"The Politics Of Ugly: Arizona, Immigration, Obama’s Birth Certificate, Rezko, Cap And Trade, Jobs, – And The Beautiful Hillary Clinton" (Hillary Is 44):
RezkoAre we the only ones that notice the lack of attention to a certain birth certificate and other missing papers in the whole debate about the new Arizona law and the issue of immigration, as well as in the Blagojevich subpoena of Obama? If Obama had his official documents open to public inspection maybe he would feel less anxiety about the “undocumented” (both alien and incorporated) in the United States and would have more credibility when asking corporations for their papers and documents. (If ever he had actually worked Obama would not try to tell people when they have made enough money.)
And where are the boxes of Illinois Senate papers that Obama has yet to produce? These papers would answer questions about the freezing tenants and whether these abused African-Americans called Illinois State Senator Obama to complain about the tenements Obama “real estate fairy” Antoin “Tony” Rezko purchased with the assistance of Obama. Maybe that’s what those bags of cash from Rezko to Obama (the latest allegations from the Blagojevich subpoena of Obama) were for? [Hey, Big Media, this is not a story that Obama will feed you, you will have to find it out for yourselves. That's right. "Work", that thing you hate to do.]
Barack Obama’s Illegal Alien Aunt
Are we the only ones that notice the non-mention of Obama’s illegal alien Aunt Zeituni in the entire illegal immigration and the Arizona debate? Isn’t that sort of pertinent? You know, illegal aliens (”undocumented aliens/workers” for the politically correct), and an Aunt of Obama who was invited to the Obama inaugural? Isn’t that at least a point of interest?
But of course when it comes to Obama we don’t expect questions to be asked. Especially not about the Aunt that Obama exploited then dumped – at least publicly. As we wrote long ago, Aunt Zeituni seems to be a very nice woman and the sins of her vile nephew should not be held against her. But she did donate money to the Obama campaign even though she is very poor and in the United States illegally and supposedly not eligible to donate money to political campaigns. Questions anybody? Big Media? Anybody?
Barack Obama’s Birth Certificate
Questions? That is so old hat. Today we find that instead of answers, what Americans get about Obama is – “shut up with your questions”. This is probably the third or fourth time we have written about Barack Obama’s birth certificate. Our view on the Barack Obama Birth Certificate issue was enunciated in July 27, during the Gates “racist” Crowley period of Hope and Change. We are in favor of full source materials and full documentation. Today Hawaii Dimocrats say “shut up”:
And where are the boxes of Illinois Senate papers that Obama has yet to produce? These papers would answer questions about the freezing tenants and whether these abused African-Americans called Illinois State Senator Obama to complain about the tenements Obama “real estate fairy” Antoin “Tony” Rezko purchased with the assistance of Obama. Maybe that’s what those bags of cash from Rezko to Obama (the latest allegations from the Blagojevich subpoena of Obama) were for? [Hey, Big Media, this is not a story that Obama will feed you, you will have to find it out for yourselves. That's right. "Work", that thing you hate to do.]
Barack Obama’s Illegal Alien Aunt
Are we the only ones that notice the non-mention of Obama’s illegal alien Aunt Zeituni in the entire illegal immigration and the Arizona debate? Isn’t that sort of pertinent? You know, illegal aliens (”undocumented aliens/workers” for the politically correct), and an Aunt of Obama who was invited to the Obama inaugural? Isn’t that at least a point of interest?
But of course when it comes to Obama we don’t expect questions to be asked. Especially not about the Aunt that Obama exploited then dumped – at least publicly. As we wrote long ago, Aunt Zeituni seems to be a very nice woman and the sins of her vile nephew should not be held against her. But she did donate money to the Obama campaign even though she is very poor and in the United States illegally and supposedly not eligible to donate money to political campaigns. Questions anybody? Big Media? Anybody?
Barack Obama’s Birth Certificate
Questions? That is so old hat. Today we find that instead of answers, what Americans get about Obama is – “shut up with your questions”. This is probably the third or fourth time we have written about Barack Obama’s birth certificate. Our view on the Barack Obama Birth Certificate issue was enunciated in July 27, during the Gates “racist” Crowley period of Hope and Change. We are in favor of full source materials and full documentation. Today Hawaii Dimocrats say “shut up”:
And that is among the many reasons I don't mock the people with questions.
The reaction regarding the birth certificate has been over the top from day one. To enroll my three kids in their home town (Atlanta) I had to show their birth certificates. The school they go to now (in California) also needed to see their birth certificates.
And I have no sympathy for Hawaii.
The state government is a brain dead idiot.
Here's what they do. They declare Barack's b.c. historical and then get the state legislature to pass a special fee. They then issue it like crazy and reduce their state debt.
Let's be really clear that not only would those with questions buy a copy, so would a lot of his supporters. The latter group would frame it and put it on the wall.
But Hawaii's legislature is too damn stupid to grasp that they have a collector's item they can sell, something they can use to make money at a time when every state is suffering.
If I lived in Hawaii, I'd pitch a fit that they refused to use it to raise money.
Cougar Town. Last night was not a good episode for me. This ABC sitcom stars Courtney Cox and airs each Wednesday.
Why wasn't it good? Travis is now old enough to go to college and he's picking schools. That's her son -- Jules (Courtney Cox) . ANd it made me realize how my oldest going to college isn't that far off. And how will I handle it. (Probably far worse than Jules did.)
Funniest moment? When they were dancing to Enya.
"Iraq snapshot" (The Common Ills):
Thursday, April 29, 2010. Chaos and violence continue, a new report on the state of religious freedom is released, Nouri says "NO!" to interum government, a US Congressional Subcommittee does their job, and more.
March 7th, Iraq held elections. When the votes were tallied, the political slate receiving the most seats in Parliament was Ayad Allawi's bloc. Yesterday, Allawi issued a call. Ernesto Londono (Washington Post) reports on Allawi's call for an interim government to ensure no election theft takes place, "Former prime minister Ayad Allawi, the leader of Iraqiya, also proposed extending the mandate of the outgoing parliament until a new one is in place, "for the purpose of monitoring the executive branch." Ned Parker (Los Angeles Times) adds, "Allawi, a secular Shiite, urged the United Nations and other international organizations to back him in his demand for a caretaker government and a new vote, if matters continue on the current path." Asia News quotes Allawi stating, "Certainly what is going on is a theft of the Iraqi will and democracy, jeopardising the safety of the country." Zahraa Alkhalisi and Caroline Alexander (Bloomberg News) report Nouri's spokesperson has rejected the proposal. Ali al-Dabbagh declared, "It is an illegal and unconstitutional request." AINA reports al-Iraqiah issued the following statement earlier this week:1. To send a letter to the Head of the Supreme Judicial Council stressing the urgency of his intervention to protect the Judiciary from political influence, as this may have serious ramifications on the stability of the country. 2. To hold to account those responsible of distorting the election results by the appropriation of the electorates' votes through malicious disqualifications and arrests affecting the candidates and supporters of Al-Iraqiah Bloc. 3. Al-Iraqiah Bloc will reject any tampering with the election results, and therefore proposes the following: 1. That since Iraq is governed under Chapter VII, Al-Iraqiah has examined the option of resorting to the international community, including the members of the Security Council, European Union, Organisation of the Islamic conference, the states of the Arab League, to exercise their moral and legal right over the protection of the political process from any injustices, and to form a caretaker government and repeat the elections in an environment free of any political manipulation. 2. To send a request to the Presidential council, as the protector of the Constitution, to call upon the House of the Representatives to continue their duties until the certification of the election results, and to form a new House of Representatives for the purpose of monitoring the executive branch, that operates without authority, as to prevent any violations of the political process and the Constitution.
Meanwhile, optimistic timelines have said six to eight days to do the Baghdad recount. That would be the recount that was to start Monday but was put on hold. In Iraq, all but the violence gets put on hold. Mu Xuequan (Xinhua) reports that the recount is now expected to take between two and three weeks and quotes the Iraqi Independent High Electoral Commission head Faraj al-Haidari stating, "The electoral commission decided to start the recont for the ballots of Baghdad province next Monday." However, Rachel Scneller offers Bernard Gwertzman (the Council on Foreign Relations) a different timeline today, "We had the Shiite coalition seeking a recount of votes in Baghdad, which, if undertaken, will take up to two months." Speaking Tuesday to John Hockenberry on The Takeaway, BBC News' Gabriel Gatehouse also felt that the counting would take longer than some estimates, "That could take several weeks. Then the votes have to be certified." In addition to noting that lengthy process, Gatehouse is apparently the only reporter aware of wh General Odierno is the overall in charge of US forces here, has promised to make an assessment -- another assessment of that withdrawal time table two months after the election so we're looking at about a week from now. So I think we'll wait to see what he says in about a week's time."
