Thursday, July 26, 2012










This morning, US House Rep Jeff Miller noted that "in 1961 John F. Kennedy said we'd put a man on the moon, eight years later, we were there.  We're talking about an integrated electronic health records by 2017.  Why could we put a man on the moon in eight years and we're not starting from ground zero on the electronic health record -- why is it taking so long?" He was asking that of the Secretary of Defense Leon Panetta and the Secretary of Veterans Affairs Eric Shinseki who were appearing before a joint-hearing of the House Armed Services and House Veterans Affairs Committee.  

Of course no real answer was given.  A grinning -- apparently amused -- Shinseki began his non-answer by declaring that "I can't account for the previous ten years."  Though he didn't say it, he also apparently couldn't account for the three years that he's been Secretary of the VA.  Three years and seven months.  You'd think Shinseki would be able to speak to the issue.  He couldn't.  He could offer that he met with Panetta four times this year with plans for a fifth meeting.  This was the same amount he met with former Secretary of Defense Robert Gates but, apparently, in a few months less time.   I have no idea what that or his ridiculous grin was about. 

But I do think Shinseki may have inadvertantly provided an answer for the delay when he went on to declare,  "It's taken us seventeen months to get to an agreement that both Secretary Panetta and I signed that describes the way forward."  There's the problem right there. 

Back in March 2011 what was Shinseki bragging about?  As Bob Brewin ( reported, "Veteran Affairs Sectretary Eric Shinseki said Thursday he and Defense Secretary Robert Gates agreed on March 17 that their departments would develop a common electronic health record system."  So that was agreed to in March 2011.  But it took Shinseki and and Gates 17 months to figure out how?  There's your time waster right there.  And it was not needed.  Shinseki and Panette did not need to 'invent' a damn thing.  This is not a new issue.  VA has long ago addressed what they need with regards to records and DoD has identified the same.  And after this had been done (and redone), Robert Dole and Donna Shalala served on the Dole -Shalala Commission coming up with many of the same things.  The Dole -Shalala Commission was established in 2007 and formally known as the President's Commission on Care for America's Returning Wounded Warriors.   Appearing before the House Veterans Affairs Committee February 7, 2008, VA's Dr. James Peake testified that this electronic record was "a critical recommendation in the Dole-Shalala Commission report."

The hearing meant nothing for progress on that issue.  It was an embarrassment.  Leon Panetta can take comfort in the fact that he's only now about to hit the one-year mark but Shinseki was sworn in back in January.   Shinseki will get easy press at the end of his term and no one will complain about the foot dragging, the refusal to utilize the work that was already done -- that tax payers footed the bill for over and over -- and instead to take a laid back and non-rush attitude towards something identified as "critical" by a presidential commission back in 2007. 

US House Rep Susan Davis would ask about the lack of coordination between VA and DoD and also about "the kind of counselors that are needed for this" -- the influx of veterans expected as the Afghanistan War draws down -- and will be aware of the service member issues and resources and veterans issues and resources?  Training was the reply from Panetta to a question that probably required something more than a stock reply.

Other issues were brought up.  For example, Sequestration was discussed.  This is an automatic measure that will kick in if the buget is not balanced.  Established in the hearing is the Veterans Affairs will not be effected but the Defense Dept will be. 

Chair Buck McKeon:   As I've already said, we know there's high unemployment among our veterans -- our young veterans.  And we know with the 487 billion cut in defense, we will have a hundred thousand leaving the military.  We will have another hundred thousand  if the sequestration takes effect.  What plans do you have to ensure that these service members will not go from the front lines to the unemployment lines?  And how do you see potential reduction in the Defense workforce resulting from the sequestration and what effect will that have on -- what will you be able to do to try to move them into some kind of meaningful employment?  Mr. Secretary?

Secretary Leon Panetta:  Well I sure as hell hope sequestration doesn't happen. 

Chair Buck McKeon:  I'm with you.

Secretary Leon Panetta:  It would be -- as I said -- time and time again, a disaster for the Department as far as our budget is concerned and as far as our ability to respond to the threats that are out there.  And it would have a huge impact.  It takes -- It doubles the cuts in the military.  It would obviously add another hundred thousand that would have to be reduced and the impact of that on top of the reductions that are currently going to take place would place a huge burden on the systems to be able to respond to that.  I think that it would be near impossible to do the work that we're trying to do and make it work effectively.  I think that we can handle what we've proposed in our budget and the drawdown numbers that are coming now.  We've tried to do this pursuant to a rational strategy over these next five years.  And I think the systems that we are working on and what we are trying to put together in place, I'm confidant in that. But if sequestration should happen and be put on top of it, I think it could really strain the system. 

Chair Buck McKeon:   Mr. Secretary, could you please give us that input for the record.

US House Rep Buck McKeon is Chair of the House Armed Services Committee, House Rep Adam Smith is Ranking Member.  On the House Veterans Affairs Committee, the leadership is Chair Jeff Miller and Ranking Member Bob Filner.  There are many things that will be takeaways from today's hearing.  But the real take away should be Shinseki's ridiculous statement about the 'progress' on the eletronic medical record front,  "The fact that we've agreed upon a concept is, I think, groundbreaking."

