Category Archives: Veterans

Amodei, Vets, and the unanswered questions

On Monday, May 2, 2016 Representative Mark Amodei (R-NV2) will host a Veterans Town Hall in Fallon, NV for two hours – from 10 am until noon.  That’s nice. Retired vets can make that time frame, working ones perhaps not so much.  [News4] Courting the veterans vote is a long time strategy for the Republican Party, and this bloc constitutes a substantial chunk of the state’s electorate.

Amodei 3 Someone might want to ask Representative Amodei how he felt about the House Appropriations Committee slashing more than $1.4 billion from President Obama’s request for veterans.  The 2016 House proposal reduces VA medical care by $690 million from the President’s request.  And, there was another $582 million cut from construction costs for outpatient services  and priority construction projects.  Additionally, the House proposal cuts funding for military cemeteries, including delaying expansion of cemetery operations in Portland OR, Riverside CA, Bayamon PR, St. Louis MO, and Pensacola FL. [VA.gov]

Another question could be raised about the fate of H.R. 2275 (Jobs for Veterans Act of 2015) introduced by Republican Jeff Miller (R-FL1).  It was referred to committee in the House on May 12, 2015 and hasn’t been heard of since.  [GovTrack]

Should someone ask what happened to the Comprehensive Veterans Health and Benefits and Military Retirement Pay Restoration Act of 2014?  Probably, because this legislation got caught in the brambles of Senate posturing about economic sanctions on Iran, and after passing at least one procedural vote went into oblivion from which it, too, hasn’t returned.

Perhaps we should go back to a particularly egregious moment in 2010 when the Republicans blocked a bill to approve a $3.4 billion program to help homeless women veterans, and homeless veterans with children.  Senator Tom Coburn brought out the “Deficit Dragon” saying, “If we don’t start paying for new programs and continue on our path to bankruptcy we’ll have a homelessness problem beyond imagination.” [HuffPo]  Interesting, by Republican lights we always seem to have enough money to start wars, and to finance them, but when we talk about spending money on the people who actually did the fighting — “OMG, we can’t add to the deficit?”

If the Veterans town hall is really about veterans, then a person might hope that there would be ample attention paid to the issues like homelessness among the veteran population? About what services we should be providing for homeless veterans with children? About how many VA facilities we need to be constructing or leasing for veterans’ care – either in medical or employment terms?

What would not be helpful is to have such sessions devolve into the collection of negative interactions between veterans and the Veterans’ Administration.  Yes, the VA is a bureaucracy, one which has trouble meshing with its counterpart agencies in the Department of Defense (Have we thought about funding computer and IT services in the DoD and VA?)  But, no, it isn’t necessary to create a whipping boy in order to “prove” that government doesn’t work, and other GOP canards, and to “solve” the problems by privatizing services for veterans.

We, as a nation, send people into wars. We promise we will support them. We promise them education, health care, and benefits when they return. We promise their families some burial benefits if they do not. They went voluntarily, under our flag and under our imprimatur.  Therefore, the least we can do as a nation is to keep those promises, and not entangle the funding for older programs and initiatives for new ones in a labyrinth of ideological rhetoric, excuses for inaction, and poison-pill amendments.  We can do better.

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To Heck With Your Service? Again?

Heck photo

The issue of protecting military families from egregious practices by predatory payday lenders gets a bit mired in Congressional legislative processes.  However, it’s not hard at all to figure out what the Republicans on the House Armed Services Committee wanted to do.

“House lawmakers narrowly voted to remove controversial language delaying new rules on payday lenders from their annual defense authorization bill early Thursday morning, calming concerns from advocates who saw the move as potentially undoing financial protections for military families.

By a 32 to 30 vote, members of the House Armed Services Committee stripped provisions from the legislation that would have delayed Defense Department plans to expand the scope of the 2006 Military Lending Act by requiring a new report due next spring on DoD’s rule-making procedures in that regard.” [MilTimes]

Congressman Joe Heck (R-NV3) has a seat on that committee.  Further, Representative Heck is the chair of the subcommittee on Military Personnel. The blurb from the subcommittee’s web page reads:

“The Military Personnel Subcommittee is responsible for military personnel policy, reserve component integration and employment issues, military health care, military education, and POW/MIA issues. This subcommittee makes sure that our troops and their loved ones are receiving the first class benefits that they deserve.”

