Wednesday, May 04, 2011

Iraq snapshot

Wednesday, May 4, 2011.  Chaos and violence continue, Iraq continues to have no heads for the security ministries, the US Congress' Caregivers Act finally gets a real start up, a Senate subcommittee meets to talk about how to slash and gut active duty and military retiree health care, and more.
We're starting with the US Congress because a hearing took place and it does matter.  It especially matters because it's part of a move to gut health care for active duty military and retirees.  It especially matters because I looked around and couldn't believe the lack of press interest (based on attendance of the hearing). 
Today the Senate Armed Services Subcommittee on Personnel met to figure out how to slash health coverage.  That is what they were doing.  If veterans had any real pull in Congres, they'd demand Senator Jim Webb be pulled from committee assignments -- especially after his temper tantrum over the VA's efforts to provide benefits for the victims of Agent Orange. 
The subcommittee heard from DoD witnesses Clifford Stnaley, Robert Hale, Dennis McCarthy and Jonathan Woodson.  Unlike the House, it heard from no representatives for active duty, retirees or veterans.  That wasn't an error, Webb didn't forget to include them.  They were intentionally shut out.
Webb chairs the Subcommittee.  Senator Lindsey Graham is Ranking Member -- as disclosed many times before, I know Lindsey, I like Lindsey and I have no problem calling him out. We're going to ignore Webb's remarks because after his attack on Vietnam veterans (the Agent Orange issue), he didn't just ensure that he couldn't run for re-election (he can't and has already announced he won't), he gave up the right to be considered even remotely trust worthy.  Ranking Member Graham joined the hearing late, noting he'd "just met with Gen [David] Petraeus wife [Holly Petraeus] who now is in charge of protecting our men and women in uniform from predatory lending practices."  When he did join it, he delivered these opening remarks:
Ranking Member Lindsey Graham: On the health care front, this is really a difficult situation.  You're talking about 16 and 1/2% of the DoD's budget by 2028 being health care cost -- and that's doubling in less than 20 years. I know -- [to Webb] Are you retired?
Subcommittee Chair Jim Webb: I am a retired Marine, yes.
Ranking Member Lindsey Graham: Okay, he's a retired Marine. I one day hope to be retired Air Force officer.  And I guess what I'm going to say is that I understand what the administration is trying to do. We have to move this debate forward on sustainability. We haven't had a premium increase since 1989.  Some of the fees to be increased proposed by the administration, I think, is something we should all consider. I respect the House. But eventually you're going to have to make some very draconian choices between health care and operational needs. And that's not where we want to find ourselves.  So, Mr. Hill -- Secretary Hill, your idea of trying to get a better bang for our buck, looking at programs to make them more efficient, improving the quality of care while lowering costs is absolutely essential.
These are serious issues, these are real issues.  Instead of functioning journalism in the US, we have a bunch of a partisan hacks.  Chief among them David Weigel.  Weigel -- who was let go by the Washington Post (forced out) -- landed at Slate.  He didn't learn to be a better journalist there either.  Instead of covering something of value or use like what Graham is attempting with the health care issue, Weigel only nows how to score partisan points -- he learned so very well from Journo-List.  Today he's red faced over a mistake he made.  Mistake?

