Donald Trump

Donald Trump Does Not Really Have a Plan to Fix the V.A.

Trump's team talks vaguely of privatization, but there's no substance.

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Does Donald Trump really have a plan to fix the Deaprtment of Veterans Affairs (V.A.)?

credit—Tom Williams/CQ Roll Call/Newscom

On the campaign trail, he blasted the Obama administration's handling of the V.A., and promised repeatedly to address problems in the system. This is an issue he's stuck with since the election, declaring as recently as Wednesday of this week that "we're working on something to make it great for the veterans."

So what's his plan? On Trump's website, there's a 10 point V.A. reform "vision." But that plan basically amounts to firing bad managers, hiring better ones, and then taking some other unspecified steps that fall under the heading of "modernization" while maybe putting more money towards providers. Or just shifting existing money around. Who knows, really?

Like a lot of Trump's policy ideas, the particulars were mostly unclear. Now that Trump is headed for the White House, however, we can presumably expect more details. Or maybe not.

Trump met with hospital executives in Florida yesterday, and then called out to nearby press, indicating that he wanted to talk about his plans to reform the V.A., according to The New York Times. After the reporters gathered, however, he directed them towards a senior aide, who would only speak under condition of anonymity.

Here is how the Times described the Trump aide's responses: "The official, speaking on the condition of anonymity, provided no details about how the plans would work, how much they would cost, or the possibility of unintended consequences from privatizing part of the V.A.'s sprawling medical system."

There are two things worthy of note in that short description. The first is that it is always refreshing to see the Times and other major outlets recognize the possibility of unintended consequences from policy reforms, even those that have not been explained in any detail, although it would be nice if this were applied somewhat more frequently.

The second is that despite Trump's signal to reporters that he wanted to lay out some reform ideas, he does not have anything resembling real plans in mind.

In a report on the same event, The Wall Street Journal notes that the anonymous Trump official indicated that it was possible that some totally unspecified sort of privatization option allowing veterans to access care outside the V.A. system was a possibility. But the official wouldn't elaborate or commit to anything. "It's one of the options on the table…Definitely an option on the table to have a system where potentially vets can choose either or, or all private." One of the options. On the table. Potentially!

This isn't a half-baked idea. It's a couple of ingredients you think you might have stocked in a cupboard.

Part of the problem here is that the headlines seem to imply that Trump has some sort of serious plans in the works. "Trump Weighs Letting Veterans Opt Out of VA Medical Care" is how the Times framed it. "Donald Trump Considers Moving VA Toward Privatization" was the Journal's top line. Trump does not appear have plans so much as vague avenues of possible action and exploration, with no clarity about what those possibilities might entail. They are plans in the sense that I have planned a trip to France in the next two years. (It's true that I have not ruled out the possibility of a trip to Europe. But that is as far as my "planning" has gone.)

But mainly it's an issue with the incoming Trump administration, which continues to appear to be totally averse to detailed policy planning.

That's a shame, because the V.A. could really use a serious and committed reform effort. The program has wasted billions of dollars in public funding each year, and overall management been spectacularly poor in recent years in ways that have been detrimental to veterans health. V.A. reform therefore should be a priority for the administration, and opening up the system to allow veterans to have more options from private providers should be part of the process. But it's not clear that Trump has any such plans in the works, or that his closest aides have any more details themselves. Rather than grasp the details of the problem and the possible solutions, Trump seems to understand the issue entirely in terms of its effectiveness as a retail politics selling tactic. Right now it seems as if Trump's plan to fix the V.A. is no plan at all.

NEXT: Dirty Words

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  1. Like a lot of Trump’s policy ideas, the particulars were mostly unclear.

    How…. unstatesmanlike.

    1. Are Suderman and Robby related somehow? Trump does have a promise to live up to, to be sure, but oddly no one seems to ponder why it is that the need for such a promise arose.

      1. Are Suderman and Robby related somehow?

        Not with that hair.

