Battle of the Bilge

Collective fear stimulates herd instinct, and tends to produce ferocity toward those who are not regarded as members of the herd. – Bertrand Russell

Background Information

On August 18th, Jim Towey, former Director of Faith Based Initiatives at the White House between 2002 and 2006 wrote an opinion piece in the Wall Street Journal in which he claimed that the Obama administration had ‘resuscitated’ a VA pamphlet called ‘Your Life, Your Choices’, which he stated was suspended under the Bush administration. The opinion article, which can be read here, went on to assert that the book, which is a guide for veterans to help with end of life decisions and living wills, is actually more of a ‘push poll’ that was meant to guide severely injured service personnel towards signing ‘Do Not Resuscitate’ orders.

The story was picked up on FoxNews and presented as a ‘VA Death Book’ and continued the inaccurate assertion that this was a new policy put in place by President Obama and the VA and linked the issue to the prevalent and false talking point of ‘Death Panels’ in opposition to the National Health Care Reform bill. The hubris surrounding the issue became a viral e-mail that went even farther, accusing the administration of advocating veterans to be euthanized. There are a good deal of inaccuracies in the email, and it is from a familiar source to Battle of the Bilge.

With tensions and emotions so high right now and town hall meetings producing raucous confrontations, this type of fear mongering is not uncommon. Bringing veterans into the equation and stating that the President wants to pressure them towards suicide is unconscionable. The bottom line is that the pamphlet has been used since the Clinton administration and was not suspended under President Bush. There is an evaluation of the book underway, but it was never removed from VA guidelines for veterans. And the contents of the book is really not all that different from other handbooks on life planning, such as those offered by MOAA in its Help Your Survivors Now, Estate Planning and Survivor Checklist booklets. Click here for a full list of MOAA publications (some require member login to download, so if you are eligible, remember to join MOAA first).

The E-mail from Chaplain Klingenschmitt

WSJ: Obama and Shinseki now pressuring Veterans toward Euthanasia
The Wall Street Journal just published a shocking editorial written by a respected University President, confirming the Obama Administration is now using VA hospitals to order doctors to pressure all military veterans to sign “pull the plug” do-not-resuscitate orders, hastening their premature deaths through mandatory “end of life” counseling.
President Jim Towey of Saint Vincent’s College, founder of the non-profit “Aging With Dignity” and former White House Director of faith based initiatives, wrote a blistering expose entitled “The Death Book For Veterans,” revealing President Obama’s new Veterans Administration (VA) directive, presumably signed by VA Secretary, General (ret.) Eric Shinseki, which mandates all veterans’ primary care physicians must graphically discuss “end of life planning” with all VA patients (not merely those nearing death), and must refer them to “Your Life, Your Choices,” a book that openly encourages Euthanasia and was written with guidance from the group formerly known as the Hemlock Society. That same pro-suicide group now boasts on their web-site of directly leading the charge to ensure “end of life counseling” is mandated in the Obamacare bill, HR 3200.
On page 21 of the Shinseki-mandated Veteran’s Euthanasia book, all military veterans are encouraged to complete a checklist of various scenarios, to decide whether their own life would be “not worth living.” For example, the booklet asks veterans 7 questions pressuring veterans to sign a “living will” that authorizes doctors to terminate your life, if you are:
1) Living in a nursing home?
2) Being in a wheelchair?
3) Not able to “shake the blues?”
4) Ever heard anyone say, “If I’m a vegetable, pull the plug?”
5) No longer able to contribute to your family’s well-being?
6) Are you a severe financial burden to your family?
7) Do you cause severe emotional burden for your family?
“This hurry-up-and-die message is clear and unconscionable,” says Towey, “Worse, a July 2009 VA directive [presumably signed by Shinseki] instructs its primary care physicians to raise advance care planning with all VA patients and to refer them to ‘Your Life, Your Choices.’ [the Euthanasia booklet.] Not just those of advanced age and debilitated condition-all patients. America’s 24 million veterans deserve better.” Towey recommends a “five wishes” living-will document that does not pressure suicide.
But instead the Hemlock Society booklet is now MANDATED for doctor referral to all patients in all VA hospitals, heaping more evidence upon the growing list of proofs that the Obama Administration is LYING TO THE PUBLIC by denying their health care plan pushes Euthanasia on the elderly. They already do it today. Just imagine if ALL hospitals become government-run like the VA.

Origins

The email above was written by the founder of The Pray in Jesus Name project, Chaplain Gordon Klingenschmitt, who has been an unrelenting critic of the Obama administration and has been the source of several Bilge articles in the past (such as Bible Burning in Afghanistan and the row over military chaplains between Military Religious Freedom Foundation and CFGC).

