Medical marijuana, privatization and the 'elephant in the room'

Jonathan Kaupanger
March 15, 2018 - 2:07 pm

Photo by Mike Theiler/Pool


Embattled VA Secretary David Shulkin was in the hot seat on Capitol Hill Thursday, answering questions about the agency's 2019 budget.  Amid reports that the White House is growing weary of their differences, Shulkin faced questions that had little to do with budgets and money

First up was the House Appropriations Subcommittee on Military Construction, Veterans Affairs and Related Agencies Chairman Charlie Dent (R-PA) asked about 'the elephant in the room,' refering to media reports that Shulkin is soon to be replaced.

“There are a lot of people who are more interested in politics than I am,” Shulkin said. “I’m interested in getting this job done. I’ve made it clear to everybody in my department that I have no tolerance for anything other than the business we have to do for VA.  I believe that we are getting back on track with that and I’m going to do everything I can to keep our focus on the work we have to do.”

In particular, Shulkin was pressed on reports that he has an armed guard outside of his office. Shulkin told the subcommittee that all cabinet members have an armed security detail, and that he was no different. “I’ve done nothing different in my security protocol.  There is no change than what it has ever been, but I don’t like discussing my security protocol, and I’m not going to give those details.”

On veteran healthcare, Rep. Debbie Wasserman-Schultz (D-FL) asked the secretary point blank if anyone in the Trump administration had pushed him towards the privatization of VA care.

“I’ve been clear that I think this would be the wrong decision for our country's veterans, to privatize VA,” responded Shulkin.  “I’ve also been clear that I think that VA can’t do this alone. That’s what we learned during the access crisis in 2014. So the right choice here is a system that allows for a strong internal VA that is working properly as well as taking advantage of working with the private sector when veterans can benefit from those services as well.

Wasserman-Shultz also pointed out that since 2017, the budget for community care has increased by 49 percent, but during the same time period there has only been a nine percent increase in funding for VA provided care. Shulkin explained that the VA is focused only on getting veterans the care they need right now instead of focusing on expanding internal VA care. 

Shulkin was then asked if he could talk about the wait times that veterans were experiencing in community care.  He said geography plays a big part if wait times.  “But in general,” he said, “VA access compared to the private sector is 11.3 days less across the country.  Now, depending on what region you’re in, that can vary. We are getting better, but there are parts of the country where we need the private sector in order to meet the needs."

Rep. Barbara Lee from California brought up the topic of medical marijuana. 

“You said that VA can’t recommend medical cannabis in accordance with state laws until the Federal laws change,” stated Lee.  “But marijuana’s schedule one status does block formal prescriptions, but it does not block the ability of doctors to fill out questionnaire forms in those states.  What’s the problem?  What’s the federal law that blocks the VA from doing this and not letting physicians simply recommend cannabis for vets who need it and has proven that it works?
Shulkin responded with his own question, “Wouldn’t filling out the questionnaire, isn’t that a step towards prescribing?”

Lee said no, it was just a recommendation.  Shulkin was a little confused and asked who then wrote the prescription.  “It’s my understanding that the Federal law would not allow the physician to write the prescription.  So, I have to understand what the questionnaire would be in order to make the recommendation, but not write the prescription.”

Lee said that she would make sure the secretary would get a copy of the questionnaire, then added, “Veterans need this and it works.  It’s a shame and disgrace that the VA is preventing this type of treatment that works!”

Shulkin’s response was simple.  “I’d be glad to review that,” he said.