THE ECONOMY IS BITTER
BARRY O HAS LOST HIS GLITTER
THE ELECTORATE GROWS COLDER
HIS EXCUSES JUST GET OLDER
AND ALL BECAUSE OF THE STATE THAT GOT AWAY
NO LONGER STANDING TALL
SEE IT WRITTEN ON THE WALL
THE CHANGE HE PROMISED HAS ALL
THE BARRY WHO WON YOU
HAS GONE OFF AND UNDONE YOU
HAS SEEN THE FINAL INNING
WE KNOW WHAT HAPPENED
IT'S ALL A CON GAME
NO MORE CAN HE PULL THE WOOL
YOU'VE BEEN PLAYED FOR A FOOL
AND NEVER WILL THE SHEEP BE HERDED
GOOD RIDDANCE, GOOD-BYE!
EVERY TRICK OF HIS WE'RE ON TO
EVEN THE FOOLS OF ALL FOOLS
KNOW WHERE HE'S LED TO
THE ECONOMY GETS ROUGHER
THE MARKET LONELIER AND TOUGHER
THE HOPE'S ALL BURNED OUT
IN NOVEMBER HE MAY BE TURNED OUT
THERE'S JUST NO FOOLING THE LIVE-LONG NIGHT AND DAY!
EVER SINCE THE START OF TIME
TRICKSTERS HAVE PLIED THEIR CRIME
BUT THE PEOPLE WISE UP IN TIME
THE STATE THAT GOT AWAY
THE STATE THAT GOT WAY
PAID FOR AND APPROVED BY THE RE-ELECT BARACK OBAMA CAMPAIGN.
FROM THE TCI WIRE:
In Spokane, Washington, the Lilac Festival is taking place. As usual, the third Saturday of the month (tomorrow) will be the Festival's Armed Forces Torch Light Parade. The festival has taken place since 1938 when the chair of the Associated Garden Clubs and the Spokane Floral Association, Ethyl Goodsell, organized the first event. This Saturday's parade will start at 7:45 p.m. by the INB Performing Arts Center and will feature "high school bands, community floats, equestrian groups and individuals, and military with groups of veterans, and active military marching." Iraq War veteran Danielle Nienajadlo's mother will be there and Lindsay Wediman will be carrying a picture of her daughter Danielle.
John Stucke (Spokesman-Review) reports that, after graduating high school, Danielle enlisted in the army and served 13 years. A year after she left the military, in 2009, Danielle was battling "an aggressive form of leukemia." Like so many others who worked in and around the burn pits (open areas where every discarded item from standard trash to human waste to medication, etc. was burned to dispose of it), Danielle saw her record good health vanish. While stationed at Balad, she coughed up blood, suffered sores and bruises over her body, experienced severe weight loss and had headaches. Attempts to address the situation resulted in her symptoms being dismissed and ignored: "Danielle was finally sent to Walter Reed Army Medical Center and diagnosed with acute myelogenous leukemia. She became one among hundreds of soldiers brought home from the war to battle cancers and other diseases. Many -- though not all -- blame the burn pits for their illnesses, and class-action litigation is pending in federal court."
In March 2010, Beth Hawkins (Mother Jones) reported on Sgt Danielle Nienajdlo's passing and observed:
The government's reluctance to acknowledge the potential hazard has frustrated veterans' advocates, who remember how long it took for the Pentagon to recognize Gulf War Syndrome in the 1990s, and to acknowledge the health problems caused by aerial spraying during the Vietnam War. "We don't want another Agent Orange," says John L. Wilson, DAV's assistant national legislative director. "Silence does not do any good."
