Saturday, June 02, 2012

Screw Bloomberg

Isaiah's The World Today Just Nuts "The Jobs Report"

The Jobs Report

That pretty much says it all on our current 'leadership.'

Meanwhile Barack's buddy, Caroline Kennedy's roll dog, Michael Bloomberg was on Today (NBC) yesterday.  I know because I had something like forty friends leaving messages (I was in back-to-back sessions on Friday).  When I finally had time to come up for air around noon, I walked out of my office and told Sunny to order from wherever she wanted.  Usually one of us will go out.  I was too tired to go out.  I had a two hour break -- lunch (I do take an hour -- I don't think I do anyone any good by skipping lunch to fit in another session, I'd just be sitting there with my eyes glazed over) and I'd blocked out an hour for a periodical article three other psychologists and I are working on.  I asked Sunny if she could wait an hour on lunch?  If she could, I'd grab my work hour (periodical article) and do lunch after.  She was fine with that because she's so wonderful and because she knew lunch wouldn't be delivered for at least 30 minutes.  (Which is why one of us usually goes out and gets it if we haven't decided before 11:00 a.m. what we're doing to eat.)

So I finish working on the article and go out of the office and building just to walk around the block -- not for exercise, just to get out of the building for a second.  I arrive back at the same the delivery guy does and Sunny and I are diving in and catching up and I'm leafing through the phone messages.  I ask Sunny what these messages are about?  Had she seen the interview?  Nope, she was busy too.  (Which is great if it's course work, she's almost got her bachelor degree, but not great if it's something else because I am planning on closing the practice.  Mike and I will move to Hawaii.  Sunny's the best assistant, office manager, anything I've ever had.  I may be open another year, I hope no longer than that.  But I really want Sunny to have easy days so she can focus on her college courses.)

So we stream the interview.

"Where did I here this before?" Michael Bloomberg asks about his garbage policy to outlaw, in NYC which was stupid enough to put him into office, all soft drinks over 32 ounces.

"That's not exactly taking away your freedoms, that's not something the founding fathers fought for."

He's such an ass.

Matt Lauer asks him why he's focusing on that with issues (I would say: Real issues) like education, crime and more facing the city.  Bloomberg lied about education.  But he would.  He's one of those who wants to dismantle.  But he wouldn't be Caroline's friend if he wasn't, now would he?

It's really Michael Bloomberg's business what size drink a person orders.

One of my messages was from a friend who's a medical doctor and very noted in her profession.  Her message included, "I told you so!!!!!"  (Sunny said she asked that Sunny please put five exclamation points after that.)  She did.

I have smoked cigarettes before.  I used to do a pack and a half a day.  I did 100s for years until C.I. and I were stuck somewhere and she kept snapping the filters off because regular smokers can't get any real drag on those big filters.  (She snapped off the filters on cigarettes she smoked, to be clear.  She wasn't just opening my pack and snapping filters.) So then I switched to lights.  I smoked Marlboro Lights after that.  (Why did I switch?  I honestly do think of others.  I'm not joking.  When C.I. was snapping off the filters after we missed the last ferry and were waiting for a boat that might be coming through, I thought about how no one I knew smoked 100s but me. I'm seriously not joking.)

So the doctor is an old friend and she and I both stopped smoking at the same time and supported each other through it.  Then a year after, she started smoking again.  This was around the time the banning movement got really nasty.  She told me that she couldn't believe it and that next up they'd be going for things they considered fattening.  She was right, that's what's happening right now.

The founding fathers fought for freedom from an intrusive and non-responsive to the people government.  I realize Michael Bloomberg's an idiot.  I realized that the first time I ever met the man.  Like many an effete male, he felt the need to 'prove' his manhood by staring at my breasts.  As if the whole world would then know, "Michael's not gay! Look at him cruising that woman's tits!"  So I'm not surprised that the moron would lead the march.  But I do find it deeply disturbing.

I'm bothered that others aren't.  I have no idea if the rule would apply to me.  I only drink diet soda.  I got into that back when Diet Dr. Pepper was one of the few diet drinks in the world.  (Tab had either gone under or was hard to find.)  I was living with a man who was diabetic.  He kept buying himself the Diet Dr. Peppers and buying me my Coca Cola.  But I'd drank Tab before and if he was drinking diet due to health issues, I really didn't want to be anything but supportive.  (He'd developed diabetes six months before we started dating.  We moved into together probably three months after we started dating.)