Specific Exaggerations or Inaccuracies in the Email

The July Update of the VHA Handbook 1004.01 was not a Directive and did not change any substantive features of the original Directive, which was issued by President Bush in February 2007. The update added ‘close friend’ as an option for decision making surrogates and defined that concept. It also attempts to resolve conflicts that have occurred on the local level by making VHA facilities consult with the National Center for Ethics in Health Care, an entity created in 1991 after Desert Storm.

The VHA Handbook’s life planning portions, which is referred to in the email as the ‘Shinseki-mandated Veteran’s Euthanasia’ is not a required program. It is a book that contains guidelines on how VA patients should approach the difficult decisions facing them and the only mandatory part of the update is that local facilities must make this information available to all veterans. Klingenschmitt’s accusation that this is part of a growing mountain of evidence that President Obama’s health care reform bill ‘pushes Euthanasia on the elderly’ and fuels the fires of fear in a blatant effort at fear mongering.

Whatever Jim Towey’s intentions were with his opinion piece (beyond pushing the use of his own handbook), he didn’t get all the facts straight either. Stating that the Bush administration abandoned the booklet’s use by the VA is in direct contradiction with a July 2008 Directive, which can be read here. There are many other instances of the VA under President Bush using the ‘Your Life, Your Choices’ handbook as a guide for end of life decision making:

• December 2006 VA Pamphlet on Living Wills
• August 2006 VHA eHealth University Training Course on Life Planning
• February 2007 Directive on Advance Care Planning and Management of Advance Directives
• December 2008 Push on VA Website for Establishing Living Wills

VA Response

The following was sent by the VA’s senior advisor on relations with major veterans groups, Kevin Secor:

Recently, some folks have been distorting the purpose of a Veterans Affairs planning tool called ‘Your Life, Your Choices.’ The booklet is designed to help Veterans deal with excruciating questions about what kind of health care they would like to receive if they are unable to make decisions for themselves, a topic that Secretary Shinseki takes very seriously as we continue to create a 21st Century Department of Veterans’ Affairs that provides the care and benefits our nation’s veterans have earned. The document was developed under a federally funded research grant over a decade ago and in 2007, the Veterans Health Administration convened an outside panel of experts to review the tool and assess its merits. Overwhelmingly, the panel of experts, which included a diverse group from the faith based and medical communities, praised ‘Your Life, Your Choices’ and endorsed its use in the Veterans Health Administration. Your Life, Your Choices’ is not an Advance Directive or Living Will, it is an educational resource. The National Advance Directive that the VA utilizes today is the same document that was authorized by the Bush Administration in 2006.

Secor, who retired as a master gunnery sergeant after serving in the Marines for 29 years, was appointed in January of 2006 and has stayed on at the VA in the new administration.

More Health Care Misinformation

Today, MSNBC is running an Associated Press story that states that the national Republican Party has sent out letters telling people that if health care reform passes, Republicans could be discriminated against when pursuing medical care. The letter stated that the government could check voting registration and use that when determining services. A snippet of the reaction to the letter:

Jon Vogel, executive director of the Democratic House campaign organization, called the GOP letter “shameless fear-mongering.”
In a fundraising e-mail of his own seeking to raise $100,000 by Aug. 31, Vogel wrote the Republican accusation was “just a preview of the falsehoods, fabrications and outright lies Republicans will be pushing when Congress returns in September.”

There seems to be no let-up in the passion and misinformation clouding the health care reform issue.



Discussion
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“Years ago, fairy tales all began with Once upon a time… now we know they all begin with, If I am elected.” – Carolyn Warner

A Speech Full of Promises

On August 17th, President Obama spoke to a packed house in Phoenix at the national convention of the Veterans of Foreign Wars and delivered a speech that was meant to bring the White House and the military closer together. In his speech, he promised to improve the lives of active and retired military personnel in a multitude of ways. But it is action, not words, that will determine the course of the relationship between the two parties.

Selected Transcript via the White House

Whether you’ve left the service in 2009 or 1949, we will fulfill our responsibility to deliver the benefits and care that you earned. And that’s why I’ve pledged to build nothing less than a 21st-century VA. And I picked a lifelong soldier and wounded warrior from Vietnam to lead this fight, General Ric Shinseki.

We’re dramatically increasing funding for veterans health care. This includes hundreds of millions of dollars to serve veterans in rural areas, as well as the unique needs of our growing number of women veterans. We’re restoring access to VA health care for a half-million veterans who lost their eligibility in recent years — our Priority 8 veterans.