    2. Yes, but just because they all know that specifics are a bore doesn’t mean Trump gets a pass.

      1. We should get especially upset by the way he panders to us with “Its gonna be great! it will be the bestest you ever saw ever, awesomely great” …

        ….rather than “soaring rhetoric” which makes us proud of America.

        1. Well, maybe if Trump used phrases like “this was the moment the rise of the oceans began to slow and our planet began to heal” instead of “I happen to be, in my own way, an environmentalist. I’ve won many awards” we would be judging him on the same level as his boastful predecessors. Of course, one was written by speechwriters and the other, I imagine, was not. We’ll see what President Trump’s Inaugural Address sounds like.

          1. We’ll see what President Trump’s Inaugural Address sounds like.

            advance copy leaked

          2. I’m more excited about the state of the Union which I’m almost positive is going to be a timeshare pitch on his various properties.

            1. It will be the first SOTU where everyone who sits through the whole thing will get a discount at the bar.

              1. A coupon for the bar at his DC hotel.

              2. O/U on the number of Mar-A-Lago references in his first SOTU?

            2. “Our union is in the greatest state it has ever been in our history, believe me.”

    3. “At least Trump is better than Clinton” is an understandable stance, at least until January 20th. But I hope that “at least Trump is better than Obama” is not the replacement mantra after the inauguration.

      1. I don’t think anyone in the press is actually saying either of those things

        1. I had Trump apologists in mind, not journalists.

          1. There’s nothing to apologize for yet, cuck.

          2. You think mocking the press makes someone a “trump apologist”?

  2. Trump talking and no substance, im shocked! Shocked i say!

    1. Trump A politician talking and no substance, im shocked! Shocked i say!

      Slight change made.

  3. Shut it down. Extend TriCare to vets need the coverage and sell off the VA buildings and equipment. I am sure the highly qualified and dedicated personnel will soon find work in the private sector!

    1. Top-flight jobs in the food service or housekeeping industries.

      1. +1 Whaddaya want?!?!

      2. I don’t want those people touching my food or my toilet!

      3. Just changing the soiled sheets of Leftists will keep them busy.

    2. I like the idea of turning VA services into a premium-support model (a la Medicare or Tricare) and refocusing VA hospitals towards treatment of specialized treatments (e.g. brain injuries and limb replacement). That seems like the easiest workable solution, one that opens up doors to other reforms.

      (That the article keeps referring to privatization when it really means premium-support is a sign of poor research, or at least a confusion between VA services and VA properties)

  4. I think it’s safe to say across almost all domains, that Trump’s plans are to hire people who have plans.

    I generally like Trump, but he’s not going to be knowledgeable about policy details. He’s not even going to be close. And he was pretty disappointing during the campaign when it would’ve been easy enough to memorize a few details and repeat them Rubio-style into important-sounding soundbites.

    But it really is impossible to know all this stuff. Every federal agency has tens of thousands of pages of law, regulations, policy, etc. Nobody *really* knows it.

    I’d be curious to know how much he knows about his actual business. I could see either side – he could know some things or he could just be “you seem smart – you’re in charge of putting this together – here’s your budget.”

    1. My reaction too. Jimmy Carter tried to micro-manage the government and it didn’t work.

      Just hire competent people, give them some latitude, and check in frequently to monitor progress. Exactly how a business executive would handle a company with lots of subsidiaries.

    2. Though I don’t like Trump, to say the least, you have a valid point. Even if Trump were just a very high level manager, a la Reagan, the government is still too damn big to “manage”. After decades of exponential growth, the office of the President is an impossible job — AN IMPOSSIBLE JOB — as it was originally construed. This is the elephant in the room when it comes to discussing the executive branch.

  5. No one has a plan to fix the VA. The problems with the VA are numerous and intractable. The most basic problem with the VA is Congress’ and the public’s refusal to set priorities and make choices. The VA was never intended to be medicare for veterans. It was created for the single purpose of providing medical care to veterans who suffered injuries while serving and needed care after they left the service. The VA is only supposed to treat service related conditions. Congress with the support of the public has expanded the definition of “service related” to such a degree that it is meaningless.