That was back in the early 70s.  I've drank diet soda ever since.  I don't believe I drink more than 32 ounces of soda in a sitting.  So between size and the diet soda issue, I doubt Michael Bloomberg's garbage would effect me if I were visiting NYC.  (I don't like NYC since he's been in charge.  NYC's become a family amusement park and not a thriving metropolis.)

But what does effect me is the tiny, little officials who think they have a right to control our lives.  They need to be informed that they do not have that right.  If NYC is smart, they'll ditch Bloomberg.





"Iraq snapshot" (The Common Ills):
Friday, June 1, 2012.  Chaos and violence continue, the political crisis continues, Nouri stands with two buddies, Iraqi women continue to suffer, a court gives the US State Dept four months to comply with an order, and more.
Like a nightmare version of Charlie's Angels, Ammar al-Hakim, Ibrahim al-Jaafari and Nouri al-Maliki stood side by side to announce their solidarity.  Alsumaria reports that the head of the Islamic Supreme Council of Iraq, the head of the National Alliance and the Prime minister of Iraq met to discuss the latest political developments in Iraq and how to address them.  Al Rafidayn has an article where Ammar's dropping terms like "sin" and "big sin" and talking about "the street" and it all sounds like a lover in the grip of passion.
So let flow the hydrants
And we'll dance in the spray
And we'll wash out all our dirty laundry
In the alleyway
Put your love out in the street
Put your love out in the street
Put your love out in the street
Put your love
Out in the street tonight
-- "Love Out In The Street," written by Carly Simon, first appears on her Playing Possum
While Ammar de amour works himself into a frenzy, Kitabat reports that Moqtada al-Sadr's followers have rejected the notion that chaos follows a no-confidence vote in Nouri.
KENYON: On paper it looks like a serious threat to Maliki's rule. But if you ask the prime minister's supporters about a no confidence motion, they tend to laugh and say bring it on.
SAAD MUTTALIBI: Oh, definitely. Just go ahead. You know, we will sit there and laugh at the puny numbers that you will gain in the parliament.
KENYON: Businessman and Maliki backer Saad Muttalibi says those who have actually tried to add up the votes say the opposition is well short at the moment. He says pro-Maliki forces are mounting a counterattack, collecting votes for a no confidence motion against the anti-Maliki speaker of the parliament. And Muttalibi says Sadr is jeopardizing his future in the governing National Alliance by cozying up to the Kurds and Sunnis.
It's great that NPR had time for bitchy but exactly when did they intend to explain the political crisis to listeners?
They are aware that they never did that, right?
That never once in the report did they mention the Erbil Agreement or the 2010 elections or anything of real substance.  But, hey, we got a bitchy supporter of Nouri's and didn't that make everything worthwhile?
Earlier this year,   Marina Ottaway and Danial Kaysi's [PDF format warning] "The State Of Iraq"  (Carnegie Endowment for International Peace) reviewed events and noted:

Within days of the official ceremonies marking the end of the U.S. mission in Iraq, Prime Minister Nouri al-Maliki moved to indict Vice President Tariq al-Hashemi on terrorism charges and sought to remove Deputy Prime Minister Saleh al-Mutlaq from his position, triggering a major political crisis that fully revealed Iraq as an unstable, undemocractic country governed by raw competition for power and barely affected by institutional arrangements.  Large-scale violence immediately flared up again, with a series of terrorist attacks against mostly Shi'i targets reminiscent of the worst days of 2006.
But there is more to the crisis than an escalation of violence.  The tenuous political agreement among parties and factions reached at the end of 2010 has collapsed.  The government of national unity has stopped functioning, and provinces that want to become regions with autonomous power comparable to Kurdistan's are putting increasing pressure on the central government.  Unless a new political agreement is reached soon, Iraq may plunge into civil war or split apart.


