered evidence-based medicine and, overall, gets better outcomes at lower costs than many private health care providers.
As someone who has studied government budgets and the organization of government agencies, I believe Admiral Jackson, like his predecessor, will have to address three major problems if the VA is to be effective in meeting the needs of the millions of veterans who depend on it for their care.
First, the VA is funded much less generously than private medical providers. That means VA doctors earn substantially less than other physicians, making it hard to fill vacancies.