Remember this for future reference.  For the moment ask how the statement squares with the effort to “delay new rules on payday lenders…?”  And, how does this align with comments made by subcommittee chairman Joe Heck:

“The 2006 lending law was passed by Congress after reports of payday lenders charging unusually high interest rates to troops — 400 percent or more, in some cases — and misleading borrowers about the long-term debt they could incur.

Implementation of the law initially was confined to payday loans, vehicle title loans and tax refund anticipation loans. But last September, defense officials proposed new rules that would expand the types of credit covered by the maximum 36-percent interest rate that can be charged to service members and their dependents.

Rep. Joe Heck, R-Nev., chairman of the armed services committee’s military personnel panel, said those moves have raised concerns that defense officials are applying rules too broadly.”  [MilTimes]

It’s the Pentagon’s belief that service members need protection from predatory forms of credit cards, deposit advance loans, installment loans, and unsecured open ended lines of credit.  The bottom line is simple – members of our armed forces can be charged no more than the quite nearly usurious 36% interest rate. Too broadly?  How does applying rules saying no member of the military can be charged no more than 36% cut off credit options? If a lender can’t profit with a 36% margin perhaps they ought not be in business?

Representative Heck’s idea was to have the Pentagon conduct ANOTHER study of the effects of the Military Lending Act, in spite of the completion of the original study. Translation: Congressional studies can be used to delay the implementation of regulations interminably. Meanwhile, member of the military remain threatened by the terms of predatory lenders. [More at TP]  And, was Representative Heck proud of his delaying maneuver?

“The one-year delay of new financial protections for the military appears to come from Rep. Joe Heck (R-NV), who chairs the subcommittee that produced the provision without discussion. Heck’s office did not respond to requests for comment on the provision.”  [TP]  (emphasis added)

Members of the Armed Forces should welcome the amendment by Representative Tammy Duckworth (D-IL) which stripped Heck’s language from the appropriations bill, and was adopted by the committee on a 32-30 vote.

But wait, there’s more.

“The House voted 213-210 Thursday against an amendment that would have allowed Veterans Administration doctors to discuss medical marijuana with soldiers suffering from post-traumatic stress disorder and other conditions. Opponents of the amendment underscored marijuana’s federally illegal status and said veterans shouldn’t be prescribed pot for psychological problems.” [IBT]

Representative Heck voted in favor of the amendment, but Nevada Representatives Hardy and Amodei voted against it.  Perhaps Hardy and Amodei are clinging to the old War on Drugs theme, a stale leftover from those days when it seemed like every candidate for every office was running for county sheriff?

The amendment certainly wouldn’t have required the VA to prescribe marijuana or related products to veterans, but it would have aligned the services of the VA more closely with NRS 435A on the medical usage for marijuana.  The state of Illinois is currently hearing a report on studies related to the use of marijuana to assist in the treatment of PTSD.  The American Glaucoma Society isn’t thrilled with the side effects of marijuana, but acknowledges that it does reduce intraocular pressure (IOP) in glaucoma patients.

Contrary to the drum beating of the Old Drug Warriors, marijuana has been used successfully to treat moderate to severe “refractory spasticity” in multiple sclerosis patients, to alleviate loss of appetite associated with HIV/AIDS cachexia, and to inhibit chemotherapy induced nausea and vomiting among cancer patients.

In short, given Representative Heck’s attempt to give a handout to the predatory lenders, and Old Drug Warriors Hardy and Amodei’s conviction that medical and marijuana don’t fit together – it wasn’t a complete loss of members of the Armed Forces and Veterans in the House, but it was a near thing.

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Support The Troops Is Just A Sound Bite?

Coburn 

“Veterans groups and military associations are blasting a move by Sen. Tom Coburn, R-Oklahoma, intended to scuttle a veterans’ suicide prevention bill that has already passed in the House with strong bipartisan support.

