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Shulkin unloads on administration as critics question Trump’s pick to replace him. President Trump’s decision to replace outgoing Veterans Affairs Secretary David Shulkin with White House physician Ronny Jackson has rankled groups that work closely with the VA and unleashed a powerful new critic of the Trump administration. Veterans service organizations have expressed concern and confusion over the selection of Jackson, a doctor and Navy veteran, to lead an organization that employs more than 300,000 people. His predecessor had gone into the VA’s top job with far more experience, both at the agency itself and in the private sector, but still survived only a year before the president disposed of him via Twitter after weeks of allowing speculation about his future to fester. The ousted VA secretary wasted no time in airing his grievances once he was freed from the restrictions that accompany working in the administration. Shulkin embarked on a scathing media tour just one day after his dismissal, beginning with an op-ed in the New York Times, continuing with an interview on NPR, and culminating in cable news appearances later Thursday evening. The former VA chief blamed his removal on privatization advocates within the administration, and he claimed his opposition to dismantling the agency cost him his job.

White House: Trump chose doctor to lead VA because ‘the status quo was not working.’ Trump chose Jackson to serve as VA leader because “the status quo was not working,” White House spokeswoman Lindsay Walters said. “The president has full confidence in Adm. Jackson,” Walters told reporters traveling aboard Air Force One with Trump on Thursday. “The president did have some early individuals that he was looking at but continuously went back to Dr. Jackson to fulfill this role as VA secretary and ultimately decided that his healthcare experience, his distinguished career in the medical profession was something that would be beneficial at the VA.” In one media interview, Shulkin even sided with Trump on persistent VA dilemmas.  “He wasn’t happy with the pace, and you know, I agree with the president. This is [an] organization that needs to change, it needs to do better at its job and we all want to do it faster and better because it’s so important to the county,” Shulkin told Fox New host Bret Baier Thursday evening. “And I think the president has the right to have the secretary that he wants with him.”

Shulkin says Trump didn’t mention he was getting fired in phone call hours before he was let go. Shulkin said he did not know he was about to be fired during a phone call with Trump Wednesday, just hours before his ouster. “We spoke about the progress that I was making, what I needed to do from a policy perspective to make sure that we’re fixing the issues in VA,” Shulkin told MSNBC host Chris Hayes during an interview Thursday. Shulkin confirmed that the conversation happened before he had been fired.

John Brennan: Trump’s nomination of Jackson to lead VA ‘will hurt both a good man and our veterans.’ John Brennan, who served as CIA director during the Obama administration, on Thursday slammed Trump’s decision to nominate Jackson as his next VA secretary, saying it “was terribly misguided.” “I personally know and greatly respect Ronny Jackson … as a terrific doctor and Navy officer. However, he has neither the experience nor the credentials to run the very large and complex VA,” Brennan wrote on Twitter. “This is a terribly misguided nomination that will hurt both a good man and our veterans.”

Walmart discussing Humana purchase: Report. Walmart has started talking with Humana Inc. about purchasing the health insurance company, according to a new report. It’s not certain what exactly the companies are discussing and it’s possible the deal won’t happen, the Wall Street Journal reports. However, Walmart and Humana are hashing out several possibilities, including an acquisition. Walmart is the world largest retailer and oversees a large drugstore operation. Humana has a market value of $37 billion. It would be Walmart’s largest deal since 1999. If the deal happens, Walmart would be the latest major retailer to jump into healthcare. Amazon is seeking to build up its healthcare business. A Walmart-Humana merger would also be the latest mega-merger to rock the healthcare industry, following a move by pharmacy retail chain CVS to buy insurer Aetna, and pharmacy benefits manager Express Scripts wants to merge with insurer Cigna. The mergers are happening as the Trump administration increases scrutiny on the drug supply chain, questioning whether pharmacy benefit managers and insurers are passing on enough benefits from drug rebates to customers.

Obamacare program meant to save money cost government $384 million. A program created under Obamacare to reduce healthcare spending is actually costing the federal government millions of dollars, a new analysis finds. The analysis released Thursday by consulting firm Avalere Health looked at the estimates for the Medicare Shared Savings Program, which gives hospitals and doctors incentives to reduce health spending. The program encourages the creation of accountable care organizations, which are healthcare providers that receive a percentage of any net savings caused by their efforts to reduce spending. The Congressional Budget Office estimated in 2010 that the organizations would save the federal government $1.7 billion from 2013 to 2016. However, the program has increased spending by $384 million over the period, which means CBO’s estimate was off by more than $2 billion. Currently, 561 ACOs exist, up from 27 in 2012.

