The VVA Veteran: Government Affairs

MAY/JUNE 2007

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GOVERNMENT AFFAIRS

Some Profiteer While Others Give Their Lives and Health

BY JOHN MITERKO, CHAIR,
VVA GOVERNMENT AFFAIRS COMMITTEE,
WITH VVA GOVERNMENT AFFAIRS STAFF

Human parasites who profiteer during a time of war through price-gouging, bid-rigging, embezzlement, kickbacks, fraud, and outright theft deserve prison time, not slap-on-the-wrist fines.

This was the theme of a brief and pointed hearing on Capitol Hill on March 20 conducted by Senators Patrick Leahy (D-Vt.), chairman of the Senate Judiciary Committee, and Arlen Specter (R-Penn.), ranking member of the committee. They were joined by a trio of colleagues from both sides of the political spectrum, Tom Coburn (R-Okla.), Russ Feingold (D-Wisc.), and Ben Cardin (D-Md.).

They heard testimony from Stuart W. Bowen, Jr., special inspector general for Iraq reconstruction, known as SIGIR; Thomas F. Gimble, acting inspector general for the Department of Defense; and a very upbeat Barry Sabin, deputy assistant attorney general in the Criminal Division, Department of Justice.

Leahy opened the hearing by quoting Abraham Lincoln, who called profiteers “worse than traitors.” In his essay, “War Is a Racket,” Marine Brigadier General Smedley Darlington Butler, twice a recipient of the Medal of Honor, railed against those who would profit unduly while soldiers and Marines were getting killed and maimed.

“Today, an Administration seemingly not thinking twice about shipping plane-loads of greenbacks to Iraq with no controls in place, a situation ripe for, and rife with, greedheads, has succeeded in undercutting, in hindering the war effort.”

Billions of dollars have just disappeared, Leahy said, citing the unprecedented use of private contractors. Citing the more than $12 billion that is simply unaccounted for, Leahy conveyed his displeasure to the panelists.

Senator Specter was just as outraged at “contractors who are taking advantage while brave young men and women are giving their lives and losing their limbs. He, like his colleague, named names: Halliburton, Kellogg Brown & Root, and Eagle Global Logistics.

The relatively small fines “are a license to steal,” Specter charged. “They are no incentive not to violate the law.”

“A few million in fines for multi-millions in overruns is no deterrent,” echoed Leahy.
The panelists, of course, attempted to defend the efforts of the Administration to crack down on fraud and abuse. Bowen attempted to shift blame from the shoulders of American contractors to corruption in the Iraqi government “in virtually every ministry.” He cited 2,000 investigations conducted by his office of Iraqi officials involving $8 billion in missing funds.

Similar acts by U.S. corporations are “relatively small and aggressively pursued,” he claimed. “Corruption within the U.S. program in Iraq, while egregious where we have found it, has been a relatively minor component of the overall effort,” Bowen insisted. “Waste, on the other hand, has been a significantly more serious issue.”
Yet the numbers he cited, and he cited lots of numbers, were disheartening. To date, more than 300 criminal and civil investigations have yielded 10 arrests, five indictments, five convictions, and two malefactors sent to prison. Part of the difficulty, he explained, is the lack of any electronic paper trail.

DoD’s Gimble also attempted to put a good face on a bad situation, tossing out a jumble of numbers. Since the beginning of the Global War on Terror, investigations by DCIS, the Defense Criminal Investigative Service, have resulted in four federal criminal indictments, nine federal criminal informations, and two Article 32 hearings under the Uniform Code of Military Justice. This resulted in nine convictions for felony crimes, for a combined total of 14-1/2 years of confinement and nine years of probation. Additionally, two individuals and one company were barred from contracting with the U.S. government, 17 companies and personnel were suspended, and two contractors signed settlement agreements with the government.

Overall, Gimble proudly pointed out, some $9.84 million was paid to the U.S. in restitution, $322,000 was levied in fines and penalties, $3,500 was forfeited, and SIGIR recovered some $10 million in cash and contraband.

Leahy was less than impressed. Part of the difficulty, he implied, is not enough staff. Every time he asked Gimble and Bowen if they could use additional investigators, their answers were vague.

“Are we being as aggressive as we need to be?” questioned Sen. Cardin. He was upset, too, because the jobs done by contractors were inferior.