The agreement was the Erbil Agreement.  March 7, 2010, Iraq held parliamentary elections.  Ayad Allawi's Iraqiya came in first ahead of Nouri's State of Law.  Nouri refused to give up the post of prime minister.  What followed were eight months of political stalemate.  The White House and the Iranian government were backing Nouri so he knew he could dig in his heels and did just that.  Finally, in November, the US-brokered Erbil Agreement was reached.  Nouri could have a second term as prime minister provided he made concessions on other issues.

Nouri used the agreement to get his second term and then trashed the agreement refusing to honor it.  Until last week, he and his supporters had taken to (wrongly) calling the agreement unconstitutional.  And though the KRG, Iraqiya and Moqtada al-Sadr have been calling for the Erbil Agreement to be fully implemented since summer 2011, it took last month for State of Law to finally discover that themselves loved the Erbil Agreement.  Needless to say, the sudden attraction to the deal is seen as mere lip service especially when Nouri refused to implement it.
In violence Al Rafidayn notes that 1 traffice police officer was shot dead in Mosul as was his driver.  In addition, Alsumaria notes a captain in the Ministry of Interior's intelligence division was shot dead in Falluja today.  AFP adds a Baghdad roadside bombing targeting a market claimed 1 life and left three more people injured and 1 police colonel was shot dead in Baghdad.
This week the United Nations Assistance Mission for Iraq (UNAMI) released "Report on Human Rights in Iraq: 2011."   In Wednesday's snapshot we noted the highly superficial section on Iraq's LGBTs.  The report does a better job with the issue of the rights of Iraqi women.  That section opens with:
UNAMI continues to monitor the status and rights of women in Iraq, including gender based violence such as so-called 'honour' crimes, trafficking and domestic violence.  Due to the security situation, UNAMI is uanble to collect first hand data on the situation of women in some parts of Iraq outside of the Kurdistan Region.
Grasp that.  'Violence is down!!!!'  We hear that stupidity over and over from the press.  No, it's not really down.  2006 and 2007 were years of ethnic cleansing -- encouraged and (I would say) aided by the US government.  Those death figures are huge.  I'm not really sure why the years of ethnic cleansing are treated as natural or normal figures with which to compare everything to?  Iraq remains violent.  And UNAMI tells us that it's so violent that they can't even collect basic data. 
But the press moved on, didn't they?  They press that largely mocked, ridiculed or ignored war resisters fled Iraq.  There's the US wire service AP.  There's the New York Times staff.  There's Jane Arraf. There's the Wall St. Journal (led by Sam Dagher).  There's CNN. That's it.  Imagine if that was it in 2002 and 2003?  If that were it in those years, only those outlets and the others ignored Iraq, it would have been so much more difficult to sell the illegal war to the American public (a public with a significant amount of resistance even at the start).
Valerie Gauriat:  We're in Iraq this month to meet women in Baghdad, Najaf and Iraqi Kurdistan who are fighting their own kind of war.  A human rights activist, two war widwos and a female soldier to regain the rights Iraqi women have lost.  Every month in Women and War we bring you the stories of women who are fighting across the world.
And Iraqi women have lost so much due to the Iraq War.  They've lost husbands and fathers and sons and brothers and uncles and mothers and daughters and sisters and aunts.  They've lost friends.  Most of all, they've gone from  living in one of the most advanced Middle East nation-states for women to a country where they have to regularly fight for basic dignities.  And fight they do.  They know what's at stake and they know the US government isn't helping them, has never helped them.  The  US State Dept's Anne C. Richard writes with all the enthusiasm that historical ignorance and optimism can provide.  We'll note this from her post today at the State Dept blog about her new job working with Iraqis:

Estimates of the numbers of widows in Iraq range from 750,000 to 1.5 million, or between 2.4 percent and 5 percent of the population -- no one knows for sure as there has not been a recent census. In Iraqi society, women traditionally do not work outside of the home. However, the women at this site emphasized that they needed jobs to provide for their children.
Iraq remains a dangerous place and our visit was not announced in advance but the visit was eye opening and well worth the effort it takes to get out and meet ordinary Iraqis.
Later, I raised the plight of the widows with senior Iraqi officials. They were determined to make progress on housing issues and acknowledged problems with registrations -- although they also expressed concerns about the squatters occupying government land.
We'll continue to follow Anne C. Richard's posts.  She's got energy and optimism and her ability to either ignore or not learn what came before may allow her to pull off some small miracles.  I wish her the best because Iraqi women could use a miracle or two.  But the issue of the widows, their plight, that's been raised with the Iraqi government for years now.  There's been no significant improvement or real plans from the government.  At one point they were suggesting that the answer was for the widows to remarry. 
The illegal war did not help Iraqi women nor has their government made any real strides on their own to help Iraqi women.  Last month the Interfaith Council for Peace & Justice explained:
But for Iraqi citizens, especially women, the ongoing violence caused by the U.S. invasion is not the only consequence that has become part of the everyday struggle to rebuild their country. Before the U.S. invasion, 75% of Iraqi women had college degrees, and 31% of Iraqi women had graduate degrees (compared to 35% of European and U.S. women). Only 10% of women in Iraq now continue to work in their professions, and they have to contend with the thousands of more experience and better-educated Iraqi women who fled Iraq at the onset of the war and are now returning. However most women stay away from their work, schools, and universities due to extreme safety concerns: Since the beginning of the war, rates of abductions and kidnappings targeting women and girls, most often related to sex trafficking, female suicides and honor killings have increased.
It was beneficial to the US government's aims to scare the Iraqi people into submission.  It would be easier to push through various policies and programs on a people too scared to fight back.  So the US backed thugs, turned their heads the other way not just to looting but to rape and so much more.  And Iraqi women could have thrown in the towel and said, "Forget it, my safety is what's most important."  Instead, these brave women regularly take to the streets and protest for their rights.  Even since Nouri's squad of thugs began beating protesters and arresting them and torturing them in custody, Iraqi women refuse to hide and refuse to give up on their country or let Iraq be turned into something that they're no longer a part of.  The US shut the women out of the process from the start.  They had to take to the streets when the US was writing their rights out of Iraq's new Constitution (in 2005) and they've done that during the continued violence and during the periods of the most violence.  Last month, the Office for the Coordination of Humanitarian Affairs (OCHA) in Iraq noted:
The rights of women in post war Iraq is clear following reports that they are victims of human trafficking to and fro Iraq and even within the outskirts of the cities with cases of forced prostitution. Women are trafficked from Southern Iraq and transported to the Gulf States by rich cartels who promise to marry them and give them a good life only to use the as servants and sex workers in their well-managed deals.
Most of the 'unveiled' women in Iraq have had their rights violated. There are groups that are making it hard for this woman to have freedom in and around Iraq and creating an atmosphere where they are intimidated. For instance, Fatwas encourages the crowd to throw rotten eggs and tomatoes to any woman around the streets who passes by without a veil. This has made it hard for the professional Iraqi woman to work or get education unless they wear the hijab.
It has to be noted that Islamic leaders from the Shi'ite and the Sunni have strong condemnation against women in Iraq without the hijab, this means trouble for the rights of women in Iraq. Since the war started, the Iraqi women have been attacked, kidnapped and even intimidated in a way that bars them from participating in any role with the society.