Drug overdoses soar in 2016, fueled by fentanyl. Drug overdoses in 2016 killed 63,632 Americans, or 174 people a day, a 21 percent spike from 2015, according to new federal data. Opioids were involved in more than 42,000, or nearly two-thirds, of those deaths. The spike in overdoses is attributed to the boom of synthetic opioids such as fentanyl, which is 100 times more powerful than morphine and 50 times more potent than heroin, according to the Centers for Disease Control and Prevention.  The analysis found that the death rate from prescription opioids increased by 10.6 percent from 2015 to 2016. The death rate related to heroin overdoses increased by nearly 20 percent. Death rates differed wildly by states. Ten states doubled their overdose death rates linked to synthetic opioids. New Hampshire, West Virginia, and Massachusetts had the highest death rates from synthetic opioids, the CDC said. West Virginia, the District of Columbia, and Ohio had the highest rates for deaths involving heroin.

HHS secretary appoints advisers on opioids, drug prices. Health and Human Services Secretary Alex Azar appointed advisers Thursday to tackle the opioid epidemic and prescription drug prices, two areas he has said will be a priority for the agency. Azar appointed Daniel Best, a former CVS executive, as senior adviser for Drug Pricing Reform, where he will “lead the initiative to lower the high price of prescription drugs.” Azar also expanded the role of his assistant secretary, Dr. Brett Giroir. In addition to that role, Giroir will be senior adviser on Mental Health and Opioid Policy, where he will coordinate HHS’s efforts across the Trump administration to combat the opioid epidemic.

Melania Trump makes surprise visit to Florida hospital. First lady Melania Trump made a surprise visit to a Florida hospital Thursday to deliver Easter baskets to children there ahead of the holiday. The baskets held a plush toy, crayons, coloring books, White House playing cards, a book, and 2018 commemorative wooden Easter eggs. “The children lit up when [the first lady] walked in the room,” Trump’s communications director Stephanie Grisham tweeted. Grisham said Trump visited with several patients and their parents at St. Mary’s Medical Center in West Palm Beach, and thanked the medical staff for their work. She also visited patients in their rooms. “So great to spend time with some of their brave patients and hard-working doctors and nurses,” Trump tweeted with photos of her visit.

Arkansas latest state to sue opioid makers. Arkansas sued three drug makers for promoting powerful painkillers while downplaying their addiction risks, becoming the latest state to sue opioid manufacturers. The lawsuit said drug makers spent millions on promotions that misled the medical community and the public over the dangers of opioids. “These manufacturers propagated use of opioids as a non-addictive treatment for chronic pain,” according to a statement on the lawsuit from Attorney General Leslie Rutledge. “This was a catastrophic lie.” The lawsuit focuses on three opioid makers: Purdue Pharma, Johnson & Johnson and Endo. Seventeen states have sued opioid makers for making similar claims when marketing the painkillers, according to Reuters.

Starbucks must add cancer warnings to labels, California judge orders. A California judge ruled Starbucks and other coffee shops must put a warning label on their cups detailing the cancer risks of your brew. The Los Angeles judge said Wednesday that about 90 coffee retailers including Starbucks must put a warning label about the chemical acrylamide, which is used in the roasting process. The amount of the chemical in coffee is miniscule, but the judge ruled that Starbucks and coffee retailers didn’t prove that the benefits of coffee outweigh the risks, Reuters said. The industry trade group National Coffee Association said the industry is looking into potential appeals and further legal action. “Cancer warning labels on coffee would be misleading,” the group said. “The U.S. government’s own dietary guidelines state that coffee can be part of a healthy lifestyle. The World Health Organization has said that coffee does not cause cancer.”

RUNDOWN

The Hill CDC director: U.S. could end AIDS epidemic in seven years

Morning Consult Lobbyists say bill easing privacy protections for addiction records may be moving ahead

Washington Post In emotional speech, CDC’s new leader vows to uphold science

Wall Street Journal Iowa presses states’ ability to skirt the health law

Kaiser Health News Time is running out: The frail in Puerto Rico face end of hurricane relief programs

STAT News Students push UCLA to improve access to a cancer drug developed by its scientists

Tennessean State Senate votes to ban TennCare funds from going to healthcare providers that perform elective abortions