Just a few weeks before he was fired, VA Secretary David J. Shulkin, MD, spoke at the HIMSS18 conference about technology issues at the agency. Photo from Shulkin’s Twitter account
WASHINGTON — After several weeks of speculation regarding his future in the Trump Administration, VA Secretary David Shulkin, MD’s tenure came to an abrupt end on March 28.
President Donald Trump said the day following the announcement that he “wasn’t happy with the speed with which our veterans were taken care of,” which was why he “made some changes.” He suggested veterans should have greater access to private care.
“We want them to have choice, so that they can run to a private doctor and take care of it, and it’s going to get done,” he said.
In a January photo, President Donald J. Trump talks with, from left to right, Capt. Mark Kobelja, director of Walter Reed National Military Medical Center; Dr. Ronny Jackson, physician to the president and now nominee for VA secretary; and Dr. James Jones, physician to the president and medical director of the Medical Evaluation and Treatment Unit, following Trump’s annual physical at the medical facility. White House Photo by Shealah Craighead The nomination of Rear Adm. Ronny Jackson, MD, as the new VA secretary was announced in tweet posted March 28 by Trump. In revealing the ouster of Shulkin, Trump said he was “thankful” for his “service to our country and to our GREAT VETERANS!”
The president also said Robert Wilkie of DoD would serve as acting secretary. Wilkie is the under secretary of defense for personnel and readiness.
While Shulkin said he only heard about his dismissal shortly before Trump tweeted it, the White House claimed the VA secretary resigned.
Shulkin was first appointed as VA undersecretary of health in July 2015 during the Obama administration. He served as VA Secretary for about 13 months before he was fired.
Early in his tenure, his firing seemed unlikely, as he appeared to have Trump’s full support. During a ceremony for the signing of the Veterans Accountability and Whistleblower Protection Act in June of 2017, Trump joked that he would never have to use the words “you’re fired,” on Shulkin.
“We’ll never have to use those words on our David. We will never use those words on you, that’s for sure,” he joked.
In the weeks before he was let go, there was speculation that Shulkin might be fired after a recent VA Office of Inspector General report found that Shulkin misused funds on a European trip last summer. The report recommended that the secretary repay more than $4,000 spent on his wife’s airplane ticket.
News reports also suggested that some administration officials wanted Shulkin fired amidst disagreement over the way forward for VA.
Shulkin pointed to an internal struggle over privatization in VA in an op-ed piece in the New York Times following his dismissal and blamed those in the agency who he said wanted to privatize VA care. He said that he has “been falsely accused of things by people who wanted me out of the way.”
“I believe differences in philosophy deserve robust debate, and solutions should be determined based on the merits of the arguments,” he said. “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.”
Pointing to the struggle in the agency, Shulkin wrote that “until the past few months, veteran issues were dealt with in a largely bipartisan way.”
“Unfortunately, the department has become entangled in a brutal power struggle, with some political appointees choosing to promote their agendas instead of what’s best for veterans. These individuals, who seek to privatize veteran health care as an alternative to government-run V.A. care, unfortunately fail to engage in realistic plans regarding who will care for the more than nine million veterans who rely on the department for life-sustaining care,” he pointed out.
On Capitol Hill
Shulkin was unanimously confirmed by the Senate last February and had enjoyed support from both key Democrats and Republicans during his tenure.
After he was fired, several congressional leaders praised the job Shulkin had done as VA secretary.
“Dr. Shulkin has made a tremendous impact toward improving the lives of veterans during his time at the U.S. Department of Veterans Affairs,” said Senate Committee on Veterans’ Affairs Chairman Sen. Johnny Isakson (R-GA). “He has been instrumental in all that we have accomplished in the last year, and I thank Dr. Shulkin for his dedicated service to our country and our veterans.”
Praise also came from Democrats on the committee. Ranking Member Sen. Jon Tester (D-MT) said that “David Shulkin has served honorably on behalf of veterans as a physician and as secretary of the VA, including progress in improving the VA’s delivery of health care and benefits to our veterans.”
“Moving forward, the VA 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.
In the House, meanwhile, Committee on Veterans’ Affairs Chairman Rep. Phil Roe, MD, said that he has “enjoyed getting to know Secretary Shulkin” and that he is glad “to call David a friend.”
“I think he’s done a fantastic job and I hate to see him go,” Roe noted. “That said, I respect President Trump’s decision, support the president’s agenda and remain willing to work with anyone committed to doing the right thin on behalf of our nation’s veterans.”
Meanwhile, Rep. Mike Coffman (R-CO), who has been a critic of Shulkin, told a news outlet that the ousted VA secretary “reflected, unfortunately, the problems of the organization.” He also criticized Shulkin’s handling of the construction of the Aurora, CO, VA.
“I believe that fundamentally that only someone from outside the VA can ultimately clean up the VA,” he said.
Legislation that would streamline VA’s community care programs into one program and expand VA’s caregiver program to veterans of all eras was signed into law earlier this month..
The good news from a recent consultant study is that, overall, the VA healthcare system is generally equal or better than others when inpatient and outpatient quality is measured.