And Now, the Search for the Obama Death Photo

Slate Magazine (blog) - David Weigel - ‎3 hours ago‎
Lindsey Graham, R-SC, who had been conflicted about the quick sea burial of bin Laden because it wouldn't satisfy doubters, put out a statement today criticizing the photo decision. I respectfully disagree with President Obama's decision not to release ...
Slate's now changed the headline to "And Now, the Search for the bin Laden Death Photo" -- Weigel meant "Osama" -- but what he should really be embarrassed about is this bulls**t approach to 'reporting' wherein he looks for gotcha moments of insignificance instead of doing something of substance. He is paid to do a job he's never done.
Hardly anyone from the press showed for today's hearing and this is not a new issue.  I believe we last covered it when the House Armed Services Military Personnel Subcommittee held their two hearing on the issue in March (see the March 15th and March 16th snapshots). You want to call out Lindsey Graham?  By all means do, but how about for something important and not phrase and words?  How about for efforts to gut the health care of active duty personnel. What's being proposed is outrageous.  And in the House, members were more than willing to note their distress.  One example.
US House Rep Chellie Pingree:  I just want to say again, I understand how well you are all doing your job and the importance of all of you looking for cost efficiencies in what you do as we face a difficult time with the budget deficit and, uh, also where there's a lot of examination of the military budget and looking for places where we can cut.  And maybe my first comment is more to my fellow Committee members then to all of you but I might see more places to cut the fat in the military budget than others of my colleagues but I am deeply concerned that we're going after medical care for both our active duty personnel and our retirees when I think there are other places to make more effective cuts. So I know you have to do your job and look for those cuts but almost everything that's before us today, either myself or one of my colleagues has mentioned a concern about, whether it's the changes to TRICARE, how we're going to deal with some of our Sole Community Hospitals I have two in my district, there are four in our state of only 1.2 million people, in a state where we have almost a fifth of our citizens are either active duty or retired military.  So there's a very big dependance on this system in our state and I'm worried about that particular program.  So for me, many  of the efficiencies that you're talking about are going to reduce the level of medical care to people who have served us to whom we have made a huge promise.  And there is going to be a -- I think -- a reduction in the services that they receive so I just -- I know you have to do your job but I don't like it and I don't think it's all necessarily good. 
But Lindsey Graham and the outgoing Jim Webb have bi-partisan agreement to slash and burn active duty and retirees health care (Hale declared active duty was safe -- no, it's not as evidenced by the testimony of all the witnesses, their prepared statements and Stanley's admission -- in his prepared remarks, not delivered -- that they have proposals that they are not yet ready to make public but they had help with from the same crew Barack's appointed for the Cat Food Commission). And the sparesly attended hearing (by Subcomittee members) did not include anyone who was outraged by the efforts to slash health care. That's all the more reason that the press needs to be paying attention.  And 50 years from now, what Lindsey Graham said about Osama bin Laden one day and what he said two or thee days later won't mean a damn thing.  But if they gut the health care, it will still be effecting active duty and retirees.  So how you about you grow the hell up, sit at the adult table and start doing some of the heavy lifting?
As we saw during the House hearings, DoD's Clifford Stanely's the (mis)leader on this issue.  After the hearing, I grabbed a copy of his prepared statement thinking, before I picked it up, that I would read it through quickly. That notion fell apart the minute I picked it up.  Stanley presented the Subcommittee with a prepared statement that is over 70 pages long.
For those unfamiliar with the workings of Congress, the prepared statements generally run five to six pages.  For important issues -- such as when then-US Ambassador Ryan Crocker and then-top US commander in Iraq Gen David Petraeus repeately testified to Congress in April 2008 about Iraq -- they may run as long as 12 to 21 pages.  But over 70 pages?  Many witnesses who appear before Congress merely read their prepared remarks aloud. There's no reason to do so.  By it being prepared and presented to Congress (long before the hearing), it becomes part of the Congressional record.  So Stanely made part of the Congressional record today something that most people will never see or know about in this news cycle.