To give teeth to the agencies charged with uncovering and prosecuting abuse, Sen. Leahy introduced the War Profiteering Prevention Act of 2007, S. 119, which would strengthen the tools available to federal prosecutors to combat profiteering. Passed in the 109th Congress, it died when the GOP-controlled House failed to act on it.

Will it pass in the 110th Congress? VVA encourages our members to ask their senators and members of Congress to vote in the affirmative. While our troops are valiantly doing their jobs, their efforts should not be hindered by corrupt practices, particularly by American corporations.

What does all of this have to with veterans’ issues? The answer is that veterans are constantly told there is not enough money to undo the downsizing of the Army’s Medical Department since 2001, and that VVA is unrealistic when we ask for the minimum increase in VA veterans health care dollars needed to maintain current levels—never mind system improvements to get the job done—for veterans of all generations.

The increases that VVA has asked for each year are much less than the amount that appears to have been stolen from the American taxpayers during that same period. As everyone is aware, the Federal budget is in large measure a “zero-sum game” in that dollars spent one place take away from dollars needed elsewhere. What Abraham Lincoln said about war profiteers—that they are worse than traitors—still holds true.

DéJA VU ALL OVER AGAIN
Sen. Daniel Akaka’s Committee on Veterans’ Affairs held an oversight hearing on “DoD/VA Collaboration and Cooperation to Meet the Health Care Needs of Returning Service members.” At its conclusion, a colleague said, “Does it seem to you that we’ve heard this about seven times before?”

The theme of the March 27 hearing was the dovetailing of services between the two departments and how to realize the by-now clichéd “seamless transition.” Everyone agrees it’s a good idea, but all the interagency task forces and executive councils and many meetings and memos have resulted in very little concrete progress.

Said freshman Sen. Jon Tester (D-Mont.), “Veterans should not have to fight for their benefits.” The answer, said fellow freshman Johnny Isakson (R-Ga.), lies in finding effective ways to achieve collaboration and coordination.

Part of the problem is the bottom line: There is not enough funding to meet the needs of patients. Denise Mettie, whose son, Evan, was grievously wounded in Iraq on New Year’s Day 2006, pointed out that more than half the beds at the VA’s Polytrauma Center in Palo Alto, California, remain unfilled because administrators don’t have the funds to hire the staff they need.

Former Major Tammy Duckworth, the helicopter pilot who lost both legs when her bird crashed in Iraq, and Captain John Pruden, who also suffered major wounds in Baghdad, praised the medical miracles of DoD doctors and bemoaned the holes in aftercare.

Dr. Michael Kussman, whose title at the time was executive-in-charge of the Veterans Health Administration, and Ellen Embrey, Deputy Assistant Secretary of Defense for Force Health Protection and Readiness, each gave rosy, statistics-laden overviews of what their respective departments are doing to meet the medical needs of their patients.

Embrey, though, was not very good in responding to questions posed by Sen. Richard Burr (R-N.C.). “Does DoD have the capability today to electronically transfer health records to the VA?” he asked. “Yes,” came Embrey’s tentative reply.
“But how many stories must we hear to the contrary?” Burr pondered. “Why not invest in flash drives to get information to the families of the wounded?”

Hopefully, before the next such hearing, the two departments will have made major inroads in achieving some semblance of a reasonable transition from military medical care to veterans’ health care at the VA, and Congress will have added funding to improve the health care delivery by both DoD and VA. What is needed, however, is for the political will to exist at DoD to quit dissembling and get it done. It appears to us that the VA has been willing in this regard all along and already has an automated patient-treatment record that works well. Therefore, the problem seems to be with the DoD. The need now is urgent, as much for the aging population of Vietnam veterans with increasing medical needs as the new wounded from Iraq and Afghanistan.

VA HEALTH CARE BUDGET FOR FY’08
If they had their druthers, some at the Office of Management & Budget (OMB) and currently on the Domestic Policy Council in this White House would eviscerate the VA health care system. They would ax Priority 7 and 8 veterans from the rolls forever and cut funding, all the while claiming that the monies budgeted to fund the system are adequate to “continue to provide timely, world-class health care to a growing number of veterans who need it the most including expanded services for veterans returning from Operation Iraqi Freedom and Operating Enduring Freedom,” to borrow from a recent VA press release.