If the pits are harming troops and Iraqis, there's no telling how many. Many cancers won't reveal themselves for a decade or more, and many respiratory symptoms tend to be misdiagnosed as asthma. Like Nienajadlo, Air Force Reserve Lt. Colonel Michelle Franco, 48, had a clean bill of health when she shipped out to Balad three years ago. The 18-foot walls surrounding her quarters kept out mortar fire, but not the smoke: "You could smell it; you could taste it." As a nurse, Franco suspected the "plume crud" was hazardous. She knew that in addition to amputated limbs from her medical facility, the base's waste included hundreds of thousands of water bottles every week -- and she knew burning plastic releases cancer-causing dioxins. After just five months at the base, Franco sustained permanent lung damage. She's lucky, she says, that she kept asking questions when harried doctors handed her an inhaler. She expects her diagnosis -- untreatable reactive airway dysfunction syndrome -- to ultimately push her into retirement.
Last Friday, Iraq War veteran Spc Dominick J. Liguori died. Bob Kalinowski (Times-Tribune) reports he died of sarcoidosis, "Family members say Spc. Liguori developed the disease from exposure to open-air burn pits while serving in Iraq, and the ailment slowly scarred and destroyed his lungs." Denise Hook says of her 31-year-old nephew, "They did scans of his lungs. You could see on the scans that most of his lungs were destroyed. You'll see a lot more in the future. You really will." She also states, "Since he was little, he wore camouflage for Halloween every year. He painted his wagon camouflage. He painted his little trucks camouflage. He hid in the trees with camouflage. All he ever dreamt about was being in the military. That was his lifelong dream. I think if God could have made him better, he would have rejoined."
While the government collectively shrugs its shoulders, Iraq War veteran Leroy Torres and his wife Rosie Torres have continued to battle on behalf of veterans exposed to burn pits -- which includes Leroy Torres -- and they have contiuned to educate the nation on the issue. The Torres have a website entitled BURNPITS 360. They are also on Facebook. Last month, she was interviewed by Rachel Cole (KRIS -- link is text and video):
His wife, Rosie, has been battling for years with Congress to get legislation passed that will recognize a connection with toxic exposure for soldiers and their poor health conditions. "To sum it up, at 39-years-old, he's lost both his careers that he's worked very hard for because of his health. Toxic exposure is something that it slowly takes over one organ at a time." Rosie said.
According to Rosie, her husband is in stable but she says others aren't so lucky. "There's several soldiers awaiting lung transplants and others on full liters of oxygen constantly." She said.
At RT for Decision Makers in Respiratory Care, Kalie VonFeldt, MS, PA-C; Maura Robinson, BS; and Cecile Rose, MD, MPH explore these issues and they note, "Reports of increased acute respiratory illnesses in deployed troops began surfacing in 2004.3 Subsequent epidemiologic studies showed that deployers have higher rates of newly reported respiratory symptoms than nondeployers (14% versus 10%), although rates of physician-diagnosed asthma and chronic bronchitis were not increased.4 More recent studies suggest that obstructive airways diseases, including asthma and constrictive bronchiolitis, are occurring in excess in returning troops.1,5 The magnitude and spectrum of respiratory illnesses from deployment are difficult to judge. Lack of predeployment spirometry and challenges with diagnosis limit accurate estimates of disease incidence and prevalence."
Currently, US House Rep Todd Akin is proposing a burn pit registry in the House. If US Barack Obama wants to earn veterans votes or to stop his empty grand standing and actually have an accomplishment to his name, he could throw some public support being Akin's bill. Yesterday, Barack did sign into law legislation Akin sponsored . . . to name three US Post Offices in Missouri after 3 native sons who died serving in Iraq: Spc Peter J. Navarro, Lance Corporal Matthew P. Pathenos and Lance Cpl Drew W. Weaver. Though an honor, it also really doesn't cost the government much more than the cost of plaque. Maybe that's why the president could get on board with that but has provided no leadership for or advocay of a burn pit registry?
