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American Legion News Clips – October 18, 2017


 
By: Leo Shane III   19 hours ago
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WASHINGTON — Officials from the largest federal workers union slammed Veterans Affairs officials’ new health care reform plan as “a total dismantling of the department” that would jeopardize veterans services.
“It’s taking resources out of VA and shifting them into the private sector,” said J. David Cox Sr., national president of the American Federation of Government Employees. “It’s voucherizing veterans health care.”
The comments came less than a day after the formal unveiling of the new Coordinated Access & Rewarding Experiences (Vets CARE) Act, proposed by VA leaders as a way to increase patient access to physicians through expanded appointments outside the department’s system.
In a statement, VA Secretary David Shulkin said the new plan puts veterans at the center of all health care plans, instead of bureaucrats.
“We want veterans to work with their VA physicians to make informed decisions that are best for their clinical needs, whether in the VA or in the community,” he said “This bill does just that, while strengthening VA services at the same time.”
The Vets CARE program would replace the three-year-old Veterans Choice program, which allows veterans to seek private sector care at government expense if they face a 30-day wait for a department appointment or a 40-mile trek to the nearest department facility.
Under the new plan — which still needs congressional approval — those options would open to any veteran who faces a wait longer than “a clinically acceptable period.” VA officials could would also be able to authorize outside care for a variety of other reasons, and make it easier for private-sector doctors to get reimbursed for veterans walk-in care.
On Tuesday, officials from the American Legion offered general support for the reforms, saying they are in favor of making VA health care options “more efficient, transparent, and effective.”
But AFGE leaders attacked the proposal, labeling it another effort to slowly undermine and destroy the VA system.
“We’re seeing a constant push to expand ‘choice’ at VA against veterans wishes,” Cox said. “This is another attempt to dismantle VA from the inside out. It’s appalling, and it has to stop now.”
AFGE has been a frequent critic of President Donald Trump’s veterans policies, including legislation he signed into law this summer which made it easier to fire VA workers. In recent weeks, those arguments have centered around the idea that Trump appointees are working to privatize VA health care, an accusation Shulkin has repeatedly refuted.
Cox — whose group represents about 250,000 VA employees — said instead of opting for an expensive expansion of outside care programs, lawmakers should back plans to reinvest in existing VA facilities and more carefully rely on private-sector doctors for specialties the federal workforce lacks.
Shulkin’s vision has instead been focused on offering an expanded network of VA and community physicians. Conservatives on Capitol Hill have backed that idea, with similar promises that they aren’t looking to pull away resources from the department.
Will Fischer, director of government relations for VoteVets, called that approach “death by a thousand cuts.” Their group, which has close ties to the Democratic Party, is working with AFGE to campaign against the new plan.
“They’re promising not to privatize VA, but their actions and words don’t match up,” he said. “Each time one of these vouchers is issued, it’s money that is leaving the VA system.”
House lawmakers are expected to review the plan and their own health care reform proposals at a Capitol Hill hearing next Tuesday.
Meanwhile, officials from Concerned Veterans for America — which AFGE attacked in a press call Tuesday as pro-privatization, Republican activists — called the Vets CARE proposal a good start to the debate over VA’s future.
“There is room for improvement,” said Dan Caldwell, policy director for the group. “One important modification that we believe should be made is that a veteran should be able to choose a primary care physician inside or outside of the Veterans Health Administration within the integrated care network.
“This reform would be an important step towards fulfilling President Trump’s promise to increase health care choice for our veterans.”
A $24 million “bait and switch” college education scam -- targeting U.S. military veterans -- could send two women to prison.
 
Court documents released Tuesday in Newark, N.J., described a scheme in which thousands of veterans using their Post-9/11 G.I. Bill tuition benefits thought they had signed up for courses at Caldwell University, a small Catholic college in New Jersey.
 
But instead, the veterans were enrolled in low-cost correspondence courses marketed by a Pennsylvania company – courses that were not covered by the Post-9/11 G.I. Bill.
 
