PBS高端访谈:罗尼·杰克逊提名担任退伍军人事务部部长（在线收听）

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.

阿曼娜·纳瓦泽：正如之前报道，罗尼·杰克逊担任退伍军人事务部部长一事，前景依然明朗。现在让我们更加深入地了解一下这个机构以及它所面临的问题，华盛顿邮报丽莎·莱恩为您讲述。丽莎·莱恩，谢谢你的参与。我们已经谈到了很多关于退伍军人事务部负责人或人选的内容。请给我讲一讲他们的职责。让我了解一下这个部门，它的职责范围，它的规模以及它现在面临的问题。

丽莎·莱恩，华盛顿邮报：那么，退伍军人事务部是联邦政府的第二大机构。仅次于五角大楼。它对政府来说确实相当独特。当然，它的使命被许多美国人所拥护，那就是退伍军人关怀。但这个机构有一个庞大的医疗系统，覆盖1300家诊所和医院，这一庞大的福利系统却积压了许多老兵问题，他们的诉求遭到了回绝，但一直在争取，该机构还有一个小型公墓系统，解决数百万老兵的安葬问题。而这个机构总是卷入各种丑闻风波。自2014年以来，这个机构已有两名秘书离职，而最近戴维·舒尔金于3月底被特朗普总统解雇，离职。

阿曼娜·纳瓦泽：那么现在就让我们来谈谈当前的提名人选。我很好奇的是，你和机构内部人员有过交谈，还有与他们紧密合作的老兵团体，和他们也接触过，当罗尼·杰克逊的名字首次公布时，大家是什么反应？人们如何看待他？

丽莎·莱恩：老兵们的回应是，我们从来没有听说过这个人。关于老兵关怀的发展动向和顾虑，各类利益相关者都有宏图目标。我不知道罗尼·杰克逊在这些问题上怎么看，但这些问题对我们来说非常重要。这就是诸如像美国退伍军人协会以及海外退伍军人协会这样的大型退伍军人团体所表达的意思。然后也有保守的团体说，嗯，我们不知道在我们的问题上他持什么立场。所以，罗尼·杰克逊是谁？最后我们知道，在总统年度体检后，他谄媚总统的健康，但无人知晓，而且也不清楚，在这个机构面临的关键问题上，他的主张。

阿曼娜·纳瓦泽：正如你所提到的，私人医疗保健就是其中一项。这就是戴维·舒尔金被迫离开的部分原因。他在这个问题上与白宫发生了冲突。

丽莎·莱恩：是的。我想说，这实际上是目前退伍军人事务部面临的最大问题。所以，退伍军人事务部历史上一直是非政治性机构。当然，它仍是一个两党机构，所有领导该机构的部长都是获得参议院全票通过的。舒尔金医生就是这样。但是这个机构在特朗普时代，变得非常政治化，部分原因是特朗普政府希望改革他们认为存在问题的方面，包括卷入不当行为事件的雇员。他们希望能更快地将他们解雇。关于系统内老兵的预约等候时间，他们希望衡量标准，能够获得更多的透明度。然而，最大的问题是，退伍军人事务部应将多少医疗服务，外包给私营部门。

阿曼娜·纳瓦泽：我们知道，外包医疗保健服务似乎是这届政府的优先选择，那是不是说所有提名的候选人都应该支持这种做法，那么对退伍军人事务部又会产生何种影响？

丽莎·莱恩：我认为该机构的任何被提名人，是的，将不得不对私人护理采取更多的支持态度。然而问题在于参议院，有民主党人，而且有温和的共和党人，包括共和党退伍军人事务委员会主席约翰尼·伊萨克森，他们并不主张废除私人护理，他们寻求一个更温和的处理方法，因为他们相信如果聘请更多系统外的医生，让他们获得报酬，那么某种程度来讲，你就是在挖退伍军人事务部的墙角。这已经成为了一场巨大的争论，你知道，这已经变得非常具有政治性。所以，特朗普可能会提名一位赞成更多私人医疗服务的人，但这名候选人一定要掌握一个平衡，一边要支持总统，一边要支持大型老兵组织，这些组织在国会中仍然具有政治影响力，而国会又对增加私人护理非常敏感。

阿曼娜·纳瓦泽：丽莎·莱恩，感谢做客节目。

丽莎·莱恩：谢谢你。