As we have in recent years, VVA has serious disagreements with the VA leadership about how much money is needed to fund what is the largest health care system in the world. In fact, what is, at minimum, needed for FY 2008, which begins October 1, 2007, is an increase of $6.9 billion more than the current year, assuming that we ultimately get the $1.7 billion additional veterans health care dollars from the Emergency Supplemental, which the Administration is opposing. If we do not get those extra funds, then timeliness of service, access, quality of care, and patient safety all will be compromised.

VVA will continue to press for enough resources and proper accountability for both quality of care, services, and cost effectiveness, no matter who is in power in the Congress or in the White House. What’s right is right—and it is wrong to short-change veterans of any generation.

HONORING MEMBERS OF CONGRESS WHO SERVED
On April 25, VVA National President John Rowan hosted a reception at the Washington Court Hotel for friends and supporters of VVA, honoring members of Congress who served in the Armed Forces.

Freshman Representative Tim Walz of Minnesota was among those who attended. “Your voice is being heard,” he said of VVA. “Your voice is being translated by this Congress into action.” Congressman Walz is the highest ranking enlisted soldier ever to be elected to the United States Congress. He led his unit to Iraq as Command Sergeant Major.

Another fresh presence in the 110th Congress, Representative Nancy Boyda of Kansas, said that “what you do as VVA makes a real difference. Thank you for your support, and let me know what I can do to help you.” She also remembered VVA activist Randy Barnes in her remarks, praising his passion for and commitment to his fellow veterans.

Nebraska Senator Chuck Hagel opened by saying he was “always glad to be among Rick Weidman’s rich friends,” which elicited an appreciative chuckle from the crowd. Senator Hagel, often mentioned as a possible presidential contender, is the only enlisted combat veteran of Vietnam in the United States Senate and a VVA member. Hagel spoke of how the Vietnam War shaped a generation. He lamented the “disconnect in our society: the responsibility, the obligation of citizens to connect to a cause greater than one’s own self-interest.” Veterans groups, like VVA, “are more important than ever before to bridge those citizenship gaps,” he said.

Current Ranking Republican on the House Committee on Veterans’ Affairs Steve Buyer praised VVA leadership. He noted that it was John Rowan and Rick Weidman, not the leadership of the American Legion or VFW or DAV who came to his office to discuss issues and matters of disagreement. And for this, he was profoundly grateful. “Our sincerity and compassion is real,” the congressman said. “We both have the same goals.”

Among those who came to show their support for VVA and for all veterans was Kevin Gillen, president of the Metro Washington market for Commerce Bank. Just as his bank is “all about service,” so, too, are “the real heroes, those who served and those who are serving” in the Armed Forces. Also present were officials of a number of unions, including AFGE, AFSCME, and SEIU.

COMMISSION ON AMERICA’S RETURNING WOUNDED WARRIORS
VVA testified before the President’s Commission on America’s Returning Wounded Warriors on April 14, 2007, the first public meeting of this group, co-chaired by former Sen. Bob Dole and former Secretary of Health & Human Services, Donna Shalala. VVA noted that recent revelations of poor care at the Walter Reed Army Medical Center (WRAMC) is a consequence of a policy to fight this war “on the cheap” and, by extension, to take care of our servicemembers the same way. To downsize the number of physicians and allied health care personnel in the military as one enters a war is both unprecedented and irresponsible. The immediate official cries that the problems at WRAMC were not a question of resources should have indicated to all that it was and is in large part a question of resources. Dr. Winkenwerder was brought to his job as Assistant Secretary of Defense for Health Affairs precisely because of his experience in advising large private health care entities on how to reduce costs by cutting services.

VVA further noted that it is our understanding that the dramatic reduction in the Army Medical Corps (and commensurate cuts in the Air Force and Navy) since 2001 are to be reversed, at least in the Army. If we understand correctly, there will be up to 3,000 clinicians added, although it will take time to “ramp up” to full strength.

Much of the overcrowding at WRAMC and at other facilities has led to soldiers in inadequate quarters and facing delays that impact quality of care. While individual care is first rate, the problem is getting appointments when they are needed, lack of care continuity, and proper case management.

The number of clinicians must be increased, and medical resources used more efficiently. We have great hope that the current commander at Walter Reed Army Medical Center, and those at all other military hospitals, will be given additional resources needed to do the job, so that key changes will occur in a timely way to insure proper care of our troops.

