I think I told this here before but my dad's cousin was tapped to potentially head the VA, he's super rich and very conservative in the way very rich people often are, and his wife (my dad's actual cousin) was Reagan's head of social security, and he was the doctor that saved Reagan after he was shot. Kinda wild but you can see where those party loyalties come from and also why they'd be looking to him as a top doctor. However he wound up turning it down on the realization that the current administration just needed a scapegoat while they intentionally dismantle the VA and point to it's failure as justification to privatize. this seems to be a pretty consistant motive of the current admin - destroy everything, create chaos, blame someone else and cash in on the private funded alternative. Honestly I think trump like playing the dictator part just cuz it "pisses off the libs" which seems to be all he needs to do to appease his base, and then he can actively pursue something much more of an oligarchy of wealthy conservative allies owning all the private business that replace our social services.