AILSA CHANG, HOST:
President Trump announced another shakeup in his Cabinet by Twitter this evening. This time it's VA Secretary David Shulkin who's out. And Trump has tapped his personal White House doctor, Ronny Jackson, to take the helm of the sprawling Department of Veterans Affairs. With us now to talk through this latest development is NPR's Scott Horsley. Hey, Scott.
SCOTT HORSLEY, BYLINE: Good to be with you, Ailsa.
CHANG: All right, Shulkin's ouster is not a surprise, right? I mean, he's been on the watch list for quite some time now. Can you just first remind us why he's been in danger of losing his job?
HORSLEY: That's right. Shulkin is the only member of the Trump Cabinet who is a holdover from the Obama administration. And he's won some points for reforms in the troubled VA health care system. But in recent weeks, he's been the focus of a scathing review by the inspector general, who found serious dereliction in his ethical lapses, including accepting an improper pair of tickets to Wimbledon, taking his wife on a trip to Europe at taxpayer expense, which VA staffers then tried to cover up.
He is not the only Cabinet member who has run afoul of this kind of ethical watchdog. Former Health Secretary Tom Price lost his job over his use of private planes, and...
CHANG: Right.
HORSLEY: HUD Secretary Ben Carson and EPA Administrator Scott Pruitt are also on the watch list. But Shulkin is the one who's gotten the ax.
CHANG: But Trump's nominee to replace Shulkin is a little bit out of the blue. I mean, his doctor Ronny Jackson - what can you tell us about him?
HORSLEY: Yeah, Jackson is the president's personal White House doctor. He's been part of the White House medical team since the Bush administration, and he was promoted to presidential physician by former President Obama. He's a native of West Texas. He went to Texas A&M and the UT Medical Branch. He's a rear admiral in the Navy, and he had a colorful career there that included a stint with an underwater salvage team and a Navy bomb disposal unit. Now he's tasked with salvaging the VA, which is a huge responsibility, trying not to blow it up. He's about to go from overseeing one patient's health to 9 million patients' health.
CHANG: Wow. Put that way...
HORSLEY: So that's a huge jump in his wingspan.
CHANG: But Jackson's name was not one of the names you were hearing whispers about in recent weeks - right? - I mean, even as Shulkin was on thin ice.
HORSLEY: That's right. He is not someone who is a frequent guest on cable television, which is where the president has been doing a lot of his recruiting in recent days. Jackson's most famous TV appearance came just a couple months ago when he gave an hour-long briefing here at the White House about President Trump's physical exam. I think he got generally high marks for that performance. He was sort of folksy and disarming. He pronounced the president in good health, said he's got very good genes, although he said Trump could stand to lose a little weight.
CHANG: Right.
HORSLEY: Lately he has been working with the White House nutritionists on the president's diet, and he's got Trump eating more salad these days. I don't think that's why he's being pushed over to the VA.
CHANG: But as you say, Jackson is facing a huge job now. What are some of the challenges facing the new VA secretary?
HORSLEY: The big question is going to be how far the Veteran Affairs Department moves down the path to privatization in health care. The VA health care system is overtaxed, but it is really popular with the veterans who do get their treatment there. And veterans service groups have warned against any kind of push towards privatizing veterans' health care even though that's what some conservative activists have been pushing for.
Those veterans groups were fans of Shulkin for at least initially holding the line against what they would see as too much privatization. I think they're going to be very curious to see where Dr. Ronny Jackson stands on that because it's not the sort of thing he's been asked about as White House physician.
CHANG: All right, that's NPR's Scott Horsley. Thanks very much.
HORSLEY: You're welcome. Transcript provided by NPR, Copyright NPR.