The GOP lawmaker put a hold on the $22 million bill, which he opposes on grounds it has no offsets in spending elsewhere and would duplicate programs already offered by the Department of Veterans Affairs, he said.” [MilitaryNews]

H.R. 5059 would have allocated $22 million to assist veterans with PTSD or traumatic brain injuries… it was supposed to help reduce the suicide rate, a rate that the military admitted was underestimated in the past:

Beginning in 2005, suicide within the military — particularly for the Army — steadily began increasing to record levels every year, and may have peaked in 2012. Among full-time soldiers, the suicide rate soared to 29.7 deaths per 100,000 in 2012, well above a 25.1-per-100,000 rate for civilians of a similar age group during 2010, the latest year available, according to a Pentagon report. Among male soldiers, the rate was 31.8-per-100,000. There were a record 164 soldier-suicides that year.

The overall national civilian suicide rate was 12.1-per-100,000 in 2010 and 19.9-per-100,000 for men in 2010, according to the Centers for Disease Control.The Army National Guard rate for 2012 reached 30.8 deaths per 100,000 with 110 suicides. The suicide rate for men in the Army National Guard was 34.2-per-100,000,Pentagon data shows.

For full-time troops across the U.S. military, the suicide rate peaked at 22.7-per-100,000 in 2012 and fell to 19.1-per-100,000 last year, according to the Pentagon. [USAT]

Might we remind members of the Senate that the U.S. supported the expenditures to fight in Afghanistan and Iraq, and seemed perfectly pleased to put these costs on the national credit card – with no “offset” required? However, when it comes to assisting veterans who fought in those wars “we don’t have the money,” and “we have to see an offset?”

Here’s a news flash… the only casualties of war aren’t the destroyed munitions!  There’s something very very wrong about a country which will spend gazillions – few questions asked – on munitions and weapons systems, but when the needs of the military personnel are obvious the politicians can’t see their way clear to address them.

Those who aren’t supporting H.R. 5059 are cordially invited to take those yellow ribbon magnets off their bumpers!

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VA Health Care: “Postponed Proceedings”

The bills to improve the performance of Veterans Administration operations have passed the House and the Senate, in fact they’ve been waiting for a conference committee to iron out the differences between the two bills since mid June. That’s why it’s disappointing to find the following update on the progress of the final bill posted as follows:

“7/17/2014 POSTPONED PROCEEDINGS – At the conclusion of debate on the Barber motion to instruct conferees on H.R. 3230, the Chair put the question on adoption of the motion to instruct conferees and by voice vote, announced the noes had prevailed. Mr. Barber demanded the yeas and nays and the Chair postponed further proceedings until a time to be announced.”

No instructions from the House, no conference, no conference no conclusion.  What are the differences between the House and Senate versions?

# The House bill specifically bans the use of bonuses for VA employees, while the Senate version does not. The VA has already suspended performance awards of this nature.

# The Senate bill would allow the VA to lease 26 new facilities for veterans’ health care and would allocate $500 million for hiring new staff.  The House version doesn’t contain these provisions.

# The Senate bill provides for guaranteed in-state tuition for veterans at public colleges and universities; the House version of the bill does not.

# The Senate version of the legislation provides for expanding access to care for military sexual assault victims. The House version does not include this provision.  [WaPo]

# The House version assumes a maximum wait time of 14 days, the Senate version could allow up to 30 days. [CBO]

# The CBO analyzed the costs of implementation for securing private health care services when VA service could not be provided

“The Senate bill would require that all privately provided care be implemented through contracts. CBO expects the costs of contracted care to be closer to commercial rates, which are generally higher than Medicare rates. Although such contracts would probably be used under the House bill to cover some care, CBO estimates that the average payment rate under the House bill, including both contractual and non-contractual payments, would be lower than that under the Senate bill.” [CBO]

# The House version would allow direct reimbursement to private facilities, while under the terms of the Senate version as analyzed by the CBO the VA would negotiate contracts with providing facilities.  Thus, the access might be faster under the House version, but with less expense predictability than if the terms of the Senate version were applied.