Listening to that, it was hard not to recall Ranking Member Filner's opening remarks, specifically this: "The issues that we have, we've been talking as a Congress and with the Executive Branch for many, many years.   Decades in fact.  We've got to break down the bureaucratic stuff that keeps us from having a common health record system.  I mean it just -- People die because that system is not integrated enough.  It seems this is not beyond our capacity to get those systems integrated."  He said those words before either witness had spoken.  20 years in Congress did not make Bob Filner psychic but it has made him one of the most informed members of Congress on veterans issues.

Ranking Member Bob Filner:  In a democracy where you need  obviously the support and vote of people to go to war, the cost of war is a pretty important item to understand.  And treating our veterans is obviously part of the cost of war and should be considered that.  I have tried on several occasions to add an amendment to any war appropriations, 15 to 20% surcharge because that's the difference in your budgets for veterans.  And of course since we've been borrowing money for war, nobody wants to borrow the money for veterans.  So it's not looked on kindly.  But part of the cost of war, you know, we have the statistics show about 6,000 killed in action -- I'm sorry, 5,000 killed in action since 9-11.  And almost 50,000 wounded.  And yet those who have showed up at the VA for help -- and I know there are different definitions and different circumstances -- I think it close to or could be over a million. Why is there such a disparity between -- and it's important for the public to understand what is the cost of war?  How do you account for a million veterans seeking help for problems in war and only 50,000 considered casualties?  Mr. Panetta, I'll go to you first since you know how to manipulate the two minutes, you're looking to him, I know, so you don't have to answer?

Secretary Leon Panetta:  Well, no, I mean it's -- it clearly is the-the impact of war over the last 10 years and how it's effected those who have served and they do return.  When they come back, the reality is that, uh, not -- not all of them -- not all of them are getting the kind of care and benefits they should get. And it's our responsbility to try to respond to those kind of needs as they return.  This -- look, this system's going to be overwhelmed.  I mean, you know, let's-let's not kid anybody, we're looking at a system that's already overwhelmed.  The likelihood is that we drawdown further troops and, uh, as we -- over these next five years, assuming sequester doesn't happen, we are still going to -- we are going to be adding another hundred thousand per year.  And the ability to be able to respond to that in a way that effectively deals with the health care issues, with the benefits issues, with all the other challenges.  That is not going to be an easy challenge.  And, uh, the cost, you talk about the cost of-of war, this is always part of the cost of war.  It's not just dealing with fighting, it's also dealing with the veterans who return and that is going to be a big ticket item, if we're going to do this right.

Ranking Member Bob Filner:  I just hope you'll look at that boot camp idea as a way to really get at that issue.

What idea?  Ava's covering it tonight at Trina's site. 

US House Rep Silvestre Reyes noted his hope that they could do more joint-hearings like this and, earlier, Ranking Member Bob Filner had noted they had tried repeatedly to do a joint-hearing like this with the two Secretaries but had been unsuccessful.  If they do have another hearing, they might want to have a basic topic.  I have never sat through such a disorganized hearing or heard someone muse at length -- and mistakenly, he would be corrected after -- as US House Rep Hank Johnson did in the middle of the hearing.  What was the point of any of those remarks -- none of which were questions?  You had two minutes to ask either or both Panetta and Shinseki questions and instead you offered some sort of enjambment poem? 

Even in a scattershot hearing, that stood out.  Why did he even show up?  I asked Betty's father on the phone if veterans issues aren't a concern in the area?  (Betty's father, who is a veteran, is also a constituent of Hank Johnson's.)  And he couldn't understand why his representative wasted the time instead of utilizing it.  I sat through it and I still don't know what that nonsense was?

"Back from the Battlefield" is probably too broad of a topic for a hearing, let alone a joint-hearing.  But many people did raise important issues in their time.  Take US House Rep Loretta Sanchez who sits on the Armed Services Committee.

US House Rep Loretta Sanchez: In preparing for this hearing, I asked my staff back in Orange County to go through the casework we have with respect to veterans in transtion.  And although we have a great relationship with our VA in Longbeach and we have two clinics -- one in Santa Ana and one in Anaheim -- in our district, the reality is that the most troublesome area with respect to these cases involved the quality and the lack of health care for our service members who are transitioning from active or having been called up and now out into the veteran world if you will.  And, in fact, I have a lot of veterans who come to my office and they express real concern about not receiving treatment or having a longtime to wait for a speciality doctor, for example.  In Longbeach, it would be oncology where we must be short-staffed or something of the sort.  And the other really big concern for them is being prepped up for surgery and then somebody on the surgery team then doesn't show up -- out of whatever -- and then the surgery is postponed..  And it isn't until these people come to my office  and we call in directly that we're able to get that rescheduled.  So my question is how are you addressing these types of concerns with respect to health care and why, if a surgery's scheduled, why aren't people showing up to be on that surgery team?  And, more importantly, why does it take a Congressional office to call to ask that it be rescheduled?

