How Does McCain Get Away With This Stuff?

Steve Benen deconstructs what Senator John McCain wants to do with Veterans health care--and is the solution to "ration" it out?

It seems hard to imagine a presidential candidate, running in the midst of two wars, openly speculate about cutting back on veterans’ health care. And yet, here we are.

Republican presidential candidate Sen. John McCain appeared Tuesday to suggest rationing of veterans’ health care may be needed so combat veterans can receive the care they deserve.

At a town hall meeting in Dover, N.H., McCain talked about the need to “concentrate” veterans’ health care on people with injuries that “are a direct result of combat.”

“Right now, there are people who drive a long way and they stand in line to stand in line to get an appointment to get an appointment,” McCain said.

Retirees are having to compete with wounded Veterans for health care appointments--the promise made to BOTH says that ALL will be cared for. It doesn't matter if you served in peace or in war--if you're a Veteran, you get care. The problem with McCain's party-line voting record is that the Republican Party has a long history of slashing benefits for every American, be they poor, young, mentally ill or just plain sick. And that voting record is dismal and shameful on Veteran's issues. The "awards" McCain brags about getting come from partisan Veteran's organizations that ignore the Republican record on providing benefits and are more closely aligned with the agenda of the National Rifle Association and the evangelical conservative movement.

If that's not your position, don't bother running for President.

--WS

A Beautifully Simple Idea

Sometimes the simplest solution is so easy and basic to understand that it hits you between the eyes and you go, "no shit!"

German nursing homes are using a novel strategy to stop Alzheimer's patients from wandering off: phantom bus stops.

The idea was first tried at Benrath Senior Centre in Düsseldorf, which pitched an exact replica of a standard stop outside, with one small difference: buses do not use it.

The centre had been forced to rely on police to retrieve patients who wanted to return to their often non-existent homes and families.

Then Benrath teamed up with a local care association called the "Old Lions". They went to the Rheinbahn transport network which supplied the bus stop.

"It sounds funny but it helps," said Franz-Josef Goebel, the chairman of the "Old Lions" association.

"Our members are 84 years old on average. Their short-term memory hardly works, but the long-term memory is still active.

"They know the green and yellow bus sign and remember that waiting there means they will go home."

The result is that errant patients now wait for their trip home at the bus stop, before quickly forgetting why they were there in the first place.

"We will approach them and say that the bus is coming later and invite them in for a coffee," said Richard Neureither, Benrath's director. "Five minutes later they have completely forgotten they wanted to leave."

This idea has an obvious application here in this country--not only for nursing homes, but for Veteran's hospitals. Yes, there should be real bus stops, but interspersing a few fake ones in there to help keep the people we need to care for from escaping might save some lives.

h/t to Greater Greater Washington, a fantastic blog about quality of life and mass transit issues in the Washington DC area.

--WS

We sent them to war - now we have to treat them

It is no surprise that the military and the VA is lagging behind in the delivery of healthcare services to women - until the early 70's, women in the military could not have dependents. Women who got pregnant were dismissed from service. Back then, they used to say that if the Army wanted you to have a baby, it would have issued you one.

Now, 35 years later, women have made great strides toward equality that coincided with an all-volunteer military, and women now comprise 20% of the uniformed services. I never thought that we would see numbers like that in my lifetime, but here we are, and that number is quite real.

Well, we have come so far that we are now sending women to war - 180,000 have deployed to the wars in Afghanistan and Iraq - and one of the consequences of doing so is presenting itself in the VA health system, because when they come home, they want the benefits they earned. Last year the VA treated just over 250,000 female veterans, but that number is projected to double within five years.

VA officials say they're better prepared to handle female patients than they were several years ago. But they acknowledge "continual challenges" as they move to open the door to a man's world, where pap smears and mammograms could become as common as prostate exams.

And where "military sexual trauma" would be treated as a serious and growing mental health problem, rather than as a subject to be avoided.

"It's not your father's VA — it really isn't," said Patricia Hayes, the VA's national director of women's health care issues. "We have geared up and are gearing up. But there are places that may have gaps."

Others say the agency is far from prepared. And given the VA's chronic budget shortfalls and increasing demands from the rapidly growing number of male veterans, the task could be even harder than expected.

"They aren't ready," said Sen. Patty Murray, D-Wash., said of VA officials. "Absent a proactive, concerted effort and knowing their limited resources, they (VA officials) are struggling with so much this might get lost."

Murray, perhaps the leading VA critic on Capitol Hill, has introduced legislation that requires studying how serving in Iraq and Afghanistan has affected the physical, mental and reproductive health of women, and how the VA is dealing with their problems.

The legislation also would require the VA to start caring for newborn children of female veterans who are receiving maternity care. Currently the VA doesn't cover newborn costs. In addition, it would require increased training for VA personnel dealing with military sexual trauma and post-traumatic stress disorder, or PTSD, in women.

Murray's bill will receive a hearing in the Senate Veterans Affairs Committee tomorrow. "It's a hard issue, and pouring a huge light on this is a risk, as some will say women just shouldn't be in the military," Murray said. "But as more women transition home from the physical and mental wounds of war and step back into lives as mothers, wives and citizens, the VA must be there for them."

It is imperative that the VA be fully funded, and that the services that female veterans will need - and have earned - be implemented and available. To do less would surpass unconscionable and go right to betrayal.

"the severest case of PTSD she'd seen in her life..."

