OCT 23, 2019
Isaac Arnsdorf / ProPublica
President Donald Trump
personally directed administration officials to report to one of his largest
donors, Marvel Entertainment chairman Ike Perlmutter, according to a new book
by former Secretary of Veterans Affairs David Shulkin.
Starting with Shulkin’s
interview for the cabinet post, Trump routinely dialed Perlmutter into meetings
and asked if the secretary was keeping Perlmutter informed and happy, Shulkin
wrote. Perlmutter would call Shulkin as often as multiple times a day, and
White House officials such as Stephen Miller would scold Shulkin for not being
in close enough contact with Perlmutter and two of his associates at
Mar-a-Lago, Trump’s private club in Florida.
“I didn’t reach out to these
guys — these guys had a prior relationship with the president and were advising
him,” Shulkin, who was fired by tweet in March 2018, said in an interview.
“There probably wasn’t too many times I met with the president when he didn’t
say, ‘What’s happening with Ike?’”
The unusual influence over the
VA wielded by Perlmutter, along with doctor Bruce Moskowitz and lawyer Marc
Sherman, was first
revealed by a ProPublica investigation in August 2018, prompting
ongoing investigations by the House Veterans’ Affairs Committee and the
Government Accountability Office. But Shulkin’s book provides new details on
Trump’s direct role in initiating and encouraging the arrangement.
“There was a ‘second track’ of
VA decision-making led by the president’s alternative advisers that didn’t
include me,” Shulkin wrote in the book,
the first inside account by a former member of Trump’s cabinet. “Ike, Bruce and
Marc had the president’s ear in ways that I did not, even as his cabinet
secretary.”
The White House didn’t
immediately respond to requests for comment. In a statement, Perlmutter, Moskowitz
and Sherman said they had no official role or responsibilities at the agency.
“We were informal advisors offering our help in service of a cause we believe
in,” they said. “The fact that Mr. Shulkin chose to read political tea leaves
and interpreted our role otherwise is disappointing, but ultimately those were
mistakes he needs to account for, not us.”
In one incident, Shulkin
attended a dinner with then-Defense Secretary Jim Mattis at the White House.
Perlmutter, his wife and Moskowitz were already there, visiting with Trump in
the residence. (Mattis didn’t respond to a request for comment.)
“This was the first time it
hit me just how much the Mar-a-Lago crowd was going to be involved in my new
life and in my ability to lead the VA,” Shulkin wrote. “I didn’t need written
instructions to understand this two-tiered social event — the guests who waited
downstairs and the guests who were entertained upstairs — as a directive.
Essentially, ‘These people are my friends and confidants, and I expect you to
listen to them and make them happy.’”
Perlmutter and his wife
contributed almost $7.5 million to Republican causes in 2016, ranking them
among Trump’s biggest backers, according to federal data
compiled by the Center for Responsive Politics. In 2018, the couple donated
$2 million to Ron DeSantis, a close Trump ally, in his successful race to
become governor of Florida. They also lent
him their private plane. Perlmutter shuns publicity, refusing interviews
and photographs, but occasionally surfaces in court proceedings, including
an acrimonious
neighborhood feud and a New
York police officer’s testimony that he got tickets to Marvel
premieres and helped Perlmutter renew his gun permit. He frequents Mar-a-Lago
and, at his nearby oceanfront apartment, collects exotic fish; Shulkin (a
physician by training) observed that the Perlmutters’ aquarium required so much
special equipment that “it looked like they were operating a fish intensive
care unit.”
Trump gave Perlmutter and his
associates sweeping influence over the VA — the second-largest federal agency,
with a $200-plus billion budget and almost 400,000 employees providing health
care services and compensation benefits to 9 million veterans — despite their
lack of any relevant experience. None of them has ever worked in government or
served in the U.S. military (Perlmutter served in the Israeli Army in the 1967
war).
Perlmutter was familiar with
much-publicized scandals at the VA’s hospitals and had a rosy view of private
health care, Shulkin said. On one of their first calls, Shulkin wrote,
Perlmutter suggested they go around the country showing up at VA hospitals
unannounced “to see what was really going on.” When Shulkin said he didn’t
think it would be appropriate for a private citizen to be conducting unplanned
inspections, Perlmutter said, “OK, we’ll give them 10 minutes’ notice.”
“Often their advice was
unusable, because none of these men seemed to have much of an understanding of
how the VA worked, nor did they possess any health system management
experience,” wrote Shulkin, who led the VA’s health division before becoming
secretary and previously ran private hospitals. “Most concerning was that these
VA ‘advisers’ had never even been to a VA facility (which was also true of the
president and his senior staff).”