    As bad as the VA is, it is also totally overwhelmed treating patients it was never intended to treat. So, the VA’s is never going to be fixed until you give it a realistic mission. And that is never going to happen because both the public and Congress refuse to face the reality that resources are not unlimited and choices have to be made.

    1. The problems with the VAevery federal bureaucracy are numerous and intractable.
      These just tend to draw more attention because of who the people being harmed are.

      The VA was never intended to be medicare for veterans.
      Which goes back to the earlier point in a way – many govt agencies/programs have grown far beyond their initial intentions because govt only knows to expand.

      Not picking on you, John, you just provided the foundation for my morning soapbox.

      1. And that is never going to happen because both the public and Congress refuse to face the reality that resources are not unlimited and choices have to be made.

        This kind of thinking is so typical among privileged, right wing whites. So easy to ignore the plight of minorities and traditionally disadvantaged peoples when you simply marginalize their struggle.

        1. Sadly, I can’t tell if you are being sarcastic. This is what Progs actually think. They are beyond satire

          1. Sometimes I can’t help myself. I have to hear this shit all the time. I’m sorry.

            1. Don’t be. It should have been funny and was truthful. It is not your fault these idiots have made humor and satire virtually impossible.

        2. I’m not sure if your comment was made in seriousness, but I’ll respond as if it were.

          Having grown up in a majority minority neighborhood, it was painfully obvious to me that the problems that led to the ‘plight’ of my neighbors was largely self-inflicted. I was just as aware of all of the attempts to ‘help’ them as they were (and that I was ineligable due to my ethnicity). This ‘aid’ created a lot of incentives that were visible on the ground – incentives to continue inflicting the same plight upon themselves.

          It led me to conclude that the best way to help these communities would be to stop trying to help.

          1. The ‘self-inflicted’ part is the elephant in the living room no one wants to notice. Problems exist because of decisions that were made, but apparently saying that is insensitive or mean or whatever. A black writer for WSJ (I think and I’m too lazy to look it up) wrote a book along the lines of “hey, liberals; stop..you have helped us blacks enough.”

            1. that was Jason Riley

    2. This is both true and not true.

      It is absolutely true that the definition of a “service related” injury or illness has been expanded beyond any same meaning of the term “service related”.

      That said the VA was created at a time when our knowledge of medicine was miniscule compared to where it is today and even if we did have a sane definition of service related the VA would still not be able to handle it’s mission because it is never going to be able to deal with long term illnesses like PTSD, traumatic brain injuries, or some of the genetic changes and cancers caused by agent orange exposure

      1. As I said, the problems are many and intractable. But, adopting a reasonable definition of service related has to be the first step in any fix.

    3. both the public and Congress refuse to face the reality that resources are not unlimited and choices have to be made

      You could say the same about health care in general. Even if we somehow got costs down, the expectation is that we will spend whatever it takes to keep every human alive as long as possible. Hence the appearance of disfavored groups (smokers, fatties) to help trim it down.

    4. Try to cut back the VA’s mission and even the Left will want to know why you hate the brave veterans who kept Americans from having to learn German or Japanese or Chinese or Russian or Arabic.

  6. Wait a minute, isn’t this a Sadbeard article? When did Sadbeard start writing for Reason?

  7. Have a Hippy New Year, Suderman!

  8. I can’t help but to think how much better things would have been if Obama didn’t have a plan. Specifically that one about fundamentally changing America. Into a 3rd world banana republic, apparently.

    1. No shit. How about we dispense with the big plans and maybe try a few small things first and see if we can make the situation better or at least not fuck it up more? It is just so crazy it might work.

  9. “Right now it seems as if Trump’s plan to fix the VA is no plan at all.”

    You’re kidding!

