The Shadow Rulers of the VA

How Marvel Entertainment chairman Ike Perlmutter and two other Mar-a-Lago cronies are secretly shaping the Trump administration’s veterans policies.

.. shortly after Peter O’Rourke became chief of staff for the Department of Veterans Affairs, he received an email from Bruce Moskowitz with his input on a new mental health initiative for the VA.

.. an informal council that is exerting sweeping influence on the VA from Mar-a-Lago

.. The troika is led by Ike Perlmutter, the reclusive chairman of Marvel Entertainment, who is a longtime acquaintance of President Trump’s. The third member is a lawyer named Marc Sherman. None of them has ever served in the U.S. military or government.

.. They have remained hidden except to a few VA insiders, who have come to call them “the Mar-a-Lago Crowd.”

.. they downplayed their influence, insisting that nobody is obligated to act on their counsel.

.. The Mar-a-Lago Crowd spoke with VA officials daily, the documents show, reviewing all manner of policy and personnel decisions. They prodded the VA to start new programs, and officials travelled to Mar-a-Lago at taxpayer expense to hear their views. “Everyone has to go down and kiss the ring,” a former administration official said.

.. If the bureaucracy resists the trio’s wishes, Perlmutter has a powerful ally: The President of the United States. Trump and Perlmutter regularly talk on the phone and dine together when the president visits Mar-a-Lago. “On any veterans issue, the first person the president calls is Ike,”

.. VA leaders who were at odds with the Mar-A-Lago Crowd were pushed out or passed over.

..  Offering more private healthcare to vets was a signature promise of Trump’s campaign, but at that point he hadn’t decided who should lead an effort that would reverse the VA’s longstanding practices.

.. Perlmutter then recommended Shulkin to Trump

.. Once nominated, Shulkin flew to Mar-a-Lago in early February 2017 to meet with Perlmutter, Sherman and Moskowitz.

.. Moskowitz elaborated on the terms of their relationship. “We do not need to meet in person monthly, but meet face to face only when necessary,” he wrote. “We will set up phone conference calls at a convenient time.”

.. Perlmutter, Moskowitz and Sherman acted like board members pounding a CEO to turn around a struggling company

.. “Everything needs to be run by them,” the first former official said, recalling the process. “They view themselves as making the decisions.”

..  They planned to promote the campaign by ringing the closing bell at the New York Stock Exchange around the time of Veterans Day.

The event also turned into a promotional opportunity for Perlmutter’s company. Executives from Marvel and its parent company, Disney, joined Johnson & Johnson as sponsors of the Veterans Day event at the stock exchange.

.. The Mar-a-Lago Crowd grew frustrated with Shulkin, feeling like he wasn’t listening to them, and Perlmutter came to regret recommending Shulkin to Trump in the first place

.. Trump initially nominated White House doctor Ronny Jackson to replace Shulkin, with Pentagon official Robert Wilkie filling in on a temporary basis. On Wilkie’s first day at the VA, Sherman was waiting for him in his office, according to a calendar record.

Within a few weeks, Wilkie made a pilgrimage to Mar-a-Lago.

Shulkin says he did not leave office willingly, setting up fight over his successor

Shulkin told The Washington Post on Friday, as he told CNN on Sunday, that he did not resign and was instead fired after being undermined by political appointees.

.. “I don’t think that this was the president,” Shulkin told Tapper. “The president is committed to improving the care for veterans. These appointees had a belief that there was a different way to do that than I did … these individuals, when they didn’t see that their way was being adopted, used subversive techniques to change the leadership at VA.”

Shulkin’s description of what happened clashes with that of the Trump administration. On Friday, Shulkin told The Post that he was told by White House Chief of Staff John F. Kelly that he was being pushed out. But Saturday, deputy White House press secretary Lindsay Walters told Politico that “Secretary Shulkin resigned from his position as Secretary of the Department of Veterans Affairs.” Asked on Sunday about Shulkin’s description of what happened, Walters repeated that statement.

.. The questions about Shulkin’s removal may well end up in court. Democrats, who, like Shulkin, believe that the Trump administration is attempting to elevate people who favor privatizing VA’s services, could sue over any major decisions made by Wilkie, arguing that the 1998 law on vacancies does not apply when appointees are fired.

