October 1, 2014--60 Minutes With Professor Barack Obama

So he went on TV and told Steve Kroft of 60 Minutes that the situation in Syria is fraught with contradictions--"I recognize the contradiction in a contradictory land and a contradictory circumstance."

Yes, he actually said that. Much appreciated Professor Obama.

Among the contradictions, he acknowledged, is the fact that we (really, he and his administration) did not know in advance that ISIS (or ISIL as he obstinately insists on referring to them) was going to turn out to be such a threat to the Middle East and ultimately us.

After 9/11 and the failure to connect the dots that should have warned us about an imminent, cataclysmic threat to the U. S. homeland, one would have thought, with that dark lesson in mind, that something as elaborate as ISIS's emergence and, yes, remarkable barbaric capabilities, would have shown up on someone's Oval Office radar.

Al Qaeda was a relatively small band of terrorists incubating in an under-scrutinized part of the world (the forbidding mountains on the Afghanistan-Pakistan border) compared to the thousands of ISIS jihadist warriors arming and preparing themselves to operate even captured American tanks in plain sight right in the middle of the civil war in Syria.

All one needed to do was go to the Internet to learn directly from ISIS itself what they were about and were intending to do. Undoubtedly and appropriately humiliated, Obama told Kroft that we (he) blew it and so now we're involved in another war in the Middle East that we can't win that will soon cost billions and the lives of more of America's finest young people.

Meanwhile, at about the same time, literally closer to home, there was that embarrassing and dangerous event at the White House. An armed intruder jumped the inadequate and unguarded fence, ran across the lawn, entered the ground floor through the unlocked North Portico, raced left to the East Room, and then, still alluding the Secret Service, entered the Green Room where he was finally tackled.

It would not be my favorite thing to have seen him shot well short of the mansion, but allowing him to make it into the building, where, if he knew the layout better, he could have raced up the stairs to the living quarters, I'd opt for the security forces taking him down.

The Secret Service is far from what it used to be--which might serve as a metaphor for much of our federal government and, alas, much of America--but this latest incident is so pathetic as to render one almost speechless.

We learned in the process that, with Obama family members in residence, in 2011 a sniper hit seven windows in the living quarters, firing armor-piecrcing bullets from hundreds of yards away and that that information was withheld from the public and the Obamas, including the distressing fact that it took White House security forces four days after the attack to even know it occurred!

Under questioning by members of Congress yesterday, Julia Pierson, director of the Secret Service, took responsibility and promised that it won't happen again.

Well it already did happen again, and on her watch. There was the shooting incident in 2011 and then the intrusion 12 days ago. I call that happening again.

And another thing that will happen again is that she will not be fired just as no one was fired for the Veterans Administration or IRS scandals or for that matter the Obamacare website rollout fiasco.

As our professor president said, ours is a contradictory land and what we are seeing are contradictory circumstances.

September 8, 2014--Two Cheers for Obamacare

I've been wondering why we've been hearing relatively little recently from Republicans about Obamacare. It had been thought that in the run up to the November midterm elections the GOP would be all over it, savaging it as an assault on both our freedom and the federal budget. It was to be their political trump card. The route to majority control of both houses.

Could it be that there is now relative silence because Obamacare is actually . . . working.

Many millions have signed up, and with the exception of some anecdotal horror stories the vast majority with health care coverage for the first time are happy with it; and, perhaps most surprising, in spite of all the scary stories about how the Affordable Care Act would bust the budget, it has in fact not only been cost effective but has already been contributing to deep cuts in the federal deficit.

Just as Obama said it would.

So then two cheers for Obamacare. It is too soon to offer three because, though the nonpartisan Congressional Budget Office's projections show significant downward trends in overall Medicare costs (the result in part of aspects of the ACA law) and thus dramatic deficit reductions over the decade, we still do not know how many more will sign up, how much subsidy they will require, and the nature of the care these new enrollees will require.