Today the US Commission on International Religious Freedom issued their [PDF format warning] "Eleventh Annual Report on Religious Freedom in the World" which is 356 pages of text. The report examines religious freedoms in 28 countries and the timeline for the report is April 2009 to March 2010. Iraq falls under the category of "Countries of Particular Concern." From page 76:
FINDINGS: Systematic, ongoing, and egregious religious freedom violations continue in Iraq. Members of the country's smallest religious minorities still suffer from targeted violence, threats, and intimidation, against which they receive insufficient government protection. Perpetrators of such attacks are rarely identified, investigated, or punished, creating a climate of impunity. The small communities also experience a pattern of official discrimination, marginalization, and neglect. In addition, there continue to be sectarian attacks, often with impunity, and tense relations between Shi'a and Sunni Iraiqs, and other egregious, religiously-motivated violence also continues.
Based on these concerns, USCIRF again recommends in 2010 that Iraq be designated as a "country of particular concern," or CPC.* The Commission recommended that Iraq be designated as a CPC in 2008 and 2009, and placed Iraq on its Watch List in 2007.
The religious freedom situation in Iraq remains grave, particularly for the country's smallest, most vulnerable religious minorities. The violence, forced displacement, discrimination, marginalization, and neglect suffered by members of these groups threaten these ancient communities' very existence in Iraq. These minorities, which include Chaldo-Assyrians and other Christians, Sabean Mandaeans, and Yazidis, continue to experience targeted violence, receive inadequate official protection or justice, and suffer discrimination. Since 2003, many have fled to neighboring countries, where they represent a disproportionately high percentage of registered Iraqi refugees. The diminished numbers remaining in the country are now concentrated in areas in the highly dangerous Nineveh governorate over which the Kurdish Regional Government (KRG) is seeking to extend its control, and they suffer abuses and discrimination as a result. Although the Iraqi government has publicly condemned violence against these groups, it continues to fall short in investigating the continuing attacks and bringing perpetrators to justice, and its efforts to increase security to minority areas are not adequate. In addition, though greatly reduced from 2006-07 levels, violence between Shi'a and Sunni Iraqis continues. Significant tensions between these groups remain, including tensions due to the ongoing government formation process. Finally, other religiously-motivated violence and abuse continues.
PRIORITY RECOMMENDATIONS: For Iraq to become a secure, diverse, and stable democracy, the United States must pay greater attention to helping ensure that the human rights of all Iraqis are guaranteed and enforced both in law and practice. With U.S. forces drawing down and a new Iraqi government being formed in the wake of the March 7 elections, the United States should emphasize, with both the new Iraqi government and the KRG, the urgent need to protect vulnerable religious minority communities and ensure them justice. USCIRF also recommends that the U.S. government appoint a special envoy for human rights in Iraq, create an inter-agency task force on Iraqi minority issues, and prioritize funding for projects that foster religious tolerance. [. . .]
Recommendations continue on pages 77 through 79. We'll zoom in on the external refugees and the internally displaced aspect.
The U.S. goverment should:
* increase assistance, and encourage the Iraqi government and U.S. allies to do likewise, to the UN, humanitarian organizations, host nations, and host communities providing necessary aid to vulnerable Iraqi displaced persons (IDPs) and refugees, including funding programs to provide medical care, psychological care, educational opportunities, direct financial assistance, basic needs packages, and information campaigns;
* fund capacity-building programs for the Iraqi Ministry of Displacement and Migration to ensure that it can adequately provide assistance and protection to IDPs;
* clearly state that the U.S. government does not encourage the return of Iraqi refugees to Iraq until necessary conditions are met, including security, assistance, legal frameworks, and integration programs;
* encourage and fund information campaigns, including "go and see visits" by religious and/or community leaders selected by the refugees/IDPs themselves, to ensure that displaced Iraqis considering return have the information needed to make informed decisions;
* work with the government of Iraq and international organizations to help the Iraqi government develop a cohesive plan to assist voluntarily returning refugees and IDPs, including addressing property disputes, assistance upon return, livelihood opportunities, and lingering security problems;
* continue to process a significant number of Iraqi refugees for resettlement to the United States, taking into account the continued targeted violence against members of Iraq's smallest, most vulnerable religious minorities and the P2 designation in the Refugee Crisis in Iraq Act of 2007; and
* ensure that members of Iraq's smallest, most vulnerable religious minorities scheduled to be resettled to the United States are not delayed unnecessarily by providing adequate personnel to conduct background screening procedures and by enforcing proper application of the existing waiver of the material support bar to those forced to provide support to terrorists under duress.
Although the above are all important, one of the strongest things the US could do -- and it would cost not one cent -- would be to follow the recommendation that they "clearly state that the U.S. government does not encourage the return of Iraqi refugees to Iraq until necessary conditions are met, including security, assistance, legal frameworks, and integration programs". It shouldn't be left to the International Red Cross and Red Crescent to be the only ones making that statement but, sometimes, they are the only ones. Many who did return to Iraq were slain. That's less the case for Iraq's Christians because they're less apt to return if they leave.
Staying with this topic, Ekklesia reports on an open letter to US Secretary of State Hillary Clinton and US Secretary of Defence Robert Gates from religious leaders calling on the US government to protect Iraq's religious minorities. The letter from the National Council of the Churches of Christ in the USA to Hillary reads: We are writing to express the concern of the National Council of Churches, and our partners in Iraq and throughout the world, about the on-going situation of violent attacks on minority groups in Iraq, including the Christian community. We strongly request that you raise this concern with the Government of Iraq, provincial authorities, and the leadership of the Coalition Forces, urging them to take all possible steps to prevent further incidents of this type. Christians in Iraq have suffered more than a dozen violent deaths so far this year, including a three-year old child in Mosul who died on March 27 after a bomb, placed next to his family's home, exploded. As you know, thousands of Christians have been forced to flee their homes because of their fear of violence. Our concern is now particularly acute because it is possible that tensions will increase as various political forces continue to vie for power following the recent elections. We fear that a growing climate of mistrust and animosity will further threaten the fragile Christian community. With this is mind, we appeal to you to work directly and with Iraqis to * protect minority groups, including Christians in Mosul and other parts of Iraq; * extend necessary humanitarian aid to displaced families and * encourage the preservation of religious and ethnic diversity in Iraq. Thank you for your attention to this most urgent concern. Among those signing the letter are Rev Michael Kinnamon, Rev Canon Peg Chmberlin, Bishop John F. White, Rev Paula Clayton, Rev Roy Medley, Bishop Charles Leigh, Archbishop Vicken Aykazian, Rev Robert Welsh, Stan Noffsinger, Rev Katharine Jefferts Schori, Rev Mark S. Hanson and Rev Michael E. Livingston. Nathan Black (Christian Post) adds:The letter comes days after Christians in northern Iraq erected a statue of Jesus, modeled after Christ the Redeemer in Rio de Janeiro, amid mounting attacks by extremists.Bashar Jarjees Habash, coordinator of Christian affairs in the city of Hamdaniya, said the statue of Jesus opening his arms was built to "send a message of peace to everyone to say that we want to live in peace with all," as reported by Agence France-Presse.Pakistan Christian TV explains, "Iraqi Christians used to make up about 3 percent of Iraq's population, but now make up for more than half of its refugees, the Telegraph has reported.Iraqi church leaders who have visited the National Council of Churches offices in New York have implored U.S. Christians to take closer notice of their fellow Christians in Iraq." And thus far nothing has been able to stem the decreased presence in Iraq. Michael Swan (Catholic News Service) reported last week that Iraqi Christians who fled to Syria for safety are not planning any return and that the secular political party of Ayad Allawi's victory in the March 7th election (a victory now in dispute) has not convinced them of changes. Toma Georgees tells Swan, "It's very, very difficult to turn back to Iraq, impossible to turn back. Our problem is not with the Iraqi government. Our problem is with Iraqi people, ignorant people who want to kill us, who want to kill all the Christians. . . . Those people are ignorant, and they just want to drink our blood as Christians." Despite repeated, false claims, Iraqi Christians who fled the country aren't planning to return. That has been the case over and over. But some in the press continue to attempt to spin. Why would they want to return? If you were threatened and attacked and people you knew were killed forcing you to flee, would you be eager to return? The spin never had the numbers to back it up but there was never any psychological truth in it either. This has been a consistent attitude on the part of Iraqi Christians. NPR's Deborah Amos is the author of this year's Eclipse Of The Sunnis: Power, Exile, and Upheaval in the Middle East. On page 199 of her book, she notes the UNHCR's deputy representative in Amman, Jordan Arafat Jamal, "As for the Christian minorities in Amman, Jamal was convinced they would never return. By 2009, the European Union had stepped up re-settlement quotas, promising places for as many as ten thousand Iraqis, mostly threatened Christians, despite appeals from Iraq that doing so would diminish the remaining Christian community and raise questions about its continued viability."