On page 19 of his prepared remarks, he begins noting the need to 'review' an alternative (in past testimony, "alternative" translates as "cut" when used by Stanley) "to the current Imminent Danger/Hostile Fire Pay structure." Equally disturbing is that while Hale spoke of the need to consider what the future role of the National Guard and Reserve should be (with regards to overseas deployments), Stanley, on page 26, informs, "Future planning envisions an era of persistent conflict where some type of RC [Reserve Component] activation authority will be required to augment the AC [Active Component] to maximize effectiveness efficiency of the Total Force." According to Stanley's written statement quoted -- and what follows in his prepared remarks -- that decision's been made and the US government "envisions an era of persistent conflict" requiring the US military to be deployed repeatedly.  Might that not be something the American people should be consulted on?  On page 38, he finally begins addressing the health care issues. We'll go into some of that tomorrow or Friday.  We don't have space or time today.
So let's leave his prepared statement and note his reaction to Webb's asking who is in charge  of contractors.
Subcommittee Chair Jim Webb: So who hires, fires and pays?
Clifford Stanley: It would be the commanders --
Subcommittee Chair Jim Webb: How many -- how many contractors are we paying
Clifford Stanley: [Snickering] I only laugh because we are much pilloried for lack of full accounting of contractors. We're getting better.
Oh, yeah, that's funny.  (That was sarcasm.)  He wants to slash the health care for active duty and retirees but he thinks it's funny that his department still can't provide an accounting of contractors.  "We're getting better" doesn't cut it.  He did allow that there were 300,000 contractors ["contractors funded by Operation and Maintenance account"] they're doing a pretty good job of accounting for; however, "there are others working on other accounts but we haven't got a full count yet." Apparently, there's no real rush.  Stanley noted that this full count was "something Congress directed us to do years ago and we're working on it."  Maybe a full count would allow for cost overruns to be caught?  And maybe if that happened you wouldn't need to gut the health care of active duty forces. And maybe DoD needs to sit down their future witnesses and tell them snickering about your inability to do your job in public doesn't instill trust in your department.
Subcommittee Chair Jim Webb: We hear widely varying numbers of how many contractors are being paid each year by DoD, by whom and how much.  Do you know how much of the DoD budget goes into independent contractors?
Clifford Stanely: You know, Mr. Chairman, if you want to look at [. . .] about 40% of our money pays for all of our employees -- that's military and civilian. The rest goes to contractors in some way. That would include all the weapon costs.  But most of that is contracted out eventually to private companies.  But many people when they think of contractors are thinking more of what you alluded to -- KBR contractors in Afghanistan that are performing those services.  That would be more for those funded by Operations and Maintenance, that 300,000.  [Laughing] Am I helping?  Apparently not.
He was so tickled by it all.  60%, using his figures of DoD money goes out to contractors -- in one form or another -- but the 'cost saving' Stanley wants to focus on will mean attacking the 40% of the budget that goes to active duty. DoD's Woodson wanted the Subcommittee to know that a benefit of hiring contractors was that you didn't have to pay them health benefits in "perpetuity."
Transitioning from Congress to Iraq . . .    US House Rep Ron Paul has formed an exploratory committee to consider a 2012 run for the GOP presidential nominationYesterday on the first hour of The Diane Rehm Show (NPR), Diane asked him why and he stated he was encouraged to "By thousands and thousands of people who are just really writing to me and talking to me, the many websites, the contiuation of what happened in the last go-around [his 2008 run].  I was rather shocked to find out what kind of reception I got, especially on the universities. And I've continued to speak at the university.  The crowds get bigger, more enthusiastic.  They don't like the war. They don't like the Patriot Act. They like personal liberties. They like to be left alone.  They don't wan the government to be taking care of them from cradle to grave. And they're enthusiastic."  Jordan Fabian (The Hill) reports, "Rep. Ron Paul (Texas), a possible Republican candidate for president, said Tuesday that the U.S. should brings its troops home from Iraq and Afghanistan now that Osama bin Laden has been killed." Others in his political party do not necessarily feel the same.  Take the Speaker.  Yesterday's snapshot noted:

The Speaker of the US House of Representatives doesn't appear to wonder. AP reports that Speaker John Boehner has declared that the US should keep a small (undefined number) of US troops on the ground in Iraq past 2011. Reuters quotes him stating, "I think a small, residual force should remain."

Carl Hulse (New York Times) reports, "Mr. Boehner said he had no recommendation on the size of the contingent that might remain or how long the troops should stay, but the military has been exploring the idea of a force of about 10,000, people briefed on the plan said. At the end of April, there were 47,000 American troops in Iraq."
US troops remain and so does violence.  Reuters notes a Baghdad roadside bombing injured one person, a Baghdad trash can bombing injured two people, 2 Kerbala roadside bombings has claimed 3 lives and left four people injured, a Baghdad police officer was shot dead by unknown assailants "in a speeding car, using silenced weapons," which is the same scenario for the Baghdad shooting death of an employee of the Minister of Finance, 2 Mosul truck drivers were shot dead and a Mosul sticky bombing claimed 1 life.
At a time when violence is on the rise, Iraq continues to do without heads of the security ministries: Ministry of Interior, Ministry of Defense and Ministry of National Security. Today Dar Addustour reports that the National Allaince is stating that the "final stages" for naming the security ministers has been reached. That stage was suppoed to have been reached in November when prime minister-designate Nouri al-Maliki was putting togehter his Cabinet. In fact, he was not supposed to move from prime miniser-designate to prime minister without naming a full Cabinet. And the Constitution gives the prime minister-designate exactly 30 days by which to name a Cabinet. SO the Constitution says that these posts will be named in 30 days. Instead, it's six months later and the positions are still vacant.