Unfortunately, the situation is reduced to a battle over money.  The CBO released its appraisal of the costs on June 17, 2014:

House Version: “Based on that preliminary assessment, CBO estimates that implementing sections 2 and 3 of the House bill for that two-year period would have a net cost of about $44 billion over the 2014-2019 period, assuming appropriation of the necessary amounts. That net amount comprises increased costs of about $51 billion for VA, less a reduction of $7 billion in federal spending for Medicare and Medicaid.” […] All told, CBO expects that if the bill was fully implemented, some veterans would ultimately seek additional care that would cost the federal government about $54 billion a year, after accounting for savings to other federal programs.”

New “scoring” from the CBO reduced the figure from the original $54 billion to approximately $30 billion, but the negotiations were still stalled. [Hill]

Conferees from the House have been looking to cover the costs by using discretionary funding, those from the Senate are supporting a mandatory funding formula.  The House sponsor, Rep. Jeff Miller (R-FL), argued: “The Senate wants to throw money at a situation that is not defined, in an amount of money that is not defined. We’re re trying to define the issue and figure out how to pay for it,” Miller said.” [MilTimes]

Miller’s assessment may be overlooking the differences in the cost predictability between the provisions for paying private entities for health care services for veterans.

Senate Majority Leader Harry Reid (D-NV) expressed his impatience with the protracted timeline of the conferencing, “We’re having a little trouble getting the House to help us complete the conference,” Reid said.. “You know … just because we want something done when we’re in conference doesn’t mean it gets done.” [The Hill]

In the mean time — proceedings are postponed.

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The Veterans and their Administration

Veterans PopulationThe Numbers Game: Issues pertaining to the management of Veterans Administration services have special meaning to 225,933 people in Nevada, 169,255 of whom served this country during war time, and 56,678 who served during peace time.  [VA actuary]  69,190 Nevadans served during the Gulf War era, 79,281 served in Vietnam, 20,462 served in Korea, and we have about 9,444 remaining veterans from World War II. [VA actuary]  Meanwhile, 13 years of operations in Afghanistan and in Iraq are adding to these numbers.

The United States deployed 2,333,972 people to Iraq and Afghanistan between 2001 and 2011, of whom 1,353,627 have since left the forces, and 711,896 used VA health care services between FY 2002 and FY 2011. [ABC] Veterans during the period 2008 to 2011 saw deployment time increased by 28%. [Rand pdf] The Iraq operations, we were told, could last “six days, six weeks, I doubt six years.”

“We don’t talk about deployments in the specific, but we have brought a good many Guard and Reserve on active duty. Fortunately, a great many of them were volunteers. We have been able to have relatively few stop losses. There are some currently, particularly in the Army, but relatively few in the Navy and the Air Force. And it is not knowable if force will be used, but if it is to be used, it is not knowable how long that conflict would last. It could last, you know, six days, six weeks. I doubt six months.” [Rumsfeld, Aviano Air Base February 7. 2003] 

We may not want to talk of deployments, but warfare creates veterans and the longer the warfare lasts the more veterans there will be.

Estimates during the debate over initiating operations in Iraq which projected totals over $3 trillion (Stiglitz) were dismissed out of hand. Instead Lawrence Lindsay, Chair of President Bush’s Council of Economic Advisers estimated the war might cost $200 billion at the most, but during the 2002 campaign season this projection was determined to be “shockingly high,” Lindsay was fired and replaced by Mitch Daniels who argued the Iraq war would cost no more than $50 to $60 billion.  [EconMonitor]

The $60 billion figure is dwarfed by the estimated $135 billion estimated as minimally necessary to provide services to veterans.