Photo: Travis and Willard Twiggs

Marine with PTSD kills brother, self:

Last month, Marine Staff Sgt. Travis N. "T-Bo" Twiggs went to the White House with a group of Iraq war veterans called the Wounded Warriors Regiment and met President George W. Bush. Twiggs had been through four tours in Iraq, one in Afghanistan and months of therapy for post-traumatic stress disorder in which he said he was on up to 12 different medications.

"He said, `Sir, I've served over there many times, and I would serve for you any time,' and he grabbed the president and gave him a big hug," said Kellee Twiggs, his widow. About two weeks later, Travis Twiggs went absent without leave from his job in Quantico, Virginia. He and his brother drove to the Grand Canyon, where their car was found hanging in a tree in what appeared to be a failed attempt to drive into the chasm. The brothers carjacked a vehicle at the park Monday.

Two days later they were at a southwestern Arizona border checkpoint, and took off when they were asked to pull into a secondary inspection area, Border Patrol spokesman Michael Bernacke said. Eighty miles (130 kilometers) later, the car was on the Tohono O'odham reservation, its tires wrecked by spike strips.

As tribal police and Border Patrol agents closed in, Twiggs, 36, apparently fatally shot his 38-year-old brother, Willard J. "Will" Twiggs, then killed himself. Pinal County Sheriff's spokesman Mike Minter said no motive has been established. But Kellee Twiggs said the decorated Marine would still be alive if the military had given him enough help.

[SNIP]

Travis Twiggs, who enlisted in the Marine Corps in 1993 and held the combat action ribbon, wrote about his efforts to deal with post-traumatic stress disorder in the January issue of the Marine Corps Gazette.

The symptoms would disappear when he began each tour, he said, but came back stronger than ever when he came home.

He wrote that his life began to "spiral downward" after the tour in which two Marines from his platoon died.

"I cannot describe what a leader feels when he does not bring everyone home," he wrote. "To make matters even worse, I arrived at the welcome home site only to find that those two Marines' families were waiting to greet me as well. I remember thinking, 'Why are they here?"'

Weeks later, Twiggs "saw a physician's assistant who said that was the severest case of PTSD she'd seen in her life," his widow said.

He began receiving treatment, but the Marine wrote that he mixed his medications with alcohol and that his symptoms did not go away until he started his final tour in Iraq.

When he came home, "All of my symptoms were back, and now I was in the process of destroying my family," he wrote. "My only regrets are how I let my command down after they had put so much trust in me and how I let my family down by pushing them away."

Kellee Twiggs said her husband was "very, very different, angry, agitated, isolated and so forth," upon his return. "He was just doing crazy things."

She said her husband was treated in the psychiatric ward of Bethesda Naval Medical Center and then sent to a Veterans Administration facility for four months.

Most recently, Travis Twiggs was assigned to the Marine Corps Warfighting Laboratory at Quantico, a job he said helped him "get my life back on track."

"Every day is a better day now," he wrote in the Marine Corps Gazette. "... Looking back, I don't believe anyone is to blame for my craziness, but I do think we can do better."

Twiggs urged others suffering from similar problems to seek help. "PTSD is not a weakness. It is a normal reaction to a very violent situation," he wrote.

Kellee Twiggs said she cannot understand why her husband was not sent to a specialized PTSD clinic in New Jersey.

"They let him out. He was OK for a while and then it all started over again," she said.

We Need Action to Go With That Outrage

This is a continuing series of posts that follow up the lawsuit against the Veterans Administration and highlights what happened yesterday before a Congressional Committee.

That's all well and good--now follow it up with something that forces these people to act and that holds them accountable for their massive fuck-up:

...Committee Chairman Bob Filner lashed out at the man in charge, Secretary James Peake, accusing the V.A. of "criminal negligence," reports CBS News chief investigative correspondent Armen Keteyian.
"What we see is a pattern -- deny, deny, cover up, cover up," Filner said.

Filner's colleagues quickly followed, piling anger on top of disbelief.

With his embattled Director of Mental Health Dr. Ira Katz at his side, Secretary Peake presented a detailed series of charts and graphs generally backing CBS News suicide data.

"I've never had a concern with their overall numbers," Katz told the committee.

"We're as far from hiding information from the public as anyone I know," Peake said.

But several lawmakers weren't buying it, citing a Feb. 13 e-mail titled "Not for CBS News" where Katz appears to be trying to keep attempted suicide numbers quiet.

These bastards have to go. Replace them with people who care and who will work hard to fix this problem.

New Report on Veterans Health Care Deficiencies

These reports need to be heeded. Sitting around and doing nothing is the wrong answer:

Many Iraq war veterans with traumatic brain injury are not getting adequate health care and job assistance for their long-term recovery despite years of government pledges to do so, Veterans Affairs Department investigators say.

"Significant needs remain unmet," according to the report released Thursday by the VA's inspector general. It is the first to examine the Bush administration's long-term efforts in supporting veterans with traumatic brain injury, a leading problem among soldiers struck by roadside bombs that often causes lasting emotional and behavioral difficulties.

The study tracked a group of 52 patients that received VA treatment after sustaining brain injury during a seven-month period in 2004. An initial review by the IG in 2006 found gaps in follow-up care and family counseling 16 months after the injury and urged the VA to improve long-term case management.

The VA pledged to coordinate the necessary follow-up care with the Pentagon, but the latest audit concludes that efforts are still falling short for roughly one in four patients.

