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Amid a barrage of negative headlines, VA chief faces push for more privatization

Despite denials of another Cabinet shakeup from President Trump, Veterans Affairs Secretary David Shulkin's standing has taken a hit on multiple fronts, including a probe revealing improper use of taxpayer funds for his wife's travel and ongoing scandals about how the VA delivers care. William Brangham learns more from Lisa Rein of the Washington Post.

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  • Judy Woodruff:

    The rate of high-level departures from the Trump administration recently is unprecedented.

    Among the original Cabinet members that remain, several questions has arisen around potential ethics violations.

    William Brangham reports on one agency with a troubled track record and a leader who is under fire.

  • Question:

    Mr. Secretary, any concerns about your job?

  • William Brangham:

    Embattled Veterans Affairs Secretary David Shulkin expressed regret for the distractions gripping his department at a House committee hearing today.

  • David Shulkin:

    I have come here for one reason, and that's to improve the lives of veterans. And that's what I'm focused solely on doing.

    There are a lot of people that, frankly, are more interested in politics than I am.

  • William Brangham:

    Shulkin, who is the only Cabinet official held over from the Obama years, is the latest member of the Trump administration who is rumored to be on the chopping block. An early favorite of Mr. Trump, the president once joked of his firing.

  • President Donald Trump:

    We will never have to use those words.

  • William Brangham:

    But in the Oval Office today, the president said rumors of a staff shakeup were wrong.

  • President Donald Trump:

    There's always be change, but very little. That was a very false story.

  • William Brangham:

    Still, the physician and former hospital executive's standing is taking hits on multiple fronts.

    The first fissure came in February, after an internal probe found the secretary improperly accepted tickets to the Wimbledon tennis match and used taxpayer funds for his wife's travel. Shulkin repaid the government for both, but began saying publicly that politically appointed members from the White House were trying to force him out over personality and policy reasons.

    The policy differences hinge on a struggle over how much to privatize the Veteran Affairs health care system, a move some conservatives have backed for a long time.

    On the campaign trail, then candidate Trump vowed to modernize the VA, and said veterans should be able to go to private doctors if needed.

  • President Donald Trump:

    Veterans should be guaranteed the right to choose their doctor and clinics, whether at a VA facility or at a private medical center.

  • William Brangham:

    In 2016, FOX News contributor Pete Hegseth, who used to run a veterans group backed by the conservative billionaire Koch brothers, agreed with this idea.

  • Pete Hegseth:

    That's the type of system the VA should have. Go to the VA if you want to, or go to a private provider.

  • William Brangham:

    Media reports have said the president is considering Hegseth, along with current Energy Secretary Rick Perry, as possible candidates to replace Shulkin.

    Back in the hearing today, Shulkin pushed back against the wider privatization of his agency, and said the president agreed with him.

  • David Shulkin:

    I have been clear that I think this would be the wrong decision for our country's veterans to privatize VA. I have also been clear that I think that VA can't do this alone. The president is very, very committed to improving services for veterans. There is no pressure to privatize.

  • William Brangham:

    This debate takes place as the VA continues to deal with ongoing scandals about how it delivers care. Last week, an inspector general report blamed failures in leadership during the Obama administration for wasteful spending and dirty conditions in one Washington, D.C., Veterans medical center.

    At the time, Shulkin was the VA's undersecretary. The secretary said today that was a systemic breakdown, he vowed to improve.

  • David Shulkin:

    It was failure at every level of our organization. It should have never gotten to that point.

  • William Brangham:

    Still, amid the controversies, Shulkin says he has no intentions of stepping down.

    So, let's take a closer look at what's ahead for Secretary Shulkin and the VA with Lisa Rein. She's been covering the story for The Washington Post.

    Welcome.

  • Lisa Rein:

    Thank you.

  • William Brangham:

    So, you reported this afternoon that President Trump is, in fact, leaning on firing Secretary Shulkin and possibly replacing him with Peter Hegseth.

    Why has the president soured on Shulkin so much?

  • Lisa Rein:

    So, as we know, he has talked about shaking up his Cabinet, which started with the firing this week of Secretary of State Rex Tillerson.

    And the president has always actually liked Secretary Shulkin. They're both New Yorkers, say what they mean, brash. Shulkin is a doctor, very well-respected, former hospital executive.

    But the president has soured on him because there have been, in the last month, kind of an unending barrage of negative headlines about Secretary Shulkin that center on two things. One is an inspector general report on a trip that he took to Europe that had some lapses, including his acceptance of some free Wimbledon tickets, some other improprieties.

    But Dr. Shulkin himself actually went very public with what he said was an attempt by his own political appointees who were installed by the White House at VA to oust him. And this kind of opened this festering wound at VA, and there was just more and more press coverage of it, and just that Shulkin didn't get along with his appointees, and they were trying to oust him because of personality and policy differences.

    And the president has told aides that it's just sort of too much for him and he's really soured on him.

  • William Brangham:

    So, am I right that the core issue underlying all of this is really this policy debate within the VA over how much we privatize the system or not? Is that right?

  • Lisa Rein:

    That's right.

    This has been talked about for several years now, since, in 2014, there was a big scandal over VA managers who were fudging wait times for patients. And it became clear that the VA system just couldn't handle all the appointments that veterans needed to see doctors.

    And there's just a huge increasing demand for health care. So, under Obama, President Obama, Congress passed a ginormous, billion-dollar, multibillion-dollar bill to give some veterans the options, but with restrictions to see doctors, private doctors in the community.

    But the Trump administration has come in. And conservatives generally favor more private care. The philosophy, you know, from many people in the Trump administration has been, let's have more private care. And conservatives in Congress are also pushing this.

    But the debate has really been, how much should we advance this policy change, and who really should have — should be making the decision over access to care? Should it be the veteran, or should it be the doctors and nurses at VA?

    And it sounds like kind of an arcane decision that really wouldn't have such a big impact, but, in reality, it does, just because it's a big ideological difference.

  • William Brangham:

    So, let's say Shulkin is pushed out and someone else comes in who does want to push for more privatization.

    How do traditional veterans groups come down on that particular choice?

  • Lisa Rein:

    So, this has been a very, very bitter conversation in recent years.

    Traditional groups like the American Legion, the VFW, these are the big groups whose members really support the president, they really fear what they call a move toward privatization that this administration is pushing, because it would drain resources from VA's current system.

    Then you have conservatives in the White House and at VA who are backed by a group called conservative — sorry — Concerned Veterans for America, backed by the Koch brothers, who really want more private care and what they call more choice, so the veteran would be able to basically have the option to see a doctor of their choice.

  • William Brangham:

    All right, Lisa Rein of The Washington Post, thank you.

  • Lisa Rein:

    Thank you so much.

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