Making the situation even more tenuous for veterans, the Sequester budget deal cut  services from other agencies (HUD, Defense, Labor) for veterans while ostensibly leaving the VA untouched — except that “administrative costs” might be cut by 2%, and what constituted an “administrative cost” remained ambiguous. [WaPo]

The Management Game:  The VA Inspector General’s office has expanded its investigation to 26 VA facilities regarding allegations of falsified records and delayed care.  One former administrator in Phoenix, AZ offered his opinion that 40 veteran may have died while waiting for care.  To date no link has been established between the delays and those deaths. [ABC]  The lack of direct linkage notwithstanding, it is certainly possible that care delayed can all to easily become care denied.  Instead of listening to carping, finger pointing, and generally distasteful politicizing of the situation at the Veterans’ Administration, here’s what I’d rather hear from our pontificating pundits and politicians:

Reducing delays and other problems within the VA system, which have long be evident, may well require a significant shift in the way in which services are perceived and administered.

#1. Future Congressional calls for war or large military operations should be accompanied by calculations projecting a reasonable TOTAL cost of the actionsincluding services and benefits for veterans. As there should be an accounting for individuals who falsified records to artificially reduce wait times, there should be an accounting for those whose minimalist estimations for the cost of operations in Iraq and Afghanistan made those actions appear “affordable.”

The failure of the VA to provide timely services is a function of staffing and facilities, infrastructure which should be considered before we launch wars in which we have an option to defer, delay, or avoid action altogether.

#2. Administration of VA services should be predicated on veterans’ needs and not dubious or inappropriate management theories.  The VA is not a commercial or manufacturing entity. Its sole function is to provide customer/client services.  In this wise, the VA perspective ought to be one in which client service is acknowledged to be labor intensive, and hiring should be adjusted accordingly.

For example, while demand for VA care services has increased by 38%, the VA has hired only 9% more medical professionals.  Public-private partnerships with local medical service providers has been applied, and more such partnerships may be one part of a larger strategy to appropriately staff the facilities.   Actions by Senate Republicans who blocked a $24 billion veterans’ health bill in February  2014 which included funding for 27 new medical facilities are unhelpful. [Reuters] [Roll Call 46 – all 41 votes blocking  S. 1982 were cast by Republican Senators]

The treatment of and for veterans should reverse the perspective that all claims are “costs” and “cost containment” is an ultimately desirable institutional goal.  If one is manufacturing widgets for WalMart this might be an acceptable perspective, but we are not talking about a price driven retail commodity — we’re speaking of veterans who have been promised a level of support services (educational, medical, and employment) which have not been delivered on a timely basis.

The much maligned Internal Revenue Service is a far more trusting agency than the VA appears to be.  When I file my return electronically the IRS assumes I am being honest. I may be audited at some point in the future, but for the latest fiscal year the assumption is that I meant what I affirmed at the end of the document — that the return is the most honest and accurate it is within my power to provide.   The VA claims process might be improved by adopting the same attitude.

Unfortunately, the VA is giving the appearance of an institution for which a claim is as much an opportunity for fraud or misuse as it might be a legitimate request for service.  This attitude could quickly spawn a multi-layered bureaucracy  devoted to weeding out any untoward claims. It’s essentially the pre-ACA attitude of health insurance corporations which sought to deny as many claims as possible in order to manipulate its medical loss ratio.  This situation might have been predicted since politicians of every imaginable stripe have loudly proclaimed their affinity for rooting out “Waste, Fraud, and Abuse.”  In the instance of the VA all this cat-calling from the bleacher seats simply serves to reinforce the “cost containment” proclivities and diminish the “service to the client” perspective.

#3 The core of the manipulation problems in the Phoenix office is said to emanate from a bonus system for “meeting the numbers.”  I’ll have to admit to a jaundiced view of bonuses.  Bonuses are what you pay employees when you don’t want to pay them up front what they are really worth. It’s close to an analogy in which the cafe owner justifies sub-minimal wages because the wait staff receives tips.

No one should be particularly surprised when people emphasize on the job what the institution/company/corporation rewards.  If the company rewards speed in delivery, speed we will get — even if a NOAA drone is delivered by FedEx to the wrong address.  If the company/agency rewards fast service, then the service will be fast, and if that can’t be done in the real world then the numbers are fudged to gain the reward and make the boss happy in the bargain.  If the disturbing consequences of the testing furor in education has taught us nothing else, it should have told us that we will get what we measure, not necessarily what we want.

