NOEL KING, HOST:
Firings and resignations from the Trump administration are nothing new. But last night, the firing of Veterans Affairs secretary David Shulkin came as a surprise. Consider this. Last summer, President Trump was praising Shulkin at a bill signing. While the audience clapped, Trump mouthed his famous catchphrase, you're fired. And then he said...
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PRESIDENT DONALD TRUMP: We'll never have to use those words. We'll never have to use those words on our David.
KING: It has been a mere eight months. And then last night, the president goes on Twitter to announce that Shulkin is out and that the current White House physician, Dr. Ronny Jackson, is in as his nominee to take over at the VA. So what is going on here, and what does it mean for the VA? NPR's Quil Lawrence covers Veterans Affairs, and he's with us now. Good morning, Quil.
QUIL LAWRENCE, BYLINE: Good morning, Noel.
KING: So Dr. Shulkin comes on during the Obama administration, and his job is to overhaul the VA's troubled health network. He's got a lot of bipartisan support. And obviously, we just heard, it seems like President Trump really liked him. But then the last six weeks get rocky. What actually led to his departure?
LAWRENCE: Well, the first thing is an ethics investigation. And the VA's inspector general came out with a scathing report about a trip Dr. Shulkin took last year. It was an official trip on VA business to Europe, but he combined two trips into one. And then he was stuck with a lot of time in between, during which he spent a lot of time doing tourism. And he brought his wife along, which the ethics investigation said was improper. He ended up spend - paying back her expenses on the trip, as well as some tickets he accepted to Wimbledon.
KING: But then you and others have reported that that ethics investigation was used by people who didn't particularly like Dr. Shulkin.
LAWRENCE: Absolutely. And this is one of those weird sort of things you would think was a paranoid conspiracy theory if it hadn't been put in writing between two political appointees of the president in an email saying, let's use this ethics investigation to get rid of Shulkin and his top aides because he's not moving quickly enough to increase the use of private care, privatization, at the VA. So this all came out in the open. And it's made it very unclear because it wasn't clear in the last few weeks who was really running the VA. The - Secretary Shulkin didn't - clearly didn't have control of his public affairs messaging. So it was a very strange situation.
KING: Well, let's talk about the man who President Trump wants to run the VA, Ronny Jackson, Dr. Ronny Jackson. What do you know about him?
LAWRENCE: He's got a great reputation as a physician. He's a combat Navy doctor. He deployed to Iraq. He was President Obama's doctor as well. Last time we've seen him in the public eye was January, when he gave President Trump a clean bill of health. It - he did it a little too enthusiastically for the president's critics. But there are a lot of questions about what his qualifications are to run a huge organization. This is - the VA's second only to the Pentagon in size, an almost $200 billion budget, more than 350,000 staff, a bureaucracy and a political environment that has eaten up three VA secretaries now in four years.
KING: And a population, veterans, that in many cases is facing a lot of challenges. Veterans really seemed to like Dr. Shulkin, didn't they?
LAWRENCE: Well, veterans' organizations definitely like him. They saw him as pragmatic. So did Republicans and Democrats on the Hill. I would say a lot of rank-and-file vets were really angry about his trip to Europe. Especially if you're living on a disability check each month, that doesn't fly. But Jackson is an unknown quantity to all of these veterans' organizations. They just know he's a combat veteran. Shulkin wasn't a vet. But other than that, they consider him an unknown quantity. They're sort of saying, well, we're looking forward to getting to know him.
KING: Do you think Admiral Jackson will have an easy time getting confirmed?
LAWRENCE: We'll see. I mean, there's already some noise among Democrats that they see that Shulkin was pushed out by forces within the administration that want to privatize the VA. Now, for all its warts, vets - increasingly they like the care they get at the VA. And compared to the private sector, the VA does pretty well. So this - there may be an effort coming up in confirmation hearings to get a pledge from Jackson that he'll resist this privatization agenda. But that's the agenda that may have just gotten his predecessor fired.
KING: Gosh. So that remains to be seen there. NPR's Quil Lawrence. Thanks, Quil.
LAWRENCE: Thank you, Noel. Transcript provided by NPR, Copyright NPR.