Again to the United Nations Assistance Mission for Iraq (UNAMI) released "Report on Human Rights in Iraq: 2011" this time for Camp Ashraf:
During the reporting period, UNAMI continued monitoring the situation of over 3,000 residents affiliated with the People's Mujahedin of Iran (PMOI) in Camp New Iraq (commonly known as Camp Ashraf) and documented a number of measures of which Iraqi authorities aimed at tightening control over the Camp and its residents with the ultimate objective of closing it down by the end of 2011, as declared in the Council of Ministers' decision of 17 June 2008. 
On 8 April, in an operation that lasted approximately 7 hours, the Iraqi army moved into the Camp and occupied its northern part, comprising some 40 percent of its total surface area.  The Iraqi authorities described the operation as a law enforcement action to restore privately owned land in Ashraf to its legitimate owners.  It resulted in the deaths of 36 and injuing of more than 300 residents who protested against, and resisted, the operation.  On 13, April, a UNAMI delegation was authorized to visit the Camp.  The UNAMI physician counted 28 bodies in a makeshift morgue.  The apparent cause of death in most cases was bullets and shapnel wounds.  Another 6 residents were confirmed dead among those injured who had been rushed to Ba'quba hospital.  Two more died later from their injuries.  The Iraqi authorities admitted that their forces caused 3 fatalities, which they described as 'accidental'.
In a statement made public on 15 April, the United Nations High Commissioner for Human Rights said the Iraqi military were well aware of the risks attached to launching an operation like this in Ashraf and added: "There is no possible excuse for this number of casualties.  There must be a full, independent and transparent inquiry, and any person found responsible for use of excessive force should be prosecuted."  On the same day, UNAMI issued a similar statement requesting a thorough investigation through an independent commission.  During the reporting period, no action was taken by the Government of Iraq to establish such an independent commission of inquiry to investigate the incident.  The 8 April operation was the second occasion, after clashes on 28/29 July 2009, when Iraqi forces appear to have used excessive restraint in conformity with international human rights law in asserting its legitimate authority over the camp and its residents
After this incident, the Iraqi Government reaffirmed the deadline of 31 December 2011 for the residents to evacuate Camp Ashraf.  UNAMI continued working closely with the Government of Iraq, the diplomatic commmunity, UNHCR and the residents' representatives in order to find durable solutions.  In late 2011, consultations between UNAMI and the Government of Iraq led to a Memorandum of Understanding, which was signed by both parties on 25 December.  In it, the United Nations offered its services as an impartial facilitator and observer in a process that would see the residents of Camp Ashraf move to a temporary transit location at Camp Liberty (a former US military base near Baghdad International Airport), undergo individual refugee status determination by UNHCR, and eventually either their voluntary return to their countries of nationality or if eligible, resettlement in third countries, subject to the availablility of receiving countries. In an open letter of 28 December 2011 to the residents of Camp Ashraf, UNAMI SRSG, Martin Kobler, affirmed that the United Nations desired to "prevent violence and confrontation" a permanent solution for the residents.  He pledged that UN staff would monitor the situation at Camp Liberty 24/7 until the last resident had left Iraq. 
By 31 December, the Prime Minister Al-Maliki announced the extension of the deadline for the departure from Iraq of Ashraf residents till the end of April 2012.  At time of publishing this report 29 May 2012, 1996 residents have relocated from Camp Ashraf to Camp Liberty (Camp Hurriya). 
UNAMI reminds the Government of Iraq to abide by its legal obligations, reaffirmed in the Memorandum of Understanding, to fully respect its human rights obligations under international law in dealing with the residents of Camp Ashraf.  It also calls upon the residents and their representatives to obey the laws of Iraq, and to voluntarily participate in the process offered by the UN and agreed to by the Government of Iraq aimed at resolving the issue peacefully.
  
