AUDIE CORNISH, HOST:
President Trump fired his secretary of Veterans Affairs last month. Trump's nominee to replace him withdrew last week. Meanwhile, many senior VA officials have quit. Veterans' groups see an agency without direction, which they worry is beginning to have an impact on the nine million veterans who rely on the VA for their health and benefits.
NPR's Quil Lawrence covers veterans. He joins us here now. Hey there, Quil.
QUIL LAWRENCE, BYLINE: Hi.
CORNISH: So tell us who else has resigned from the VA and why they're leaving.
LAWRENCE: The chief information officer, the deputy undersecretary for health, senior staff from the communications department. The deputy secretary's considered a lame duck. And some prominent ones who were recruited from the high - from high-paying jobs in the private sector, they left behind big salaries to come work for the VA, and they're quitting. The VA spokesman says that people are - who are leaving were wedded to the status quo, not on board with the pace of change at VA, essentially saying sort of good riddance. We're going to fix the VA, and now everyone is working on the same page to implement President Trump's agenda for vets. But sources in and around the VA say that the agency feels rudderless and kind of hollowed out. And they're concerned that a fringe group in favor of privatization is now sort of leading in control of the VA.
CORNISH: What is the status of this privatization movement? That was a big issue on the campaign trail.
LAWRENCE: Right. I mean, the VA's always relied on some private care. Right now they use - over 30 percent of their appointments are using care in the private system. The VA then reimburses those private doctors. And the way they pay them back is one of the programs that's kind of up in the air because of this leadership shuffle. The money for that program runs out by June, and the woman overseeing that program just quit the VA on Monday. So no one will say that they outright want to privatize the VA. It's sort of a dirty word because veterans oppose that idea.
But there's growing concern - and this is coming from mainstream Republicans, not just Democrats - that this increased private care might be kind of a Trojan horse pushed by people who are opposed to any government health care. And that the cost of it, which is huge, could starve the VA's own health care system and sort of put it into a death spiral that pushes more people into the private sector, which doesn't really outperform the VA in health care according to a RAND study, for example, that was out last week.
CORNISH: Meanwhile, I know you've also been reporting that there's another program that seems to be stuck, that the VA was said to buy a new electronic health records system. What happened?
LAWRENCE: Right. So it's a $16 billion contract that's on hold. It was done in a no-bid fashion. So there are plenty of legitimate questions about such a big contract and certainly plenty examples in the past of government IT contracts going poorly. But the reason this one is held up are kind of strange. According to former VA sources, the previous VA secretary had settled on this contract with a company called Cerner. It was a culmination of years of work to finally make the VA health records compatible with the Pentagon records. And then around last Thanksgiving, President Trump was at home in Mar-a-Lago. He had a discussion with Bruce Moskowitz, who's a well-known private doctor in Florida, who expressed his doubts. And then the president apparently called up then-Secretary Shulkin and said something like, my friend says that software is lousy.
CORNISH: So people are saying essentially that one of Trump's friends in Florida is changing Washington policy.
LAWRENCE: And throwing into chaos a process the VA's been working on for over a decade. And it's still on hold. And the acting VA secretary says it's a priority to get this moving again. It's even been suggested that this deal contributed to the previous VA secretary Shulkin getting fired. But this sort of management is one of the reasons vets' organizations say they're concerned about a leadership vacuum, that people from outside the vets community or on its fringes are advising the president. And they're concerned that this could slow down what they have seen as progress at the VA in the first year of the Trump administration.
CORNISH: That's NPR's Quil Lawrence. Quil, thank you.
LAWRENCE: Hey, thanks. Transcript provided by NPR, Copyright NPR.