Earlier this week, Amnesty International issued a 28-page report entitled "Iraq: Civilians under fire," [PDF format warning] click here. Emigrate.co.uk News notes of the report "thousands of Christians, as well as many members of the Sabean Mandaean religion, Yazidis and women and girls, being targeted for un-Islamic behavior. Amnesty International said that many of these people are at risk of being killed." Spero News reports that a recent Babel College (Erbil) seminar was entitled "The Role and Identity of the Priest in Iraq Today" and:The key issue - a priest present at the seminar told Fides - was that of the ministerial priesthood, examined in a human, spiritual, theological, and biblical sense, and all lived within the reality of Iraq today, which has among its most pressing challenges to face: violence, forced emigration of Christians, and the critical security conditions of Christian communities. The conference also stressed the importance for the Church as a whole to accompany the priests during their journey of formation and during their pastoral life, as every priest needs to feel the community's support in the form of concrete aid and prayer.Rudi Stettner (Indyposted) observes, "Even if the physical survival of Iraq's religious minorities can be assured, their endurance as distinct religious groups is endangered by the displacement they have endured in the aftermath of the war in Iraq. It is important that the world show its support for Christians, Mandaeans and Yazidis in Iraq, whether they choose to remain there or not. Concerns for their safety should be made clear to the Iraqi government. A desire to welcome them should be made clear to the American government as well." And Kathleen McManus, OP of the University of Portland writes the Catholic Sentinel:As a Dominican Sister, I know from our own Iraqi Sisters about the persecution Christians are experiencing. Our Sisters in Baghdad and Mosul have chosen to stay and minister to Christians and Muslims alike. A tragic effect of the war and our U.S. presence has been a persecution of Christians never experienced during the admittedly brutal and unjust reign of Saddam Hussein.In recent weeks assassins entered the home of a Christian family in Mosul, killing an elderly father and his two sons. Panicked by the realization that they are no longer safe in their own homes, more than 100 families fled Mosul. Rapes and murders have been reported. The elderly sisters in the Dominican motherhouse in Mosul have chosen to stay in the convent, lest terrorists seize it.The U.S. Dominican Iraq Coordinating Committee has written to Cardinal Francis George, president of the U.S. Conference of Catholic Bishops, to urge the bishops to exhort Washington to pressure the Iraqi government to attend to the violence. Swift and definitive intervention is necessary to ensure the protection of all, and, through them, the democratic process for which so many have already suffered and died.Today's report from the US Commission on International Religious Freedom never sees the problem as one person or one group's problem to address. Like the illegal war that created the Iraq refugee crisis, fixing the problem would require a global effort.
Silver tongues
Digest the truth
What have we done
And where was any proof
In the heat of the sun
Nothing can be done
And the blood lies on the hands of everyone
-- "Blood Lies," written and performed by David Saw whose most recent album is Broken Down Figure (Kat reviewed it here).
Turning to some of today's violence . . .
Reuters notes a Baghdad car bombing which claimed 8 lives and Reuters notes a Baghdad roadside bombing which injured six people and a Kirkuk sticky bombing which claimed 1 life.
Following a brief mark up meeting, Chair Michael Michaud called to order the Health Subcommittee (of the House Veterans Affaris Committee) to order. The Subcommmittee was receiving an update on a pilot program. Michaud noted, "I recognize and appreciate the VA's efforts in addressing the health care needs of our rural veterans who are more likely to be in poorer health than their urban counterparts. However, more work remains in this area as our rural veterans face unique challenges that are both extensive and complex. The enhanced contract care pilot program is a potential tool for expanding access to health care for our rural veterans in areas where the VA is unable to provide care." VA's Patricia Vandenberg appeared before the Subcommittee accompanied by Gita Uppal. VA is, of course, Veterans Administration. "VISN" is Veterans Integrated Service Network.
A problem that arises repeatedly is that Congress writes a bill, passes it, it's signed into law and then it's not followed. Sometimes there's accidental confusion, sometimes there's intenational confusion. Many times the confusion is not even noticed until well after the project is underway. Today the Subcommitee heard about the status on a pilot program that they passed the legislation for and that is in the process of being implemented. Because the Subcommittee members paid attention and asked important questions, a problem dealing with confusion on the part of the VA quickly became evident.
US House Rep Jerry Moran: You're testimony raises a significant concern for me, however. This started out as legislation that would effect the entire country and, if you lived a certain number of miles from a provider, you would then be eligible for VA care provided with a local provider. It was narrowed to be a certain number of VISNs as a pilot or demonstartion project but your testimony suggests to me that you're now narrowing it even further and that you're going to do a particular community within that vison and that's troublesome for me because we've gone from a broad scope taking care of a large number of veterans to -- I was convinced that we should see how this works. But the CBO score, as we talk about its costs, to me, it was never suggested that we were not going to provide the same opportunity for community based service for every veteran that lived that number of miles -- now that number of minutes from a provider, from a VA provider. Is --Am I understanding the testimony correctly that now we're just going to select certain communities within the VISN? And make that the pilot program?
Patricia Vandenberg: We have asked the visons to identify multiple sites as focal points within their vison for potentially standing up this pilot project. At this point and time that is the direction that we're moving in. We understood the wording in the law when it said the Secretary will select areas, sites -- that that was permissable, that that was feasible in the pilot structure. So we are here obviously today to gain further insight from the committee as to your expectations.
US House Rep Jerry Moran: Well that certainly would be different than my expectations then Mr. Michaud and others may have an opinion but I would -- I'd be very critical of the concept that we're going to narrow the opportunities for veterans even further so if you're a veteran that lives a number of minutes from the provider you may or may not qualify depending upon whether the VISN director decided that your community is one that now qualifies. What I envision and what I hope that the VA would pursue is that if you meet the definition of highly rural and you're in that pilot demonstration VISN, you qualify. In fact, the VA has the obligation for providing a provider, finding a provider for you to meet your health care needs. So I welcome additional dialogue. Maybe other Committee members have an opinion regarding the intention but as I recall the CBO budget information did not narrow it one more step as it suggests that you suggest may occur. So my red flag is up.
Patricia Vandenberg: Thank you for the clarification, sir.
US House Rep Jerry Moran: You're very welcome. The legislation that the president's now expected to sign, do you have a sense, which defines miles to minutes, and the definition of . . . Help me?
Patricia Vandenberg: Hardship.
US House Rep Jerry Moran: Thank you! Hardship. Will it speed up the implementation date? Do you have a sense that now we're moving ahead six months more quickly?
Patricia Vandenberg: It certainly will facilitate us not being impeded by the regulatory process and so we believe that we are on a, uh, path at this point having issued the guidance to the field and asking them to identify sites. We may have to amend that per the conversation we are having. But we don't see any firm impediment except for the fact that I referenced earlier, we have no way of knowing when this goes out to the provider community what the level of receptivity would be. So I would say that the rate of progress going forward will be a function of the contracting mechanism and the receptivity in the provider community to work with us.
US House Rep Jerry Moran: I think that receptivity will in part depend upon the reimbursement rate that you conclude is appropriate and my understanding is that the VA's current fee base is fee base and you cover the entire cost of care. You provide health care for veterans with local providers today.
Patricia Vandenberg: Yes, sir.
US House Rep Jerry Moran: And I think you cover the entire cost of doing so. That I assume would be the most desirable model for the veteran and for the health care provider in getting this implemented and wide spread use. So I'm hoping that you follow the same practices that you've been following in the past of how you reimburse hometown providers today. Mr. Chairman, my time is expired, but I would welcome your input or the staff input on this issue of a pilot within a pilot. I'm fearful that we're narrowing the scope and the number of veterans that we wanted to take care of across the country was already narrowed to a certain number of veterans -- to a certain number of VISNs. And we need to make sure, in my opinion, that it's not narrowed further, that you have to live in a particular area within that community to access this health care. I thank the Chairman.