The CBO, adjusting for inflation, recently reported that the average amount spent annually per Medicare recipient declined from $12,000 each in 2011 to $11,200 this year and will be reduced further to $11,000 per Medicare enrollee by 2017. Technically, this is called "negative excess cost growth."

All told, the CBO is projecting that, as a result, over the next ten years the federal deficit will be reduced by $715 billion. Nearly three-quarters of a trillion dollars.

To be fair, this good news is not fully the result of the ACA. This downward trend is also a consequence of "young" Baby Boomers becoming eligible for Medicare for the first time and the apparent, not entirely understood, reduction in costly tests, treatments, and drug use. All good things as our health care system has grown bloated with over-testing and the over-selling of unneeded treatments and medications.

This $714 billion in savings dwarfs all deficit reduction plans being discussed, including Paul Ryan's draconian budget.

Wouldn't it be good if we could stop playing demagogic games with the budget and health care and get on to the real problems we face--how to create more jobs, improve the treatment of veterans, fix our crumbling infrastructure, improve public education, and tackle the inequality crisis.

Why am I not optimistic?

May 30, 2014--The Republicans Are Right

The title is not a pun about Republicans being to the right of the political spectrum. But rather about what they are advocating in regard to reforming the Veterans Administration healthcare system.

They are right about that and the Democrats are wrong in what they are proposing.

What was suspected--that corruption, greed, and incompetence at a number of VA hospitals have led to the maltreatment and even the death of many veterans--is now documented.

The acting inspector general of the Veterans Administration has completed his report and, among other findings, reported that more than 1,700 vets seeking appointments at the Phoenix VA alone were either ignored or never entered into the system. In spite of this, to generate bonuses for administrators, a second set of books was kept and submitted to Washington that showed them being treated within 30 days. In the meantime, many hundreds went untreated and scores died while waiting or ignored.

And, I suspect, as more is uncovered, we will see the same kind of malfeasance at other VA facilities as other administrators seeking bonuses cooked the books.

Putting aside for the moment why any government worker should be eligible for a bonus, why has it taken years to get to the bottom of this deadly scandal when alerts were filed by whistle-blowers from within the bloated system?

The head of the VA, General Eric Shinseki, should have been told about this in a timely way (and for all we know he was) and it should have been brought to the president's attention since for years since his first campaign he has been demanding better after-service care for wounded veterans (and, for all we know, he also was).

Minimally, Shinseki should be fired, a VA tsar should be appointed, someone with vast health-administration experience, and the system should be overhauled.

Serious consideration should also be given to the House Republicans' plan to privatize the VA hospitals and clinics. If that is too radical, minimally, as the GOP is proposing, any veteran who has had to wait for care for 30 days or more should be able to seek it through private medical providers at the VA's expense.

This is far better than the Democrats' approach--the Senate is preparing legislation to add 27 new healthcare facilities to the VA system to address the backlog of cases. Beyond the billions in additional cost, this is an unrealistic approach since it would take up to 10 years to get the hospitals built and functioning. For the nearly 8 million vets treated (or not treated) each year this is hardly a solution.

Each month a cousin who is a WW II veteran uses the VA for routine blood work since his out-of-pocket cost is just $15 per test, a third what it would cost if he went to his local hospital.

I asked him if he would prefer to go there if it could match the VA price. "Sure," he said, "It's much closer. And they do a good job."

This is true for most vets who require non-urgent testing and care. So why not give them an eligibility card to enable them to go to any hospital and have the VA cover the difference in cost? Sure this approach would have to be phased in over a number of years, but it would greatly simplify things, especially for service men and women who do not live close to VA treatment centers.

Over time we would no longer need a separate and unequal VA healthcare system. Veterans would get timelier and better care closer to home and taxpayers would save billions.

May 27, 2014--Ladies of Forest Trace: What's Left?

When I answered the phone, I heard my mother sigh.

"Soon, it will be another year."

