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A new report questions how the Veterans Affairs Department is being run in the Trump administration. ProPublica says the VA has three "shadow rulers," three men who have never served in the U.S. military or government but have outsize influence over all department decisions. Nick Schifrin talks with Isaac Arnsdorf of ProPublica and Melissa Bryant of Iraq and Afghanistan Veterans of America.
President Trump has promised to improve how the Department of Veterans Affairs cares for former service men and women.
But a new report out today questions how the department is being run, and whether outside influences are affecting the treatment that veterans receive.
Nick Schifrin has the story.
When former Veterans Affairs Secretary David Shulkin closed the stock exchange last November, he had an unusual helper. That's Shulkin in the middle. On the right, Captain America, a character in the Marvel Universe.
It just so happens that Shulkin's most powerful and most informal adviser was this man, Ike Perlmutter, the chairman of Marvel Entertainment and a longtime friend of President Trump.
Perlmutter became the leader of what the investigative news site ProPublica calls the VA's shadow rulers. Perlmutter, Bruce Moskowitz, a doctor, and Marc Sherman, a lawyer, none of the three have served in the U.S. military or the government, but they have outsized influence over all VA decisions, according to the story written by ProPublica reporter Isaac Arnsdorf, who joins us in the studio. Also here, Melissa Bryant, a former Army intelligence officer and the chief policy officer of the Iraq and Afghanistan Veterans of America.
Thank you to you both.
Isaac, let me start with you.
What is the relationship — what has been the relationship between these three men, the shadow rulers, as you have called them, and the VA overall?
We have basically got these three guys down in Mar-a-Lago who, for the past year-and-a-half, have been acting as a shadow leadership for the Department of Veterans Affairs and weighing in on all manners of policy and personnel decisions, despite having officially no role in government, never having served in the U.S. military or the U.S. government previously, and not really having any direct experience that's relevant to this.
They have been kind of hovering over the officials who are actually in the government and telling them how they think things should be done.
So, presidents, Cabinets, they will have informal advisers, right? Everybody gets advice from outside of government. Why is this unusual? Why is this a big deal?
It's definitely different, the way that they have been assigned a particular agency under their purview. We have never really seen something like that, where it's so directly assigned to outside advisers like this, demanding that officials fly down to Mar-a-Lago at taxpayer expense to meet with them and run things by them.
And it very quickly became clear within the department that people who didn't get along with them were pretty quickly out of a job.
And the relationship is quite interesting.
Let me read an e-mail between Bruce Moskowitz, one of these three, and David Shulkin, the former secretary of Veterans Affairs. Bruce Moskowitz writes, "We do not need to meet in person monthly, but meet face to face only when necessary. We will set up phone conference calls in a convenient time."
David Shulkin, the secretary of Veterans Affairs at the time, writes, "I know how busy all of you are, and having you be there in person and so present after we met was truly a gift."
What does that say about the relationship?
Well, what it says is they're clearly trying to establish that Shulkin needs to come to them to do his job.
And there — you can see from the very beginning there, there's this there's this friction that would grow over the time Shulkin was serving as secretary, and ultimately contributed to him being fired, that they began to feel like he wasn't listening to them.
So, certainly, we have got a lot of turmoil in the leadership of the Veterans Affairs, as we're talking about this outsized influence.
We should just read the statement from Perlmutter, Moskowitz and Sherman that they provided to you. They said: "While we were always willing to share our thoughts, we didn't make or implement any type of policy, possess any authority over agency decisions, or direct government officials to take any actions."
But did they influence policy, especially the efforts toward privatization?
There's no question that they had vast influence.
And, technically, they're not making the decision themselves. But when everyone knows that Ike will just pick up the phone and call the president if he doesn't get his way, it's very clear to everyone at the VA that it has to be their way, and that's the way it goes.
Now, obviously, the big debate about the VA over the past year-and-a-half has been about the extent to which it should be using in-house medical care, government-run, vs. private care.
And there was a point last year where Perlmutter weighed in on the side of private care. His idea was basically to bring private providers into the VA to have a look around and see what services they thought should be outsourced to providers like themselves. And that obviously presents something of a conflict of interest.
Explain that more. I mean, again, what's wrong with that? There are some people who believe that there should be more privatization in the VA. What's wrong with people arguing for more privatization?
Absolutely. And this was a big part of President Trump's campaign.
But most veterans oppose that. And the major veterans groups oppose that, because their view is that they get better care in the VA and that it would be much more expensive and serve veterans worse to just have them out in the private sector.
So, Melissa Bryant, let me turn to you. I want to ask about your notion of privatization in a second.
But this notion of outsized influence from the outside, informal advisers, and also turmoil at the top of the Veterans Affairs, does that negatively influenced the care that the VA can provide veterans?
It absolutely does.
What we see from the veteran service organizations and my colleagues across the veteran spaces, that we have seen fits and starts for programs and for policies throughout the last particularly eight months, since Dr. Shulkin has faced his ethics challenges, and then he was ousted.
But then following that, we saw a lot of challenges to contracts, such as the electronic health care records contract with Cerner, $10 billion contract that we saw start and then fall back, and then it was eventually restarted again. But that's something that will be implemented over the next 10 years.
We have seen a decrement in care for suicide prevention, even though that there are major plans and there's the joint plan of action between the Department of Defense and the VA to ensure that there's no veteran that's left behind, that slips through the cracks of care for mental health care.
And so we're concerned that we're not seeing the absolute best the VA can do, because they're so distracted with the turmoil within leadership and these outside influences who are able to distract civil servants and others who are trying to do what's best for the VA.
And why do you and your organization oppose efforts that President Trump has talked about, that these outside advisers have talked about toward privatization?
We oppose privatization, in that it would — as Isaac spoke to you, it would cost upwards of trillions of dollars, by our best estimates, and it could possibly lead to poorer health care and poorer health care outcomes for veterans.
We know that the VA, it's — under its infrastructure, its facilities and the providers that they have, they best understand the military community. They understand health care and the challenges of the invisible wounds of war, such as PTSD, traumatic brain injury. They understand things like amputation and the advances that they made in prosthetics for veterans.
And so these are types of health care advances that the VA does best. And we would love to see infrastructure being invested in within the VA to ensure they can continue to serve the military community, and particularly for the wounds of war that we know are germane to our population. And that's what we see could be compromised with privatization.
And quickly, in the time we have left, we have a new secretary this week, but his first full week on the job.
What are you looking for in his decision-making this week to know whether the VA can fix some of its problems going forward?
We would like to see Secretary Wilkie to have the autonomy and the authority to be able to do what's right for veterans. We know that this is near and dear to his heart. He talks all the time about how this is a part of his family legacy. And I get that too.
This is a family business for many of us. My father is a Vietnam vet. I'm an Iraq War vet. And so we want to ensure that that commitment to service translates into commitment to care for those who have borne the battle, our survivors and our dependents.
And we would hope that Secretary Wilkie has the latitude to be able to make the right decisions, and not be influenced by outside money and outside influencers who may not have the best care or interest of veterans at heart.
Melissa Bryant, Isaac Arnsdorf, thank you to you both.
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