Subcommittee Chair Michael Michaud: Thank you very much, Mr. Moran. You're absolutely correct, the whole intent was to have the VISN -- the whole VISN. Not a pilot within that VISN. And I believe we actually got a CBO score predicated on the full VISN, not on pilots within that VISN. And you're 100% correct, the intent of the legislation was for the full VISN. And that is a concern. This is not the first time we've seen this thing. We actually saw it back in legislation that was passed in 2006 relating to state veterans' nursing homes which required the VA to provide full cost of veterans and, through the rule making process, the VA narrowed that down to what full cost meant for the VA and we're trying to correct that issue currently. So but you're 100% correct, Mr. Moran, it was for the full VISN.
US House Rep Jerry Moran: Mr. Chairman, excuse me, and I would point that to my knowledge this is -- at least this is the first time I've heard as we've had briefings from the VA on this topic, this is the first time I've seen the narrowing of the narrowing. And so -- I appreiciate the Chairman's comments.
Patricia Vandenberg: Mr. Chairman, may I make a further comment?
Subcommittee Chair Michael Michaud: Yes.
Patricia Vandenberg: We obviously will respond to the feedback that we're receiving today but just to go back to the question of what further challenge or impediment might we experience I would just like to observe that when attempting to put a provider in place for highly rural veterans who will, no doubt, be dispersed in a VISN, we will likely experience a situation of multiple contracting relationships so that could potentially extend the timely implementation for coverage in an entire VISN. So I'm-I'm just wanting to acknowledge that I hear you, I-I further appreciate the intent and, just practically speaking, obviously going to honor the intent and just realize that we may be dealing -- In a number of instances, it would be ideal if there were a provider network established that had outlets if you will in those multiple venues. Having had some experience in my prior life in Idaho where the organization I was associated with attempted to set up those multiple venues in rural communities, it made it very easy if someone wanted to serve those communities, they just came to my organization and we helped them get that done. In our experience thus far in rural contracting, that hasn't always been the case. So I hear what the Committee is telling us today. We will proceed to respond to this and just work with due diligence to work through the contracting as timely as possible.
Jerry Moran: Mr. Chairman, I think what Ms. Vandenberg is telling me is my two desires of having broad scope and quick implementation may be mutually exclusive. And putting the reminder back to us that this may slow the process down if they've got to contract in a multiple number of ways. But, at least from my perspective, I would put the priority on doing it right, which is to take care of every veteran regardless of where they live, not within a particular communisty as compared to the speed of its accomplishment. We want both but, again, I think we'd make a terrible mistake if we go through this pilot program and we only, in a sense, take the easy areas within a rural VISN in which it's easier to find a provider or there's a multiple number of providers or there's a larger number of veterans. We're still isolating that veteran who lives a long distance from a VA hospital. And so my priority would be back to being sure that we implement this in a way that we can demonstrate that it can be done VISN wide. Thank you.
Subcommittee Chair Michael Michaud: Thank you. Ms. Halvorson?
US House Rep Debbie Halvorson: Thank you, Mr. Chairman. And while we've been discussing all this, there's probably many veterans who haven't been able to find a way to get taken care of. So while we're trying to figure out how to do this, our veterans still need help. So instead of reinventing the wheel or trying to figure out what's "rural," what's "hardship," why aren't we just taking care of our veterans and letting them go where ever it is that they need to be taken care of? Now I may be naive and I am new, this is my first term, but while we're trying to figure out the intent of a law or how to do it the right way, no matter if it takes long, what are we doing right now for our rural veterans? Where are they going and how are they getting taken care of?
Patricia Vandenberg: Thank you for the question. I'm glad you asked it because I can speak very directly to it. We are already providing a significant amount of fee care to rural and highly rural veterans. And under the aegis of the Office of Rural Health in Fiscal Year '10, we have just put out $200 million to the VISNs to afford them the extra resources to provide fee care to rural and highly rural veterans. So I think it's important to note that is a mechanism that is already in place and what I understood the intent of this law to do was to give VA additional incentive and capacity to further contract out care to extend that access even more. But, to answer your question, we are already meeting the needs of rural and highly rural veterans through the fee care mechanism
US House Rep Debbie Halvorson: So then and not to interrupt but so then what's the estimate of how many extra veterans are we gong to take care of and the cost? So we're already spending money, we're already taking care of people, so this program -- what are we assessing the pilot program's cost, the quality and how many veterans are going to be eligible for the pilot program?
Patricia Vandenberg: Let me take the assessment of costs. First, in our initial analysis of the implementation of the pilot as we previously understood it, we estimated up to $100 million. However, we knew that that was putting significant empahsis on primary care service delivery. And as you add in the multi-speciality dimensions of a patient's care, that that cost could rise. So our current working assumption is that the pilot project as we previously conceived it would cost at least $100 million. Now you're second question about quality? That's part of the analysis and the process of contracting and we're using all of the resources of VHA that we currently employ in the contract process. Pulling those in to look at the specifics of assessing the quality of the care and the patient's satisfaction with the care.
US House Rep Deborah Halvorson: So for a hundred million dollars, w'ere going to help more people?
Patricia Vandenberg: Yes, ma'am.
US House Rep Debbie Halvorson: And better?
Patricia Vandenberg: I-I think, uhm, I would just observe that we believe that the standard of care, the quality of care, that is evident in our current fee relationships is of a high quality nature so when we say beter, that could connote that there is something lacking in our current approach. . .
US House Rep Debbie Halvorson: Right and it's not a good word. "Better" is not a good word.
Patricia Vandenberg: I just want to be precise. We definiately are trying to enhance access. And by spreading the network of contract relationships further into highly rural communities and attempting to structure those relationships -- in some instances, they don't exist today -- that will definitely enahnce the quality of veterans care because of the --
US House Rep Debbie Halvorson: Okay, I just hope that we're not reinventing the wheel. It looks like you've taken all this time to discuss "hardship" and "rural" when we should be taking this time to help our veterans with their health care. And now, with 1963 I believe, we take hardship out altogether. We should have no problem now implementing this bill. So I know my time is about up, but I'm concerned about the care of my veterans. Not debating whether they're rural or if they have a hardship. We are talking about people that we just want to take care of. Thank you.
I included Halvorson because I think she did a good job and I think a lot of people are getting very tired and very annoyed by the constant need to refer to study. When you're given a directive, the study process should not be a hold up. Now we saw the government just waste money on a PSTD 'study' which issued their report a few weeks ago and the 'answer' was 'more research and study required.' Nothing to do with really helping those who deal with PTSD. And there is a growing frustration on the part of veterans. Halvorson has worked very hard to be very connected to the veterans in her district and her comments represent what she and other House Reps in contact with veterans are hearing.
And the confusion as to what VA was supposed to be implementing? Chair Michael Michaud noted "this legislation passed in October of 2008. We did not hear back from the VA until March of 2009 of why they can't implement it. And the concern being that when we went through the hearing process, the mark up process, that was the time the VA should have been before us saying, 'Well we need these changes'." Maybe there'd be less confusion, if they'd been present for those hearings. Not just to speak, but to listen.
In other news, US Rep Henry Brown is a Republican who serves on the Subcommittee (in fact, he's the Subcomittee's Ranking Member). His online office, his Congressional website, just won an award from the Congressional Management Foundation "for having one of the best Web sites in Congress." You can click here to visit and evaluate for yourselves. And here's the press release noting the award. His was one of offices receiving an award. The top honor, Platinum Mouse Award went to the online offices of US House Rep Steve Israel (Democrat), US House Republican Conference, Mike Pence (Republican) is the Chair, the House Committee on Science and Techonology which Bart Gordon (Democrat) chairs and the online office of US Senator Lisa Murkowski (Republican). CMF notes:
"These four stood out from the rest and serve as examples for others to follow. Overall, we found the good sites are getting better and the bad are getting worse," said Beverly Bell, executive director of CMF, a nonpartisan nonprofit founded 33 years ago to promote a more effective Congress. "It looks like half of the Congress is racing to the top while the other half race to the bottom. The outstanding sites follow best practices, leverage the power of social media, and serve their constituents well. Those offices falling behind are losing a great opportunity to interact with their constituents in ways the public has grown to expect."