How much less traumatic might the problems with the VA be if we could admit to ourselves that there are immeasurable things which are nonetheless important to the delivery of competent and complete care for veterans and their families?

#4. Technology moves faster than our fingers.  Granted that the inability of computer data systems to share information quickly and accurately is a problem, especially it seems between Department of Defense and VA systems.  At some point we need to acknowledge the hard horrible fact that older stand-alone data systems were never designed to function in a file-sharing world.  No amount of patching or plugging is going to make them compatible.

Until we accept that if we want compatible systems we have to buy them.  They are expensive, they are complicated, and they are unintelligible to most voters — however, the old retail saw holds true — we will get what we are willing to pay for.

Meanwhile there are 225,933 veterans in Nevada who deserve to receive the educational, employment, and medical services they were promised when they signed on to serve us, and who deserve more than a political outrage du jour, and a brief turn in the media limelight.

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Where the Heck on H.R. 975?

VeteransOn March 5, 2013 Representative Timothy Walz (D-MN) introduced H.R. 975 in the 113th Congress of the United States.  The full ‘title’ of the bill is as follows:

“To amend title 10, United States Code, to extend the duration of the Physical Disability Board of Review and to the expand the authority of such Board to review of the separation of members of the Armed Forces on the basis of a mental condition not amounting to disability, including separation on the basis of a personality or adjustment disorder.”

The Fleet Reserve Association explains why this act would be beneficial for our veterans:

“FRA recommends support the for “Servicemembers Mental Health Review Act” (S. 628), sponsored by Sen. Jon Tester (Mont.) and its House companion bill (H.R. 975) sponsored by Rep. Tim Walz (Minn.) The bills would authorize the Physical Disability Board of Review (PDBR) to review and, when necessary, correct service records for veterans diagnosed by DoD with a Personality Disorder (PD) or Adjustment Disorder (AD) and discharged after active duty deployment. Many of these brave veterans have seen combat and may actually be suffering from Post-Traumatic Stress (PTS). Because PD and AD are considered pre-existing conditions, the DoD is not obligated to award the benefits they earned that may help them properly reintegrate into their communities.”  (emphasis added)

Now why would the Fleet Reserve Association, and others, be calling for a bill to review the application of Personality Disorders and Adjustment Disorders diagnoses?  Part of the answer is revealed in a Viet Nam Veterans study (pdf) from the Yale Law School legal services department published in February 2014.

According to the study of Coast Guard applications of PD and AD labels the study found, “The vast majority of AD and PD discharges failed to comply with Coast Guard regulations 255 of a random sample of 265 discharges analyzed violated regulations in some way. ”  More disturbingly, the study found that 100% of the combined AD and PD discharges between FY 2001 and FY 2005 (and FY 2008, FY 2012) were not in compliance with Coast Guard regulations.  And the problem continues — since 2009 the number of AD and PD discharges has risen.

It’s not just the Coast Guard, and it’s not just a few veterans, and it’s not that the problem has not been noticed before.    The problem has been, more or less, in the public domain since 2007.   Dr. Debra Draper, GAO testified to the House Committee on Veteran Affairs, “DoD data show that from November 1, 2001, through June 30, 2007, about 26,000 enlisted servicemembers were separated from the military because of a personality disorder. Of these 26,000 servicemembers, about 2,800 had deployed at least once in support of OEF/OIF.”   As of 2009 there were questions about the response to GAO recommendations from the Pentagon.   The GAO observed that the services had saved some $12.5 billion in health care and compensation via the AD/PD discharge route. [DP]

So, there has been a problem, there is a problem, and so far 49 members of the House have signed on as co-sponsors of this legislation.  None from Nevada, a state with approximately 246,000 veterans. [VA pdf] There are five sponsors for Senator Jon Tester’s version (S. 628), none from Nevada.

H.R. 975 was assigned to the House Armed Services Committee’s Subcommittee on Military Personnel on March 26, 2013, one of the members of this subcommittee is Representative Joe Heck (R-NV).