"You mean, another birthday?"

"What kind of future do I have?"

"In truth, Mom, you've been saying that for years. Many years. Since before you turned 100 and here you are only a month away from 106. Amazing."

"For you maybe amazing . . . For me, too much." As she has recently, she sounded breathless.

"I admit, I've thought about that too. After all . . ."

"I have no time for after-alls."

"So, what's on your mind?" I wanted to distract her from thinking about aging and the inevitable.

"You tell me to distract myself," she said, as if knowing my intentions, "To listen to music, to watch the TV . . . to read the paper, to do my puzzle . . . to call the family. And when I do those things . . . it makes it only worse. Pavarotti is wonderful but makes me sad because wonderful makes me sad . . . And the puzzle I can no longer do without reminding me how much I don't know about . . . Forty-one across, from today's, 'Schoolmarmish sound?' You think not knowing this makes me happy? Distracted?"

"Mom, I can hear you trying to catch your breath. Please, you shouldn't overstress yourself. You need to remain calm. For your heart. None of this is important and it's making you sick."

"To you maybe it's not important . . . To me, it's my life."

I couldn't think what to say. I understood. She was right. It was, it has become her life.

"So what is it, darling?"

"What is what?"

"Forty-one across?"

"Oh, the puzzle. How many letters?"

"Six."

"Do you have any?"

"It ends with a K. About that I am sure . . . I should only be sure about anything else."

"This is a hard one."

"I'm working on it now. I think it starts with a T."

"T and K," I said, literally not having a clue.

"This I should know. For 40 years I was a schoolmarm. A teacher. First grade."

"And a wonderful one at that." I was happy we were talking about something other than mortality and catastrophes.

"TS," she said, a T and an S are the first two letters because 33 down is LOANSHARK. I like that one." She was sounding playful.

"I'm still stumped."

"I too was but not now--it's TSKTSK. Isn't that a good one? Though as a teacher . . . I never said that."

"Good for you Mom. I don't know how many 106-year-olds can do the New York Times crossword puzzle."

"And in ink. Though with my arthritis I can barely hold the pen."

"Your handwriting is still better than mine."

"So, as I was saying," the distraction was over, "on CNN and in the Herald . . . what do I see?" She paused, I thought to catch her breath. "Tell me, what do I see?"

"I suppose . . ." I stammered.

"Fires . . .  Arizona is burning down. Killings . . . Those beautiful little girls in Africa. More killings . . . By crazy people in California. Fighting . . . Did you see what they are doing to my beautiful Odessa? We had family there before they took them away."

From that memory I thought I could hear her beginning softly to cry.

"And our veterans . . . Isn't today their day?"

It was in fact Memorial Day. I was happy to see she was still keeping track of such things.

"It's a shonda, what they are doing to those poor boys."

"I've been following that too. It's what you say. Disgraceful."

"Worse than that . . . Criminal."

"I agree."

"They cry, the politicians, alligator tears about the veterans . . . call them 'heroes,' which they are, and then treat them this way. Making them beg for what they deserve and were promised . . . Even Wolf on TV is upset. He says many have been dying who shouldn't."

"The good news, Mom, is that . . ."

"You're doing that distracting business again." I was please to again hear her tone lighten.

"I am," I confessed. "It's what I advise you to do. In fact, all of us need distractions. To think only about sad things makes . . ."

"I know what it makes, but I can't help myself . . . That's the way I am . . . Always looking for the dark lining."

I couldn't disagree. She is prone to that, but to try to buck her up and to distract me from her reality, I said, "You have to try to look on the bright side of things." I knew I was speaking in clichés.

Hushed, she asked, "For me, what's left?"

"As I said, no one knows. About you or any of us." As gently as I could, I said, "Ten minutes. Ten years. It's all unknowable."

"Now you sound like me." She, I was happy to hear, between breaths, chuckled.

"And no matter how much time you have, any of us have, there are things to look forward to, to feel good about."

