Ex-VA Secretary Shulkin Leaves With Scathing Comments on Privatization

After David Shulkin, MD, was abruptly fired by President Donald Trump, he claimed he was pushed out of the Department of Veterans Affairs (VA) by political opponents who saw him as a obstacle to expanding privatization of care at the Agency.

Dr Shulkin wrote an op-ed in the New York Times, criticizing factions at the VA who he claims are more interested in achieving political goals than keep veterans healthy. 

“They saw me as an obstacle to privatization who had to be removed,” Dr Shulkin wrote. “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.”

Dr Shulkin noted in the farewell address that he agrees with some components of privatizing VA care, but noted that the factions within the VA pushing privatization are not open to any criticism or pushback.

“I believe differences in philosophy deserve robust debate, and solutions should be determined based on the merits of the arguments,” he wrote. “The advocates within the administration for privatizing VA health services, however, reject this approach.”

Dr Shulkin argued that the health care at the VA is a complex mechanism, that is serving veterans well, and by abruptly shifting it to the unequipped private sector, veterans would be put at risk.

“The private sector, already struggling to provide adequate access to care in many communities, is ill-prepared to handle the number and complexity of patients that would come from closing or downsizing VA hospitals and clinics, particularly when it involves the mental health needs of people scarred by the horrors of war,” Dr Shulkin wrote. “Working with community providers to adequately ensure that veterans’ needs are met is a good practice. But privatization leading to the dismantling of the department’s extensive health care system is a terrible idea.”

He noted that care at the VA has been specifically engineered and tailored to meet the complex needs of the veteran patient population.

“The department’s understanding of service-related health problems, its groundbreaking research and its special ability to work with military veterans cannot be easily replicated in the private sector,” he wrote.

Dr Shulkin also heavily criticized the recent wave of politicization of veteran’s health care, and its detriment to the patients.

“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,” he wrote. “These individuals, who seek to privatize veteran health care as an alternative to government-run VA care, unfortunately fail to engage in realistic plans regarding who will care for the more than 9 million veterans who rely on the department for life-sustaining care.”

The day before Dr Shulkin’s editorial, President Trump abruptly replaced him via twitter, with the nomination of his personal physician, Ronny L Jackson, MD. It is unclear if Dr Jackson will be able to attain confirmation by the divided Senate, let alone the 100-0, unanimous confirmation Dr Shulkin received in 2015.

—David Costill