The lack of concern about filling these ministries -- when, allegedly, all US forces will be leaving Iraq in less than seven months -- is being been seen as a sign by some in the State Dept that Nouri al-Maliki plans to ask for an extension of the SOFA.

Many Iraqis are opposed to that. Demonstrations in Iraq have called for the end of the occupation -- whether the demonstrators were Iraq's youth or they were from Sadr City.   New Sabah notes that Moqtada al-Sadr's followers insist that they must resist until the end of the US occupation of Iraq. They are planning a protest May 23rd and you can be sure the US press will go ga-ga over it as usual. Reporting on the same issue, Dar Addustour notes that the followers insist they will follow rule of law . . . after the occupation ends. That should be deeply troubling. Those who say they'll follow rule of law some day are generally revealed to be those who never follow rule of law because all their conditions for respecting the law never come to be. More importantly, the Sadr bloc is not outside of the government, they make up 40 seats in Parliament and are grossly over-represented as Cabinet heads. Revolutionaries or opponents to occupation can and often do take the position the Sadr bloc is attempting to take today. When they take that position, they are generally believable but part of the reason for that is that they offer a true resistance. You can not be part of the government and also part of the resistance. You cannot be the inside outsider.

Along with no heads of the security ministries, Iraq really has no vice presidents. Jalal Talabani, the previous president of Iraq, was re-elected president and he asked Iraq's two vice presidents to stay on until the spots could be filled but one who has stayed on has been criticized for presenting as a vice president. Today New Sabah reports that Nouri's State Of Law is stating they don't need a vice presidency. State Of Law's Khaled al-Asadi states that they see it as unnecessary and that they are pleased with the number of ministries they have been put in charge of. Also reporting on the curious story is Al Rafidayn which states that the Iraqi Supreme Islamic Council is ready to give up the post. Shi'ite Adel Abdul-Mahdi was one of the two vice presidents prior to the March 2010 elections. He is a member of the Supreme Islamic Council. They joined with other groups -- including State of Law -- to form the National Alliance. At one point, Adel Abdul-Mahdi wanted to be prime minister (he wanted that in 2005 as well and was supported by foreign oil factions).

Iraq Tweet of the day is from Prashant Rao (AFP).
prashantrao Prashant Rao
New Arab colleague from #Lebanon just asked if there are any sushi bars in Baghdad. I had to let him down lightly. Poor guy.

And now we go back to the Congress . . .
Yesterday's snapshot noted the House Veterans Affairs Committee hearing.  The Committee released released the following statement on the hearing:

VA Admits Problems at Medical Facilities are a Failure of Leadership

For more information, contact: Amy K. Mitchell, (202) 225-3527
WASHINGTON, DC -- Today, the House Committee on Veterans' Affairs held a hearing entitled, "Sacred Obligation: Restoring Veteran Trust and Patient Safety," regarding the failure to act and haphazard notification processes on behalf of the Department of Veterans Affairs (VA) concerning medical sanitization processes at major VA facilities including those in Miami, Florida, St. Louis, Missouri, and Dayton, Ohio.
"This is unconscionable. Imagine having survived the battlefield to return home, visit a VA hospital, only to receive a letter in the mail years later stating you may be at risk of having contracted an infectious disease because of the improper sterilization of medical equipment. These incidents shatter the very trust we all assume on behalf of our veterans," stated Representative Jeff Miller (FL-01), Chairman of the House Committee on Veterans' Affairs.
The Committee was disconcerted by the apparent lack of leadership VA has demonstrated in handling these issues to date.
Since the issues in Dayton, stemming from actions by a dentist employed by VA from 1982-2010, came to the public's attention, VA has not fully enacted accountability in its systems nationwide with regard to medical practitioners in order to avert such incidents in the future.
"Without the leadership of Chairman Miller and this Committee, veterans in our district would not have known about these egregious violations of basic medical standards. The VA owes us a clear explanation of the events that have occurred and have yet to release to our community, documents which show that they taken every step necessary to notify veterans that may have been infected by the dentist in question," said Representative Mike Turner (OH-03), who represents the Dayton area and joined the Committee for the hearing.
"The time for talk is over. VA must confront these issues head on, deepen the obligation to care for the veterans affected by these incidents, and make the necessary changes within the VA healthcare system to prevent any future incidents that put our veteran patients at risk," said Miller.

