June 2, 2014--Negotiating With the Enemy

"Now you're the one who sounds like a Republican." I was happy to have the opportunity to turn the tables on Rona.

"You mean because I'm against the prisoner exchange with the Taliban?" I just smiled. "Well, I am against it so I that makes me a Republican, so be it."

"I'm just fooling with you," I said. "Some Democrats are raising questions too."

"Mainly those facing tough reelection challenges in November. Some of the same one who early on called for General Shinseki's resignation because of the VA debacle."

"I can see your point. At least, to some extent."

"You mean you're OK with us negotiating with the Taliban?" Rona asked, "The enemy?"

"I know that was the GOP talking-point way of discussing this on the Sunday talk shows."

"But they conveniently forgot that a Republican president, Richard Nixon, with Henry Kissinger, negotiated secretly for years with the Vietcong, the enemy, before finally making a deal to end the war in Vietnam."

"And, another Republican president, Eisenhower, agreed to negotiate with the enemy, the North Koreans, to end that war."

"To end wars, unless you can get away with demanding unconditional surrender, like at the end of World War II, you always negotiate with whom your fighting."

"And even with Japan, in WW II, we negotiated with them about keeping the emperor. Many in the U.S. wanted him deposed, but we allowed him to remain. So what's your problem this time?"

"I have a problem with exchanging prisoners before a larger deal can be struck with the Taliban."

"I have some trouble with that too," I conceded.

"A couple of things. First, I don't like the idea that we agreed to release five very bad guys who have been imprisoned in Guantanamo--hold off for a moment about that issue--allowing them to go to Qatar of all places. The deal calls for the Qatar government to keep an eye on them and not allow them to travel for a year--you know how much that agreement's worth--in exchange for an American soldier who has been held as a prisoner of war for five years."

"Among the five Taliban, according to the Times, which I have right here, so let me read what it says--two at least are 'senior military commanders said to be linked to operations that killed Americans and allied troops as well as implicated in murdering thousands of Shiites in Afghanistan.'"

"Correct. One was the head of the Taliban army. Bad enough guys to be held at Gitmo without trial for more than 10 years but OK to release for one American soldier. Which brings me to my other point."

"Which is?"

"About the soldier. When you sign up for combat, and all our troops are volunteers, you know the risks. You could be wounded, killed, and even taken prisoner. And the deal is that if you're captured you're likely to be held until the war is over, a full truce is worked out, and all prisoners are then exchanged. And in the particular case, to make matters worse, he may have been a deserter, going over to the Taliban side."

"But, Susan Rice and Chuck Hagel, on the same Sunday shows, implied that this may be a prelude to a larger agreement with the Taliban. We've been trying to engineer something like that for years."

"Which would be a good thing," Rona said, "But why can't we wait until a deal is struck, or at the minimum, when we're real close to having one, before exchanging prisoners? This feels very premature and, who knows, very political."

"Political?"

"You know, with the VA mess and the resulting bad political news for the Obama White House, maybe they wanted to do something that would show dramatic concern for the troops."

"And if the released Taliban get back into the fray, how many more Americans will they maim and kill? How good for our troops would that be?"

"Fair point. But I have another idea. Admittedly a crazy one."

"Shoot," Rona said.

"While we busy exchanging prisoners, why not release everyone we're holding in Guantanamo? You know, all 150. That way Obama would get to fulfill at least one of his campaign promises--to shut it down."

"Now, you're going too far."

"At least, I don't sound like a Republican!"

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 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.