Trump's VA options: Play it safe, or roll the dice on outside-the-box reform

Perhaps no Cabinet department got more attention from Donald Trump than the Veterans Administration. From the first rallies of his campaign in the summer of 2015, Trump focused on veterans who got denied medical care and other benefits. He raised the profile of the scandals at the VA by demanding that broadcasters profiting off of the televised debates make contributions to veterans’ charities, and conducted his own fundraiser. His campaign website offered a detailed vision on VA reform, more detailed than some of Trump’s positions on other normally higher-profile issues.

The choice of VA Secretary will send a big message as to how seriously Trump takes these pledges. As Allahpundit noted earlier, the Washington Free Beacon reports that the transition team seems to have narrowed their choices down to two or possibly three options: Sarah Palin (reported by ABC), former Senator Scott Brown, and former president of Concerned Veterans for America Pete Hegseth, now a Fox News contributor. Allahpundit’s excellent analysis on Palin’s chances speaks extensively to that option, so be sure to read it.

If the focus has come down to the other two potential nominees, Trump has options for two different approaches — either of which would be valid, for different reasons. Scott Brown served in the US Senate and is a veteran himself. Brown would definitely be a safer choice in a confirmation hearing, in part because of his former membership in the upper chamber, and also because of his centrist reputation. He’d be easier to sell as an agent for incremental reform.

If Trump is inclined to start VA reform by attempting to repair and improve the bureaucracy in place now and clean up performance issues alone, Brown would be better option. Keep in mind that Trump has already made that case when it comes to the other major single-payer health system in Washington, rejecting any major Medicare restructuring in favor of fixing “waste, fraud, and abuse.” Trump might not be terribly keen on a total overhaul at the VA while fighting to repeal and replace ObamaCare, and might be concerned with prioritizing political capital for that fight. Unlike ObamaCare repeal, which could be accomplished in large part through the “reconciliation” process by which it was passed, it will be much tougher to get a real VA overhaul through the Senate, and Brown might not be the messenger to see it through.

If Trump wants to fulfill the pledges made in his campaign, however, incremental reform won’t work. Point 10 on his agenda in particular points to an overhaul rather than a tweak: “Ensure every veteran has the choice to seek care at the VA or at a private service provider of their own choice. Under a Trump Administration, no veteran will die waiting for service.” That is a commitment to move away from the single-payer system, and it will take someone well versed in that kind of reform to achieve it.

Hegseth fits that bill well. Although only 36 years old, Hegseth served as an infantry officer in Guantanamo Bay, and in Baghdad and Samarra on his next tour, receiving a Bronze Star among other commendations. When he returned, he founded Vets for Freedom to argue for a commitment to victory in Iraq, but eventually became CEO of Concerned Veterans for America, a group that focused on overhauling the Veterans Administration to provide choice for veterans in health care. Under his leadership, CV4A produced an extensive, detailed, and bipartisan proposal for exactly the kind of bold action that Trump promised during the campaign. Despite offering to work with the Obama administration on reform, that proposal and CV4A have been shut out in favor of Barack Obama’s ideas of incremental reform. And we have seen how well that’s worked out.

The CV4A approach might have a better chance of getting through the Senate under the direction of a well-versed and energetic young VA Secretary with depth on the issue of reform. Hegseth put it together with former Senate Majority Leader Bill Frist, and Democratic Congressman Jim Marshall, both of whom can assist in generating support across the aisle. It will need to get 60 votes because of the legislative filibuster, which Republicans should leave in place, so it will need some bipartisan support. It’s still going to be a political risk, but Trump has pledged to fight for just that in regard to veterans.

For full disclosure, Pete and I have known each other for more than a decade; he was a frequent guest on our Northern Alliance Radio Network during and after his active-duty Army service, and I’ve interviewed him a number of times for Hot Air. Almost every interview has focused on the issue of health care for veterans, though, because that’s where Pete’s focus has been all along, even before the more recent VA scandals.  However, I am hardly alone in noting his qualifications for this appointment. Key Trump adviser Newt Gingrich and CNN contributor S.E. Cupp told American Military News that he has the background and plan needed for the job:

Former Speaker of the House Newt Gingrich told American Military News, “No one has been more effective than Pete Hegseth in advocating reform of veterans health.” Gingrich previously called the 10-point plan developed under by Hegseth and his team at CVA a “historic document” and gave large praise and support for the plan in 2015.

To many, Hegseth has the ideal combination of experience, passion, national following and goodwill from all corners of the military and veteran community to overhaul and dramatically reform the Veterans Administration for the 21st century. …

The next VA Secretary will be expected to provide an organizational rethink and modernization of the agency. Criticism over the current management of the VA is at an all-time high, and whoever is appointed to the position under President-elect Trump will be expected to focus on accountability, transparency, and communicating changes to the public.

CNN commentator S.E. Cupp, when asked about Hegseth, told American Military News, “When it comes to veterans’ issues, no one is more qualified or compassionate than Pete. He is, in no uncertain terms, exactly who the Veterans Affairs department needs to lead it out of the dark ages and into the 21st century.” One senior healthcare executive that works with the VA said the VA needs, “clear eyes, mission focus and passion to lead the VA.” and that “Hegseth embodies what is needed.” The executive declined to have their name appear publicly due to potential complications his comments could create.

Both of these candidates have value for this position, although notably not as bureaucratic turn-around artists. If Trump wants to take a careful approach, both politically and in policy, Brown would deliver a low-key confirmation and would certainly be capable of managing the bureaucracy. If Trump wants to boldly transform the VA through a structural overhaul and create a responsive agency aimed at veterans rather than bureaucratic perpetuation, it will take an outside-the-box candidate with Hegseth’s expertise, and willingness to face the political risk to achieve it. The appointment will tell us which path Trump plans to take.