You can’t make this stuff up: President Trump has announced he will nominate a medical doctor who has no discernible management experience to run the second-largest agency in the federal government.

Can presidents be sued for malpractice?

The man Trump has named to “>become secretary of veterans affairs, Dr. Ronny Jackson, happens to be the president’s personal physician. More to the point, given Trump’s perpetual hunger for sycophancy, is the fact that Jackson showered the president with hyperbolic Dear-Leader-style praise during a widely viewed television appearance in January.

Trump has “incredibly good genes,” Jackson said in describing the physical examination he had given the president. Trump’s overall health is “excellent.” His “cardiac assessment” put him “in the excellent range.” If his diet had been a bit better, “he might live to be 200 years old.” In any event, “I think he will remain fit for duty for the remainder of this term and even for the remainder of another term if he’s elected.”

That is an unusual way to describe a 71-year-old man whose height was reported as a generous 6 feet 3 inches and weight at an eyebrow-raising 239 pounds, which classifies him as overweight—but conveniently just one pound short of obese. Jackson’s comments are odd words for a man whose cheeseburger-laden diet my doctor would describe as suicidal and whose coronary calcium scan results, according to many other physicians, indicate some degree of heart disease and a clearly elevated risk of heart attack.

I assume Jackson has been more, shall we say, plain-spoken with the president about his health than he was with the public. But am I suggesting that flattery, rather than merit, is what makes him Trump’s choice to replace ousted VA Secretary David Shulkin? Absolutely, because no other explanation makes sense.

Pliability may also be playing a role. In a New York Times op-ed, Shulkin wrote that he believed he was being sacked because he opposed a push by the Trump administration “to put VA health care in the hands of the private sector.”

Shulkin is also a physician, but before he took over at the VA he had experience running hospitals. With no comparable administrative background, Jackson—if confirmed by the Senate—would take over a sprawling agency with 360,000 employees, a $186 billion budget and responsibility for providing medical care to 9 million veterans who deserve better, faster service than they now receive.

Shulkin was one of several high-ranking Trump appointees under fire for lavish spending on the taxpayers’ dime. He was also a holdover from the Obama administration, and even though the job is perhaps the least partisan in the cabinet, that prior association clashed with Trump’s bratty determination to oppose everything Obama supported and support everything he opposed.

But Shulkin, by most accounts, had stabilized the VA’s vast system of hospitals and health clinics. What he refused to do was support the notion of privatizing veterans’ health care—an idea pushed by some of the political appointees the White House had installed under him.

“I am convinced that privatization is a political issue aimed at rewarding select people and companies with profits, even if it undermines care for veterans,” Shulkin wrote in his op-ed. “The private sector … is ill-prepared to handle the number and complexity of patients that would come from closing or downsizing VA hospitals and clinics, particularly when it comes to the mental health needs of people scarred by the horrors of war.”

Shulkin wrote that “in recent months” the political environment in Washington has become “toxic, chaotic, disrespectful and subversive,” making it impossible for him to do his job. “It should not be this hard to serve your country,” he wrote.

But it should be hard to get a job running any organization as big, complex and vital as the Department of Veterans Affairs. Perhaps Jackson has an innate genius for management that awaits only the opportunity to flower. If not, Trump will be doing a grave disservice to men and women who are owed the nation’s thanks and gratitude.

I can’t say I’m surprised. Trump put neurosurgeon Ben Carson in charge of the Department of Housing and Urban Development, despite Carson having zero experience in housing policy. He put Betsy DeVos in charge of the Department of Education, despite her apparent unfamiliarity with actual schools. He put politician Rick Perry in charge of the Department of Energy, which Perry wanted to eliminate until he learned what the agency does.

Perry actually said that at his confirmation hearing. One doesn’t know whether to laugh or cry.


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