Of course Shinseki had to take it for the record (meaning his office will respond to her questions after they've looked into the matter, respond outside the hearing).  But you better believe veterans in her district are about to find rescheduling postponed surgeries a lot easier.  She used her time wisely and served her constituents -- probably better than anyone else present (and that was just her first question). 

Contrast that with Johnson's "spread my love for you  publicly" and "true gentleman" and "the underdog is now on top" rambles.  Offering up bios "become the Secretary of the Army -- Chairman of the Army?  Or whatever.  Uhhhhmmm.  Hmmm."  At the end of his pause -- word -- pause -- stumble what is one to say?

"Far out!"?  "Groovy!"? 

Maybe: "Who's holding?" 

He stops his ramble to note he's hearing thing and then attempts to reproduce the sound.  When told his time has expired, he responds, "Already?" 

Again, what do you say after all that?

No one was served by that crap.  No one.  And if you're going to tell a witness their own biography, have your facts straight.  But better yet, don't waste everyone's time with that garbage to begin with.  It's a real shame Johnson doesn't seem to believe that he has veterans in his district and that they have needs that should have been addressed.  That was embarrassing and there's no excuse for it.  Maybe Jay Leno was right and we should be drug testing members of Congress?

I have no idea but enduring that nonsense was like one of those Congressional townhalls where you are all waiting hours to way in on an issue but everyone has to first endure the idiot who brought a guitar and can't sing and can't write a song but wants to force all gathered to endure his little ditty as he stands at the mike.

It was a distraction and a diversion.  Fortunately, others had serious issues to explore.  Such as suicide.

US House Rep Mike Michaud:  Quick question, and I want to read from a Veterans Service Organization letter that they actually sent to Senator [Jim] Webb just last week.  And just part of it says, "The only branch of the military to show a marked improvement decreasing the number of persons taking their own life is the United States Marines.  They should also be praised for their active leadership from the very top in addressing the problem and implementing the solutions.  The remaining services have yet to be motivated to  take any substanative action. "  Secretary Panetta, I've been to Iraq and Afghanistan several times and I've looked the generals in the eye and I've asked them what are they doing personally to help the stigmatized TBI, PTSD?  And the second question is: Do they need any help?  I get the same answer over there as I do over here in DC: 'Everything's okay.  We've got all the resources we need.  We don't need any help.'  But the interesting thing is someone much lesser ranked came up to me, after I asked the general that question, outside and said, "We need a lot more help."  And he suggested  that I talk to the clergy to find out what they are seeing happening.  And I did that trip and every trip since then.  And I'm finding that our service members are not getting the help that they need.  And my question, particularly after looking at this letter that was sent to Senator Webb, it appears the Marines are doing a good job so why is it so different between the Marines, the Army and other branches?  And can you address that?

Secretary Leon Panetta: You know -- Obviously, there's no silver bullet here.  I wish there were to try to deal with suicide prevention.  We-we have a new suicide prevention office that's trying to look at programs  to try to address this terrible epedemic. I  mean, we are looking.  If you look at just the numbers, recent total are you've got about 104  confirmed and 102 pending investigation in 2012.  The total of this is high,, almost 206.  That's nearly one a day.  That is an epedemic.  Something is wrong.  Part of this is people are inhibited because they don't want to get the care that they probably need. So that's part of the problem, trying to get the help that's necessary.  Two, to give them access to the kind of care that they need.  But three -- and, again, I stress this because I see this in a number of other areas, dealing with good discipline and good order and, uh, trying to make sure that our troops are responding to the challenges -- it is the leadership in the field.  It's the platoon commander.  It's the platoon sergeant.  It's the company commander. It's the company sergeant.  The ability to look at their people, to see these problems.  To get ahead of it and to be able to ensure that when you spot the problems, you're moving that individual to the kind of-of assistance that they need in order to prevent it.  The Marines stay in close touch with their people.  That's probably one of the reasons that the Marines are doing a good job.  But what we're stressing in the other services is to try to develop that-that training of the command.  So that they two are able to respond to these kinds of challenges. 

US House Rep Mac Thornberry also raised the issue of suicides, noting Time magazine's recent cover story (July 23rd issue), Mark Thompson &; Nancy Gibbs' "One A Day: Every day, one U.S. soldier commits suicide.  Why the military can't defeat its most insidious enemy."  He raised the issue of "33% of all military suicides have never deployed overseas at all and 43% had deployed once."  Panetta confirmed that statistic from the article was accurate.  Panetta argued that suicide is on the rise "in the larger society" and that this is reflected within the military.  Chair McKeon wanted to know if the age group committing suicide in the military was reflective of the age group doing the same in the civilian sphere?  Shinseki stated that in the age group of 15-34, suicide is the third leading cause of death and, in the age group of  25 to 34,  it is the second leading cause of death.

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