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WASHINGTON â President Obama on Monday intends to nominate Robert A. McDonald, the former chief executive of Procter & Gamble, to be the next secretary of Veterans Affairs, a White House official said Sunday, betting that a global corporate officer can turn around a government health system that has been rocked by allegations of mismanagement and cover-ups of long patient waiting times.
The president last month accepted the resignation of Eric Shinseki, the retired four-star Army general he tapped in 2009 to lead the agency. By appointing Mr. McDonald, Mr. Obama is turning to an outsider to overcome deep bureaucratic problems and the mismanagement that stemmed, in part, from a surge in the number of veterans needing care.
In the weeks since Mr. Shinsekiâs departure, White House officials had explored the idea of tapping from among three kinds of potential replacements: someone with deep management experience; someone with a military background similar to the departmentâs former leader; or someone with a track record running a sprawling hospital system.
By picking Mr. McDonald, Mr. Obama signaled that he views the problems at the department as primarily a management concern, although his nominee is a West Point graduate with a military service record. A report issued on Friday by Mr. Obamaâs deputy chief of staff, Rob Nabors, described a âcorrosiveâ management culture and âa lack of responsiveness and an inability to effectively manage or communicateâ at the agency.
The choice is dramatically different from one Mr. Obama made five years ago, suggesting that he no longer believes that a military commander can fix the substantial problems at the countryâs largest integrated health care network, with over 1,700 facilities that serves more than eight million veterans a year.
âThis is definitely a surprising pick,â said Paul Rieckhoff, the C.E.O. and founder of Iraq and Afghanistan Veterans of America. âMcDonald is not a name that was on anyoneâs radar over the last few weeks. His branding background may prove helpful because there are few organizations in America with a worse reputation toward customers than the V.A. right now.â
But Mr. Rieckhoff added that because Mr. McDonald has âbeen away from the military for quite a while, heâll have to move quickly to show he is committed to and understands the post-9/11 generation of veterans.â
At Procter & Gamble, Mr. McDonald oversaw more than 120,000 employees as he directed a company that had operations around the globe. Officials noted Sunday that Mr. McDonaldâs former company served more than five billion customers.
The presidentâs plans to nominate Mr. McDonald were first reported Sunday by The Washington Post.
If he is confirmed, Mr. McDonald will face a beleaguered $ 154 billion-a-year department whose major functions are stricken with a combination of operational and technological dysfunction; serious morale problems exacerbated by what administration officials now acknowledge is a corrosive management culture and hostility to whistle-blowers; and a lack of trust among many veterans.
The most severe problem is the scandal over falsified waiting lists that last month led to the ouster of the departmentâs top two officials, including Mr. Shinseki, who characterized the lack of honesty and proper behavior at some of the departmentâs facilities as a âsystemic, totally unacceptable lack of integrityâ that he could not explain.
The waiting-list controversy revealed that veterans in many places faced long delays for appointments â delays that were hidden by administrators and scheduling staffers who were under pressure to convince their bosses that patient wait times were typically no longer than 14 days. Results of investigations and audits in recent weeks have suggested that the cover-ups of the delays were spurred in many places by administrators whose performance ratings were tied to measurements of how long it took veterans to see doctors.
V.A. officials have already taken steps to eliminate what they now acknowledge were potentially perverse incentives to manipulate waiting-time data, such as eliminating performance bonuses this year for senior health care executives and deleting the 14-day patient waiting time goal from employee contracts.
But the underlying cause of the delays will be harder to address: The departmentâs medical centers and clinics have seen a sharp increase in the number of visits scheduled by patients, particularly for primary care appointments, but the number of doctors and nurse practitioners available to see them has in many places barely grown.
Much of the demand has come from younger veterans of Iraq and Afghanistan with profound and complex injuries that require close monitoring and many follow-up visits. But most veterans seeking treatment at department clinics, though, are Vietnam veterans, many with chronic illnesses like diabetes that require long-term care, or with cancer or cardiovascular disease, which require complicated and expensive treatments.
In addition, if confirmed, Mr. McDonald will be confronted with the ongoing problem of how to make sure veterans returning from the battlefield, some of them seriously injured or battling psychological problems, receive their disability compensation in a timely manner. In his 2008 campaign, Mr. Obama criticized delays in providing benefits to veterans and promised to make fixing the agency a top priority. But while the White House has bragged about making progress in distributing benefits in a timely manner, the revelations this spring about delays in seeing patients has raised the agencyâs profile to a new political level.
To win confirmation, Mr. McDonald will have to win over lawmakers in both parties. Records show that Mr. McDonald has made political contributions only to Republicans, giving $ 5,000 to Mitt Romney, the Republican presidential nominee in 2012, and $ 11,000 to the Romney Victory Committee. He also has made several contributions to House Speaker John A. Boehner and Senator Rob Portman, Republican of Ohio.
Senator Bernie Sanders, Independent of Vermont, the chairman of the Veterans Affairs committee, offered a neutral reaction to the presidentâs pick on Sunday.
âThe V.A. needs significantly improved transparency and accountability, and it needs an increased number of doctors, nurses and other medical staff so that all eligible veterans get high-quality health care in a timely manner,â Mr. Sanders said.
House Speaker John Boehner released a statement complimenting the nominee as âa good man, a veteran and a strong leader.â But the Ohio Republican also said that any V.A. secretary can only succeed âif his boss, the president, first commits to doing whatever it takes to give our veterans the world class health care system they deserve by articulating a vision for sweeping reform.â
Because of an editing error, an earlier version of this article misspelled the name of the company where Bob McDonald had been chief executive. He was chief executive of Procter & Gamble, not Proctor & Gamble.
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