Wednesday the House Veterans Affairs Subcommittee on Health held a hearing. Subcommittee Chair Ann Marie Buerkle noted the hearing was entitled "Optimizing Care for Veterans With Prosthetics." The Subcommittee heard from four panels. The first one was featured Gulf War Veteran John Register and Vietnam Veteran Jim Mayer. Disabled American Veterans' Joy Ilem, American Orthotic & Prosthetic Association's Michael Oros, Paralyzed Veterans of America's Alethea Predeoux and Southeast Wounded Warrior Project's Jonathan Pruden made up the second panel (we covered the second panel in Wednesday's snapshot). The third panel was the VA's Office of Inspector General's Linda Halliday accompanied by Nicholas Dahl, Kent Wrathall and Dr. John D. Daigh Jr. and Dr. Robert Yang. The fourth panel was the VHA's Dr. Lucille Beck accompanied by Dr. Joe Webster, Dr. Joe Miller and Norbert Doyle. Yesterday we covered some of Chair Ann Marie Buerkle's questions during the fourth panel. Today, we're going to note Ranking Member Mike Michaud questioning the same panel.
Before we do though, we're going to note some of the remarks Iraq War veteran Jonathan Pruden made on the second panel.
Jonathan Pruden: Under the change, only a contracting officer could procure a prosthetic item costing more than $3,000. This policy would effect essential items including most limbs like mine and wheel chairs. It would require the use of a system designed for bulk procurement purchases that involves manually processing over three hundred -- that's 300 -- individual steps to develop a purchase order. This system may be great for buying cinder blocks and light bulbs but it is certainly not appropriate for providing timely and appropriate medical care. Equally troubling, this change offers no promise of improving service to the warrior. Instead, it would mean greater delays. The change could realize modest savings but at what cost? A warrior needing a new leg or wheel chair should not have to wait longer than is absolutely necessary. I know warriors who have stayed home from our events, stay home from school, from work, can't play ball with their kids or live in chronic pain while they wait for a new prosthesis. I know first hand what it's like to not be able to put my son into the crib while I'm waiting for a new prosthetic, to live in chronic pain and to have my daughter ask my wife once again, "Why can't Daddy come and walk with us?" With VA moving ahead on changing procurement practices, wounded warriors need this Committee's help. A prosthetic limb is not a mass produced widget. Prosthetics are specialized, medical equipment that should be prescribed by a clinician and promptly delivered to the veteran. We urge this Committee to direct VA to stop implementation of this change in prosthetic procurement.
That sets us up for the problem. VA is proposing a change which will add steps to attempting to get prosthetics and which veterans groups fear (I agree with them) will lead to veterans not getting what their doctors are prescribing but instead some cheap knock-off that doesn't do what they need and that's why their doctor didn't prescribe it in the first place. Will this fear come true? That's a yes-or-a-no answer. But as we saw in the hearing during the fourth panel, a lot of words flow out of the mouths of VA employees appearing before the Subcommittee but "yes" and "no" are not among them.
Ranking Member Mike Michaud: I just want to follow up, Mr. Doyle, on your comment that you made where you mentioned that contracting officers do not change what the clinician prescribes but actually, in testimony that we heard earlier, from PVA, that is not the case -- because that is not the case. Their testimony states that contracting officers when they do receive the orders the request for the devices is modified and even denied in cases because of the cost. So that is a huge concern. There seems to be a disconnect between what you are hearing versus what the VSOs are hearing The cost is a factor, it's not the veteran's health care. So do you want to comment on that and --
Norbert Doyle: Yes, yes, sir. Thank you. First of all contracting officers -- all contracting officers do have a mandate under Federal Acquistion regulations to ensure that there's a price reasonable aspect to the cost we're providing. So I don't know if that is a concern or not. I can't really speak to, uh, what may have happened before but I have put out to the contracting community that under 8123 that if a contract -- that if the contracting officer recieves a physicians consult for a specific product we'll do due dil -- due deligence to ensure that we pair a fair and reasonable price for that product but we're going to get that product for that individual. So I -- So I don't know if it's a -- a concern that -- again I'll take full blame for not bringing the veterans service organizations into the loop, into this discussion, and we can fix that but I don't know if that's part of the issue there -- if that's why that concern was being raised.