Authorities in New Jersey said two women have pleaded guilty to one count each of wired fraud in connection with the scam: Lisa DiBisceglie, 56, of Lavallette, N.J., a former associate dean at Caldwell University; and Helen Sechrist, 61, of Sandy Level, Va., a former employee of Ed4Mill, the Pennsylvania company.
 
The pair defrauded the government of $24 million between 2009 and 2013, federal prosecutors said. They could face up to 20 years in prison and a $250,000 fine when they are sentenced Jan. 24, 2018.
 
The women have also been ordered to repay the $24 million, although authorities were uncertain how much money would ultimately be recovered. It was unclear Tuesday whether the women had benefitted personally from the scam.
 
“DiBisceglie and Sechrist were part of an elaborate bait-and-switch scheme that stole millions of dollars in Post-9/11 GI Bill tuition assistance," acting U.S. Attorney William E. Fitzpatrick said in a statement. "Instead of receiving a quality education under the Caldwell brand, the veterans that were recruited by Ed4Mil were enrolled in unapproved online courses without their knowledge, all while members of the conspiracy profited from their hard-earned benefits.”
 
“Scams like this steal money from hardworking taxpayers and legitimate students -- and in this case, our veterans -- and that is completely unacceptable," said Debbi Mayer, assistant special agent in charge of the U.S. Department of Education Office of Inspector General's Northeastern Regional Office, which helped investigate the case.
 
Also indicted was David Alvey, 50, of Harrisburg, Pa., the founder and president of Ed4Mil. He is charged with one count of conspiracy to commit wire fraud. His case is still pending.
Caldwell University officials said in a statement that they ended their relationship with Ed4Mil in 2013 and only learned of the "bait-and-switch" scheme after DiBisceglie quit her assistant dean position to work for Ed4Mil.
 
“Neither Caldwell University nor its current administration or staff is accused of wrongdoing, and only learned of the conduct after the former employee left the school to work for Ed4Mil,” the university said in a statement. “Caldwell University has and will continue to cooperate with the government until this investigation is concluded.”
 
The government was charged between $4,500 and $26,000 per course, instead of the $600 to $1,000 per course the correspondence company charged for the same classes, prosecutors said.
The $24 million in tuition benefits collected through the GI Bill was allegedly paid to Caldwell University, which then turned over between 85 percent and 90 percent of the money to Ed4Mil, according to court documents.
 
The Post-9/11 GI Bill was created after the Sept. 11, 2001, terrorist attacks to give military veterans money for tuition, housing and other education costs. The money is paid directly to colleges for eligible courses.
 
 
David Shulkin, Opinion contributorPublished 6:00 a.m. ET July 24, 2017
 
We are ramping up internal VA capacity along with private referrals. Critics don't want to lose all that VA has to offer. I don't either, and we won't.
 
As a physician, my professional assessment is that the Department of Veterans Affairs has made significant progress over the past six months — but it still requires intensive care. In order to restore the VA’s health, we must strengthen its ability to provide timely and high quality medical care while improving experiences and outcomes for veterans.
 
I believe the best way to achieve this goal is to build an integrated system that allows veterans to get the best health care possible, whether it comes from the VA or the private sector.
 
This is not a novel idea. No health care provider delivers every treatment under the sun. Referral programs for patients to get care through outside providers (known as Choice or Community Care at the VA) are as essential to the medical profession as stethoscopes and tongue depressors. But VA attempts to offer veterans these options have frequently stirred controversy.
 
Some critics complain that letting veterans choose where they get certain health care services will lead to the privatization of VA. Nothing could be further from the truth.
 
VA has had a community care program for years. Congress significantly expanded these efforts in 2014 in response to the wait time crisis. As a result, since the beginning of this year, VA has authorized over 18 million community care appointments — 3.8 million more than last year, or a 26% increase, according to the VA claims system.
 
But as VA’s community care efforts have grown, so has our capacity to deliver care in-house. The VA budget is nearly four times what it was in 2001. Since then, the department’s workforce has grown from some 224,000 employees in 2001 to more than 370,000 today, according to the Office of Personnel Management. And we’re delivering 3 million more appointments at VA facilities per year than we were in 2014.
 
