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AMNA NAWAZ: As we reported earlier, Ronny Jackson path to confirmation as head of the Veterans Affairs Department remains all but clear. We take a deeper look now at the agency and the problems it's facing with Lisa Rein of The Washington Post. Lisa Rein, thanks for being here. We have talked a lot about the people in charge or potentially in charge of the Veterans Affairs Department. Tell me a little bit about what they would be in charge of. Give me a sense of the department, its scope, its size, and what they're facing right now.
LISA REIN, The Washington Post: So, VA is the federal government's second largest agency. Only to Pentagon is bigger. And it is really kind of unique to the government. Its mission, of course, is embraced by so many Americans, caring for veterans. But it has a sprawling health care system of about 1,300 medical clinics and hospitals, a massive benefits system that is now plagued by backlogs in people who are veterans seeking appeals of their denials of claims, and a smaller cemetery system that is responsible for, you know, burying millions of veterans. And the agency is always in some sort of scandal. And it has lost two secretaries since 2014, most recently David Shulkin, who left -- who was fired President Trump in the end of March.
AMNA NAWAZ: So let's talk about the current nominee right now. I'm curious, because you talk to people inside the department, veterans groups who work closely with them, when Ronny Jackson's name was first announced, what was the response? How did people view him?
LISA REIN: So the response from the veterans community is, we have never heard of this guy. And so there are various stakeholders who have very passionate goals for where veterans care should be going, and the concern was, hmm, Ronny Jackson, I don't know where he stands on the issues that are important to us. This was what the large veterans groups like the American Legion and the Veterans of Foreign Wars were saying. And then you had conservative groups who were saying, hmm, we don't know where he stands on our issues. So it was just, who is Ronny Jackson? The last we knew was that he was fawning over the president's health after his annual physical, but no one had any idea and still doesn't really where he stands on the key issues that are facing this agency right now.
AMNA NAWAZ: Privatizing health care is one of them, as you mentioned. And that was part of the reason, right, that David Shulkin was forced out. He clashed with the White House on that one issue.
LISA REIN: That's right. I would say that that's actually the biggest issue that is facing VA right now. So, VA has historically been a very apolitical agency. It is still, of course, a bipartisan agency, and every nominee to run the agency to be secretary has been approved by the Senate 100-1 -- sorry -- 100-0. And that was the case with Dr. Shulkin. But here it's become very politicized in the Trump era, partly because the Trump administration wants to reform what they consider to be problems with, you know, employees who are involved in misconduct. They want them to be fired faster. They want more transparency in terms of how metrics on how long veterans inside the system have the wait for appointments. The biggest issue, though, is how much the VA should be outsourcing medical care to the private sector.
AMNA NAWAZ: Knowing that outsourcing that health care seems to be a priority for this administration, is it fair to say that any nominee that they put forward would be in support of that, and what would that do to the VA?
LISA REIN: I think any nominee from this administration, yes, is going to have to support more private care. The problem, though, is in the Senate, you have Democrats and you have moderate Republicans, including Johnny Isakson, the head of the -- the Republican head of the Veterans Affairs Committee, who, while they are not advocating no private care, they see a much more moderate approach, because they believe that if you have more doctors from outside the system who are getting paid, you're sort of siphoning resources from VA. And that's a huge debate that has become, you know, just hugely political. So, what happens is, Trump may nominate someone who is in favor of more private care, but that nominee has to walk a very fine line between, you know, that -- supporting the president and also supporting the huge veterans organizations that still have political clout in Congress who are wary of more private care.
AMNA NAWAZ: Lisa Rein, thank you so much for your time.
LISA REIN: Thank you.