Ranking Member Mike Michaud: Well its very clear from the VSOs, some of their statements, that it's not uncommon for clinicians to prescribe something and it's being modified by contracting officers. And primarily because of cost. And that's a big concern that I would have. My other question is, Mr. Oros talked about older veterans at his practice complaining that there appears to be a new administrative hurdle to prevent their continuing to receiving care at Scheck and Siress. The VA has assured veterans that they may choose their own prosthetist and yet veterans who wish to use community-based providers report wide-spread administrative hurdles and other pressures to choose in house VA care. How would you explain the perception among the veterans and the community based providers because there seems to be a disconnect here as well as far as what you have told us versus what's actually happening out there.
Dr. Lucille Beck: Uhm, uhm, yes, sir. I'll start and, uhm, uh, we do have contracts with 600 providers -- uhm, approximately 600 providers. Uhm, we do offer choice to the -- to our veterans. Uhm, and, uhm, when our -- In our amputee clinic, when we initiate the process for the multi-disciplinary care that we provide, uhm, we have our physicians and our clinicians and our prosthetists there. We also have contract -- our vendors, our contracted community partners, our contracted prosthetic vendors from the community are there as well. The veterans do have that choice. That's part of our policy. And, uhm, and, uhm -- We -- As we become aware of we-we will reaffirm that policy with the field based on what we have heard from our veterans today. And, uhm, and we are improving the processes. I think the Inspector General report pointed out that we -- There's some contract administration initiatives that we need to undertake including streamlining the way that we do our quote reviews so that they happen in a more timely fashion and, uhm, that they really clarify the prescriptive elements for fabrication of the leg and we are doing that -- or fabrication of the limb and we are doing that. Uhm, the second thing that we are doing is, uhm, we are, uh, making sure that our contracting officers and their technical representatives who have as part of their, uh, responsibility to review those quotes and certify that they are doing that regularly and in a timely fashion, there's guidance that's being prepared even now, uhm, with, uh, to get -- to get -- to reinstruct the field and educate them on that. And the third thing that we are doing is that we are taking a contracted -- what we call contracted template where we are developing policy and guidance that can actually go into our contracts so that it is clearly specified for the contract provider and the VA exactly what the requirements are and the timelines. So, uhm, we've taken the report that we've had from the Inspector General about the need to improve contract adminstration and support our veterans seriously and we are making those corrections, uhm, and have been doing that over the last several months.
Ranking Member Mike Michaud: And do you feel that with the new changes you're providing, which goes back to my original question, that the clinicians will have final say in what a veteran receives versus a contracting officer who has to look at contracts and saving costs -- which I believe that we have to do. But the bottom line for me is to make sure that the veterans get the adequate prosthetics that they need. And if it costs a little bit more then they should be able to get it if it fits them more appropriately. And the concern that I have is that, yes, you have to look at cutting costs but not at the cost of providing what our veterans need and I do have a concern with contracting officers injecting, uh, more costs versus the clinician looking at the veterans' needs.
Dr. Lucille Beck: Uhm, yes, sir, I have a concern with that too. I'm a clinician myself, working in another area, who provides rehab technologies to veterans. And it is critically important that what the clinician requests and that of course is done in collaboration and in partnership with the veteran -- these are the choices and decisions about technologies that our veterans make with out clinicians. And, uhm, we are absolutely -- Uhm, rehabiliation is not effective unless we are able to, uh, provide the-the products and services that our veterans need. And, uhm, our role in prosthetics and in rehabilitation is to assure that any, uhm, uh-uh, that any, uh, contracts, uh -- And the way we procure items uhm, enhances and-and, uh, not only enhances but provides high quality individualized care. Uhm, we have done that successfully, uhm, for a long time. And, uh, we believe that we are able to do that, uhm, as we move forward. And as Mr. Doyle has cited, the, uhm -- We can certainly, uhm, work within the framework of contracting requirements and the added authority that Congress gave us many years ago for 8123 is, I think, the other piece of-of sole source procurement that we can do when we need to provide and are providing highly individualized products and services.
