VA's Nonexpert Health Expert

Unlike all of his predecessors, Trump’s soon-to-be veterans health care chief is not a doctor.

by Jasper Craven September 26, 2025


In late July, Major Gen. John Bartrum sat before a Senate committee for his confirmation hearing to be the Department of Veterans Affairs’ next undersecretary of health, or USH, as it’s colloquially called. Time and again, Bartrum was pressed by lawmakers about how to best meet the health care needs of American veterans, and what roles the VA and the private sector, respectively, should play in this work. These were knotty, complex questions, and Bartrum was woefully underprepared to answer them.

Kansas Republican and Senate Veterans’ Affairs Committee Chairman Jerry Moran, a longtime champion of outsourcing veterans’ care to the private sector, asked Bartrum how, as USH, he would utilize his prior experience to address VA health care matters. Bartrum responded with a vision that amounted to little more than broad platitudes. “It’s form and function, it’s structures, it’s basic leadership 101,” Bartrum said, adding vaguely that, if confirmed, he would “look at the processes and how to better affect the veteran’s patient outcome.”

This amounted to a woeful misunderstanding of the complexities of health care management. Leading a single community clinic requires far more than “Leadership 101.” Bartrum is poised to run America’s largest and only national health care system, which requires a whole lot more. The Veterans Health Administration cares for patients at nearly 1,400 clinics, who, as a whole, are older, sicker, and poorer than civilian-sector patients. The system also deals with more complex medical and mental health conditions than private civilian hospitals, and also offers economic, legal, and housing assistance.

Among the specific tasks of a USH are: adding or subtracting drugs from the VA’s prescription formulary; assessing legitimately novel treatments versus the equivalent of snake oil salesmen; charting the future of VA patient needs based on battlefield wounds and military-related exposures; understanding veterans’ specific and complex conditions; establishing centers for excellence; hiring senior medical directors; consulting with chief medical staff and surgeons; and developing and implementing patient safety rules and regulations.

https://prospect.org/health/2025-09-26-vas-nonexpert-health-expert-bartrum/