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Profile: US Veterans Administration (VA)
US Veterans Administration (VA) was a participant or observer in the following events:
As Congress prepares to give the White House its requested $75 billion war supplement for Iraq, Representative Dennis Kucinich (D-OH) asks, “Why is there not a single dime for veterans’ health benefits in that $75 billion?” Kucinich also notes that the Bush administration’s cuts in veterans’ benefits will force an estimated 1.25 million veterans out of the system. Not only does the Bush administration not want to provide money for benefits, it attempts to charge veterans for health care. Congress will block the administration’s efforts to charge troops returning from Iraq a $250 fee to enroll in the VA medical plan. The administration also opposes a plan to expand health care for returning reservists and National Guard troops (the White House will drop its opposition after coming to a compromise with Congress). And the administration will implement a charge of $8 per day for each hospitalized soldier for his meals, until Congress votes to block the charge. [Carter, 2004, pp. 61-65]
Private contractors in Iraq. [Source: NBC]The New York Times reports that private contract employees who have worked in Iraq often return home with the same kinds of combat-related mental health problems that affect US troops and military personnel, but these private workers are largely left on their own to find care. Their disorders and traumas often go untreated. Unlike US soldiers, private employees are at the mercy of their corporate health care systems, or in some cases, are left to fend entirely for themselves. There is no widespread screening for returning contract workers, and many who suffer from post-traumatic stress disorder (PTSD) and other disorders go unidentified. And many others receive poor-quality treatment because of limited civilian expertise in combat-related disorders. "I think the numbers are in the thousands, maybe tens of thousands," says psychologist Paul Brand. "Many are going undiagnosed. These guys are fighting demons, and they don’t know how to cope." The federal government, which has paid billions of dollars to corporations for services in Iraq since the war began, has so far failed to address the issue of mental health problems among private workers, according to Pentagon and Department of Veterans Affairs (VA) officials. "To my knowledge, it has not been looked at systematically," says VA official Dr. Matthew J. Friedman. [New York Times, 7/5/2007]
Wendell Potter (r) being interviewed by Bill Moyers (l). [Source: PR Watch (.org)]Former health care executive Wendell Potter, who left the insurance giant Cigna after fifteen years, appears on “Bill Moyers’ Journal.” He was formerly the head of corporate communications before he resigned his position, a post he calls “the ultimate PR job.” He says he was not forced to leave the company, and was extremely well compensated for his duties. He left after realizing that the health care industry is using underhanded and hurtful tactics to undermine the drive towards health care reform. He never went to his bosses with his observations because, he says, “for most of the time I was there, I felt that what we were doing was the right thing. And that I was playing on a team that was honorable. I just didn’t really get it all that much until toward the end of my tenure at Cigna.”
Health Care Expo Changed His Perceptions - In June 2007, Potter recalls, his perceptions were drastically changed by his visit to a health care exposition in Wise, Virginia (see June 2007).
Changing Plans - The industry shifted from selling primarily managed care plans, he says, to what they call “consumer-driven plans.” Despite the name, they are health care plans with high deductibles and limited coverage.
'Highlight Horror Stories' - Moyers shows Potter a copy of an “action plan” devised by America’s Health Insurance Plans (AHIP), the industry’s trade association. In large gold letters, the plan tells lobbyists and industry representatives to “Highlight horror stories of government-run systems.” Potter says that AHIP and other industry representatives try to paint government-run health care as socialism, and as inevitable failures. “The industry has always tried to make Americans think that government-run systems are the worst thing that could possibly happen to them,” he says, “that if you even consider that, you’re heading down on the slippery slope towards socialism. So they have used scare tactics for years and years and years, to keep that from happening. If there were a broader program like our Medicare program, it could potentially reduce the profits of these big companies. So that is their biggest concern.” Moyers also notes that the AHIP plan targets the film Sicko, a 2007 documentary by leftist filmmaker Michael Moore that portrayed America’s health care industry in a dismal light. AHIP’s action plan is to “Position Sicko as a threat to Democrats’ larger agenda.” Potter says that was an effort to discredit the film by using lobbyists and AHIP staffers “to go onto Capitol Hill and say, ‘Look, you don’t want to believe this movie. You don’t want to talk about it. You don’t want to endorse it. And if you do, we can make things tough for you.’” If they did, AHIP would retaliate by running negative ads against the lawmakers in their home districts or other electoral punishments. AHIP focused strongly on the conservative Democratic Leadership Council. Another tactic, as delineated in the memo: “Message to Democratic insiders. Embracing Moore is one-way ticket back to minority party status.” Moyers says that AHIP attempted to “radicalize” Moore and portray him as an extremist who could not be believed. Many politicians used AHIP talking points in discussing Moore and his film. “So your plan worked,” Moyers observes. Potter agrees: “It worked beautifully.” The lesson that was lost from Moore’s film, Potter says, was that Americans “shouldn’t fear government involvement in our health care system. That there is an appropriate role for government, and it’s been proven in the countries that were in that movie.”