    1. Because admitting there is a problem and looking for people able to tackle said problem isn’t a plan, and Suderman would like the president elect to have a granular proposition for every shift needed to turn the leviathan into a lean, well-oiled paragon of efficiency and service.

      Sometimes just burning away the detritis can have a beneficial effect.

      1. seriously, isn’t the first step toward fixing any issue admitting first that the issue exists. Suderman is mad because the medics are focused on stopping the bleeding instead of moving immediately to the patient’s rehab program.

      2. The fact that VA Secretary is the last outstanding major nomination seems to show that some debate remains underway (otherwise some random name would have been set up, most likely someone like Scott Brown).

    2. Don’t worry, they will still assume that Trump’s plans to ban flag-burning and repeal gay-marriage and implement Jim-Crow-2.0 are all still 100% on course to become reality,

  10. And the name of that anonymous official? John Barron.

    1. Now you’ve done it. You’re going to subject us to a thirty post troll screed for outing someone’s speaking to the press.

  11. But mainly it’s an issue with the incoming Trump administration, which continues to appear to be totally averse to detailed policy planning.

    Truly tone-deaf of them, given how wildly popular those 2000+ page bills have been thus far.

    And there sure as hell aren’t any “unintended consequences” with creating a “detailed” policy plan that will be implemented piecemeal by departments and personnel with their own prerogatives.

    It’s understandable that life in Washington will turn you into one of its swamp creatures, but can you at least pretend that you understand how pathetic and disgusting you look to the rest of the country?

    1. Suderman is such a elitist jock strap sniffer. His bitch here is that Trump isn’t hiring a bunch of self appointed “wonks” to draw up elaborate plans to spend other people’s money and change policies the consiquences of which other people will have to bear. You see hiring credentialed half wits to draw up detailed plans that are at best tangentially connected to reality is how things are supposed to be done. Anyone who thinks that complex problems should be tackled gradually or at least after a lot of thought are just anti intellectual deplorables in Suderman’s view.

      1. Think about how much lust for control DC has to be thick with, that even in the case of their fellow government apparatchiks entrusted to implement these Rube Goldberg schemes, there has to be a 200 page white paper telling them minutely how to do the things that they are supposed to have been hired to do in the first place. Consider that Suderman doesn’t even want to be the Big Man telling other people, bureaucrats and otherwise, the very details of how their lives will go — he just wants to make sure the Big Man takes this part of “leadership” seriously. Imagine just how scary actual, true freedom must be to those people.

        Donald Trump is no libertarian. He’s not even really a conservative. But even his minimal belief in autonomy for the people implementing his goal is just too much for these people to understand — this is the demon on the Potomac that sits on the back of America’s citizens and hideously whispers, “shouldn’t there be a form for that” whenever they think of running their own lives.

        1. If you can’t trust your subordinates to do their jobs – why did you hire them? And if you realized that they were no good at their job – why haven’t you fired them?

          1. +1 I’m a better speechwriter than my speechwriters and a better campaign manager than my campaign manager.

        2. In my experience our “elites” for lack of a better term are motivated more than anything by a fear of uncontrolled change. It is not that they are reactionaries or even malevolent most of the time. It is just that they have a deep distrust of the public. They believe that any kind of change that isn’t controlled and managed from the top by “top men” is dangerous and must be placed under control or stopped at all costs. The idea that people know best for themselves or that the collective wisdom of the public is superior to that of the most enlightened central planner is completely anathema to them. The elite attitude towards the world can be summed up as “there is all of this stuff going on and no one is in charge or placing it under any kind of control. This must change!!” Suderman is utterly steeped in this culture and it shows.

          1. i disagree, John. Their motivation is religious. No honest person can look at the standardized IQ scores of Ashkenazi jews (113) and Australian aborigines (59) and think that’s the result of a cultural or educational gap that another government program could bridge. They are true believers. If not at first, their belief gets rewarded until they are. Mice and cheese.