In a perfect world, you would be able to help everyone. I realize that this is far from a perfect world, and there are always going to be people who, for whatever reason, either don't want or can't cope with receiving help. I get that. But there are too many stories about Veterans being turned away, or ignored, or told the wrong thing.

The report included a VA response in which the department acknowledged problems with case management but stated that with recent improvements it now had "systems in place to ensure that all veterans with TBI are being followed as their clinical needs require."

For example, the VA pointed to plans announced last week to start calling 570,000 recent combat veterans to make sure they know what services are available to them.

In the audit, investigators praised the new measures as "positive steps" but questioned whether the VA's latest promise to keep watch over veterans would prove to be a reality. They said that "at least 8 of 49 veterans we contacted had significant unmet needs and no evidence of VA case management in the previous year."

"We continue to be concerned that all veterans discharged after inpatient rehabilitation for TBI receive case management, unless this has been explicitly denied by the patient," investigators stated, adding that they will continue monitoring the VA to ensure Iraq war veterans are receiving the care they need.

When you read stories about what is going on with The Broken Soldier, and hundreds of other cases, you can't help but wonder why there isn't more outrage.

UPDATE I - PALE RIDER 3:07PM

Closing arguments in the VA trial we've been following were today:

In closing arguments in a federal lawsuit against the Department of Veterans Affairs (VA), plaintiff lawyers accusing the agency of failing to effectively take care of our nation’s military veterans said, “1,457 veterans died while their appeals were pending” in the last six months alone. “More of these veterans are dying in the United States than out in combat,” attorney Arturo Gonzalez said.

Two veterans rights groups - Veterans for Common Sense and Veterans United for Truth - sued the VA hoping a federal judge could order the government agency to overhaul and improve its system. The trial took place in San Francisco with seven days of court testimony. Closing remarks were held Wednesday.

Plaintiff lawyers claimed the agency has dropped the ball in a number of ways and as a result has not provided proper access to health care and benefits to veterans. For example, they said the VA has yet to fully implement the Mental Health Strategic Plan that was introduced back in 2004. Gonzalez said, “there is no plan for dealing with all of these veterans who are returning and who are in need of help.” The argument was also made that veterans are waiting too long to get medical appointments and the benefits they deserve.

Daniel Bensing, the Department of Justice lawyer representing the VA, told the judge that the VA has a “very well-regarded system for providing health care.” He insisted that 80 percent of the Mental Health Strategic Plan recommendations have been adopted and he said, “98 percent of Iraq/Afghanistan veterans are seen within 30 days.”

A Dark Week For the Department of Veterans Affairs

We expect resignations this week. Lots of them. Barring that, hopefully, these officials will have the decency to at least start owning up to their colossal lies and outrageous mistakes.

A top-ranking official at the Department of Veterans Affairs defends the agency's treatment of disabled veterans and denies the agency has tried to cover up the number of veterans committing suicide. Dr. Michael Kussman, a department undersecretary for health, testified during a trial in San Francisco federal court that will determine whether the VA is shirking its duty to provide adequate mental health care and other medical services to millions of veterans.

The two veterans groups suing the VA want U.S. District Court Judge Samuel Conti to order the agency to dramatically improve how fast it processes applications and how it delivers mental health care, especially when it comes to preventing suicides and treating post-traumatic stress disorder.

This trial actually features some lawyers who are willing to put the VA under some scrutiny and challenge their methods. For other agencies and for other issues like public safety, public health and public housing, hopefully this trial will serve as the framework for beginning the process of unravelling the incompetence and the outrageous behavior of the Bush Administration:

The groups contend that veteran suicides are rising at alarming rates in large part because of VA failures. In court, plaintiffs' lawyer Arturo Gonzalez clashed Thursday with Kussman over how to compile and report the suicide rates.

For instance, VA Secretary James Peake told Congress in a Feb. 5 letter that 144 combat veterans of Iraq and Afghanistan committed suicide between October 2001 and December 2005.

But Gonzalez produced internal VA e-mails that contended that 18 veterans a day were committing suicide. Kussman countered that the figure, provided by the Centers for Disease Control and Prevention, included all 26 million veterans in the country, including aging Vietnam veterans who are reporting an increased number of health problems.

You know, lying is a good way to get your ass in a sling, especially if you're in a position of public trust:

Gonzalez also asked Kussman to explain several e-mail chains among agency officials that discussed an unwillingness to share suicide statistics with CBS News, which was preparing a story on the subject.

"I don't want to give CBS any more numbers on veterans suicides or attempts than they already have - it will only lead to more questions," wrote Everett A. Chasen, chief communications officer in a March 10 e-mail to several VA officials.

On Monday, the first day of trial, an e-mail message written in December by Dr. Ira Katz, the agency's mental health director, was given as evidence. It alerted Kussman and others that 12,000 veterans under VA care were attempting suicide a year.

"Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?" the e-mail asks.

Katz also reported that of the average of 18 military veterans who kill themselves each day, four to five of them are under VA care when it happens.

Three Democratic senators, including Sen. Daniel Akaka of Hawaii, chairman of the Veterans Affairs Committee, called for Katz's dismissal this week.

"I disagree with the premise that there was some effort to cover something up," Kussman testified Thursday. "We don't obfuscate."