Conservative Counter-Strategy - Moyers then displays a memo from Republican strategist Frank Luntz, who in the spring of 2009 wrote a strategy memo for health care reform opponents. The memo reads in part: “First, you have to pretend to support it. Then use phrases like, ‘government takeover,’ ‘delayed care is denied care,’ ‘consequences of rationing,’ ‘bureaucrats, not doctors prescribing medicine.’” He then shows film clips of House Minority Leader John Boehner (R-OH), Senate Minority Leader Mitch McConnell (R-KY), Senator Jon Kyl (R-AZ), and others using Luntz’s talking points in discussions on the floors of Congress. Potter says that many conservatives—Democrats as well as Republicans—“are ideologically aligned with the industry. They want to believe that the free market system can and should work in this country, like it does in other industries. So they don’t understand from an insider’s perspective like I have, what that actually means, and the consequences of that to Americans. They parrot those comments, without really realizing what the real situation is.” He notes that Representative Zach Wamp (R-TN), who grew up very near Potter’s childhood home in Chattanooga, told reporters that half of America’s uninsured don’t want health care, they would rather “go naked and just take the chance of getting sick. They end up in the emergency room costing you and me a whole lot more money.” Potter notes that the word “naked” is an industry term for people who choose not to buy health insurance. He calls Wamp’s comment “ridiculous” and “an example of a member of Congress buying what the insurance industry is peddling.” Moyers cites conservative Democrat Max Baucus, the chairman of the Senate Finance Committee, as another politician central to the health care reform process who is heavily influenced by corporate lobbyists—two of whom used to work on his own Senate staff. Potter says: “[I]t does offend me, that the vested special interests, who are so profitable and so powerful, are able to influence public policy in the way that they have, and the way that they’ve done over the years. And the insurance industry has been one of the most successful, in beating back any kinds of legislation that would hinder or affect the profitability of the companies.”
Fierce Opposition to Public Option - The “public option,” the idea that the government would extend a non-profit, government-run health care alternative for citizens, is fiercely opposed by the health care industry. Potter says the reason why is “[t]he industry doesn’t want to have any competitor. In fact, over the course of the last few years, has been shrinking the number of competitors through a lot of acquisitions and mergers. So first of all, they don’t want any more competition period. They certainly don’t want it from a government plan that might be operating more efficiently than they are, that they operate.” Government programs such as Medicare and the Veterans Administration’s medical providers are far more efficient than private, for-profit health care providers, and the industry fears that having to compete with such a program will slash their profits. Medical companies will do whatever it takes to keep their profit margins—and shareholder returns—above a certain threshold. They will deny more claims, kick more people off their rolls, purge employer accounts, whatever it takes. Potter, evidently bemused, says, “You know, I’ve been around a long time. And I have to say, I just don’t get this. I just don’t understand how the corporations can oppose a plan that gives the unhealthy people a chance to be covered. And they don’t want to do it themselves.… I’m a capitalist as well. I think it’s a wonderful thing that companies can make a profit. But when you do it in such a way that you are creating a situation in which these companies are adding to the number of people who are uninsured and creating a problem of the underinsured then that’s when we have a problem with it, or at least I do.” A public option would help “keep [health care corporations] honest,” he says, and they would inevitably lose profits.