In other words, community care or private capacity and VA’s internal capacity are not mutually exclusive. We are ramping up both simultaneously in order to meet the health care needs of the veterans we are charged with serving. Our fiscal 2018 budget continues this trend. It will spend $2.7 billion more for in-house VA care, compared to a $965 million increase for community care. This means that the total dollar increase for medical care within VA is three times that of the increase for community care. Overall, when all funding sources are taken into account, we expect to spend $50 billion on health care services within VA and $12.6 billion on VA community care in fiscal 2018.
Even though these numbers make it abundantly clear VA is not at all headed toward privatization, I understand the underlying concerns of some critics. They don’t want to lose all that VA has to offer. I don’t either — and we won’t.
 
Many of VA’s services cannot be replicated in the private sector. In addition to providing some of the best quality overall health care in the country, VA delivers world class services in polytrauma, spinal cord injury and rehabilitation, prosthetics and orthotics, traumatic brain injury, post-traumatic stress treatments and other behavioral health programs. The department plays a critical role in preparing our nation’s doctors and nurses — 70% of whom train at VA facilities. And we lead the nation in innovation, with VA research having contributed to the first liver transplant, development of the cardiac pacemaker, advancements in treatments for PTSD, cutting-edge prosthetics, and many other medical breakthroughs.
 
All of these factors underscore that fears of privatization are simply unfounded. President Trump is dedicated to maintaining a strong VA, and we will not allow VA to be privatized on our watch. What we do want is a VA system that is even stronger and better than it is today. To achieve that goal, VA needs a strong and robust community care program.
 
Veterans deserve the best. If a VA facility isn’t meeting the community standard for care, doesn’t offer a specific service, or doesn't have an appointment available when it's needed, veterans should have access to care in their community.
 
This is precisely what they have earned and deserve. It's what the VA is working with Congress and Veterans Service Organizations to deliver. And it's what the system needs to remain a valuable resource for our country’s great veterans, now and in the future.
 
David J. Shulkin, M.D. is the ninth Secretary of Veterans Affairs.
 
