The 4 Biggest Challenges the Next VA Secretary Faces

McDonald will inherit a scandal-plagued department with few easy fixes.

National Journal
Jordain Carney
June 30, 2014, 8:23 a.m.

We now know who will in­her­it the broken Vet­er­ans Af­fairs De­part­ment, but fix­ing the agency’s bur­eau­crat­ic night­mare will be no easy task.

Pres­id­ent Obama on Monday af­ter­noon nom­in­ated Robert Mc­Don­ald, a former CEO at Procter & Gamble who re­tired from the com­pany in 2013. And though vet­er­ans ad­voc­ates and law­makers alike hope that Mc­Don­ald will be able to use the ma­na­geri­al skills he honed in the private sec­tor to whip the de­part­ment in­to shape, he must pri­or­it­ize the VA’s many mov­ing parts.

Here are some of the biggest chal­lenges fa­cing Mc­Don­ald, as­sum­ing he is con­firmed by the Sen­ate.

Stop the bleed­ing: Let’s not fool ourselves: Mc­Don­ald is be­ing brought in to clean up a cata­stroph­ic mess.

The de­part­ment has suffered through scan­dal after scan­dal as gov­ern­ment in­vest­ig­at­ors un­cov­er evid­ence of na­tion­wide ma­nip­u­la­tion of data on how long vet­er­ans wait to re­ceive med­ic­al care at VA fa­cil­it­ies as well as al­leg­a­tions of vet­er­ans dy­ing while wait­ing for care.

And, most likely, with in­vest­ig­a­tions still on­go­ing — in­clud­ing crim­in­al al­leg­a­tions of fraud — there are more rev­el­a­tions to come.

Al­though the scan­dal — and the be­ha­vi­ors that caused it — pred­ate Mc­Don­ald’s nom­in­a­tion, vet­er­ans ad­voc­ates ar­gue that the easi­est way he could do harm would be to not be hon­est about how deep the scan­dal goes.

“Ac­cess­ib­il­ity and ac­count­ab­il­ity are the key,” said John Raughter, a spokes­per­son for the Amer­ic­an Le­gion, when asked how Mc­Don­ald should bal­ance a scan­dal he had no part in cre­at­ing.

But simply mak­ing sure things don’t get any worse won’t be enough.

Fix the VA’s “cor­ros­ive cul­ture”: It’s an ill-defined prob­lem with even more am­bigu­ous an­swers on how to fix it, and it is — without a doubt — Mc­Don­ald’s biggest chal­lenge.

The fo­cus on the VA cul­ture, in­clud­ing a damning re­port re­leased Fri­day from White House ad­viser Rob Nabors and act­ing Sec­ret­ary Sloan Gib­son — has spot­lighted the ma­nip­u­la­tion of wait times by hos­pit­al staff as well as the wide­spread prob­lems with per­son­nel ac­count­ab­il­ity.

And though the buck stops with Mc­Don­ald, he has plenty of people who would like to tell him ex­actly what to do. This in­cludes law­makers and a grow­ing num­ber of ad­voc­ates who want the VA sec­ret­ary to have great­er fir­ing power — par­tic­u­larly over seni­or of­fi­cials, who they say have al­lowed the secret wait lists to ex­ist for years as they faced pres­sure to meet dead­lines handed down from the top.

At the same time, ad­voc­ates want the VA to hire more doc­tors and in­crease vet­er­ans’ ac­cess to private health care. They also want law­makers to give the de­part­ment more money, something Rep. Jeff Miller, who heads the House Vet­er­ans’ Af­fairs Com­mit­tee, has sug­ges­ted won’t solve the deep­er crisis at the VA.

The Flor­ida Re­pub­lic­an wrote in an op-ed last week that giv­ing the VA more money “is merely a short-term, emer­gency solu­tion de­signed to deal with a bona fide emer­gency that VA cre­ated.”

And though law­makers have been fo­cused on the re­cent health care scan­dal, vet­er­ans ad­voc­ates be­lieve the prob­lems at the de­part­ment spread far bey­ond its med­ic­al fa­cil­it­ies. For ex­ample, the U.S. Of­fice of Spe­cial Coun­sel an­nounced earli­er this month that it will look in­to al­leg­a­tions of re­tali­ation against 37 VA whistle-blowers, which could muzzle fu­ture com­plaints.

“The re­tali­ation against whis­tleblowers — that’s a cul­tur­al prob­lem that needs to be ad­dressed,” Raughter said.

And be­ne­fits work­ers also have to tackle the moun­tain of fre­quently over­looked pay and pen­sion claims — namely an in­creas­ing num­ber of ap­peals that can leave vet­er­ans in limbo for an av­er­age of two and a half years.

Win back vet­er­ans’ trust: Mc­Don­ald is a sur­prise pick by any­one’s ac­count. Scan the many lists pub­lished on who could be the next VA sec­ret­ary, and you’ll no­tice one thing pretty quickly: He isn’t on any of them.

Vet­er­ans ser­vice or­gan­iz­a­tions have com­plained that they have felt they were left out of the loop by the VA as it faces one of its worst scan­dals in re­cent his­tory. They hope Mc­Don­ald will change this.