Kat covered the hearing at her site and noted Turner, Ranking Member Bob Filner and US House Rep Ann Marie Buerkle.  Ava covered the hearing last night at Trina's site and emphasized the exchange between US House Rep Ileana Ros-Lehtinen and Robert Petzel. On that hearing, I noted US House Rep Phil Roe.  He is a doctor, a medical doctor.  An e-mail came in about his name.  I can be wrong, I can think I know something I don't know, I can also make a mistake when I'm dictating the snapshot and juggling cell phones, so if you see a name you think is wrong, e-mail.  I won't be offended.  But his name is Phil Roe.  A visitor e-mailed to say I must mean David P. Roe.  No, I meant Ted Roe.  The visitor is not "wrong."  The visitor thought it was "David P. Roe" because that's how the House Veterans Affairs Committee website wrongly credits him on their members page.  If you click on the link for "David P. Roe" you will be taken to Phil Roe's Congressional website. Republicans control the House, the Democrats are the minority party.  Bob Filner is the Ranking Member on the House VA Committee and today the Democrats on the Committee issued the following:
Washington, D.C. -- Bob Filner (D-CA), Ranking Democratic Member of the House Committee on Veterans' Affairs, today at a hearing on patient safety at Department of Veterans Affairs' facilities called on the VA to fix the "culture of secrecy and cover-ups that is far too prevalent" within the VA.
"How many times do we have to go down this road? Let's get beyond the bureaucracy and secrecy and restore veterans' confidence in VA," stated Filner.
Recent patient safety events at the Dayton, Ohio; St. Louis, Missouri; and Miami, Florida VA medical centers have raised serious questions in Congress regarding the ability of the VA to properly respond to these occurrences and address concerns regarding safety, communications, and accountability.
"The findings beg the questions of proper accountability, effective oversight and enforement of clear policies and procedures. Policies and procedures that are sometimes not followed -- or worse -- get completely ignored.  The best industry-leading policies and procedures are worthless when no one seems to be responsible to ensure that they are conscientiously followed day in and day out.  I would like to know, where is the strong leadership and effective communication that is critical when you are entrusted with the care and well being of our Nation's veterans?"
Staying with veterans issues, the  Caregivers and Veterans Omnibus Health Services Act of 2010 (May 5, 2010)  was supposed to go into effect January 30, 2011.  However, that did not happen as was established in the March 2nd  Senate Veterans Affairs Committee hearing.  Senator Patty Murray is the Chair of the Senate Veterans Affairs Committee.  That day, she questioned Eric Shinseki, Secretary of the VA, about the fact that the law written was not what was being implemented.  We'll note this part of the exchange.
Chair Patty Murray:  But I wanted to ask you today of the 180 million that the budget submission specifies for caregivers and veterans pact, how much is going to be actually allocated for the implementation of the family caregiver program?
Secretary Eric Shinseki:  Uh, in the 2012 budget it's 66 million.
Chair Patty Murray:  66 million for the implementation. Okay. The legislation authorized an average of 308.4 million for this program each year. Can you tell us why the VA uses about 21% of that?
Secretary Eric Shinseki:  Madame Chairman, I'd just say that that again is where we established the start point. We expect this program will go -- grow.
Chair Patty Murray: Pardon me?
Secretary Eric Shinseki:  We expect that this program will grow. The 66 million was based on our estimate of uh going through the veterans who are in various categories of serious injuries, severe injuries and, uh, the numbers on which, uh, 66 million are based was that initial eligibility start point.Roughly about a thousand.
Chair Patty Murray: Very narrowly defined, though.  Not designed as the law was defined.
Secretary Eric Shinseki:  That is correct.
Chair Patty Murray: And it was the intent of Congress that that law not be narrowly defined.
There's an update on the Caregivers Act.  Yesterday Deborah Amdur,  the VA's Chief Consultant for Care Managedment and Social Work Service, posted at the VA's Vantage Point blog and her post included:
VA has long known that having a Family Caregiver in a home environment can enhance the health and well-being of Veterans under VA care. Therefore, we are pleased to add this new program to the wide range of services VA already offers to support Veterans and their Family Caregivers at home. The regulation is available on our Caregiver website and the application process for the new program for post-9/11 Veterans injured in the line of duty is also described in a fact sheet. We're excited to begin accepting applications on May 9th. Look for the application at the morning of the 9th or call our Caregiver Support Line at 1-855-260-3274. We're waiting to assist.
We know that this wait has been long for those dedicating so much to provide for nearly every aspect of their beloved Veteran's well-being. With these resources in place, we mark the beginning of a new era in the delivery of enhanced services for Family Caregivers. Family Caregivers are our partners in providing quality care to our Nations heroes; Caregivers are the heroes on the home front.
Additionally, VA has many other programs and services already in place that support Veterans and their Family Caregivers at home. At you will find a description of more than two dozen programs we offer all Caregivers, training tips and advice on care giving, including the importance of taking time to take care of yourself. All Caregivers are also encouraged to utilize the National Caregiver Support Line, 1-855-260-3274, for counseling and information about resources and services. The trained professionals who staff our Support Line will also connect you to your local VA medical center's Caregiver Support Coordinator who stands ready to offer support and assistance as you navigate this journey of being a Family Caregiver.
George Prentice (Boise Weekly) rightly terms the move "an about-face."  Senator Patty Murray's office issued the following:
(Washington, D.C.) -- Today, U.S. Senator Patty Murray, Chairman of the Senate Veterans' Affairs Committee released the following statement after the White House and the Department of Veterans Affairs (VA) announced that they would ease restrictions that had been added to a bill passed by Congress that would provide financial and health care support to family members caring for severely wounded Iraq and Afghanistan veterans. The change will allow more caregivers of more veterans to be eligible for the long-overdue benefit.
"This is an important turnaround for family members of severely wounded veterans who have dropped everything to care for their loved ones. The Administration realized their mistake in limiting and delaying this benefit and is taking steps to fix it, and to fix it quickly. In particular, the President has shown real leadership on this issue by listening to our concerns and ensuring the VA made this right.
"Going forward, I will monitor how the VA implements this program, paying particular attention to how caregivers of veterans with the invisible wounds of war are considered for this benefit. But the bottom line is that because we held them accountable, the VA will make a larger investment, will support more caregivers, and will ensure that health care providers, not bureaucrats make decisions about who is eligible.
"This law was passed to help support the thousands of family members of veterans who have left behind careers, lives, and responsibilities to see that their loved one can recover from wounds they suffered defending our country. It's a cost of war that for too long has gone unaccounted for and one we can no longer ignore."
As Chairman of the Senate Veterans' Affairs Committee, Murray has led congressional efforts to restore the criteria to the intent of Congress when the bill was passed last year. In fact, since the criteria limiting eligibility for certain caregivers was announced by the VA  in early February of this year Senator Murray has taken numerous steps to fight the decision including:
* Personally discussing the issue with President Obama in the Oval Office,
* Questioning VA Secretary Eric Shinseki on the program changes and delays in front of her Committee,
* Sending a bi-partisan letter, cosigned by 17 additional Senators, calling on the Administration to end delays in moving forward with the law, and
* Joining with leaders of the Senate and House Veterans' Affairs Committees to call on President Obama to stop the VA from severely limiting the benefit.