By: Joe Gould   16 hours ago
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WASHINGTON — Senate Armed Services Committee Chairman John McCain on Tuesday painted a dire picture of his relationship with Defense Secretary Jim Mattis and National Security Advisor H.R. McMaster, saying it’s worse than it was with Obama-era Defense Secretary Ash Carter.
“I had a better working relationship, back and forth, with Ash Carter than I do with an old friend of 20 years,” McCain said, referring to Mattis. He added that he has considered both Mattis and McMaster “friends of mine for many years.”
As McCain has waged a public battle with cancer, his penchant for asserting the Senate’s powers to check and balance the executive branch has only grown. On Tuesday, McCain implied national security officials have seen his committee as a rubber stamp, and he is using his seat’s powerful levers to conduct oversight.
“I think they had this idea, once that Trump won, that we are a unicameral government,” said McCain, R-Arizona, “and we have to do what we have to do.”
The Carter comparison says something, as Obama was McCain’s frequent foil. In Obama’s final year in office, McCain jousted with Carter and the administration over the defense budget, his reform efforts and his slow-rolling of DoD nominees. At one point, McCain vented over a frayed relationship between Congress and the Pentagon’s civilian leadership when Carter denied McCain a courtesy preview of the 2017 Pentagon budget.
It has appeared there might be a thaw in the senator’s relationship with the Pentagon. McCain said he was receiving information from Mattis about his strategy for Afghanistan and the Islamic State fight—and that he would not block a handful of Pentagon nominees from Senate floor votes.
On the other hand, McCain was in a war of words with the commander in chief. While accepting the Liberty Medal in Philadelphia Monday night, McCain warned the United States against turning toward “half-baked, spurious nationalism” — widely read as a repudiation of Trump.
Trump responded in a radio interview Tuesday, “I’m being very, very nice. But at some point I fight back, and it won’t be pretty.”
Still, McCain told reporters, “I’m not interested in confronting the president, I’m interested in working with the president.” When a reporter asked whether the relationship was so bad that McCain would not support anything Trump approaches him with, McCain took it as a suggestion he would shirk his responsibilities and blew up.
“Why would you ask something that dumb, eh?” McCain said. “My job as a United States senator from Arizona — which I was just re-elected to — you mean that I would somehow behave in a way that I would block everything because of some personal disagreement? That’s a dumb question.”
Earlier this month, McCain said he would refuse to advance Trump’s nominees to the Pentagon until he is satisfied the administration is communicating its plans for the wars in Afghanistan and Iraq. As SASC chairman, he sets the schedule for DoD nomination hearings and as a senator, he may request a hold on any presidential nominee.
It’s been nearly two months since Trump announced a new strategy, criticized for its vagueness, that involves sending more U.S. troops to advise the Afghan military. The Defense Department has acknowledged that it has 11,000 forces on the ground, more than the 8,500 previously reported, and that it plans to send an additional 3,000-plus.
On Tuesday, McCain told reporters he expects to receive soon some answers to questions on strategy and tactics that he has been waiting months to get. But he would not commit to advancing Trump’s picks through his committee until he has the information he’s been seeking in hand.
The Senate’s 79-19 confirmation Tuesday of David Trachtenberg, Trump’s choice for a deputy Pentagon post focused on defense policy, came about seven months after the nomination was announced. McCain said he did not block it because he was “partially satisfied with their commitment to provide us with answers to the questions.”
Of Trachtenberg, who has experience in the Pentagon and on Capitol Hill, McCain said, “I think he’s qualified.”
The SASC’s top Democrat, Rhode Island Sen. Jack Reed, said the way looks clear for other DoD nominees awaiting Senate votes, since the Senate is done with health care reform. John Gibson, the deputy chief management officer pick, Navy general counsel nominee Charles Stimson, and Owen West, Trump’s choice for assistant defense secretary, have ― like Trachtenberg ― been waiting since July.
Reed was supportive of McCain’s delaying actions as “the prerogative of the chairman” to pursue details about Afghanistan, Iraq and North Korea, saying, “I would suggest not only for Sen. McCain’s benefit, but the public’s benefit, that it be made clear.”
McCain’s frustration is, in part, rooted in fears the administration is unprepared to deal with the aftermath, should the Islamic State be defeated, highlighted by news Tuesday that U.S.-backed Syrian rebels have claimed to have taken Raqqa, the de facto capital of ISIS’ so-called caliphate..
“Again, we will not sit by without having a complete understanding of what is going on,” McCain said. “Raqqa just fell. Who’s going to take over? The Iranians are there, the Shiites. The whole situation is in chaos, as we predicted.”
Still, McCain said the committee is working with the administration on “a whole lot of other issues,” including the massive 2018 defense authorization bill. The House and Senate, as of Tuesday, are due to go to conference to reconcile their versions of the bill.
Jack Detsch October 17, 2017
As US-backed forces take victory laps in the Islamic State’s (IS) self-proclaimed capital of Raqqa, the Pentagon is considering extending its presence deeper into Syria, a move that could bring US troops into contact with pro-regime forces.