Trump’s pick to head veterans department faces skepticism over his experience

Jackson is a career naval officer who was an emergency trauma doctor in Iraq before spending the past 12 years as a White House physician. But his résumé lacks the type of management experience usually expected from the leader of an agency that employs 360,000 people, has a $186 billion annual budget and is dedicated to serving the complex needs of the country’s veterans.

.. “It’s great that he served in Iraq and he’s our generation. But it doesn’t appear that he’s had assignments that suggest he could take on the magnitude of this job, and this makes Jackson a ­surprising pick,” said Paul Rieckhoff, chief executive of Iraq and Afghanistan Veterans of America.

 .. The active-duty rear admiral had been a behind-the-scenes figure while serving the past three administrations as a White House physician, but he moved into the spotlight in January when he delivered a glowing assessment of Trump’s physical and mental health to reporters, which aides said endeared him to the president.
.. Democratic senators said privately when Pompeo was tapped to replace Tillerson that they expect far fewer Democrats to back him than the 14 who voted for him to lead the CIA.
.. Jackson’s policy views are unknown, particularly on the most pressing issue facing VA: how much access veterans should have to private doctors outside the system at government expense. Shulkin’s moderate views on the subject, which were at odds with many administration officials, helped end his tenure.
.. VA secretary is one of Washington’s most unforgiving jobs even for someone with extensive management experience. Shulkin, also a physician, had run large hospital systems — including VA’s — before taking the job. His predecessor, Robert McDonald, was a chief executive of Procter & Gamble. The secretary before him was a decorated retired Army general, Eric K. Shinseki, who was forced out after managers in the far-flung health system were found to have fudged waitlists for veterans’ medical appointments.
.. “I’ve seen him managing a staff of a couple dozen, which he did to perfection,” said Ned Price, a National Security Council spokesman under Obama who recalled that he was treated by Jackson for a toe injury in the Philippines.“But how that would translate to managing the second-largest department in federal government I have no idea,” Price said. “He has competence and integrity. I don’t think he’s going to fly around the world first-class or be buying thousands of dollars in furniture. But can he run VA? Anyone’s guess is as good as mine.”

 

Weighing the Good and the Bad in the Spending-Caps Deal

Republicans dislike “increased domestic spending” in general, but once you see the specifics, you understand why Republican leaders signed off on it: $80 billion in disaster relief funding, $6 billion toward opioid and mental health treatment, $4 billion to the Veterans Administration to rebuild and improve veterans hospitals and clinics, $2 billion toward research at the National Institutes of Health.

.. It was always a stretch to claim that Republicans had “basically repealed Obamacare” just by repealing the individual mandate. But getting rid of the individual mandate and the Medicare Independent Payment Advisory Board? Now we’re getting somewhere. The IPAB was created under Obamacare and given the duty to slow the growth of Medicare spending, but no board members were ever nominated. But as written under the law, IPAB would have enjoyed a lot of power over what Medicare was willing to pay for and how much, with little opportunity for Congress to overrule their decisions. This deal gets rid of IPAB for good.

.. An abusive person will often become a lot calmer when confronted with an authority figure they cannot abuse, such as a cop at the door. Abusive people can usually recognize the difference between the consequences of hitting a partner or spouse in public — where someone may see and confront them or call the cops — and doing so in private, and thus they keep those impulses in check in public. This is, in fact, one of the traits that can emotionally and psychologically trap the victim; the victim finds herself baffled and wondering, “he’s so nice and normal sometimes, so what am I doing that’s setting him off?”

.. Abusive people are generally pretty good at measuring what they can get away with in a given circumstance. They want to indulge their impulses right up to the point where it generates a permanent consequence. For example, if the abuser picks up a knife and begins chasing his partner around the house pledging to stab the partner, the partner is almost always going to flee and end the relationship, and/or file a restraining order.

.. restraining orders usually only work on the kind of people who don’t require restraining orders.) A man who is violently angry on the first date is not going to get a second date.

.. The creepy guy who hangs around a playground and stares at the children is going to get reported and caught pretty quickly. The creepy guy who works his way into a position of trusted authority, and who manages to seem kind, caring, and all of those other good traits around other adults, can pursue prey at will for a long time, because accusations of abuse will seem so unthinkable to other adults.

.. Many people have a hard time rectifying the two, and we should have a bit of sympathy for the friends and co-workers experiencing that cognitive dissonance upon learning of a person’s private sins.