March 29, 2018

Shulkin's out—and blames a 'brutal power struggle' over VA privatization

Daily Briefing

    President Trump on Wednesday in a series of tweets announced that he has fired Veterans Affairs (VA) Secretary David Shulkin and will nominate Navy Rear Adm. Ronny Jackson, who currently serves as the White House's top physician, for the post.

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    Trump in the tweets wrote, "I am pleased to announce that I intend to nominate highly respected Admiral Ronny Jackson, MD, as the new Secretary of Veterans Affairs." He added, "In the interim, Hon. Robert Wilkie of [the Department of Defense] will serve as Acting Secretary. I am thankful for David Shulkin's service to our country and to our GREAT VETERANS!"

    The announcement comes after the Associated Press on Sunday reported that three administration officials said Trump was strongly considering firing Shulkin amid government investigations into his alleged misuse of taxpayer money and infighting within VA over Shulkin's opposition to privatizing the department's health care system—a position that is in line with several major veterans groups. According to Politico, Jackson’s stance on privatization is "unclear."

    Trump in the White House statement called Shulkin "a great supporter of veterans across the country" and praised his work "and the many great things [they] did together at [VA], including the VA Accountability Act."

    In post-ouster op-ed, Shulkin blames dispute over VA privatization

    Shulkin—a holdover from former President Barack Obama's administration—has opposed efforts to privatize VA's health care system and instead has focused on improving the existing system. That stance has put him at odds with several White House appointees who support privatizing the VA health care system and allegedly have been working to supplant Shulkin.

    Shulkin in an opinion piece published Thursday in the New York Times wrote that he was fired from the position because he opposed privatizing VA's health system. Citing a "brutal power struggle" in VA over privatization efforts, Shulkin said, "They saw me as an obstacle to privatization who had to be removed." He continued, "That is because I am convinced that privatization is a political issue aimed at rewarding select people and companies with profits, even if it undermines care for veterans."

    The debate between Shulkin and other Trump appointees over privatization had jeopardized negotiations on a bill to reauthorize the Veterans Choice Program (VCP), which aims to increase veterans' access to care by providing those who live 40 miles or farther from a VA facility or face undue burdens accessing care at VA medical centers with federally subsidized care at non-VA facilities.

    Jackson's background

    Jackson, who must be confirmed by the Senate before assuming the VA secretary role, has served as the White House's top physician since Obama appointed him to the post in July 2013. Previously, Jackson worked in the White House Medical Unit under Obama and former President George W. Bush.

    Jackson has a medical degree from the University of Texas Medical Branch and was deployed in the Iraq War during the Bush administration. He has been awarded multiple commendations for his military service. According to CBS News, Jackson does not have experience running a large health care system or federal agency.

    Trump in a statement said he was "proud" to nominate Jackson to lead VA. "Jackson is highly trained and qualified and as a servicemember himself, he has seen firsthand the tremendous sacrifice our veterans make and has a deep appreciation for the debt our great country owes them," Trump said.

    Speaking to Jackson's background, deputy press secretary Raj Shah during an appearance on Fox News Thursday, said, "We've had kind of bureaucrats or individuals who understand, kind of have the experience and resumé of, you know, hospital organizations ... and they haven't fixed the problems."

    Reaction

    Sen. Lindsey Graham (R-S.C.) praised Trump's decision to nominate Jackson to lead VA. "If there ever was a home run pick, Adm. Jackson fits the bill—combat surgeon, career military officer who loves his country and will provide the highest quality health care and services to our wonderful veterans."

    House Veterans' Affairs Committee Chair Phil Roe (R-Tenn.) in a statement said although he thinks Shulkin has "done a fantastic job," he "respect[s]" Trump's decision, "support[s] the [Trump's] agenda and remain[s] willing to work with anyone committed to doing the right thing on behalf of our nation's veterans." Roe added, "I am in the process of reaching out to … Jackson and I look forward to building a strong relationship with him also."

    Sen. Jon Tester (D-Mont.), the ranking member on the Senate Veterans' Affairs Committee, in a statement said Shulkin had "severed honorably." He added that VA now "needs a strong leader at the top who will listen to veterans, strengthen the VA, and work with Congress to implement bipartisan reforms." Tester said he "look[s] forward to meeting … Jackson soon and seeing if he is up to the job."

    But some stakeholders expressed concerns about whether Jackson is qualified to run VA. "The administration needs to be ready to prove that [Jackson's] qualified to run such a massive agency, a $200 billion bureaucracy," Joe Chenelly, national executive director of AMVETS, said in a statement.

    Garry Augustine, executive director of Disabled American Veterans, said, "We don't know much about this fellow," adding, "We're concerned about what seems to be someone who is coming in and doesn't seem to have any background or experience in government."

    Similarly, Will Fischer, director of government relations for VoteVets, said, "Other than a total lack of awareness of where he stands on any issue, we are also concerned that he has never managed an agency like the VA. Now is not the time for people who need training wheels, when it comes to managing a massive health care system." Fischer continued, "While we wouldn't doubt … Jackson's medical credentials, it is essential that he prove that he is intimately aware of how the agency works" (Lawrence/Taylor, NPR, 3/28; Wax-Thibodeaux, Washington Post, 3/28; Summers/Diamond, CNN, 3/28; Yglesias, Vox, 3/28; Colvin, AP/Sacramento Bee, 3/29; Allen/Nussbaum, Politico, 3/28; Rein et al., Washington Post, 3/29; Shulkin, New York Times, 3/29; Arnsdorf, ProPublica, 2/16; ).

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