Well, the E-mail chain says otherwise. Hopefully, these men will do the right thing and leave public life. This wasn't their thing, apparently, and they've done a great disservice to Veterans. Now that Doug Feith is out of work, maybe they can all get together and start a company that gives people bad advice and then covers it up--that might get some play. My advice is, give that service to retiring Republican Congressmen who face indictment or disgrace and quit playing with the lives of people who have actually served this country.

VA Reported 790 Suicides per Year Instead of 12,000

We've been updating you on what's been going on with the cover-up inside of the Veteran's Administration and the extremely high rate of suicides.

Brace yourself:

Two Democratic senators have called for the chief mental health official of the Veterans Affairs Department to resign, saying he tried to cover up the rising number of veteran suicides.

Sens. Daniel Akaka of Hawaii and Patty Murray of Washington state said Tuesday that Dr. Ira Katz, the VA's mental health director, withheld crucial information on the true suicide risk among veterans.

[SNIP]

A number of Democratic senators said they were appalled at e-mails showing Katz and other VA officials apparently trying to conceal the number of suicides by veterans. An e-mail message from Katz disclosed this week as part of a lawsuit that went to trial in San Francisco starts with "Shh!" and claims 12,000 veterans a year attempt suicide while under department treatment.

"Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?" the e-mail asks.

How many did they say were committing suicide?

790. Instead of 12,000.

"It is completely outrageous that the federal agency charged with helping veterans would instead cover up the hard truth — that more and more Americans coming home after bravely fighting for their country are suffering from mental illnesses and in the most tragic circumstances, committing suicide," said Sen. Tom Harkin, D-Iowa. "Anyone at the VA who is involved in this cover-up should be removed immediately."

Harkin, Murray and Sen. Russ Feingold, D-Wis., introduced legislation Tuesday calling on the VA to track how many veterans commit suicide each year. Currently, VA facilities record the number of suicides and attempted suicides in VA facilities — but do not record how many veterans overall take their own lives. The agency, however, is reluctant to disclose specific numbers, veterans advocates complain.

The new bill would require the VA to report to Congress within 180 days the number of veterans who have died by suicide since Jan. 1, 1997, and continue reports annually. Harkin's office said statistics provided earlier this year by the VA showed that 790 veterans under VA care attempted suicide in 2007. That figure is contradicted by the e-mail revealed this week.

Two veterans groups last year filed the class-action lawsuit against a sprawling VA system that handled a record 838,000 claims last year. A government lawyer on Monday urged a judge to dismiss the lawsuit, saying the agency runs a "world class" medical care system.

Treasonous fucking bastards. That's all I have to say. Treasonous fucking bastards...

Veteran's Administration HID Suicides - a Follow-up

We're following this story, and we are picking our jaws up off the floor over THIS revelation:

In San Francisco federal court Monday, attorneys for veterans' rights groups accused the VA of nothing less than a cover-up - deliberately concealing the real risk of suicide among veterans.

"The system is in crisis and unfortunately the VA is in denial," said Veterans Rights Attorney Gordon Erspamer.

The charges were backed by internal emails written by Dr. Ira Katz, the VA's head of Mental Health.

In the past, Katz has repeatedly insisted while the risk of suicide among veterans is serious, it's not outside the norm.

"There is no epidemic in suicide in VA," Katz told Keteyian in November.

But in this e-mail to his top media advisor, written two months ago, Katz appears to be saying something very different, stating: "Our suicide prevention coordinators are identifying about 1,000 suicide attempts per month among veterans we see in our metical facilities."

Katz's email was written shortly after the VA provided CBS News data showing there were only 790 attempted suicides in all 2007 - a fraction of Katz's estimate.

"This 12,000 attempted suicides per year shows clearly, without a doubt, that there is an epidemic of suicide among veterans," said Paul Sullivan of Veterans for Common Sense.

And it appears that Katz went out of his way to conceal these numbers.

First, he titled his e-mail: "Not for the CBS News Interview Request."

He opened it with "Shh!" - as in keep it quiet - before ending with
"Is this something we should (carefully) address … before someone stumbles on it?"

Today we showed the e-mail to Rep. Bob Filner, D-Calif., who chairs the House Committee on Veterans Affairs.

"This is disgraceful. This is a crime against our nation, our nation's veterans," Filner told CBS News. "They do not want to come to grips with the reality, with the truth."

And that's not all.

Last November when CBS Newsexposed an epidemic of more than 6,200 suicides in 2005 among those who had served in the military, Katz attacked our report.

"Their number is not, in fact, an accurate reflection of the rate," he said last November.

But it turns out they were, as Katz admitted in this e-mail, just three days later.

He wrote: there "are about 18 suicides per day among America's 25 million veterans."

CLICK the link and go to the original CBS News story--it's full of evidence that shows possible malfeasance and outright lying by the VA. It's worth the read, and they're doing a great job keeping us informed--show them some love. I think we'll be reading about the departure of Dr. Katz before too long...

Something to follow this week...

Happy Sunday--here's something we'll be paying attention to in the coming weeks...

(AP) The U.S. Department of Veterans Affairs isn't doing enough to prevent suicide and provide adequate medical care for Americans who have served in the armed forces, a class-action lawsuit that goes to trial this week charges.

The lawsuit, filed in July by two nonprofit groups representing military veterans, accuses the agency of inadequately addressing a "rising tide" of mental health problems, especially post-traumatic stress disorder.