And on the topic of online Congressional offices, we'll close with Michael Applegate's "Stop Outsourcing Security Act HR 4650" (Iraq Veterans Against the War):
Rep Jan Schakowsky and 24 cosponsors are introducing a bill to phase out private military contractors. A similar bill is being introduced to the Senate by Sen Bernie Sanders I(VT) S 3023
http://thomas.loc.gov/cgi-bin/bdquery/z?d111:h.r.04650:
Contact your reps to urge them to support this bill. Latest Major Action: 2/23/2010 Referred to House committee. Status: Referred to the Committee on Foreign Affairs, and in addition to the Committees on Armed Services, and Intelligence (Permanent Select),
Currently there are 24 cosponsors: Rep Baldwin, Tammy [WI-2] - 2/23/2010 Rep Conyers, John, Jr. [MI-14] - 2/25/2010 Rep DeFazio, Peter A. [OR-4] - 3/10/2010 Rep Doggett, Lloyd [TX-25] - 4/21/2010 Rep Ellison, Keith [MN-5] - 2/23/2010 Rep Filner, Bob [CA-51] - 2/23/2010 Rep Frank, Barney [MA-4] - 4/21/2010 Rep Gonzalez, Charles A. [TX-20] - 2/23/2010 Rep Grayson, Alan [FL-8] - 3/10/2010 Rep Grijalva, Raul M. [AZ-7] - 2/23/2010 Rep Gutierrez, Luis V. [IL-4] - 2/23/2010Rep Hall, John J. [NY-19] - 2/23/2010 Rep Hinchey, Maurice D. [NY-22] - 2/23/2010 Rep Holt, Rush D. [NJ-12] - 2/23/2010 Rep Kaptur, Marcy [OH-9] - 4/21/2010 Rep Lee, Barbara [CA-9] - 2/23/2010 Rep Maloney, Carolyn B. [NY-14] - 2/23/2010 Rep McGovern, James P. [MA-3] - 2/23/2010 Rep Moore, Gwen [WI-4] - 2/23/2010 Rep Polis, Jared [CO-2] - 2/23/2010 Rep Shea-Porter, Carol [NH-1] - 2/23/2010 Rep Stark, Fortney Pete [CA-13] - 2/23/2010 Rep Woolsey, Lynn C. [CA-6] - 2/23/2010 Rep Wu, David [OR-1] - 4/21/2010
Please become a citizen cosponsor by going to:
http://act.janschakowsky.org/p/dia/action/public/?action_KEY=12
iraq
the washington posternesto londonothe los angeles timesned parkerasia news
bloomberg newscaroline alexander
xinhuamu xuequan
deborah amos
david saw
iraq veterans against the warmichael applegate
ekklesiathe christian postnathan blackpakistan christian tvcatholic news servicemichael swanspero newsindypostedthe catholic sentinel
Thursday, April 29, 2010. Chaos and violence continue, a new report on the state of religious freedom is released, Nouri says "NO!" to interum government, a US Congressional Subcommittee does their job, and more.
March 7th, Iraq held elections. When the votes were tallied, the political slate receiving the most seats in Parliament was Ayad Allawi's bloc. Yesterday, Allawi issued a call. Ernesto Londono (Washington Post) reports on Allawi's call for an interim government to ensure no election theft takes place, "Former prime minister Ayad Allawi, the leader of Iraqiya, also proposed extending the mandate of the outgoing parliament until a new one is in place, "for the purpose of monitoring the executive branch." Ned Parker (Los Angeles Times) adds, "Allawi, a secular Shiite, urged the United Nations and other international organizations to back him in his demand for a caretaker government and a new vote, if matters continue on the current path." Asia News quotes Allawi stating, "Certainly what is going on is a theft of the Iraqi will and democracy, jeopardising the safety of the country." Zahraa Alkhalisi and Caroline Alexander (Bloomberg News) report Nouri's spokesperson has rejected the proposal. Ali al-Dabbagh declared, "It is an illegal and unconstitutional request." AINA reports al-Iraqiah issued the following statement earlier this week:1. To send a letter to the Head of the Supreme Judicial Council stressing the urgency of his intervention to protect the Judiciary from political influence, as this may have serious ramifications on the stability of the country. 2. To hold to account those responsible of distorting the election results by the appropriation of the electorates' votes through malicious disqualifications and arrests affecting the candidates and supporters of Al-Iraqiah Bloc. 3. Al-Iraqiah Bloc will reject any tampering with the election results, and therefore proposes the following: 1. That since Iraq is governed under Chapter VII, Al-Iraqiah has examined the option of resorting to the international community, including the members of the Security Council, European Union, Organisation of the Islamic conference, the states of the Arab League, to exercise their moral and legal right over the protection of the political process from any injustices, and to form a caretaker government and repeat the elections in an environment free of any political manipulation. 2. To send a request to the Presidential council, as the protector of the Constitution, to call upon the House of the Representatives to continue their duties until the certification of the election results, and to form a new House of Representatives for the purpose of monitoring the executive branch, that operates without authority, as to prevent any violations of the political process and the Constitution.
Meanwhile, optimistic timelines have said six to eight days to do the Baghdad recount. That would be the recount that was to start Monday but was put on hold. In Iraq, all but the violence gets put on hold. Mu Xuequan (Xinhua) reports that the recount is now expected to take between two and three weeks and quotes the Iraqi Independent High Electoral Commission head Faraj al-Haidari stating, "The electoral commission decided to start the recont for the ballots of Baghdad province next Monday." However, Rachel Scneller offers Bernard Gwertzman (the Council on Foreign Relations) a different timeline today, "We had the Shiite coalition seeking a recount of votes in Baghdad, which, if undertaken, will take up to two months." Speaking Tuesday to John Hockenberry on The Takeaway, BBC News' Gabriel Gatehouse also felt that the counting would take longer than some estimates, "That could take several weeks. Then the votes have to be certified." In addition to noting that lengthy process, Gatehouse is apparently the only reporter aware of wh General Odierno is the overall in charge of US forces here, has promised to make an assessment -- another assessment of that withdrawal time table two months after the election so we're looking at about a week from now. So I think we'll wait to see what he says in about a week's time."
Today the US Commission on International Religious Freedom issued their [PDF format warning] "Eleventh Annual Report on Religious Freedom in the World" which is 356 pages of text. The report examines religious freedoms in 28 countries and the timeline for the report is April 2009 to March 2010. Iraq falls under the category of "Countries of Particular Concern." From page 76:
FINDINGS: Systematic, ongoing, and egregious religious freedom violations continue in Iraq. Members of the country's smallest religious minorities still suffer from targeted violence, threats, and intimidation, against which they receive insufficient government protection. Perpetrators of such attacks are rarely identified, investigated, or punished, creating a climate of impunity. The small communities also experience a pattern of official discrimination, marginalization, and neglect. In addition, there continue to be sectarian attacks, often with impunity, and tense relations between Shi'a and Sunni Iraiqs, and other egregious, religiously-motivated violence also continues.
Based on these concerns, USCIRF again recommends in 2010 that Iraq be designated as a "country of particular concern," or CPC.* The Commission recommended that Iraq be designated as a CPC in 2008 and 2009, and placed Iraq on its Watch List in 2007.
The religious freedom situation in Iraq remains grave, particularly for the country's smallest, most vulnerable religious minorities. The violence, forced displacement, discrimination, marginalization, and neglect suffered by members of these groups threaten these ancient communities' very existence in Iraq. These minorities, which include Chaldo-Assyrians and other Christians, Sabean Mandaeans, and Yazidis, continue to experience targeted violence, receive inadequate official protection or justice, and suffer discrimination. Since 2003, many have fled to neighboring countries, where they represent a disproportionately high percentage of registered Iraqi refugees. The diminished numbers remaining in the country are now concentrated in areas in the highly dangerous Nineveh governorate over which the Kurdish Regional Government (KRG) is seeking to extend its control, and they suffer abuses and discrimination as a result. Although the Iraqi government has publicly condemned violence against these groups, it continues to fall short in investigating the continuing attacks and bringing perpetrators to justice, and its efforts to increase security to minority areas are not adequate. In addition, though greatly reduced from 2006-07 levels, violence between Shi'a and Sunni Iraqis continues. Significant tensions between these groups remain, including tensions due to the ongoing government formation process. Finally, other religiously-motivated violence and abuse continues.