Predictions - Right now the industry is primarily involved in what Potter calls a “charm offensive,” where it is attempting to give the perception that it, too, is for health care reform. But once Congress begins putting out specific legislative language, the industry and its flacks will begin attacking specific provisions. Moyers says the upshot is for the industry to either “kill reform” or prevent lawmakers from agreeing on a bill, just like what happened in 1993-94 under the Clinton administration. No matter what they say—favoring the elimination of pre-existing condition restrictions, for example—the industry will adamantly oppose reform of any kind. “They don’t want a public plan,” Potter says. “They want all the uninsured to have to be enrolled in a private insurance plan. They want—they see those 50 million people as potentially 50 million new customers. So they’re in favor of that. They see this as a way to essentially lock them into the system, and ensure their profitability in the future. The strategy is as it was in 1993 and ‘94, to conduct this charm offensive on the surface. But behind the scenes, to use front groups and third-party advocates and ideological allies. And those on Capitol Hill who are aligned with them, philosophically, to do the dirty work. To demean and scare people about a government-run plan, try to make people not even remember that Medicare, their Medicare program, is a government-run plan that has operated a lot more efficiently.… [T]hey want to scare you into thinking that through the anecdotes they tell you, that any government-run system, particularly those in Canada, and UK, and France that the people are very unhappy. And that these people will have to wait in long lines to get care, or wait a long time to get care. I’d like to take them down to Wise County. I’d like the president to come down to Wise County, and see some real lines of Americans, standing in line to get their care. [PBS, 7/10/2009]
Entity Tags: John Boehner, Frank Luntz, Cigna, Bill Moyers, America’s Health Insurance Plans, Zach Wamp, Wendell Potter, US Veterans Administration, Senate Finance Committee, Michael Moore, Medicare, Max Baucus, Mitch McConnell, Jon Kyl, Clinton administration
Timeline Tags: US Health Care
Representative Anthony Weiner (D-NY), a progressive Democrat who favors single-payer (government-provided) health care and is one of the strongest voices from the Democratic left in favor of the “public option” in health care reform, introduces an amendment to the pending health care reform legislation, HR 3200, that would eliminate Medicare. Weiner has no intention of actually trying to eliminate Medicare, instead he wants to get Republicans, who have repeatedly said they don’t want “government health care” (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, and July 28, 2009) to go on record as supporting Medicare, a government-run health care provider. Weiner tells interviewer Rachel Maddow: “I guess Republicans don’t like publicly funded, publicly administered health plans except for Medicare, and, I guess, except for the Veterans Administration and except for the health care that our military gets from the Department of Defense. The fact of the matter is, what we’ve learned is that government administered health care works pretty darn well. It’s got lower overhead and people like it. So, when my Republican colleagues pound the drum and pound the podium about how they hate government-run health care, I guess they haven’t looked at what they get.” Weiner says he introduced the amendment in part to embarrass House Republicans whose rhetoric on public health care he thinks has become quite harsh. [MSNBC, 7/31/2009]
Anti-health care reform protesters sound off at a health care forum in Hartford, Connecticut, featuring Senator Christopher Dodd (D-CT). Many of the protesters identify themselves as either belonging to a “tea party” protest organization or a related group calling itself “Dump Dodd.” One protester seems to suggest that Dodd, who has been diagnosed with early-stage prostate cancer, either commit suicide or be forced to die: “How come we don’t just give Chris Dodd painkillers? Like a handful of them at a time! He can wash it down with Ted Kennedy’s whiskey!” The protester is apparently referring to a claim by Rush Limbaugh that the reform proposal would deny senior citizens needed treatment, and would instead force them to rely on pain medications while waiting to die (see July 28, 2009). One reform advocate, who later posts his impressions of the event on the liberal blogs Daily Kos and My Left Nutmeg, writes that the “Dump Dodd” protesters rail about communism and socialism taking over American democracy, and notes, “Never mind that they were essentially calling Medicare, the VA, and the military’s Tricare communist and socialist.” [My Left Nutmeg, 8/4/2009; Stephen Herron, 8/5/2009; Washington Post, 8/6/2009]
Representative Michele Bachmann (R-MN) tells Fox News viewers that health care reform is unconstitutional. She says: “It is not within our power as members of Congress, it’s not within the enumerated powers of the Constitution, for us to design and create a national takeover of health care. Nor is it within our ability to be able to delegate that responsibility to the executive.” Ian Millhiser of the progressive news and advocacy Web site Think Progress takes issue with Bachmann’s statement, writing that she “is wrong about both the contents of the health care plan and the requirements of the Constitution.” None of the versions of health care legislation being considered in Congress make any provision for a “national takeover of health care.” Bachmann may be referring to the “public option,” which would create a government-run health care plan that citizens could choose to participate in. Millhiser notes that Article I of the Constitution gives Congress the power to “lay and collect taxes, duties, imposts, and excises,” and to “provide for… the general welfare of the United States.” Millhiser writes, “Rather than itemizing specific subject matters, such as health care, which Congress is allowed to spend money on, the framers chose