But government lawyers say the VA has been devoting more resources to mental health and making suicide prevention a top priority. They also argue that the courts don't have the authority to tell the department how it should operate.

The trial is set to begin Monday in a San Francisco federal court.

An average of 18 military veterans kill themselves each day, and five of them are under VA care when they commit suicide, according to a December e-mail between top VA officials that was filed as part of the federal lawsuit.

"That failure to provide care is manifesting itself in an epidemic of suicides," the veterans groups wrote in court papers filed Thursday.

A study released this week by the RAND Corp. estimates that 300,000 U.S. troops - about 20 percent of those deployed - are suffering from depression or post-traumatic stress from serving in Iraq and Afghanistan.

"We find that the VA has simply not devoted enough resources," said Gordon Erspamer, the lawyer representing the veterans groups. "They don't have enough psychiatrists."

Eighteen Veterans a day commit suicide--that's a staggering number. How many of those could be prevented with simple care? If only 5 of the 18 are under VA care, how many are under no care at all and have no health insurance?

This is, hopefully, a lawsuit that will bring changes for the better.

The Fight on the Homefront

Tim Sanders is home from the war, but he is still fighting. Now he is fighting for himself, and his foe is the system that promises to stand up for those who stand up for us.

Walking up and down the sidewalk near the Colmery-O'Neil VA Medical Center, Tim Sanders looks like a model for the "Army Strong" ad campaign.

Except, that is, for the placard he is holding high proclaiming, "Vets are losing their benefits."

Sanders, an imposing 6-foot-3 inches tall, isn't the picture of health he appears to be. After tours of duty in Iraq and Afghanistan, he is considered 50 percent disabled by the Department of Veterans Affairs. He suffers physical, emotional and now bureaucratic problems.

For starters, he suffers from post-traumatic stress disorder. He also has back and knee problems from paratrooper duty.

"The transition from combat veteran to civilian was very difficult for me," he said.

Now 32, he is entitled to care at the VA medical center and normally receives a VA check for $730 each month. This month his check was reduced to $196. He can't pay his rent or other bills.

The VA asserted he owed money for medical expenses he incurred in 2006. The VA began retrieving the money from his monthly allotment. But Sanders insists he doesn't owe the money and believes the error is being corrected, thanks to the efforts of a Veterans of Foreign Wars representative who went to bat for him.

Sanders still hasn't seen the missing money, but even if it arrives soon, he is on a mission to bring public attention to what he considers the VA's insensitivity to the needs of veterans like himself.

So, he continues picketing at S.W. 21st and Gage as a matter of principle.

"I believe our government is being a tyrant. I'm proud of my country. I'm not proud of my government," he said.

Because of the toll that his service has taken on his body, some days he can only picket for two hours, but he makes sure that he is out for those two hours, waving to friendly motorists and holding his sign. "I've had it," he said. "I've been passive. I'm not going to be passive anymore."

I have a long track record of being pissed off over the hosing our veterans have been getting. I have watched in horror as the VA, rebuilt from the ashes to become a model system, has been destroyed by underfunding and the stresses of treating the veterans of two wars that have ground on for over five years.

If it were up to me, all veterans would have their benefits approved provisionally and vetted later, since over 90% are eventually approved anyway. I would also cease and desist in collection efforts. If a Veteran who receives a monthly stipend is found to be in arrears, if the veteran is not at fault and did not commit fraud, the balance should be written off. No veteran should ever open an envelope expecting to see seven hundred bucks and instead see less than two. That's just wrong - no one can live on that, and it is callous to expect it. If overpayments absolutely must be recouped, and the veteran is going to be getting benefits the rest of his or her life, for Christ's sake, take twenty bucks a month! We can tighten a hell of a lot of other belts before we get down to the point we take VA benefits from people who served in combat because some 702 somewhere made a clerical error.

Critical Mass

It's a critical mass of factors. The length of this war, the nature of the fight, the lack of adequate protective gear, the lack of medical care while on active duty, the shortage of available care when people get out of the military--ALL of these things are contributing to the destruction of a generation of military members:

According to Army statistics, the incidence of U.S. Army soldiers attempting suicide or inflicting injuries on themselves has skyrocketed in the nearly five years since the start of the Iraq war.

Last year's 2,100 attempted suicides -- an average of more than 5 per day -- compares with about 350 suicide attempts in 2002, the year before the war in Iraq began, according to the Army.

The figures also show the number of suicides by active-duty troops in 2007 may reach an all-time high when the statistics are finalized in March, Army officials said.

The Army lists 89 soldier deaths in 2007 as suicides and is investigating 32 more as possible suicides. Suicide rates already were up in 2006 with 102 deaths, compared with 87 in 2005.

More later...but Senator Jim Webb is sponsoring legislation that will start to address these issues. We'll have more this week.

UPDATE I - PALE RIDER

Here's the info from Senator Webb's website:

Webb Calls for Stronger Suicide Prevention Programs in Defense Department

"Armed Forces Suicide Prevention Act" One of Many Webb-Supported Measures to Address Troop Welfare

Washington, DC- With new reports this week showing a steady rise in U.S. Army suicides among its active-duty personnel since the invasion of Iraq, Senator Jim Webb (D-VA) and several of his colleagues introduced a bill that would direct the Department of Defense to enhance its suicide-prevention programs. The legislation, Webb said, “places greater emphasis on the well-being and welfare of our troops.”