There were some tangential references  to the discharge label issues in the last Defense Appropriations Bill “(Sec. 593) Establishes the Commission on Military Behavioral Health and Disciplinary Issues to study the adequacy of DOD mechanisms for disciplinary military personnel action in addressing the behavioral impact of service-connected mental disorders and traumatic brain injury.”   However,  in today’s  insurance parlance  AD and PD are “pre-existing conditions,” which may not fall under the “service connected” classifications.  In short, not enough has been done, and it appears that not enough is being done.   It’s a topic Representative Heck might want to bring up at the next meeting of his Subcommittee on Military Personnel.

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Thank You For Your Service, Not Really.

Senate Against Vets

41 Republican members of the U.S. Senate voted to sustain their filibuster of S. 1982 — the Comprehensive Veterans Health and Benefits and Military Retirement Pay Restoration Act of 2014.  [rc 46] They voted against S. 1982 which would have included:

Restoring the full cost-of-living adjustment for all military retirees; Reforming the system for processing veteran’s disability claims to reduce the existing backlog; Providing in-State tuition assistance for post 9/11 veterans pursuing a college degree; Expanding programs designed to help veterans find a job; Requiring new services for survivors of sexual assault: and Improving health care services related to mental health, traumatic brain injury and other conditions. [CR1209]

Got that? Restore those COLA adjustments. Work on that unconscionable backlog of disability claims. Provide in-state tuition assistance for veterans. Help veterans find jobs. Provide services for survivors of sexual assaults and improve veteran’s services for mental health, TBI, and other conditions.  The objections from the GOP side of the aisle? Those were addressed by Senator Barbara Mikulski (D-MD):

Now, other Republicans have come to the floor and they have objected to this bill because they argue that by expanding VA health care to veterans currently not eligible for it–veterans who in some cases are trying to get by on $28,000, $30,000 a year in this tough economy; and it is true, we do expand VA health care to those veterans who do not have a whole lot of money–the Republicans who object say, well, that would open the floodgates for millions or tens of millions–I think somebody said 22 million veterans–every veteran in America would be eligible for VA health care, that the health care system would be swamped and health care, especially for those most in need, would deteriorate because so many people came into the system.

“As I mentioned yesterday, this is absolutely untrue. No new veteran would be added into VA health care until the VA had the infrastructure to accommodate those new veterans. So we are not opening the door for millions of new veterans–not true–and, as currently is the case, those with service-connected disabilities would continue to get the highest priority service, as they currently do and which, in my view, should always be the case. Those who were injured in war are the top priority, and those folks must always be the top priority, and that is certainly the case in this legislation.”

What were the Republicans afraid of?  That the bill would cost money, that more veterans might be served by the government that assigned them combat and support roles where they were expected to literally give their all in our service.   So, it’s perfectly acceptable to send approximately 1,431,403 [DoD] into Iraq, Afghanistan… Libya? Syria? Crimea? Korea?  BUT when they come home we can’t “afford” to have “millions of veterans” soaking up those VA benefits?

Syria: “For America to sit on the sidelines and do nothing is a huge mistake,” Georgia Republican Sen. Saxby Chambliss told CBS’ “Face the Nation.” (April 28, 2013 Fox News)

Libya: “We cannot just stand by with Libya, America. We cannot just say to the Brits, the French, or even the U.N., ‘You go; we’ll watch from the shore.’ Imposing a no fly zone isn’t enough because it doesn’t protect the people on the ground from being killed at ground level; just from the air.”  [USNWR]

Crimea: “Ukraine may not be the trigger event, but it sure as heck provides an insight into the mindset of the leaders vying for power. We can be fairly certain that Vladimir Putin is willing to go all the way to protect Mother Russia’s interests. How far is our Nobel Peace Prize winning President willing to go to do the same for the Homeland?” [OathKeepers]

The Republicans can’t have it both ways.  Advocating the of the use of military options for each and every foreign crisis — and then refuse to pay for benefits when the troops come home.

Update: See this post from the Nevada Rural Democratic Caucus!

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