    2. Don’t you remember all of the Reason articles about Obama not having a good plan to fix everything?

    3. Truly tone-deaf of them, given how wildly popular those 2000+ page bills have been thus far.

      And there sure as hell aren’t any “unintended consequences” with creating a “detailed” policy plan that will be implemented piecemeal by departments and personnel with their own prerogatives.

      Detailed 2,000 page policy plans (like the ACA) tend to mostly be political scaffolding for commissions of ‘crats and appointed ‘crats supported by back-up ‘crats who score said gigs outside of any political discourse – and those clowns then actually dream up the “details” part and “implementation” part. Which is just Trump’s approach, but with several thousand moving pieces working under a vast immunity deal for what happens later.

      1. You are probably right. Suderman is a little like listening to one of those old Soviet dinosaurs lecture Gorbachev about glasnost, because that’s not how Khrushchev would have wanted it.

    4. Has detailed policy planning ever resulted in an expansion of human freedom? It seems to me that the more you try to get around the fact that there are going to be losers from a policy or try to adjust to create some sort of planner’s dream, the more you put yourself in the position of trying to plan out everything for the population.

    5. Macadoodle is such a one-note Johnny. He’s been doing this schtick with all the republicans for years now, saying “they don’t have a plan”, where if he wasn’t such a completely dishonest piece of shit what he would be saying instead is “I don’t like their plan.”

      This ridiculous pose of his as an intellectual man of ideas is especially nauseating given that Macadoodle couldn’t come up with a good, detailed idea of his own with all the time in the world, for all the money in the world.

  12. Why not shut it down and put all vets on Medicare or Medicaid?

    1. There are obviously better long term market solutions but it seems like this should is something they could do pretty quickly to at least get these guys suitable care.

    2. I don’t believe the term “shut it down” is recognized as an option in DC. Or in govt at any level, for that matter.

    3. Why do you hate vets?!?

      1. Because anything that lacks limbs is pointless.

        Oh… vets. I thought you said vests.

        1. Well, that still works as a heartless libertarian plan.

          Kudos.

  13. Does anyone have a plan to “fix” the VA? I’m sure there are pie-in-the-sky free market proposals out there, but I wouldn’t expect any politician to have something more substantive than what Trump’s team has put up.

    1. Does anyone have a plan to “fix” the VA

      As mentioned above =

      I’ve pledged to build a 21st century VA as President. It means no more red tape – it’s time to give every service-member electronic copies of medical and service records upon discharge. It means no more shortfalls – we’ll fully fund VA health care, and add more Vet Centers, particularly in rural areas. It means no more delays – we’ll pass on-time budgets. It means no more means-testing – it’s time to allow every veteran into the VA system. And it means we’ll have a simple principle for veterans sleeping on our streets: zero tolerance

      It is fortunate our vigilant press held his feet to the fire and ensured that these promises were all fulfilled.

  14. “Like a lot of Trump’s policy ideas, the particulars were mostly unclear. Now that Trump is headed for the White House, however, we can presumably expect more details. Or maybe not.”

    If I were a journalist, I supposed I’d want as many details as possible so I could start tearing down the proposal.

    If I were Trump, I don’t see why it would behoove me to subject my proposals to that unnecessarily.

    When Trump makes his proposal, then I guess you can start tearing it apart, but if he subjected his proposals to that before it was necessary to do so, I’d think that was stupid.

    Maybe he should send out bad photographs of himself for the media’s convenience, too?

    1. Well one of the reasons the Obamacare web portal launch was such a disaster is because they didn’t want any internal testing to happen prior to launch, because any perceived shortfalls would become political ammo for Republicans.

      Needless to say that backfired spectacularly, both on the political ammo and on the getting things to work front.

      So if they’re just not showing their plans until the day it’s fully finalised, that’ll be fine (if they’ve got robust internal discourse to deal with flaws).

      If the incentives lead them to not have plans at all (because that protects against any risk of leaks), then they’re repeating the previous administration’s mistakes.