The “Armed Forces Suicide Prevention Act” mandates an evaluation and enhancement of the military’s suicide prevention programs to ensure that they address the combat stress faced by troops today. The bill also establishes an outreach campaign to soldiers and families to reduce the stigma associated with mental health problems and to encourage those needing help to seek it.

Veterans Issues in the Debates

Not really a post, more of an observation.

I'd like to see ALL the candidates admit that we are going to have to find billions of dollars to refit, refurbish, and retrain our troops. I'd like to hear specific examples of how they're going to expand health coverage for active duty, reserve and National Guard troops. As the Vietnam Veterans begin to retire and need more health care, there will be a crush over the next decade or so as Veterans of Iraq and Afghanistan begin to use the VA system and the active duty system more and more.

Retirees already have to wait in line on post to get their promised coverage. What's it going to be like when there are more and more of them, competing with families and troops in need?

Just a thought.

Traumatic Brain Injuries or PTSD?

[image: an upgraded Personal Armor System for Ground Troops helmet with Operation Helmet-supplied kit--cost is $87 for old models, $56 for newer ones.]
I think Blue Girl might have more to say about this, but here's what we know so far:

A new military study published Wednesday in the New England Journal of Medicine says soldiers who suffered concussions in Iraq were not only at higher risk of developing post-traumatic stress disorder and depression, but also that the depression and PTSD, not the head injuries, may be the cause of ongoing physical symptoms.

Five percent of the 2,500 soldiers surveyed by Walter Reed Army Institute of Research said they had concussions in which they lost consciousness during combat. Forty-four percent of these soldiers ended up with PTSD.

Researchers were surprised to find symptoms normally associated with concussions -- headaches, dizziness, irritability and memory problems -- were actually related to PTSD or depression.

"It isn't the combat exposure or physical injury, it's the PTSD that seems to drive these symptoms. That's a surprise," said Joseph A. Boscarino, Ph.D., who studies PTSD at the Geisinger Center for Health Research in Danville, Pennsylvania. "You would expect they would have these other symptoms related to traumatic brain injury, that maybe they have a permanent injury, but it's explained by whether they have PTSD or depression."

About 8 million American adults have PTSD. A 2003 New England Journal of Medicine Study found that 15 percent to 17 percent of Iraq and Afghanistan veterans were suffering from PTSD, and more than 60 percent of those showing symptoms were unlikely to seek help because of fears of stigmatization or loss of career advancement opportunities.

As of June 30, 2007, the Department of Defense reported 3,294 soldiers in Iraq and Afghanistan suffering from traumatic brain injuries, or TBIs. Bomb blasts caused nearly 70 percent of those TBI cases.

Dr. James Kelly, a neurology professor at the University of Colorado and a co-author of guidelines the military uses to identify traumatic brain injury, expressed concerns that doctors will attribute lingering health problems to psychological issues.

"I think if people misunderstand or overextend beyond what this survey shows, they could dismiss true brain injury features as psychological only," Kelly said. "It would be a terrible disservice to our military for that to happen."

Kahlor is worried this study will make it harder for soldiers to get appropriate medical care.

"The military doesn't want to diagnose people with brain injury," he said. "So what they'll do is play it off as PTSD as the sole injury for everyone, because PTSD and traumatic brain injury have very similar symptoms," he said. "The disability [compensation] is a lot higher for traumatic brain injury. What the military is saying is, you can't be diagnosed from a brain injury unless you get better from PTSD. It's kind of like a paradox."

First of all, citing a study from 2003 is WAY out of date. The larger IEDs used against our troops are causing a more severe type of brain injury, obviously. The different vehicles being used, such as the MRV and the Stryker, are helping, but is it enough. And then there was the campaign called Operation Helmet. Here's something from their site, which you could visit and support if you choose to:

Jan 21, 2008: Received a request from a Marine Reserve unit (155 Marines) headed back into combat...and unable to use the 'GI' pads at all, so have reverted to the un-protected form of combat helmet. We MUST NOT let this happen. While we're pressuring Congress and the military to do what's right, we need an urgent fund-raising campaign to outfit these troops before they reach their combat assignment. PLEASE HELP WITH YOUR DONATIONS IF YOU CAN.

Which outrage do you want--that a Marine reserve unit is going into Iraq in 2008--nearly five years since the start of the goddamned war--WITHOUT adequate headgear? Our military health care system finding a way to get rid of people and not pay benefits??? Now, why would the military do something like that?

Remember when the military started going after people who had "personality disorders" that were really manifestations of PTSD? How could you blame them? It was a fantastic way of getting rid of people and cutting costs!

But instead of sending Town to a medical board and discharging him because of his injuries, doctors at Fort Carson, Colorado, did something strange: They claimed Town's wounds were actually caused by a "personality disorder." Town was then booted from the Army and told that under a personality disorder discharge, he would never receive disability or medical benefits.

Town is not alone. A six-month investigation has uncovered multiple cases in which soldiers wounded in Iraq are suspiciously diagnosed as having a personality disorder, then prevented from collecting benefits. The conditions of their discharge have infuriated many in the military community, including the injured soldiers and their families, veterans' rights groups, even military officials required to process these dismissals.

They say the military is purposely misdiagnosing soldiers like Town and that it's doing so for one reason: to cheat them out of a lifetime of disability and medical benefits, thereby saving billions in expenses

Here's the original link to WWTC [where Blue Girl spends some of her valuable time] Your government. Acting like a craven HMO. You gotta love it when they pull this kind of thing. All that stands between them and their goals is exposing their attempts at shortchanging Veterans.