Which takes us into legal news, it's a shock to the administration but most others saw the ruling coming.  Jamie Crawford (CNN) reports, "A federal appeals court has ordered Secretary of State Hillary Clinton to make a prompt decision on whether to remove an Iranian dissident group from the State Department's list of foreign terrorist organizations."  This was a unanimous decision handed down by the US Court of Appeals for the District of Columbia Circuit.  Why was it unanimous?  Because the administration has been in violation for some time now.  James Vicini (Reuters) reminds, "The appeals court ruled nearly two years ago that Clinton had violated the group's rights and instructed her to 'review and rebut' unclassified parts of the record she initially relied on and say if she regards the sources as sufficiently credible.  It said Clinton had yet to make a final decision."  The administration was in contempt.  The courts and the executive branch were in conflict.  (They still are.)  What generally happens there is the court of appeals makes a united front because this is now a court issue (as opposed to the merits of the case from when it was heard earlier).  Unlike the executive branch, the judicial branch has no security forces.  So they want to send a message but they also want to do so without looking weak if the administration ignores them.  So since two months was the target date for the State Dept to finish a review on the MEK, they gave State four months which, they hope, is more than enough time. However, the two months (as the judges know) was a guideline, not a promise.  State made very clear before the court that they were not promising two months.  So it could go on past four months.  Four months carries them into October.  If they're not complying by then, there's a good chance they won't.  Whether Barack Obama wins a second term as US President or not, Hillary Clinton has already stated she was only doing one term as Secretary of State.  So when November arrives, if there's no decision, there won't be a rush for one.  If Barack wins re-election, he'll state that he has to find someone to oversee the department first.  If Barack loses, they've already blown off the appeals court for over two years now, continuing to blow them off for sixty more days will be a breeze.
There should be outrage over this but faux activists like you know who only pretend to give a damn about the rule of law.  The administration has refused to comply with a court order.  If it were on any other topic, you could expect yet another shrill column; however, he doens't like the MEK so rule of law gets tossed out the window. 
Turning to veterans issues,  yesterday we noted the Dept of Labor is holding a Veterans Hiring Fair next week on Wednesday, June 6th.  It will be at the Great Hall of the Frances Perkins US Dept of Labor Building on 200 Constitution Ave. starting at ten in the morning and ending at one in the afternoon.  You will need veteran i.d. to enter the job fair.  And it is open to all adult veterans.   Repeating, that's next week on Wednesday.   Tara Merrigan (Austin American-Statesman) reports, "Austin will honor Iraq War veterans in a July 7 parade and job fair, city leaders announced Thursday."
Michael Oros:  I would suggest that the very broad definition of "prosethetics" can lead to confusion and, worse, application of policies that are inappropriate to replacement limbs and orthotics.  The result: inappropriate barriers to care for veterans with limb loss who need timely access to high quality prosthetics in order to go to work, care for their families, and live their everyday lives.  In fact, the Health Subcommittee saw that confusion on display in its hearing in this very room only two weeks ago.  Chairwoman Buerkle held a hearing on "Optimmizing Care for Veterans with Prosthetics" on May 16th.  During the hearing, she clarified multiple times that the topic of the hearing was prosthetics as traditionally understood and defined.  During that hearing, the VA's Chief Procurement and Logistics Officer told the Subcommittee that because changes in procurement policies applied only to items that cost $3,000 or more, those charges would not apply to 97% of the prosthetics budget. I'm sure that statement is accurate for everything included in the billion-dollar-plus line item described by the VA as "prosthetics." However, for the approximately $58 million portion of that line item spent on replacement limbs and orthoses, that statement is confusing and unhelpful.  Virtually every part of even a fairly low-tech prosthetic limb costs more than $3,000.  So adopting procurement policies with the understanding that the policy does not apply to 97% of prosthetic purchases can lead to decisions that delay specialized and vitally needed care for veterans with limb loss or limb impairment.  The veterans we see have already sacrificed enough.  They are working hard to put their personal, family and professional lives back together.  This task should not be made more difficult by the application of overly broad policies that do not take into consideration the very specialized and unique nature of prosthetics and orthotics.
Buerkle is US House Rep Ann Marie Buerkle who chairs the House Veterans Affairs Subcommittee on Health.  The hearing he's referring to was May 16th (we covered it in the May 16th, May 17th and May 18th snapshots).  Oros was speaking at Wednesday's House Veterans Affairs Subcommittee on Oversight and Investigations hearing on VA's purchasing of prosthetics.  The Subcommittee Chair is Bill Johnson and US House Rep Joe Donnelly is the Ranking Member.  There were three panels.  The first was made up by the American Orthotic & Prosthetic Association's Michael Oros (quoted above) and Academy Medical LLC's Daniel Shaw.  The second panel was DoD's Charles Scoville who is the Chief of Amputee Patient Care Service at Walter Reed and rom the VA's Office of Inspector General's Linda Halliday (accompanied by Nick Dahl and Kent Wrathall).   The third panel was VA's Philip Matkovsky (accompanied by Dr. Lucille Beck, Norbert Doyle and C. Ford Heard). 
