President-elect Donald Trump is considering the CEO of Cleveland Clinic — a former cardiac surgeon who has led a major international expansion at the clinic — to run the troubled Department of Veterans Affairs.
Dr. Delos “Toby” Cosgrove has emerged as the leading contender for secretary of Veterans Affairs after meeting with Trump in Florida earlier this week, according to several media reports. Also in the running is Luis Quinonez, an Army veteran who served in Vietnam and founded IQ Management Services, which provides health care services to the military.
Cosgrove would bring military credentials, experience running a global business, a deep knowledge of the health care system — and a strong belief that the private sector can solve problems that have plagued US health care for decades.
During a public appearance in 2015, Cosgrove said that only private industry can solve the nation’s epidemics of obesity and chronic disease, not to mention runaway health care costs. He said that had to start with employers investing in the health of their workers.
“We are not going to begin to control the cost of health care until we deal with things that cause chronic disease,” Cosgrove said. “The government is not going to do it.”
As CEO of Cleveland Clinic, Cosgrove has practiced what he preaches: He banned smoking on the clinic grounds and instituted a personal wellness program to help employees lose weight. He also overhauled the cafeteria food offerings, and bounced McDonald’s from the food court.
Though personally brusque at times, Cosgrove emphasizes the value of compassion in health care. After becoming CEO, he distributed 40,000 buttons with the words “patients first,” a motto that is emblazoned on the wall of the main campus in Cleveland.
Cosgrove, 75, has worked at Cleveland Clinic for 41 years, starting as a cardiac surgeon in 1975.
Since ascending to the CEO spot in 2004, Cosgrove has reached around the globe to expand the clinic’s services. It now operates a full-service hospital in Abu Dhabi, United Arab Emirates, and is building another facility in London. It also runs a brain health center in Las Vegas and has facilities in Florida and Toronto. The clinic brings in $8 billion in annual revenue.
Cosgrove is also a veteran, having served in Vietnam as chief of the US Air Force Casualty Staging Flight. He was awarded the Bronze Star.
Cosgrove turned down the VA job when it was offered to him by President Obama in 2014. At the time, the department was under fire for lapses in quality and delays in delivering care to veterans.
Those problems have not been fully resolved — not by a long shot. Veterans in many areas are still forced to wait weeks for appointments. Trump has pledged to restore order; he’s put a particular emphasis on improving mental health services for veterans.
Throughout his career, Cosgrove has been known as an innovator and entrepreneur.
He performed the first minimally invasive mitral valve surgery over an international video network in 1996 and holds 30 patents for medical products, including the Cosgrove Mitral Valve Retractor.
He led the establishment of the clinic’s commercial arm, Cleveland Clinic Innovations, which has spun off dozens of companies that sell medical technologies. In 2013, he published “The Cleveland Clinic Way,” a 200-page book that focuses on the role of health systems in developing new products and ideas to advance medicine.
Cosgrove reshaped the clinic’s operations in response to the Affordable Care Act, a law he at times has criticized for failing to control costs or include incentives for people to take better care of themselves. In the years after its passage, he cut costs at the clinic by $500 million and worked to standardize procedures across the health system.
In 2015, the clinic recorded its best financial year ever, reporting $481 million in operating income despite reimbursement cuts associated with the Affordable Care Act.