PRIORITY RECOMMENDATIONS: For Iraq to become a secure, diverse, and stable democracy, the United States must pay greater attention to helping ensure that the human rights of all Iraqis are guaranteed and enforced both in law and practice. With U.S. forces drawing down and a new Iraqi government being formed in the wake of the March 7 elections, the United States should emphasize, with both the new Iraqi government and the KRG, the urgent need to protect vulnerable religious minority communities and ensure them justice. USCIRF also recommends that the U.S. government appoint a special envoy for human rights in Iraq, create an inter-agency task force on Iraqi minority issues, and prioritize funding for projects that foster religious tolerance. [. . .]
Recommendations continue on pages 77 through 79. We'll zoom in on the external refugees and the internally displaced aspect.
The U.S. goverment should:
* increase assistance, and encourage the Iraqi government and U.S. allies to do likewise, to the UN, humanitarian organizations, host nations, and host communities providing necessary aid to vulnerable Iraqi displaced persons (IDPs) and refugees, including funding programs to provide medical care, psychological care, educational opportunities, direct financial assistance, basic needs packages, and information campaigns;
* fund capacity-building programs for the Iraqi Ministry of Displacement and Migration to ensure that it can adequately provide assistance and protection to IDPs;
* clearly state that the U.S. government does not encourage the return of Iraqi refugees to Iraq until necessary conditions are met, including security, assistance, legal frameworks, and integration programs;
* encourage and fund information campaigns, including "go and see visits" by religious and/or community leaders selected by the refugees/IDPs themselves, to ensure that displaced Iraqis considering return have the information needed to make informed decisions;
* work with the government of Iraq and international organizations to help the Iraqi government develop a cohesive plan to assist voluntarily returning refugees and IDPs, including addressing property disputes, assistance upon return, livelihood opportunities, and lingering security problems;
* continue to process a significant number of Iraqi refugees for resettlement to the United States, taking into account the continued targeted violence against members of Iraq's smallest, most vulnerable religious minorities and the P2 designation in the Refugee Crisis in Iraq Act of 2007; and
* ensure that members of Iraq's smallest, most vulnerable religious minorities scheduled to be resettled to the United States are not delayed unnecessarily by providing adequate personnel to conduct background screening procedures and by enforcing proper application of the existing waiver of the material support bar to those forced to provide support to terrorists under duress.
Although the above are all important, one of the strongest things the US could do -- and it would cost not one cent -- would be to follow the recommendation that they "clearly state that the U.S. government does not encourage the return of Iraqi refugees to Iraq until necessary conditions are met, including security, assistance, legal frameworks, and integration programs". It shouldn't be left to the International Red Cross and Red Crescent to be the only ones making that statement but, sometimes, they are the only ones. Many who did return to Iraq were slain. That's less the case for Iraq's Christians because they're less apt to return if they leave.
Staying with this topic, Ekklesia reports on an open letter to US Secretary of State Hillary Clinton and US Secretary of Defence Robert Gates from religious leaders calling on the US government to protect Iraq's religious minorities. The letter from the National Council of the Churches of Christ in the USA to Hillary reads: We are writing to express the concern of the National Council of Churches, and our partners in Iraq and throughout the world, about the on-going situation of violent attacks on minority groups in Iraq, including the Christian community. We strongly request that you raise this concern with the Government of Iraq, provincial authorities, and the leadership of the Coalition Forces, urging them to take all possible steps to prevent further incidents of this type. Christians in Iraq have suffered more than a dozen violent deaths so far this year, including a three-year old child in Mosul who died on March 27 after a bomb, placed next to his family's home, exploded. As you know, thousands of Christians have been forced to flee their homes because of their fear of violence. Our concern is now particularly acute because it is possible that tensions will increase as various political forces continue to vie for power following the recent elections. We fear that a growing climate of mistrust and animosity will further threaten the fragile Christian community. With this is mind, we appeal to you to work directly and with Iraqis to * protect minority groups, including Christians in Mosul and other parts of Iraq; * extend necessary humanitarian aid to displaced families and * encourage the preservation of religious and ethnic diversity in Iraq. Thank you for your attention to this most urgent concern. Among those signing the letter are Rev Michael Kinnamon, Rev Canon Peg Chmberlin, Bishop John F. White, Rev Paula Clayton, Rev Roy Medley, Bishop Charles Leigh, Archbishop Vicken Aykazian, Rev Robert Welsh, Stan Noffsinger, Rev Katharine Jefferts Schori, Rev Mark S. Hanson and Rev Michael E. Livingston. Nathan Black (Christian Post) adds:The letter comes days after Christians in northern Iraq erected a statue of Jesus, modeled after Christ the Redeemer in Rio de Janeiro, amid mounting attacks by extremists.Bashar Jarjees Habash, coordinator of Christian affairs in the city of Hamdaniya, said the statue of Jesus opening his arms was built to "send a message of peace to everyone to say that we want to live in peace with all," as reported by Agence France-Presse.Pakistan Christian TV explains, "Iraqi Christians used to make up about 3 percent of Iraq's population, but now make up for more than half of its refugees, the Telegraph has reported.Iraqi church leaders who have visited the National Council of Churches offices in New York have implored U.S. Christians to take closer notice of their fellow Christians in Iraq." And thus far nothing has been able to stem the decreased presence in Iraq. Michael Swan (Catholic News Service) reported last week that Iraqi Christians who fled to Syria for safety are not planning any return and that the secular political party of Ayad Allawi's victory in the March 7th election (a victory now in dispute) has not convinced them of changes. Toma Georgees tells Swan, "It's very, very difficult to turn back to Iraq, impossible to turn back. Our problem is not with the Iraqi government. Our problem is with Iraqi people, ignorant people who want to kill us, who want to kill all the Christians. . . . Those people are ignorant, and they just want to drink our blood as Christians." Despite repeated, false claims, Iraqi Christians who fled the country aren't planning to return. That has been the case over and over. But some in the press continue to attempt to spin. Why would they want to return? If you were threatened and attacked and people you knew were killed forcing you to flee, would you be eager to return? The spin never had the numbers to back it up but there was never any psychological truth in it either. This has been a consistent attitude on the part of Iraqi Christians. NPR's Deborah Amos is the author of this year's Eclipse Of The Sunnis: Power, Exile, and Upheaval in the Middle East. On page 199 of her book, she notes the UNHCR's deputy representative in Amman, Jordan Arafat Jamal, "As for the Christian minorities in Amman, Jamal was convinced they would never return. By 2009, the European Union had stepped up re-settlement quotas, promising places for as many as ten thousand Iraqis, mostly threatened Christians, despite appeals from Iraq that doing so would diminish the remaining Christian community and raise questions about its continued viability."
Earlier this week, Amnesty International issued a 28-page report entitled "Iraq: Civilians under fire," [PDF format warning] click here. Emigrate.co.uk News notes of the report "thousands of Christians, as well as many members of the Sabean Mandaean religion, Yazidis and women and girls, being targeted for un-Islamic behavior. Amnesty International said that many of these people are at risk of being killed." Spero News reports that a recent Babel College (Erbil) seminar was entitled "The Role and Identity of the Priest in Iraq Today" and:The key issue - a priest present at the seminar told Fides - was that of the ministerial priesthood, examined in a human, spiritual, theological, and biblical sense, and all lived within the reality of Iraq today, which has among its most pressing challenges to face: violence, forced emigration of Christians, and the critical security conditions of Christian communities. The conference also stressed the importance for the Church as a whole to accompany the priests during their journey of formation and during their pastoral life, as every priest needs to feel the community's support in the form of concrete aid and prayer.Rudi Stettner (Indyposted) observes, "Even if the physical survival of Iraq's religious minorities can be assured, their endurance as distinct religious groups is endangered by the displacement they have endured in the aftermath of the war in Iraq. It is important that the world show its support for Christians, Mandaeans and Yazidis in Iraq, whether they choose to remain there or not. Concerns for their safety should be made clear to the Iraqi government. A desire to welcome them should be made clear to the American government as well." And Kathleen McManus, OP of the University of Portland writes the Catholic Sentinel:As a Dominican Sister, I know from our own Iraqi Sisters about the persecution Christians are experiencing. Our Sisters in Baghdad and Mosul have chosen to stay and minister to Christians and Muslims alike. A tragic effect of the war and our U.S. presence has been a persecution of Christians never experienced during the admittedly brutal and unjust reign of Saddam Hussein.In recent weeks assassins entered the home of a Christian family in Mosul, killing an elderly father and his two sons. Panicked by the realization that they are no longer safe in their own homes, more than 100 families fled Mosul. Rapes and murders have been reported. The elderly sisters in the Dominican motherhouse in Mosul have chosen to stay in the convent, lest terrorists seize it.The U.S. Dominican Iraq Coordinating Committee has written to Cardinal Francis George, president of the U.S. Conference of Catholic Bishops, to urge the bishops to exhort Washington to pressure the Iraqi government to attend to the violence. Swift and definitive intervention is necessary to ensure the protection of all, and, through them, the democratic process for which so many have already suffered and died.Today's report from the US Commission on International Religious Freedom never sees the problem as one person or one group's problem to address. Like the illegal war that created the Iraq refugee crisis, fixing the problem would require a global effort.
