In the 88 years since the founding of the modern Department of Veterans Affairs, presidents have mostly turned to retired military officers and politicos to run the massive agency. Most have failed. The agency’s size, complexities, and politics have flummoxed even the most capable of leaders.
Enter Ronny Jackson—a Navy doctor who saw combat in Iraq and went on to serve as White House physician, caring for three presidents including President Donald Trump. Jackson is now being nominated to replace David Shulkin at the helm of the government’s second-largest agency. Jackson’s impressive military medical record, and bipartisan support, will likely smooth the path for a relatively quick confirmation. But after that, a swamp of policy, political, and cultural fights awaits him at the VA.
The VA’s policy fights owe much to its size and complexity. The agency runs a portfolio that includes physical and mental health care, disability compensation, education benefits, home loan guarantees, life insurance, burials, and much more, consuming nearly $200 billion a year and requiring more than 340,000 employees. Most of the VA will be new to Jackson, whose professional life has existed within the relatively insular military.
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