NOEL KING, HOST:
Once a favorite Cabinet member of President Trump’s, Veterans Affairs Secretary David Shulkin is out. And it wasn’t a surprise. Shulkin’s future has been in doubt ever since the VA’s inspector general found there was a misuse of taxpayer funds when Shulkin and his wife took a trip to Europe last year. But Shulkin also clashed with Trump’s political appointees who want to privatize health care for veterans. President Trump wants him replaced with Navy Rear Admiral Ronny Jackson, the White House physician. David Shulkin is with me now. Good morning, Doctor.
DAVID SHULKIN: Good morning.
KING: And we're also joined by NPR's veterans correspondent Quil Lawrence. Hey, Quil.
QUIL LAWRENCE, BYLINE: Hi, Noel. Good morning, Dr. Shulkin.
SHULKIN: Good morning, Quil.
KING: So, Dr. Shulkin, there have been rumors for weeks that you might be fired. When and how did you find out that you’d been dismissed?
SHULKIN: Well, I think as you reported last night, I found out.
KING: Sorry. Tell us how you found out. Who told you?
SHULKIN: You know, this issue of - this intrigue about how people find out and things like that really doesn't have any interest to me. This is part of all this Washington nonsense that, frankly, gets in the way. What I'm really concerned about is making sure that the progress that we have to do as a country for veterans continues and that we're doing the right things for our veterans.
KING: Doctor, I wonder, were you given a reason for why you were let go?
SHULKIN: When you're a Cabinet member, you serve at the pleasure of the president. And, you know, when the president makes a decision, that's the way that that goes. We all understand that taking these jobs.
LAWRENCE: So, Dr. Shulkin, the big point of friction within the administration, within the VA, is about privatization, to what degree the VA should rely on private care or should it privatized outright. And political appointees in the administration were discussing removing you over this issue. Was that coming directly from the president? Is that what he wants to do with the VA?
SHULKIN: As you said, there are many political appointees in the VA that believe that we are moving in the wrong direction or weren't moving fast enough towards privatizing the VA. As I've always said, 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. And I think that it was really the political appointees that were trying to undermine our efforts at VA.
LAWRENCE: I mean, you've already increased privatization - private care use at the VA up above 30 percent or so. How much more does President Trump want to privatize VA care?
SHULKIN: As I've said, I think that the right answer for veterans to meet their needs is a very strong VA but also to work with the private sector and to do it in an integrated way where veterans can get the very best that this country can offer. And that includes a strong VA. I think that these debates about how to reform VA and continue the transformation are going to be very active in the months to come and are going to be important for people to watch to make sure that we are fulfilling our commitment to our veterans.
LAWRENCE: I just have to ask one more time, do you know where the president stands on privatization?
SHULKIN: I know the president feels strongly about making sure that we're doing better for veterans. I don't - you know, as secretary, he gave me a lot of authority in making sure that we were making that type of progress. I think that there's probably going to be a lot of open discussion about the best way forward. And I certainly want to make sure that we're making good, informed choices as we do move forward.
KING: Dr. Shulkin, what were your final months in the administration like? Was this debate over privatization or how much to privatize, was this happening out in the open?
SHULKIN: Well, you know, I - I've had a very good experience as secretary for most of my tenure. It's been one that I would characterize as strong bipartisan support. We have great committees in Congress with Chairman Isakson and Ranking Member Tester and Chairman Rone, Ranking Member Walz, who are doing great things for veterans. And we've gotten so much done. But as you mentioned, in the last few months, it really has changed, not from Congress but from these internal political appointees that were trying to politicize VA and trying to make sure that our progress stopped.
And it's been a very difficult environment. It's been one where we've been distracted from our mission. And hopefully, we have a chance now to get back on target to make sure that we are making the types of continued transformations for veterans that they deserve to have a VA that works for them.
KING: Do you expect that to happen?
SHULKIN: Well, I have a lot of confidence in our congressional leadership. I have a lot of confidence in our veterans service organizations, and I have a lot of confidence in the men and women who serve in the VA who are some of the best professionals in the industry. And I do believe that the country wants to see this happen, so I am optimistic for the future.
KING: You...
LAWRENCE: Dr. Shulkin - sorry.
KING: Yes, go ahead.
LAWRENCE: So if - you had support of all the leadership on veterans committees in the Senate and the House, Republicans' and Democrats' support of all of the major veterans service organizations, and yet, you were let go. Does that mean that President Trump was more interested in a different agenda than the one they were pushing, which is, again, anti-privatization?
SHULKIN: Well, you know, I don't think I'm the best person to speak for the president. And I think we all see the president feels strongly about certain issues and makes sure that he's putting his policies in place, and he should have the people that he wants in place. But I do think that the way that you work effectively towards transforming the VA is to work closely with our members of Congress, particularly because we have such great leadership there, and our veterans service organizations and the people who serve in the VA. And when you try to make a transformation as large as this without having alignment of interests, without having a consensus about where we're going, it just makes the job a lot tougher.
KING: Well, Doctor, let me ask you about the job. I mean, you said you go in understanding that any Cabinet secretary could lose their job at any time. You obviously care about veterans. Is this turnover doing veterans any good? I mean, don't they deserve some stability and some clarity?
SHULKIN: I think when you look back over the history of VA - and I think everyone has to recognize - this is a system that has struggled for decades across multiple administrations. One of the issues that has kept it from making the type of progress that it needs to make is the turnover of leadership. And I do think in any organization where you're making such big change, continuity of leadership is important. So I do think that this is going to be a challenge going forward. But I believe that we will find the right leadership, and hopefully, we'll all support the new secretary so that they can make the type of progress and have the type of continuity that you need to see this transformation happen.
LAWRENCE: Dr. Shulkin, your relationship with the White House seemed to change when this ethics probe was - a report was released by the inspector general of the VA saying that you had improperly spent VA funds - several thousand dollars - on an official trip to Europe where you improperly brought your wife along, accepted gifts of tickets to Wimbledon. You had just released a memo to all VA staff about unnecessary spending. What were you thinking?
SHULKIN: Well, I'm really glad to talk about that. You know, no one's ever mentioned what the purpose of this trip was. This was the five allies conference, a trip that the VA secretary has participated in for 43 years with our major allies. We had over 40 hours of direct meetings. I gave three separate lectures. We - this is our one forum where we share how to care for our veterans among all of our allies. This was being characterized as a European vacation. It was far from that. This was official business. On nights and weekends, I went out, never used government money for that. 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. So this was completely mischaracterized. There was nothing improper about this trip, and I was not allowed to put up an official statement or to even respond to this by the White House, who told me that they didn't want me responding. So I think that this was really just being used in a political context to try to make sure that I wasn't as effective as a leader moving forward. And, quite frankly, this has really always been about the issue of the future of VA and the direction of VA.
KING: Let's talk about the future. Your replacement, White House physician Ronny Jackson, the man the president wants to replace you, doesn't have much background heading an agency. How long do you think it's going to take to get him up to speed, and what do you think of his appointment?
SHULKIN: Well, I know Dr. Jackson very well. I would consider him a good friend. He is a very honorable man - you know, served the country, cares a great deal about veterans. And I think that he wants to do the right thing and will work hard to do that. And I will personally help him in any way possible. No one, I think, is naturally prepared to take on a task like this. This is a very challenging role.
KING: It is - it is a behemoth. And I'm sorry. We're going to have to leave it there, Doctor, for time. We've been speaking with former Veterans Affairs Secretary Dr. David Shulkin. And NPR's Quil Lawrence.
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