Silver tongues
Digest the truth
What have we done
And where was any proof
In the heat of the sun
Nothing can be done
And the blood lies on the hands of everyone
-- "Blood Lies," written and performed by David Saw whose most recent album is Broken Down Figure (Kat reviewed it here).
Turning to some of today's violence . . .
Reuters notes a Baghdad car bombing which claimed 8 lives and Reuters notes a Baghdad roadside bombing which injured six people and a Kirkuk sticky bombing which claimed 1 life.
Following a brief mark up meeting, Chair Michael Michaud called to order the Health Subcommittee (of the House Veterans Affaris Committee) to order. The Subcommmittee was receiving an update on a pilot program. Michaud noted, "I recognize and appreciate the VA's efforts in addressing the health care needs of our rural veterans who are more likely to be in poorer health than their urban counterparts. However, more work remains in this area as our rural veterans face unique challenges that are both extensive and complex. The enhanced contract care pilot program is a potential tool for expanding access to health care for our rural veterans in areas where the VA is unable to provide care." VA's Patricia Vandenberg appeared before the Subcommittee accompanied by Gita Uppal. VA is, of course, Veterans Administration. "VISN" is Veterans Integrated Service Network.
A problem that arises repeatedly is that Congress writes a bill, passes it, it's signed into law and then it's not followed. Sometimes there's accidental confusion, sometimes there's intenational confusion. Many times the confusion is not even noticed until well after the project is underway. Today the Subcommitee heard about the status on a pilot program that they passed the legislation for and that is in the process of being implemented. Because the Subcommittee members paid attention and asked important questions, a problem dealing with confusion on the part of the VA quickly became evident.
US House Rep Jerry Moran: You're testimony raises a significant concern for me, however. This started out as legislation that would effect the entire country and, if you lived a certain number of miles from a provider, you would then be eligible for VA care provided with a local provider. It was narrowed to be a certain number of VISNs as a pilot or demonstartion project but your testimony suggests to me that you're now narrowing it even further and that you're going to do a particular community within that vison and that's troublesome for me because we've gone from a broad scope taking care of a large number of veterans to -- I was convinced that we should see how this works. But the CBO score, as we talk about its costs, to me, it was never suggested that we were not going to provide the same opportunity for community based service for every veteran that lived that number of miles -- now that number of minutes from a provider, from a VA provider. Is --Am I understanding the testimony correctly that now we're just going to select certain communities within the VISN? And make that the pilot program?
Patricia Vandenberg: We have asked the visons to identify multiple sites as focal points within their vison for potentially standing up this pilot project. At this point and time that is the direction that we're moving in. We understood the wording in the law when it said the Secretary will select areas, sites -- that that was permissable, that that was feasible in the pilot structure. So we are here obviously today to gain further insight from the committee as to your expectations.
US House Rep Jerry Moran: Well that certainly would be different than my expectations then Mr. Michaud and others may have an opinion but I would -- I'd be very critical of the concept that we're going to narrow the opportunities for veterans even further so if you're a veteran that lives a number of minutes from the provider you may or may not qualify depending upon whether the VISN director decided that your community is one that now qualifies. What I envision and what I hope that the VA would pursue is that if you meet the definition of highly rural and you're in that pilot demonstration VISN, you qualify. In fact, the VA has the obligation for providing a provider, finding a provider for you to meet your health care needs. So I welcome additional dialogue. Maybe other Committee members have an opinion regarding the intention but as I recall the CBO budget information did not narrow it one more step as it suggests that you suggest may occur. So my red flag is up.
Patricia Vandenberg: Thank you for the clarification, sir.
US House Rep Jerry Moran: You're very welcome. The legislation that the president's now expected to sign, do you have a sense, which defines miles to minutes, and the definition of . . . Help me?
Patricia Vandenberg: Hardship.
US House Rep Jerry Moran: Thank you! Hardship. Will it speed up the implementation date? Do you have a sense that now we're moving ahead six months more quickly?
Patricia Vandenberg: It certainly will facilitate us not being impeded by the regulatory process and so we believe that we are on a, uh, path at this point having issued the guidance to the field and asking them to identify sites. We may have to amend that per the conversation we are having. But we don't see any firm impediment except for the fact that I referenced earlier, we have no way of knowing when this goes out to the provider community what the level of receptivity would be. So I would say that the rate of progress going forward will be a function of the contracting mechanism and the receptivity in the provider community to work with us.
US House Rep Jerry Moran: I think that receptivity will in part depend upon the reimbursement rate that you conclude is appropriate and my understanding is that the VA's current fee base is fee base and you cover the entire cost of care. You provide health care for veterans with local providers today.
Patricia Vandenberg: Yes, sir.
US House Rep Jerry Moran: And I think you cover the entire cost of doing so. That I assume would be the most desirable model for the veteran and for the health care provider in getting this implemented and wide spread use. So I'm hoping that you follow the same practices that you've been following in the past of how you reimburse hometown providers today. Mr. Chairman, my time is expired, but I would welcome your input or the staff input on this issue of a pilot within a pilot. I'm fearful that we're narrowing the scope and the number of veterans that we wanted to take care of across the country was already narrowed to a certain number of veterans -- to a certain number of VISNs. And we need to make sure, in my opinion, that it's not narrowed further, that you have to live in a particular area within that community to access this health care. I thank the Chairman.
Subcommittee Chair Michael Michaud: Thank you very much, Mr. Moran. You're absolutely correct, the whole intent was to have the VISN -- the whole VISN. Not a pilot within that VISN. And I believe we actually got a CBO score predicated on the full VISN, not on pilots within that VISN. And you're 100% correct, the intent of the legislation was for the full VISN. And that is a concern. This is not the first time we've seen this thing. We actually saw it back in legislation that was passed in 2006 relating to state veterans' nursing homes which required the VA to provide full cost of veterans and, through the rule making process, the VA narrowed that down to what full cost meant for the VA and we're trying to correct that issue currently. So but you're 100% correct, Mr. Moran, it was for the full VISN.
US House Rep Jerry Moran: Mr. Chairman, excuse me, and I would point that to my knowledge this is -- at least this is the first time I've heard as we've had briefings from the VA on this topic, this is the first time I've seen the narrowing of the narrowing. And so -- I appreiciate the Chairman's comments.
Patricia Vandenberg: Mr. Chairman, may I make a further comment?
Subcommittee Chair Michael Michaud: Yes.
Patricia Vandenberg: We obviously will respond to the feedback that we're receiving today but just to go back to the question of what further challenge or impediment might we experience I would just like to observe that when attempting to put a provider in place for highly rural veterans who will, no doubt, be dispersed in a VISN, we will likely experience a situation of multiple contracting relationships so that could potentially extend the timely implementation for coverage in an entire VISN. So I'm-I'm just wanting to acknowledge that I hear you, I-I further appreciate the intent and, just practically speaking, obviously going to honor the intent and just realize that we may be dealing -- In a number of instances, it would be ideal if there were a provider network established that had outlets if you will in those multiple venues. Having had some experience in my prior life in Idaho where the organization I was associated with attempted to set up those multiple venues in rural communities, it made it very easy if someone wanted to serve those communities, they just came to my organization and we helped them get that done. In our experience thus far in rural contracting, that hasn't always been the case. So I hear what the Committee is telling us today. We will proceed to respond to this and just work with due diligence to work through the contracting as timely as possible.