Col. Ryan Dillon, a spokesman for the US-led mission fighting the terror group, told reporters that the international coalition is in talks with Syrian Democratic Forces (SDF) commanders about continuing the campaign into IS-held areas along the Euphrates River following today’s victory in Raqqa. He said the more than 600 US troops currently training and assisting the SDF won’t be staying in Syria “indefinitely,” but acknowledged that “there still is fighting that is left to be done.”
For now that fighting is taking SDF units straight to Deir ez-Zor, where an alliance of soldiers loyal to Bashar al-Assad, Russian troops and Iran-backed Shiite troops are trying to grapple territory back from IS and anti-regime rebels. And while the Pentagon is considering extending de-confliction agreements with Russia to cover a wider swath of Syria, former US officials say it will be difficult for the US military to avoid getting enmeshed in the politics of the wider war. 
“You don’t want to deploy US forces willy-nilly and find them in the middle of conflict,” Robert Ford, a former US ambassador to Syria, told Al-Monitor. “It’s kind of a mission creep beyond going to get [IS]. They’re going to have to be dealing — as much as they don’t want to — with the politics of the Syrian civil war. It’s just unavoidable now.”
Dillon said the US-led coalition hasn’t heard anything from Russian forces about President Bashar al-Assad ending his tacit consent of the US troop presence in his country. After weakly protesting the US military operation as illegitimate and illegal since the beginning of Operation Inherent Resolve in 2014, however, the Syrian leader can be expected to make an increasingly forceful case as IS is eradicated. The US-led mission in Iraq and Syria ordered by then-President Barack Obama began three years ago.
"They’re going to have to be dealing — as much as they don’t want to — with the politics of the Syrian civil war. It’s just unavoidable now."
Pro-regime troops and US forces have already been coming into closer contact over the past few months; indeed, the United States shot down a Syrian drone and a Syrian Su-22 fighter jet headed toward US-backed rebels in June. Still, US and Russian officials have maintained communication through a de-confliction line that extends from Al-Udeid air base in Qatar to Moscow’s command posts in Syria.
The potential for conflict grows as the United States shifts its focus from IS to other foes, notably Iran and its proxies. During a gaggle with reporters on the way to US Central Command on Friday, Defense Secretary Jim Mattis said the Pentagon is “not changing” US military posture in Iraq and Syria from a counter-IS to a counter-Iran mission, but added that American officials “watch for Iran's destabilizing movements and activities everywhere.”
Yet the complexity of southern Syria, which some analysts worry could fall under Iranian control as a way for the Islamic Republic to solidify gains in the region, may incentivize the US to look toward rejiggering the anti-IS force.
“Iran is looking to solidify logistical supply lines across Syria and Iraq,” said Melissa Dalton, a former Pentagon official and now a senior fellow at the Center for Strategic and International Studies. “It certainly benefits Iran to try and build some connectivity between the Shia militias it supported in Iraq and Syria. There’s that added incentive for Assad to solidify those gains even if there’s some intersection with US forces countering [IS].”
With the United States looking down the contested Euphrates River Valley as a possible battle space, there’s a question of whether the American troops in the country or US-trained forces "can be transformed into a presence against Iran,” Dalton said.
The Kurdish elements of the SDF may also increase the risk of conflict with the regime as they close in on the eastern side of the Euphrates River Valley, the site of Syria’s most important oil field. Meanwhile, Assad’s government retains formal claim to the Syrian Kurdish city of Qamishli, the site of another important oil field.
“It’s very difficult for Assad’s government to live comfortably alongside regions that aspire to an autonomous status and can thumb their noses at Damascus,” Ford said. “I see no sign that the government is more willing to employ reforms than they were before. As [IS] recedes, the likelihood of conflict between the Syrian government and other Syrian entities increases.”
And it remains unclear if the United States and Russia will agree to an extended dividing line in the region, especially if US troops pursue a broader mission, such as stalling Iranian gains. Experts also worry that it could exhaust extended special forces operators that have been committed more broadly around the world in recent years as train-and-equip missions expand.
“How much risk is the United States willing to expose its forces to on the ground?” Dalton said. “Iranian forces haven’t hesitated to kill and maim US forces in Iraq.”
The Pentagon has also faced heat from Congress. Earlier this month, Senate Armed Services Committee Chairman John McCain, R-Ariz., refused to move ahead with confirmation hearings for Pentagon nominees until Mattis provided more details on the Donald Trump administration’s strategy in Iraq and Afghanistan. While McCain has backed off of that threat, it’s not clear Congress is happy with US strategy in Syria after the Raqqa campaign.
 "For far too long, the United States has approached the Middle East through the narrow vantage point of counterterrorism,” McCain said in a statement today. “What we need instead is a comprehensive strategy that takes all regional factors into account — a clear articulation of our interests and the ways and means we intend to secure them. The absence of such a strategy is acutely felt even as we celebrate this important success."