So, why was really Dr. Shulkin fired?
As he noted in a recent NY Times op-ed, “advocates within the administration for privatizing V.A. health services… 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.”
Dr. Shulkin had taken concrete steps towards expanding veteran access to private health services. Specifically, he had to upgrade the VA’s electronic medical records system and create a culture of accountability that was sorely lacking. And then there was the de facto rationing that plagues the VA health delivery system: When he became secretary the hepatitis C cure rate was 70 percent. That’s because the VA PBM following ICER recommendations withheld cures from HCV patients until they had advanced forms of the disease. Within a year, the cure rate was up to 90 percent.
Ironically, while Shulkin’s tenure was being questioned by privatization advocates, he was also being undermined by VA bureaucrats who opposed his actions on privatizing services as well as his holding agency and hospital directors directly accountable for meeting quality and customer service benchmarks.
It is perfectly understandable when someone is replaced for political or strategic reasons. Great baseball managers are fired all the time and resurface elsewhere. The same goes for people in senior management. But why orchestrate a campaign of personal destruction while doing so?
Ben Wattenberg, who was one of America’s go to political commentator until his untimely death in 2015, once told me that “Washington is a carnivorous town.” He meant that the political establishment enjoys cannibalizing other people and devote much of their time and effort on doing so. Nothing personal mind you.
Shulkin wondered aloud: It shouldn’t be this hard to serve your country. Unfortunately, it seems it will become even harder in the years ahead. So, while I am disappointed that Dr. Shulkin is no longer running the VA, I am happy knowing that he will continue to make an impact in a position that appreciates his passion for patient care and his talents. And I am happier still that he and his family will enjoy Passover together, freed from innuendoes and character assassinations.