Chair Bill Johnson noted the VA's defintion of prosthetics at the start of the hearing:
All aids, devices, parts or accessories which patients require to replace, support, or substitute for impaired or missing anatomical parts of the body.  The items include artifical limbs, terminal devices, stump socks, braces, hearing aids and batteries, cosmetic facial or body restorations, optical devices, manual or motorized wheelchairs, orthopedic shoes, and similar items.
Now let's go back to one segment of  Michael Oros' testimony from earlier.
In fact, the Health Subcommittee saw that confusion on display in its hearing in this very room only two weeks ago. Chairwoman Buerkle held a hearing on "Optimmizing Care for Veterans with Prosthetics" on May 16th. During the hearing, she clarified multiple times that the topic of the hearing was prosthetics as traditionally understood and defined. During that hearing, the VA's Chief Procurement and Logistics Officer told the Subcommittee that because changes in procurement policies applied only to items that cost $3,000 or more, those charges would not apply to 97% of the prosthetics budget. I'm sure that statement is accurate for everything included in the billion-dollar-plus line item described by the VA as "prosthetics." However, for the approximately $58 million portion of that line item spent on replacement limbs and orthoses, that statement is confusing and unhelpful. Virtually every part of even a fairly low-tech prosthetic limb costs more than $3,000. So adopting procurement policies with the understanding that the policy does not apply to 97% of prosthetic purchases can lead to decisions that delay specialized and vitally needed care for veterans with limb loss or limb impairment.
The person Oros was referring to is Norbert Doyle.  He avoided speaking on Wednesday, instead
Chair Bill Johnson:  You note the VA's new policy for purchases over $3,000.  Approximately 5% of biologics cost more than $3,000 so your policy will have minimal bearing on 95% of biologics purchased.  Can you describe how your policy will effect the other 95% of biologics purchased? 
Philip Matovsky: Uhm.  Well I don't actually have the specific cost break out for the biologics themselves.  But the, uh, three thousand dollar threshold was noted that it was 97% of the cost would be below $3,000.  Actually the number is a little bit north of 50, 55% of all of the prosthetic purchases are greater than $3,000 in cost. It's the number of transactions is the 3% number.  In terms of the biologics themselves, uhm, our expectation is that we're asking in this policy moving forward that we document, uh, that a waiver from FSS was requested and that part of what we hope to achieve from this and that we expect to achieve from this is that we'll collect information about why FSS is actually not being selected as the source for biologics or for other items or national contracts for that matter.  And be able to attenuate practice through education,communication in the field as well.
Why is that VA can't use terms accurately?  In the hearing on Wednesday, it was about definitions.  The conflict in what the Subcommittees were told has to do with VA using a figure and then saying, "Wait, wait, we testified about this 97% on $3,000 orders and you thought we meant cost, we meant number of orders!"  Why is it so damn difficult for the VA officials to speak in a straight forward manner?  (And remember that they try to dismiss the IG's report by claiming the IG is using one set of terms while they're using another.)  VA needs to get with the rest of the government.  The prosthetic issue, for example.  VA ges its own definition?  It doesn't match with the Defense Dept's definition.  Why is so hard for the VA to utilize the same terms and same definitions as the rest of the executive branch?  That really needs to be addressed.
If you doubt it, this confusion never stops.  In his opening remarks, Chair Bill Johnson touched on this:
Among my follow-up questions was a request for a copy of the VA's guidance in how it would ensure purchasing agents followed the VAAR [VA Acquisition Regulations].  Just yesterday, a response to that and the other questions was provided.  It is interesting that only now is the VA working to ensure that purchasers using Section 8123 are documented and in line with the FAR and VAAR.  After all, the VA has had nearly three decades to work on this.  Failing to document purchases under 8123, as acknowledged in the answers I received yesterday, is a reckless use of taxpayer dollars.  To us on this Committee, it appears as though the VA operates as it sees fit until attention is called to its operation. 
The VA was worthless in terms of witnesses.  Matkovsky wanted everyone to know that purchases under Section 8123 in the future would be auditable.  Johnson's question was can they go back and audit past purchases under that number.  In a long meandering answer about 'from this point forward,' Matkovsky implies that they've never been able to audit Section 8123 purchases in thae past.  That would be over 30 years worth of purchases.  Is the VA not able to speak English? 