Victor Davis Hanson - Lancing the Boil

VDH wrote a column called "Lancing the Boil" in 2005. It's important to note that there's nothing wrong with making predictions and for someone to go around taking what a pundit says and having a laugh at their expense because they turned out to be wrong is kind of a childish exercise.

EXCEPT when that pundit is just, well, completely and utterly wrong and should have his pundit privileges taken away from him for being so goddamned ridiculous in public. Just when you think VDH has done enough damage at NRO, you can always find Derbyshire. A little Derbyshire goes a long way, though. And I definitely do not have the requisite fourteen hours per day to parse the insanity of a John Derbyshire and expose it to the light of reason.

I won't do the whole thing--no one has that kind of free time--but here's a few classic examples from "Lancing the Boil" that are good for a laugh. Click the link and go find others if you are so inclined. That's what comments are for.

VDH:

--For some time, a large number of Americans have lived in an alternate universe where everything is supposedly going to hell. If you get up in the morning to read the New York Times or Washington Post, watch John Murtha or Howard Dean on the morning talk shows, listen to National Public Radio at noon, and go to bed reading Newsweek it surely seems that the administration is incommunicado (cf. “the bubble”), the war is lost (“unwinnable”), the Great Depression is back (“jobless recovery”), and America about as popular as Nazi Germany abroad (“alone and isolated”).

Now, VDH probably couldn't have forseen the collapse of the ownership society, the devaluation of the dollar, and the beginning of a long march towards seeing entire neighborhoods abandoned because the homes are built on debt and lies, but he should have forseen that if we continued with our policies in Iraq, we would see a decline in our stature. He knew in 2005 that we were torturing people, and when you go down that path, you lose your soul.

--But in the real adult world, the economy is red-hot, not mired in joblessness or relegating millions to poverty. Unemployment is low, so are interest rates. Growth is high, as is consumer spending and confidence. Our Katrina was hardly as lethal as the Tsunami or Pakistani earthquake. Thousands of Arabs are not rioting in Dearborn. American elderly don’t roast and die in the thousands in their apartments as was true in France. Nor do American cities, like some in China, lose their entire water supply to a toxic spill. Americans did not just vote to reject their own Constitution as in some European countries.

Notice how he looked at Katrina in 2005 and predicted that, because several hundred thousand people weren't killed, it wouldn't be considered a real "disaster." Well, the incompetence that was apparent in 2005 has reared its ugly head, and he should have forseen that it is still an issue. It's just not an issue anyone talks about in the media. American cities may not be losing their water to chemical spills, but Atlanta might lose its drinking water because the governor would rather pray for rain than actually change public policy (you know, raise taxes to fix the crumbling infrastructure? heard of doing that?). And interest rates are low because the Fed has enacted a policy of rewarding bad behavior. They simply can't go much lower. You can't have interest rates at zero.

--The military isn’t broken. Unlike after Vietnam when the Russians, Iranians, Cambodians, and Nicaraguans all soon tried to press their luck at our expense, most of our adversaries don’t believe the U.S. military is losing in Iraq, much less that it is wise now to take it on. Instead, the general impression is that our veteran and battle-hardened forces are even more lethal than was true of the 1990s — and engaging successfully in an almost impossible war.

Our veteran and battle-hardened forces are desperate for any kind of relief, and the most pressing relief they need is support from a medical support infrastructure that isn't meeting their basic needs. Their suicide rates are skyrocketing and are being hidden from view, covered up, and barely reported upon. When an Army wins a war, the injured and sick need to be taken care of just the same as when they lose or when they're caught in a perpetual meat grinder. Generally, homelessness, poverty, mental illness and suicides don't go through the roof when someone is winning and doing a good job of running things. Every time someone tries to get them relief--more funding, equal time at home for time deployed, etc., the Republican Party fucks over the Democratic Party in order to win a trivial political point.

On a side note, VDH says that the military isn't broken. Well, certain people know that it is, and they're taking advantage of it to line their pockets.

One egregious example, Borochoff said, is Help Hospitalized Veterans, which was founded in 1971 by Roger Chapin, a veteran of the Army Finance Corps and a San Diego real estate developer. The charity, which provides therapeutic arts and crafts kits to hospitalized veterans, reported income of $71.3 million last year and spent about one-third of that money on charitable work, the philanthropy institute said.

In its tax filings, Help Hospitalized Veterans reported paying more than $4 million to direct-mail fundraising consultants. The group also has run television advertisements featuring actor Sam Waterston, game show host Pat Sajak and other celebrities.

Chapin, 75, the charity's president, received $426,434 in salary and benefits in the past fiscal year, according to a filing with the Internal Revenue Service. His wife, Elizabeth, 73, received $113,623 in salary and benefits as "newsletter editor," the Post's review of the tax filing showed.

Generally, scams that prey on the generosity of the American people come and go with the times. It's scary how many are able to use the lies surrounding the Iraq war to make a nice profit. And it looks like they've turned over a barrel full of rats by looking at the charities that are taking advantage of the Iraq war. So many of them get "F's" that there isn't time to look at all of them.

Anyway, back to VDH:

--Nor are we creating new hordes of terrorists in Iraq — as if a young male Middle Eastern fundamentalist first hates the United States only on news that it is in Iraq crafting a new Marshall Plan of $87 billion and offering a long-oppressed people democracy after taking out Saddam Hussein. Even al Jazeera cannot turn truth into untruth forever.