Ranking Member Mike Michaud: Thank you. Thank you, Madam Chair.
The above dance was only topped by the moves Doyle proved when Chair Ann Marie Buerkle asked him more questions in the second round. Specifically, when the Chair asked, "In the panel with Mr. Pruden -- Captain Pruden, I should say -- he talked about this new system that you're going to go to, the Electronic Contract Management System -- and talked to us about the fact that it requires 300 steps to get the request in. Can you comment on that?"
Guess who couldn't comment? Did you think it was Lucille? Yeah, it was Dr. Beck. Why was she present? She had nothing to say, no answers to questions but after Doyle misdirected for two to three minutes every time he opened his mouth, Dr. Beck would jump in at the end to start offering slogans she must have read on hand outs in the VA's waiting room.
She couldn't comment. But Norbert Doyle did want to comment on the Electronic Contract Management System. He began insisting that it "new" and that he knows the process is "labroious" and has many steps but 300? "That's a new one on me."
How many steps is he familiar with?
He never said.
What sounded like a highly frustrated Chair Ann Marie Buerkle replied that they weren't talking about "lightbulbs," they were talking about something "intimate," something that "becomes a part of the veteran's body." And if she was frustrated then (she sounded it -- many of us observing the hearing had frustrated looks on our faces as well during the fourth panel's testimony), she most likely only grew more frustrated by the flat affect with which the VA witnesses greeted her comments.
Meanwhile if you're think Iraq falling off the US media radar means it's safe and rainbows flow from Nouri al-Maliki's armpits and carmel and butterscotch out of his ass, think again. The White House issued the following today:
The White House
Office of the Press Secretary
For Immediate Release
May 18, 2012
Message -- Continuation of the National Emergency with Respect to the Stabilization of Iraq
TO THE CONGRESS OF THE UNITED STATES:
Section 202(d) of the National Emergencies Act (50 U.S.C. 1622(d)) provides for the automatic termination of a national emergency unless, within 90 days prior to the anniversary date of its declaration, the President publishes in the Federal Register and transmits to the Congress a notice stating that the emergency is to continue in effect beyond the anniversary date. In accordance with this provision, I have sent the enclosed notice to the Federal Register for publication continuing the national emergency with respect to the stabilization of Iraq. This notice states that the national emergency with respect to the stabilization of Iraq declared in Executive Order 13303 of May 22, 2003, as modified in scope and relied upon for additional steps taken in Executive Order 13315 of August 28, 2003, Executive Order 13350 of July 29, 2004, Executive Order 13364 of November 29, 2004, and Executive Order 13438 of July 17, 2007, is to continue in effect beyond May 22, 2012.
Obstacles to the orderly reconstruction of Iraq, the restoration and maintenance of peace and security in the country, and the development of political, administrative, and economic institutions in Iraq continue to pose an unusual and extraordinary threat to the national security and foreign policy of the United States. Accordingly, I have determined that it is necessary to continue the national emergency with respect to this threat and maintain in force the measures taken to deal with that national emergency.
Recognizing positive developments in Iraq, my Administration will continue to evaluate Iraq's progress in resolving outstanding debts and claims arising from actions of the previous regime, so that I may determine whether to further continue the prohibitions contained in Executive Order 13303 of May 22, 2003, as amended by Executive Order 13364 of November 29, 2004, on any attachment, judgment, decree, lien, execution, garnishment, or other judicial process with respect to the Development Fund for Iraq, the accounts, assets, and property held by the Central Bank of Iraq, and Iraqi petroleum-related products, which are in addition to the sovereign immunity accorded Iraq under otherwise applicable law.
Recommended: "Iraq snapshot"