"Give me a for-instance . . . Tell me something good."

"Well, there are young people in your life who love and care about you."

"Me? I only know old people."

"That's not true. You may live mainly with older people but there are your grandchildren and your many nieces and nephews."

"A few."

"No, many. They call you, they write you notes to tell you what you mean to them. Don't you remember what Shelly wrote to you, from Africa where she is working?"

"Shelly?"

"Yes, your sister Yetta's daughter."

"She is wonderful and does such good work . . . With poor people."

"She sent it to me as an email and I have it here. A printout, which I was about to mail to you."

"She wrote to me?"

"Yes, I told you about that."

"Now I can't even remember my own nieces . . . But they are all darlings."

"Fran wrote--

I am thinking about her at the age I am now and recall how she expressed her affection through a singularity of attention that I was not used to."

"About me this is?"

"Yes, she is looking back, remembering you more nearly 50 years ago. Let me read you the rest--

She recalled the names and ages of my children and took pleasure from their small accomplishments. I remember how being on the receiving end of our family's excessive concern was like getting a wet kiss on my 12 year-old cheek. An annoying intrusion but comforting reminder that I belonged."

"I didn't mean . . . to be annoying."

"I know that. She knows that. She's being playful, which is the way she is, but most important she wants to remind you that through your concern and love you reminded her that she belonged in our family."

"Of course she did . . . Belong. She was such a darling child."

"So you see, you still have a lot to live for. You're not just waiting for . . ."

"I know what I'm waiting for."

I took a chance and asked, "Waiting for what?"

"Like I said . . . for what's left."

"Which is?"

"The things you say and reminded me about . . . And other things too."

"Now I'm interested in a for-instance."

"Things in the world to get better."

She was becoming very short of breath, but still I asked, "For instance?"

"Maybe the Pope . . . will be able to help." She had never mentioned a Pope before. "And for Hillary. You know . . . two of my sisters were . . .  Sufferers."

"Suffragettes."

"Yes, however you say it. And couldn't vote . . . But now . . . this is something, no?"

"Hillary Clinton?

"Yes. And everyone . . . can go to the same school and drink the same water. . .  That's good too."

"The list is long of things that have changed."

"It's still long . . . Maybe I'll see . . . Maybe that's what's left."

May 23, 2014--The VA Mess

It's déjà vu again.

For my entire adult life I have heard stories about the Veterans Administration healthcare system. Mainly horror stories.

About how bureaucratic it is and thus difficult for our veterans to get timely, high-quality treatment. And now we are learning how delays and suffocating administrative procedures may have led to the deaths of score of veterans in Phoenix and elsewhere.

When Barack Obama first ran for office in 2008, he made fixing the VA system his highest priority so our troops could get the treatment they deserve. His promise came at a time when there were reports about the disgraceful quality of care and conditions at Walter Reed Hospital, walking distance from the White House.

Obama pledged to clean up the mess and bring the VA up to "21st century standards." He even designated his wife Michelle to make the care of veterans her priority.

So where are we five years later?

Business as usual. Maybe, business worse than usual.

And the mess cannot be attributed to George W. Bush. The full blame rests with the current occupant in the White House.

What has Michelle Obama been up to in regard to veterans' care? Mainly periodic hospital visits between planting a vegetable garden in the White House lawn and jumping rope with inner-city kids. I know this is overstated, but not by much.

Like almost everyone, I am mad as hell about this.

The president cannot honor those killed and shed tears at the bedside of the grievously wounded, hypocritically, for political reasons, calling them as often as possible "heroes," while presiding passively over this ongoing disgrace.

Obama's head of the VA, General Eric Shinseki may have been a good general (though not everyone would agree) but he was  not qualified to head the Veterans Administration. What job did he ever have to prepare him for such a huge and complicated assignment? He was selected mainly because he publicly disagreed with President Bush's approach to the war in Iraq and fit an Asian Cabinet demographic to which Obama was eager to pander.

