After weeks of speculation, President Donald Trump fired VA Secretary David J. Shulkin, MD, on March 28 and proposed White House physician US Navy RADM Ronny L. Jackson, MD, as his replacement. In another unusual move, President Trump did not ask Deputy Secretary of Veterans Affairs Thomas G. Bowman to manage the agency during the confirmation process, but instead asked Robert Leon Wilkie Jr who was serving as the US Department of Defense Undersecretary of Defense for Personnel and Readiness.
While acknowledging that all cabinet members serve at the pleasure of the President, Shulkin placed the blame for his dismissal squarely on other VA political appointees. “There are many political appointees in the VA that believe that we are moving in the wrong direction or weren’t moving fast enough toward privatizing the VA,” Shulkin told NPR in an early morning interview. “I think that it’s essential for national security and for the country that we honor our commitment by having a strong VA. I was not against reforming VA, but I was against privatization.”
Shulkin was clearly prepared and quick to indentify his oponents in the administration. He wrote a New York Times op-ed that was published just hours after his firing. “Successes within the department have intensified the ambitions of people who want to put VA health care in the hands of the private sector,” Dr. Shulkin wrote. “I believe differences in philosophy deserve robust debate, and solutions should be determined based on the merits of the arguments. The advocates within the administration for privatizing VA health services, however, reject this approach. They saw me as an obstacle to privatization who had to be removed. 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.”
“As I prepare to leave government,” Shulkin concluded, “I am struck by a recurring thought: It should not be this hard to serve your country.”
Although controversy has swirled around Dr. Shulkin since the release of a VA Inspector General report that was highly critical of a trip to Europe, he dismissed the trip as a cause of his dismissal. According to Shulkin, the White House had refused to allow him to defend himself and point out that the trip was for the White House and the VA. “This was the five allies conference, a trip that the VA secretary has participated in for 40 years with major allies,” he told NPR “The single expenditure spent was on a coach airfare for my wife who was officially invited. Everything was pre-approved by our ethics committee. When the Inspector General didn't like the way that my staff had handled the approval, I wrote a check back to the government.”
Despite the controversy, veteran service organizations (VSOs) and congressional leaders have remained supportive of Dr. Shulkin and skeptical of Dr. Jackson. Most of the VSOs were quick to issue statements. “We are grateful for [Dr. Shulkin’s] efforts to steer VA toward sensible, lasting transformation of veterans health care and hope to see those plans continue moving forward,” said Commander Delphine Metcalf-Foster of Disabled American Veterans in a statement. “While we look forward to learning more about the qualifications and views of the new nominee, we are extremely concerned about the existing leadership vacuum in VA. At a time of critical negotiations over the future of veterans health care reform, VA today has no Secretary, no Under Secretary of Health or Benefits, and the named Acting Secretary has no background in health care and no apparent experience working in or with the Department.”
In his statement, AMVETS Executive Director Joe Chenelly raised a number of issues that are likely to take center stage in the confirmation hearings, asking “is it appropriate for an active-duty military officer to run a federal agency?” and “with an official bio that does not seem to contain any indication that he’s held a command, is the president’s nominee fully prepared to lead such a massive bureaucracy?” Chenelly added, “I am deeply concerned about the nominee. Veterans’ lives depend on this decision, and the Trump administration needs to substantiate that this active-duty Navy officer is qualified to run a $200 billion bureaucracy, the second largest agency in the government.”