“He will need to reach [out] to VSOs and oth­er lead­ing ad­voc­ates for vets. The White House did not reach out to VSOs dur­ing their search pro­cess, and we hope they will now. The VA can­not do it alone,” Paul Rieck­hoff, founder of Ir­aq and Afgh­anistan Vet­er­ans of Amer­ica, said in a state­ment.

The Amer­ic­an Le­gion was an early back­er of the push for Eric Shin­seki to resign, com­ing out ahead of the wave of law­makers who would even­tu­ally call for him to step down.

While Mc­Don­ald is him­self an Army vet­er­an, he doesn’t fol­low the trend of tap­ping a top mil­it­ary of­fi­cial to lead the de­part­ment. Mc­Don­ald will “have to move quickly to show he is com­mit­ted to and un­der­stands the post-9/11 gen­er­a­tion of vet­er­ans,” Rieck­hoff said.

“We think that restor­ing trust is the No. 1 chal­lenge ahead of him,” Raughter said.

In many ways, Mc­Don­ald will have to prac­tice jug­gling his pri­or­it­ies to vet­er­ans while also keep­ing the de­part­ment on track to reach two key de­part­ment goals next year: End­ing the back­log of dis­ab­il­ity com­pens­a­tion and pen­sion claims and stop­ping vet­er­ans’ home­less­ness.

“They’re far, far short of the goal to elim­in­ate vet­er­ans home­less­ness.”¦ We hope to see them con­tin­ue to make pro­gress,” he said.

Don’t say any­thing stu­pid: Of course, to be­come the lucky per­son re­spons­ible for all of these chal­lenges, Mc­Don­ald has to get over one cru­cial hurdle — Sen­ate con­firm­a­tion.

So far law­makers are ex­press­ing hope that he can cure the VA’s many ills. Or they are at least — in the case of Sen­ate Vet­er­ans’ Af­fairs Com­mit­tee Chair­man Bernie Sanders — hold­ing off on pub­licly form­ing their opin­ion on Mc­Don­ald un­til after they meet with him.

But the VA is cur­rently a polit­ic­al light­ning rod, and law­makers have shown little tol­er­ance for VA of­fi­cials who they think are try­ing to down­play how ser­i­ous the crisis is that is now fa­cing the de­part­ment.

What We're Following See More »
FIRST WOMAN NOMINATED BY MAJOR PARTY
Hillary Clinton Accepts the Democratic Nomination for President
1 hours ago
THE DETAILS

"It is with humility, determination, and boundless confidence in America’s promise that I accept your nomination for president," said Hillary Clinton in becoming the first woman to accept a nomination for president from a major party. Clinton gave a wide-ranging address, both criticizing Donald Trump and speaking of what she has done in the past and hopes to do in the future. "He's taken the Republican party a long way, from morning in America to midnight in America," Clinton said of Trump. However, most of her speech focused instead on the work she has done and the work she hopes to do as president. "I will be a president of Democrats, Republicans, and Independents. For the struggling, the striving, the successful," she said. "For those who vote for me and for those who don't. For all Americans together."

COUNTER-CHANTS AT THE READY
Protesters Make Good on Threat to Disrupt Speech
1 hours ago
THE LATEST

Supporters of Bernie Sanders promised to walk out, turn their backs, or disrupt Hillary Clinton's speech tonight, and they made good immediately, with an outburst almost as soon as Clinton began her speech. But her supporters, armed with a handy counter-chant cheat sheet distributed by the campaign, immediately began drowning them out with chants of "Hillary, Hillary!"

SUFFOLK POLL
New Survey Shows Clinton Up 9 in Pennsylvania
10 hours ago
THE LATEST

If a new poll is to be believed, Hillary Clinton has a big lead in the all-important swing state of Pennsylvania. A new Suffolk University survey shows her ahead of Donald Trump, 50%-41%. In a four-way race, she maintains her nine-point lead, 46%-37%. "Pennsylvania has voted Democratic in the past six presidential elections, going back to Bill Clinton’s first win in 1992. Yet it is a rust belt state that could be in play, as indicated by recent general-election polling showing a close race."

Source:
$500 MILLION PROJECT
Obama Library Heading to Jackson Park in Chicago
10 hours ago
THE DETAILS

"President Barack Obama has chosen Jackson Park, a lakefront park that once hosted the world’s fair on the city’s South Side, for his $500 million presidential library, according to a person familiar with the matter."

Source:
THREE NIGHTS RUNNING
Democrats Beat Republicans in Convention Ratings So Far
10 hours ago
THE DETAILS

Wednesday was the third night in a row that the Democratic convention enjoyed a ratings win over the Republican convention last week. Which might have prompted a fundraising email from Donald Trump exhorting supporters not to watch. "Unless you want to be lied to, belittled, and attacked for your beliefs, don't watch Hillary's DNC speech tonight," the email read. "Instead, help Donald Trump hold her accountable, call out her lies and fight back against her nasty attacks."

Source:
×