In the VA system there are 151 hospitals and 820 outpatient clinics that serve 6.5 million people a year. The annual budget is more than $57 billion. To run that is a very big job, it's a highest-priority assignment, and who do we have running it?  Someone whose major responsibility previously was serving four years as Army Chief of Staff.

If fixing the VA was such a high priority, was there no head of a major healthcare system, Humana, HCA, or the Mayo Clinic, who could have been recruited to take on the assignment?

Sadly, Shinseki's appointment was typical of the kind of people Obama named to Cabinet-level positions--minimally-competenet lightweights such as Tim Geithner who would not challenge or threaten Obama's leadership.

Name one Cabinet appointment with a truly distinguished track record in public or private life who went on the serve with true distinction? Or on the White House staff for that matter. Even Hillary Clinton's record is at best mixed.

So, where do we go from here?

First, fire Shinseki. Do not ask him to reign, summarily dismiss him. That would be a first for Obama and send a message of concern and seriousness.

And then about the larger problem--restructuring the VA healthcare system itself--there are two good approaches.

Privatize the VA hospitals and clinics. Get rid of the ineffective bureaucracy and sell the whole thing to HCA or Mayo and in this way eliminate of the Civil Service deadwood.

Equally important, and not mutually exclusive, make all veterans eligible for Medicare. No matter that they are not all 65. Pretty much everyone with Medicare likes it so why not extend this cost-effective, high quality healthcare system to all those Americans who did so much to serve our country?

Tinkering at the margins of this massive problem will not solve it. Doing something radical and smart is the better approach. Our brave men and women deserve no less.

April 11, 2013--Our Heroes

Under fire for its growing backlog of disability benefits claims, the U.S. Department of Veterans Affairs last July set itself a goal: by year’s end, 40 percent of veterans would wait no more than four months for an answer on compensation claims for conditions as serious as post-traumatic stress disorder and traumatic brain injury.

Instead, things got worse. A Center for Investigative Reporting analysis shows the ranks of veterans facing long waits increased by 18,000 since July 11, when the agency’s undersecretary for benefits, Allison Hickey, told reporters that the delays were unacceptable and pledged that the backlog would begin to shrink “right now.”

By early January, the total number of veterans waiting for all claims had dipped slightly but remained above 900,000, with 630,000–70 percent–waiting longer than four months.

Informed of the missed deadline, VA spokesman Steve Westerfeld amended the goal: the agency, he said in an email, now expects to turn the corner in 2014.

Yet two initiatives to reduce the logjam have failed to produce results so far, according to a CIR analysis of VA data—

Four years after it was widely touted, a $537 million computer system has successfully processed 75 claims. Yes, 75. And an effort to offload claims from the busiest offices has overloaded offices that previously had been performing well.

This is not only unacceptable; it is unconscionable that Barack Obama has presided over this mess. Recall that when he first ran for president he said that doing right by our veterans was his highest priority. Yes, the problem began during George W. Bush’s administration, but it has since gotten progressively worse.

President Obama can make all the speeches he wants to praise our military “heroes”; he can shed tears when meeting with families whose sons, daughters, husbands, and wives have been killed in action; and he can go to Walter Reed Hospital to spend time with the grievously wounded; but this makes his hypocrisy even worse when it comes to doing nothing to fulfill our national promise to those who volunteered to protect us.

When he was first inaugurated, it was announced that Michelle Obama and Jill Biden would devote themselves to advocating for the needs of military families. What have they done to carry out that pledge? 

I see the First and Second Ladies out and about calling for kids to lose weight while appearing on the Ellen DeGeneres Show. Fine, but what I prefer would be to see the president demanding action and personally keeping track of progress or the lack thereof. And if former hospital administrator Michelle Obama wants to do something more serious than hula-hooping and rope-jumping, she should become the president’s full-time representative at the Veterans Administration to make sure this problem gets fixed in months, not years.