Something as simple as Chair Johnson attempting to find about the hows and whens of the definition VA is using for prosthetic and when it was last updated required a song and dance until Matkovsky finally passed off to Dr. Beck who had to flip through a manual to find out (2001 was the answer for when it was last updated).  But after finally providing an answer, all the sudden it's there's-an-internal-review-going-on-now (with many more words than that).  I would assume if you're part of an update review, you would know what you were updating especially if the manual hadn't been updated in over a decade.
VA officials can't answer a straight question.  So we'll drop back to earlier in the hearing to wrap up our coverage of it here.  Excerpt.
Chair Bill Johnson: And maybe you've already answered this in some of your comments but, if you were going to design a system, Mr. Oros, for the VA to evaluate the quality of care provided to veterans, what would you do? What provisions would you put in that system to improve the quality of care that veterans receive?
Michael Oros: I would start to look at implementation of some functional outcome measurements at the time of the original prescription and then follow it throughout that veteran's care so that you see that there has been restoration of function.  And that can be done with validated instruments and there's also technology available that can support that kind of measurements. 
Chair Bill Johnson:  Okay.  As one of the elements of quality you describe the need to educate veterans about their right to choose a provider of prosthetic care the Committee is starting to hear more and more stories about veterans who say that the VA is creating barriers to their selection of non-VA care.  What has been your experience?  Have you heard from veterans that this is a growing problem?  
Michael Oros: I've seen it locally.  I think that's what I could probably speak most directly to is locally we no longer have access -- it's been at least two years that our company, while we've had a VA contract, has not been invited to that amputee clinic that I referred to previously -- where really, those referals are -- and the veterans ability to communicate with a prosthetist as well as the referring VA physician are kind of present in the same building. 
Chair Bill Johnson:  Here's that word again, from your point of view what barriers are preventing veterans from selecting a prosthetist of their own choice? Is it just that veterans don't know their rights?
Michael Oros: I think its their unfamiliarity with their rights. 
Chair Bill Johnson:  Okay. You talked in your written testimony specifically about older veterans at your practice complaining that there appears to be new administrative hurdles to prevent their continuing to receive care in non-VA facilities.  Can you give us some examples?
Michael Oros:  We've seen in our own facility where veterans who received care from our company for a number of years -- and actually I've heard similar stories from other providers too -- where they've gone back to the VA for other services, prescriptions, etc. and the patient has been -- I'll use the word "discovered" to be an amputee and they've been directed to receive their care within the VA system versus, again, that outside provider. 
Yesterday's snapshot covered the House Veterans Affairs Committee hearing on the Vow to Hire Heroes Act and efforts at raising awareness on the program.  We'll close with the news release the Committee issued after the hearing:
WASHINGTON, D.C. —Today, the House Committee on Veterans' Affairs held an oversight hearing entitled "Reviewing the Implementation of Major Provisions of the VOW to Hire Heroes Act of 2011." The VOW to Hire Heroes Act of 2011 is the signature veterans' legislation of the 112th Congress. Officials from the departments of Labor (DoL) and Veterans Affairs (VA) testified on the implementation of the law to date.
The Veterans Retraining Assistance Program (VRAP) was the main focus of the hearing. The cornerstone of the VOW to Hire Heroes Act, VRAP will provide up to one-year of Montgomery GI Bill benefits to unemployed veterans, ages 35-60, for in-demand jobs and careers. The Committee applauded efforts by the departments at the program staff-level, but cautioned that more needed to be done to promote VRAP.
"I am pleased to see that over 11,000 applications have been received so far, meaning that we are well on our way to filling all of the 45,000 slots paid for in the VOW Act for the remainder of this fiscal year," stated Rep. Jeff Miller, Chairman of the House Committee on Veterans' Affairs. "But I am concerned that not enough is being done by either department, or the President himself, to promote this benefit. Getting the message out about this opportunity is critically important to putting unemployed veterans on a path to a job in a high-demand field."
In addition, Committee Members also expressed concern that DoL and VA were not taking the appropriate steps to ensure that veterans were aware VRAP existed. Allison Hickey, Under Secretary for Benefits at VA, noted some of the challenges facing the two departments to effectively reach out to veterans about VRAP were that "a centralized system to identify eligible veterans does not exist."
Few Members had seen any outreach in their local communities, leading the Committee to ask if a plan was in place to reach unemployed veterans in non-metropolitan areas, specifically through TV advertising.
"Despite having had ample time to come forth with one, VA has failed to deliver an advertising budget," Miller said. "Advertising is a quick, effective way to control the message in order to reach a large number of veterans in a very short period of time. That is the level of promotion for VRAP that our unemployed veterans deserve. We cannot afford to let even one training slot go unfilled. I encourage all eligible veterans to sign up for this opportunity at their local one stop career center or online."
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