instead to give Congress a broad mandate to spend money in ways that promote the ‘general welfare.’” Millhiser writes that it is unclear what Bachmann means by “delegat[ing] that responsibility to the executive,” but notes that no one has proposed giving the White House anything approaching the authority to run or reconfigure the US health care system. He calls Bachmann’s view of the Constitution “radical,” and writes: “If Congress does not have the power to create a modest public option which competes with private health plans in the marketplace, then it certainly does not have the authority to create Medicare. Similarly, Congress’ power to spend money to benefit the general welfare is the basis for Social Security, federal education funding, Medicaid, and veterans’ benefits such as the VA health system and the GI Bill. All of these programs would cease to exist in Michele Bachmann’s America.” [Think Progress, 8/19/2009]
The cover of the VA booklet ‘Your Life, Your Choices.’ The cover text reads: ‘Planning for Future Medical Decisions’ and ‘How to Prepare a Personalized Living Will.’ [Source: American Veteran Magazine]Fox News Sunday host Chris Wallace tells his viewers that the Veterans Administration (VA) has a secret “death book” that urges veterans to “pull the plug” and commit suicide. The 51-page booklet is called “Your Life, Your Choices,” and, Wallace says, was pulled for rewriting and reissuance in 2007, yet the VA under President Obama is still using it. In his Fox News blog, Wallace writes: “What makes the book controversial is that—according to critics—it seems to push veterans in the direction of ‘pulling the plug.’ For instance—page 21 is a worksheet in which the veteran is asked to consider various situations and then check—whether in each case, life would be ‘difficult, but acceptable’—‘worth living, but just barely’—or ‘not worth living.’ You might think that the scenarios would involve irreversible comas and the like. But no—they include: ‘I can no longer walk but get around in a wheelchair’—‘I live in a nursing home’—‘I am a severe financial burden on my family’—and ‘I cannot seem to “shake the blues”’.” Wallace’s guest, Wall Street Journal columnist James Towey, whom Wallace describes as helping to “end use of the book under President Bush, and was shocked to see it has now been reinstated,” tells viewers that the message of the book is simple: “hurry up and die.” (Wallace notes that he learned of the VA’s “death book” from Towey’s August 18 Journal column.) And, Wallace writes, quoting Towey, “he says—when government can steer vulnerable individuals to conclude that life is not worth living—‘who needs death panels?’” Wallace briefly notes that he also interviewed VA’s Assistant Secretary, Tammy Duckworth, who noted that the book is “just one of many reference tools the VA makes available—and that it is currently being revised.” [Veterans Administration, 1997 ; Wall Street Journal, 8/18/2009; Fox News, 8/23/2009]
Debunking the Claim - The story of the “death book” is quickly debunked. Richard Allen Smith of the veterans’ organization VetVoice notes that the VA booklet is actually aimed at helping veterans choose not to commit suicide, and provides them with methods and resources to battle depression, post-traumatic stress disorder (PTSD), and other conditions which lead veterans to consider prematurely ending their lives. [Richard Allen Smith, 8/23/2009] Progressive media watchdog Web site Media Matters notes that the claim that the Bush administration “rescinded” the booklet in 2007 is false. While it was reviewed in 2007, the Bush administration actively promoted the use of the booklet throughout its tenure; an online document on the VA’s Web site labeled “Reviewed/Updated Date: December 29, 2008,” states, “To learn about a living will, read ‘Your Life, Your Choices.’” Wallace’s claim that the VA mandates all veterans receive the booklet is also false; it is considered an optional reference, not mandatory. [Media Matters, 8/24/2009]
Hidden Agenda? - Smith notes that Towey may have another reason for opposing the VA booklet. In 1996, Towey founded an organization called “Aging with Dignity.” In 1997, the organization released a 12-page pamphlet, “Five Wishes,” that it says does the same job as the VA’s booklet. It gives the ailing veteran a list of five questions that, it claims, when answered will guide your life decisions. For years, Towey has been trying to get the VA to stop distributing its own booklet and instead buy “Five Choices” to use with its veterans. In 2007, Towey did help force the VA to reassess and revise its booklet after complaining that it was biased against the anti-abortion viewpoint. Smith writes bluntly: “Astonishing. Jim Towey is one sick mother f_cker to argue that veterans should be presented with LESS information, not MORE, when it comes to making a living will, all so he can make a profit from peddling his end-of-life pamphlet that is shorter than the books my two-and-a-half-year-old reads.” [Huffington Post, 8/22/2009; Richard Allen Smith, 8/23/2009]
Claim Spread by Conservative Media - Even before Wallace’s August 23 broadcast, some conservative media outlets, having read Towey’s August 18 Wall Street Journal editorial, began spreading the story of the VA’s “death book.” The National Review printed editorials denouncing the booklet, and Fox News host Sean Hannity called it “the equivalent of a death panel.” Former Governor Sarah Palin (R-AK) used her Facebook blog to accuse the VA of “encourag[ing] veterans to forego care as they make end-of-life decisions.” And radio host Rush Limbaugh told his listeners: “This thing is obsessed with death. It’s obsessed with you deciding—or with some—maybe some influence—that your life isn’t worth living. It’s—there’s nothing positive in this.” [Media Matters, 8/24/2009]
Entity Tags: Chris Wallace, Media Matters, National Review, James Towey, Fox News, Obama administration, Bush administration (43), Tammy Duckworth, Richard Allen Smith, Rush Limbaugh, US Veterans Administration, Sarah Palin, Sean Hannity
Timeline Tags: US Health Care
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