Jerry Moran: Mr. Chairman, I think what Ms. Vandenberg is telling me is my two desires of having broad scope and quick implementation may be mutually exclusive. And putting the reminder back to us that this may slow the process down if they've got to contract in a multiple number of ways. But, at least from my perspective, I would put the priority on doing it right, which is to take care of every veteran regardless of where they live, not within a particular communisty as compared to the speed of its accomplishment. We want both but, again, I think we'd make a terrible mistake if we go through this pilot program and we only, in a sense, take the easy areas within a rural VISN in which it's easier to find a provider or there's a multiple number of providers or there's a larger number of veterans. We're still isolating that veteran who lives a long distance from a VA hospital. And so my priority would be back to being sure that we implement this in a way that we can demonstrate that it can be done VISN wide. Thank you.
Subcommittee Chair Michael Michaud: Thank you. Ms. Halvorson?
US House Rep Debbie Halvorson: Thank you, Mr. Chairman. And while we've been discussing all this, there's probably many veterans who haven't been able to find a way to get taken care of. So while we're trying to figure out how to do this, our veterans still need help. So instead of reinventing the wheel or trying to figure out what's "rural," what's "hardship," why aren't we just taking care of our veterans and letting them go where ever it is that they need to be taken care of? Now I may be naive and I am new, this is my first term, but while we're trying to figure out the intent of a law or how to do it the right way, no matter if it takes long, what are we doing right now for our rural veterans? Where are they going and how are they getting taken care of?
Patricia Vandenberg: Thank you for the question. I'm glad you asked it because I can speak very directly to it. We are already providing a significant amount of fee care to rural and highly rural veterans. And under the aegis of the Office of Rural Health in Fiscal Year '10, we have just put out $200 million to the VISNs to afford them the extra resources to provide fee care to rural and highly rural veterans. So I think it's important to note that is a mechanism that is already in place and what I understood the intent of this law to do was to give VA additional incentive and capacity to further contract out care to extend that access even more. But, to answer your question, we are already meeting the needs of rural and highly rural veterans through the fee care mechanism
US House Rep Debbie Halvorson: So then and not to interrupt but so then what's the estimate of how many extra veterans are we gong to take care of and the cost? So we're already spending money, we're already taking care of people, so this program -- what are we assessing the pilot program's cost, the quality and how many veterans are going to be eligible for the pilot program?
Patricia Vandenberg: Let me take the assessment of costs. First, in our initial analysis of the implementation of the pilot as we previously understood it, we estimated up to $100 million. However, we knew that that was putting significant empahsis on primary care service delivery. And as you add in the multi-speciality dimensions of a patient's care, that that cost could rise. So our current working assumption is that the pilot project as we previously conceived it would cost at least $100 million. Now you're second question about quality? That's part of the analysis and the process of contracting and we're using all of the resources of VHA that we currently employ in the contract process. Pulling those in to look at the specifics of assessing the quality of the care and the patient's satisfaction with the care.
US House Rep Deborah Halvorson: So for a hundred million dollars, w'ere going to help more people?
Patricia Vandenberg: Yes, ma'am.
US House Rep Debbie Halvorson: And better?
Patricia Vandenberg: I-I think, uhm, I would just observe that we believe that the standard of care, the quality of care, that is evident in our current fee relationships is of a high quality nature so when we say beter, that could connote that there is something lacking in our current approach. . .
US House Rep Debbie Halvorson: Right and it's not a good word. "Better" is not a good word.
Patricia Vandenberg: I just want to be precise. We definiately are trying to enhance access. And by spreading the network of contract relationships further into highly rural communities and attempting to structure those relationships -- in some instances, they don't exist today -- that will definitely enahnce the quality of veterans care because of the --
US House Rep Debbie Halvorson: Okay, I just hope that we're not reinventing the wheel. It looks like you've taken all this time to discuss "hardship" and "rural" when we should be taking this time to help our veterans with their health care. And now, with 1963 I believe, we take hardship out altogether. We should have no problem now implementing this bill. So I know my time is about up, but I'm concerned about the care of my veterans. Not debating whether they're rural or if they have a hardship. We are talking about people that we just want to take care of. Thank you.
I included Halvorson because I think she did a good job and I think a lot of people are getting very tired and very annoyed by the constant need to refer to study. When you're given a directive, the study process should not be a hold up. Now we saw the government just waste money on a PSTD 'study' which issued their report a few weeks ago and the 'answer' was 'more research and study required.' Nothing to do with really helping those who deal with PTSD. And there is a growing frustration on the part of veterans. Halvorson has worked very hard to be very connected to the veterans in her district and her comments represent what she and other House Reps in contact with veterans are hearing.
And the confusion as to what VA was supposed to be implementing? Chair Michael Michaud noted "this legislation passed in October of 2008. We did not hear back from the VA until March of 2009 of why they can't implement it. And the concern being that when we went through the hearing process, the mark up process, that was the time the VA should have been before us saying, 'Well we need these changes'." Maybe there'd be less confusion, if they'd been present for those hearings. Not just to speak, but to listen.
In other news, US Rep Henry Brown is a Republican who serves on the Subcommittee (in fact, he's the Subcomittee's Ranking Member). His online office, his Congressional website, just won an award from the Congressional Management Foundation "for having one of the best Web sites in Congress." You can click here to visit and evaluate for yourselves. And here's the press release noting the award. His was one of offices receiving an award. The top honor, Platinum Mouse Award went to the online offices of US House Rep Steve Israel (Democrat), US House Republican Conference, Mike Pence (Republican) is the Chair, the House Committee on Science and Techonology which Bart Gordon (Democrat) chairs and the online office of US Senator Lisa Murkowski (Republican). CMF notes:
"These four stood out from the rest and serve as examples for others to follow. Overall, we found the good sites are getting better and the bad are getting worse," said Beverly Bell, executive director of CMF, a nonpartisan nonprofit founded 33 years ago to promote a more effective Congress. "It looks like half of the Congress is racing to the top while the other half race to the bottom. The outstanding sites follow best practices, leverage the power of social media, and serve their constituents well. Those offices falling behind are losing a great opportunity to interact with their constituents in ways the public has grown to expect."
And on the topic of online Congressional offices, we'll close with Michael Applegate's "Stop Outsourcing Security Act HR 4650" (Iraq Veterans Against the War):
Rep Jan Schakowsky and 24 cosponsors are introducing a bill to phase out private military contractors. A similar bill is being introduced to the Senate by Sen Bernie Sanders I(VT) S 3023
http://thomas.loc.gov/cgi-bin/bdquery/z?d111:h.r.04650:
Contact your reps to urge them to support this bill. Latest Major Action: 2/23/2010 Referred to House committee. Status: Referred to the Committee on Foreign Affairs, and in addition to the Committees on Armed Services, and Intelligence (Permanent Select),
Currently there are 24 cosponsors: Rep Baldwin, Tammy [WI-2] - 2/23/2010 Rep Conyers, John, Jr. [MI-14] - 2/25/2010 Rep DeFazio, Peter A. [OR-4] - 3/10/2010 Rep Doggett, Lloyd [TX-25] - 4/21/2010 Rep Ellison, Keith [MN-5] - 2/23/2010 Rep Filner, Bob [CA-51] - 2/23/2010 Rep Frank, Barney [MA-4] - 4/21/2010 Rep Gonzalez, Charles A. [TX-20] - 2/23/2010 Rep Grayson, Alan [FL-8] - 3/10/2010 Rep Grijalva, Raul M. [AZ-7] - 2/23/2010 Rep Gutierrez, Luis V. [IL-4] - 2/23/2010Rep Hall, John J. [NY-19] - 2/23/2010 Rep Hinchey, Maurice D. [NY-22] - 2/23/2010 Rep Holt, Rush D. [NJ-12] - 2/23/2010 Rep Kaptur, Marcy [OH-9] - 4/21/2010 Rep Lee, Barbara [CA-9] - 2/23/2010 Rep Maloney, Carolyn B. [NY-14] - 2/23/2010 Rep McGovern, James P. [MA-3] - 2/23/2010 Rep Moore, Gwen [WI-4] - 2/23/2010 Rep Polis, Jared [CO-2] - 2/23/2010 Rep Shea-Porter, Carol [NH-1] - 2/23/2010 Rep Stark, Fortney Pete [CA-13] - 2/23/2010 Rep Woolsey, Lynn C. [CA-6] - 2/23/2010 Rep Wu, David [OR-1] - 4/21/2010
Please become a citizen cosponsor by going to:
http://act.janschakowsky.org/p/dia/action/public/?action_KEY=12
iraq
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