Another problem is case management. The case management system at WRAMC and elsewhere in the military is not working properly. There are not enough persons designated as full-time case managers. Nor are they always the personnel with the background and training to be effective in this demanding role. This has resulted in many problems for wounded, injured, and sick soldiers that should never have happened.

Additionally, there are tracking systems in use at some DOD hospitals but not at the majority of them, including Walter Reed. All should use available electronic monitoring systems beginning immediately, and a simple but effective tracking mechanism should be used by every case manager, with proper oversight by superiors.

While all are serious problems, these are problems that can be fixed if strong commanders are given the proper resources, a clear mandate for improvement, and held accountable for results. WRAMC has hired twenty-five new case managers, but VVA would argue that this is probably not enough. Further, the key is their training, the tools given to them, the ongoing supervision, and ensuring proper quality of care at every phase.

VVA also noted that the medical board system is deeply flawed. Although some high-ranking individuals in the Army may be right that perceived inequities are, to some degree, due to the nature of the military’s medical retirement guidelines and legal requirements/constraints, even within that context there are terrible injustices perpetrated on more wounded soldiers every day.

These fine young Americans who have already given so much are too often treated like chattel, not like American citizens who voluntarily pledged life and limb in defense of the Constitution and have paid a great price for defending our Republic. This must change immediately.

VVA recommends an immediate end to buy-out payments, where essentially soldiers are being bought off at pennies on the dollar. Also, there must be proper education, advice, and quality representation for all service members going through this process, which does not now exist. The separation physical should be a joint VA/DOD physical. Military medical records (both paper and electronic where it exists) should be given both to the separating individual and transferred to the VA. This is supposed to happen, but doesn’t in most cases.

How well returning soldiers are treated by the military medical system, and how they are treated in the medical boards process has a direct and major impact on the VA system that begins almost immediately. What the military bungles, VA must spend much more money and many more resources to fix what should have been done correctly for the soldier before medical discharge. What happens to soon-to-be veterans will have a major impact on the already struggling VA benefits system, and the already over-crowded and under-resourced VA medical system. This is why we have taken the unusual step of delving so deeply into these issues in this space.

DOD MISSES CONTRACTING GOAL WITH DISABLED VET BUSINESSES BY $26 BILLION
The Department of Defense fell $26 billion short of their minimum legally mandated goal of contracting 3 percent of all DOD contracts with Service Disabled Veteran Owned Small Businesses (SDVOSB) from FY 2000 through FY 2005. In a letter to Secretary of Defense, VVA National President John Rowan noted “DOD simply must be able to be in better compliance with the law than this record shows thus far. Is this one more instance of simply casting those wounded or sick from war aside, without proper respect for both what they have done and for their remaining capabilities for what they can still do now that they are no longer in uniform?”

VVA and other veterans advocates are working with DOD to help DOD both understand their obligations, and to help forge a plan to meet those legal and moral obligations.

BYE, BYE NICHOLSON?
Freshman Rep. Phil Hare, who succeeded his former boss, Lane Evans, as congressman from the 17th Congressional District in Illinois, has called for the resignation of VA Secretary R. James Nicholson in light of the coverage of executive bonuses paid to high-ranking VA officials.

“Veterans deserve a secretary that will fight for them, not use his or her authority to advance an ideological agenda,” Hare said in a press release. “Our veterans have suffered tremendous setbacks on Secretary Nicholson’s watch. After presiding over a $1 billion shortfall, a backlog of 600,000 disability cases, staffing shortages at Vet Centers, two security breaches that jeopardized the personal information of our veterans, and now, lavish bonuses to the very VA officials responsible for the whole mess, it is time to say enough is enough.”

We agree, however, with Sen. Daniel Akaka, who chairs the Veterans’ Affairs Committee in the Senate. According to one news report, Akaka “was not certain that senior members of the budget staff at the VA deserved bonuses averaging $33,000 about 20 percent of their annual salaries when the VA had a major budget crisis because costs were underestimated.”

Bonuses can be a valuable tool to retain experienced senior managers. But we simply do not believe that all those who received bonuses deserve them. Were they rewarded when they ought to have been sanctioned for not performing up to expectations?

It should be about accountability, which is not, unfortunately, how the VA central office tends to operate.