When Shulkin did bring
Perlmutter on a tour of the VA in West Palm Beach, Perlmutter seemed genuinely
surprised by the appearance and orderliness of this facility. Perlmutter
pressed patients for complaints — “he seemed adamant about finding
dissatisfaction, or better yet, horror stories,” Shulkin wrote — but heard only
praise, according to the book.
The book recounts that Shulkin
and the trio structured their interactions to avoid triggering disclosure
requirements. Shulkin said he asked the agency’s lawyers about the propriety of
the Mar-a-Lago trio’s involvement, since a Watergate-era
sunshine law requires federal agencies to disclose input from outside
advisers. Shulkin said he explained the law to Perlmutter and Moskowitz, and
they didn’t want the obligations of becoming an official advisory committee. So
they agreed to give advice “as individuals.”
“I also knew the limitations
placed on private citizens meddling in government affairs, and I was always
cautious to make sure that these three did not cross the line,” Shulkin wrote.
Since the Mar-a-Lago advisers
had no official positions, they were not subject to laws requiring federal
employees to disclose and divest assets to avoid conflicts of interest. Still,
Shulkin said he never saw them use their influence for personal gain.
“Truthfully,” he wrote, “I think they mostly wanted to feel useful.”
And they were useful to
Shulkin, at least at first, as a sounding board and conduit to Trump. But they
later grew frustrated that Shulkin wasn’t communicating enough and told him
he’d lost their confidence. The three aligned themselves with other political
appointees at the VA who distrusted Shulkin because he served in the Obama
administration and accused him of undermining Trump’s campaign promise to push
more veterans’ health care into the private sector. During one visit to
Mar-a-Lago, Sherman followed Shulkin into the men’s room and, after checking
that no one else was around, told him: “Don’t touch the politicals. You’re
playing with fire.”
Once the “politicals” impugned
Shulkin to Perlmutter, according to the book, Perlmutter poisoned the
president’s view of him. Trump had always been publicly effusive toward
Shulkin, but after one trip to Mar-a-Lago he wouldn’t acknowledge him and
avoided eye contact. John Kelly, then the chief of staff, told Shulkin that
Trump was upset with him because of what he heard from his friends in Florida.
(Kelly didn’t respond to a request for comment.)
Asked whether he was referring
to Perlmutter, according to the book, Kelly responded, “Yes, that guy tells
POTUS what to do despite not knowing what he’s talking about.”
Shulkin called Perlmutter and
demanded, “What did you do?” but Perlmutter refused to respond, Shulkin wrote.
Shulkin’s interactions with
the Mar-a-Lago trio are just one thread in a detailed, diarylike account of his
tumultuous tenure at the VA. He also recounts the policy and organizational
changes he led. And Shulkin defends himself against findings, in a report by
the agency’s inspector general, that he misused government funds on a European
trip, a scandal that became ammunition for his internal
enemies.
“Obviously I decided that it
was important to describe the relationship with the Mar-a-Lago people, but I
really don’t want that to be the legacy of this book,” Shulkin said in the
interview. “I spent three years working hard to fix the system, and I actually
felt like we were making progress and we were on a path to making this a sustainable
modern system. And then my time got cut short. So I felt like it was an
obligation of mine to put down on paper what I felt was working and how I was
doing it so that hopefully people in the future might refer to it and learn
something from it.”
The stakes for veterans could
not be higher, Shulkin wrote, since the VA’s other Trump appointees were
determined to privatize more of their health care. Shulkin believes that’s not
the best outcome for veterans, he wrote, but it’s exactly the path the agency
has taken since his ouster.
Shulkin’s successor, Robert
Wilkie, has denied having an agenda to privatize the VA. But in June he
approved new rules to dramatically
expand the circumstances when the agency will pay to send veterans to
private doctors instead of treating them in government-run health centers.
Shulkin said this approach will cost more and result in worse care. A VA spokeswoman
said, “That’s a false, fringe view.”
“Empowering political
appointees, with no experience in health care, no interest in involving
industry experts, and no accountability to voters, will prove to be one of the
larger mistakes of the Trump administration,” he wrote. “The path now chosen,
if allowed to continue, will leave veterans with fewer options, a severely
weakened VA, and a private health care system not designed to meet the complex
requirements of high-need veterans. While largely unaware of his political
appointees’ scheming, President Trump was most likely pleased with the result,
because it fit well into a political sound bite and was consistent with his
campaign platform. Most likely he does not realize the long-term implications.”