      1. Well one of the reasons the Obamacare web portal launch was such a disaster is because they didn’t want any internal testing to happen prior to launch, because any perceived shortfalls would become political ammo for Republicans.

        Which only reveals how stupid they are. There are FOIA exceptions for internal process discussions and reports.

    1. Are these the same people who predicted no Brexit and a Hillary win?

      1. They didn’t even include solo so how accurate can that be.

  15. OT: It looks like those Greeks were on to something.

    Earlier in the year, a study was published of which the results suggest that having 4th and 5th graders engage in weekly philosophical discussions of concepts like “truth” or “justice” was correlated to increased achievement in Math and English. The sample consisted of around 3,000 students in 48 schools across the UK, of which half the schools were randomly assigned as the control group (both groups were about equal in the amount of students). Overall, compared to the control group, the experimental group showed a small increase in Math and English achievement, as measured by a standardized test of academic achievement (Hedges’ g = .10 for Math, .12 for Reading, and .03 for Writing). When the results were disaggregated by SES, the effect size was larger, in that compared to the control group, free lunch kids showed a medium increase in English achievement, in particular, (Hedges’ g = .20 for Math, .29 for Reading, and .17 for Writing). Additionally, a standardized test of reasoning showed slight gains in the experimental group from pre to post test; however, the control group ended up with a higher post-test score overall.

    1. The researchers were unable to test the effect of homosocial pederasty upon academic achievement due to ethical issues and all that.

      1. It’s the UK so probably can assume

        1. A Jamaican who likes to take walks?

        2. “I’ll take Whore Ads for a hundred, Alex!”

    1. Who was riding shotgun?

      1. Actually, the article says the passenger was the one who was, shall we say, riding shotgun.

  16. Sorta OT: More TDS.
    Please remind me when the Mormons accepted that blacks were real people.

    “Mormon Tabernacle Choir Singer Quits Over Trump Inauguration: ‘I Could Never Throw Roses to Hitler'”
    http://www.sfgate.com/entertai…..826478.php

    He’s a racist, you see.

    1. I’m pretty sure they still can’t advance beyond a certain level of the LDS leadership

      1. That changed around 1978.

    2. Bonus:
      The Chron juxtaposes portraits of Hitler and Trump. Real subtle, that rag.

  17. Sig Sauer – there is no substitute

  18. I’m just spitballing here but not engaging in wars would help reduce the number of new VA patients.

    This horrible meme was brought to my attention by reading blogs from the alt-right and regular H&R commenter john.

    China is not going to field an army to attack us because Chinese parents only have 1 or 2 children. They have no spares! Latin American birth rates are way down too. The Pope did not convince latinos not to use birth control. The only outliers are African and few south Asian nations hyped up on fundamentalist Istam.

    1. From the perspective of the Chinese Government, they have plenty of spares – the ex-selective abortion programs have left them with more men than can ever possibly start families because of a shortage of women. They might attack Vietnam instead though (historical context re: vietnamese women and the chinese)

        1. Shh, you’re not supposed to mention the ‘undocumented’ people.

            1. An excess of women is easily redressed through polygyny.

  19. I’d like to take a moment to reflect on the fact that the thing that made Sundermand the most spittle-soaked mad over the past eight years was when the republicans shut down the government in order to reduce spending. Something that libertarians constantly claim Republicans don’t actually care about.

    1. This, this, this. That was the moment that removed any remaining doubt at all that Macadoodle doesn’t have a libertarian bone in his body.

      If only this fake libertarian, fake intellectual, fake health care expert piece of crap would leave so he could go be at Vox full time. Because that’s where he belongs.

  20. It’s going to be 2,000 miles of new veteran facilities assembled as a barrier on the southern border, built by mexicans who bring their own tools and work for free.

    At least that’s what I got from the debates.

  21. Trump has no Plan!
    You can’t be a Top Man
    Without a Plan

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