Stop. You're embarrassing yourself. The war in Iraq has created scads of new terrorists and that "Marshall Plan" you're talking about has been pissed away by the most corrupt government in the world. Iraq's ministries are more corrupt than anything we've ever seen before. They're setting new standards for blatant thievery and corruption.

--Like it or not, wars are usually won or lost when one side feels its losses are too high to continue. We have suffered terribly in losing 2,100 dead in Iraq; a vastly smaller enemy in contrast may have experienced tens of thousands of terrorists killed, and is finding its safe havens and money drying up. Panic about Iraq abounds in both the American media and the periodic fatwas of Dr. Zawahiri — but not in the U. S. government or armed forces.

VDH didn't know anything about asymmetrical warfare in 2005, and it shows. It doesn't matter what the body count is. It never matters how many of them you kill versus how many of yours gets killed. It's a discussion about political solutions versus military solutions, and we're over four years down the road, and trying to save the egg by hitting it as hard as we can with the hammer, and it's not working any better today than it was in 2005.

I'll skip the rest--it's just boilerplate anyway--for this kicker:

--Donald Rumsfeld’s supposed gaffe of evoking “Old Europe” is trumped tenfold and almost daily by slurs that depict Abu Ghraib as worse than Saddam, Guantanamo as the work of Hitler, Stalin, or Pol Pot, Bush as the world’s greatest terrorist, the effort to democratize Iraq as unwinnable, and American troops terrorizing Iraqi women and children.

"Old Europe" sure looks a hell of a lot smarter than we do. Are they bogged down in the war? Of course not. The British and the Poles are abandoning the Iraqi theater as quickly as they can. Those aren't "slurs" that are being used to describe what is actually going on in Iraq. Unfortunately, those are the proceedings from various courts martial, and they become all too familiar each day. As in, more unnecessary bombings from the air, more unnecessary shootings from skittish guards who are forced to drive politicians and VIPS everywhere for dog and pony shows.

With the V.A. overwhelmed, Veterans suffer needlessly

The Department of Veterans Affairs has produced it's annual year-end report to the congress, and for the third year running, the rate at which the V.A. acts to render decisions on disability claims fell further behind.

While the goal is to make determinations within 125 days, the reality is, on average it takes a claim 183 days to be acted on.

When a claim is rejected and appealed, the goal is to act on that appeal within one year, or 365 days. In reality, rejected claims take on average 660 days to be acted on; just under two years.

The VA has responded to this backlog by hiring new personnel, but it takes a reviewer two to three years to become efficient at their job, and the backlogs had a huge head start. While new personnel have been hired, and are being trained and gaining the acumen to do their jobs efficiently, veterans continue to be caught in limbo.

And when it is all said and done, just under 90% of all claims are found to be reasonable and valid, and the veteran receives the benefits he or she is due.

Very few wounded veterans have the ready resources that politicians seem to take for granted, and virtually none have the resources of the Bush clan. While they wait for their benefit determinations, they often face poverty, destitution and homelessness. No returning soldier should face homelessness, and no soldier should be relieved that they lost both arms because then the VA will have to give them a 100% disability rating!

That is why I favor the heartbreakingly simple approach advocated by Linda Bilmes of the Kennedy School of Government at Harvard: Give the Veteran the benefit of the doubt. Provisionally approve all claims made by Veterans for disability benefits, and don't withhold health care benefits while the claim is under review by the Department of Veterans Affairs.

Bilmes has been studying veterans’ medical care and disability benefits for years, and it is her considered and esteemed opinion that the current backlog simply overwhelmed a system that was already struggling under budget cuts before the wars started and created a whole bunch of new veterans needing services. Now things only stand to get worse. Last spring, in testimony before a congressional subcommittee, she predicted 250,000 to 400,000 claims will be filed over the next two years alone by veterans of the wars in Iraq and Afghanistan. This, she maintained, would create a situation that she said “will rapidly turn the disability claims problem into a crisis.” The problems of the VA are exacerbated as the wars in Iraq and Afghanistan grind on and on with no end in sight, and and the flood of wounded shows no sign of abating. And the DoD health system continues to dump patients into the underfunded VA system. This negatively impacts all veterans who use the system.

Keep in mind that Bilmes offered this testimony nearly a year ago, before the latest information on TBI was publicized.

The most recent findings are the result of percussive experiments conducted on animals, then the animals were sacrificed and the brain tissue examined microscopically. In the animal studies, scientists have discovered a fundamentally different injury than the “concussion” wound that has traditionally been ascribed to exposure to explosions. A concussion is essentially a bruise on the brain that generally heals with time.

Brain damage at the cellular level is likely permanent – and will almost certainly lead to further neurological degradation over time. Put bluntly, G.I.’s afflicted by TBI are not likely to get better, and in fact will get worse. How much worse is still unknown, but this will strain the system even further.

When the V.A. falters, it is the Veterans who stepped up and served who pay the price - again! - and who suffer as a result. That is a situation I find wholly intolerable. And frankly, anyone who professes unflagging support for the troops, but isn't hopping mad about the way our veterans are being treated once back home, should probably not profess their patriotism in direct proximity to me.

They gave the government the benefit of the doubt that they would not be sorely used when they joined up - the government owes them the same courtesy in return.