And since there’s been so much misinformation out there about health insurance reform, let me say this: One thing that reform won’t change is veterans’ health care. No one is going to take away your benefits — that is the plain and simple truth. We’re expanding access to your health care, not reducing it.

We’re also keeping our promise on concurrent receipt. My budget ensures that our severely disabled veterans will receive both their military retired pay and their VA disability benefits. And I look forward to signing legislation on advanced appropriations for the VA so the medical care you need is never held up by budget delays.

I’ve also directed Secretary Shinseki to focus on a top priority — reducing homelessness among veterans. After serving their country, no veteran should be sleeping on the streets. No veteran. We should have zero tolerance for that.

And we’re keeping our promise to fulfill another top priority at the VA — cutting the red tape and inefficiencies that cause backlogs and delays in the claims process. This spring, I directed the Department of Defense and Veterans Affairs to create one unified lifetime electronic health record for the members of the armed forces — a single electronic record, with privacy guaranteed, that will stay with them forever. Because after fighting for America, you should not have to fight over paperwork to receive the benefits that you’ve earned.

Today, I can announce that we’re taking another step. I’ve directed my Chief Performance Officer, my Chief Technology Officer and my Chief Information Officer to join with Secretary Shinseki in a new reform effort. We’re launching a new competition to capture the very best ideas of our VA employees who work with you every day.

We’re going to challenge each of our 57 regional VA offices to come up with the best ways of doing business, of harnessing the best information technologies, of cutting red tape and breaking through the bureaucracy. And then we’re going to fund the best ideas and put them into action, all with a simple mission: cut those backlogs, slash those wait times, deliver your benefits sooner. I know you’ve heard this for years, but the leadership and resources we’re providing this time means that we’re going to be able to do it. That is our mission, and we are going to make it happen.

Now, taken together, these investments represent a historic increase in our commitment to America’s veterans — a 15 percent increase over last year’s funding levels and the largest increase in the VA budget in more than 30 years. And over the next five years we’ll invest another $25 billion to make sure that our veterans are getting what they need.

These are major investments, and these are difficult times. Fiscal discipline demands that we make hard decisions — sacrificing certain things we can’t afford. But let me be clear. America’s commitment to its veterans are not just lines on a budget. They are bonds that are sacred — a sacred trust we’re honor bound to uphold.

These are commitments that we make to the patriots who serve — from the day they enlist to the day that they are laid to rest.

Note: Notations of ‘applause’ have been removed for clarity
For the full transcript of the speech, click here.

Action, Action, Action

While we applaud the promises and priority the White House places on the military community, the promises of keeping health care secure and expanding services must be followed up by real action on the Hill. Preside Obama is obviously reaching out directly to the military because of the rumors and emails that have been spread around concerning the CBO report and TFL. But this is no longer a campaign, this is the presidency, and rhetoric will not work with an extremely vigilant group such as our veteran community. We’ll follow up on this post and see how things are going a bit down the line…

Discussion

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We present the most annoying, befuddling or just plain strange stories of the week.

On to the ‘honor roll’ (sources are linked in the headlines)…

#5 – Columbia/U.S. Negotiations Spark Venezuelan Fears

In an effort to fight drug trafficking and terrorism, the U.S. and Colombian governments are said to be close to a deal to allow U.S. forces to use five air and two naval bases on its territory. In response, Venezuelan President Hugo Chavez, a far left populist that has built his career by using strong arm tactics and a flair for moving anti-American speeches, told his nation to prepare for war.As tensions between Columbia and Venezuela have been deteriorating in the past year due to Chavez’s support of anti-Columbia rebels. Placing troops on the ground is a risk, but a clear message. Don’t be jerks, or we’ll have to take care of this. It will be interesting to see the Iranian and Russian response to this move, given both nations’ interests in South America and Venezuela in particular.

#4 – Senator Grassley’s Week

This week saw the Republican senator from Iowa Charles Grassley gain the spotlight for supporting the ‘death panel’ assertions being raised by such figures as Sarah Palin. However, it turns out the senator’s passion wasn’t so strong in 2003 when he voted for Medicare providing benefits to terminally ill patients that wish to get their house in order while still of sound mind. Senator Grassley objected to the new version of the bill, all senior citizens would be covered under Medicare for end of life counseling.

#3 – President Obama Spreads A Little Bilge Himself

At a time when David Axelrod is trying to get a message go viral debunking health care myths, the president made a major gaffe of his own. At a town hall meeting in New Hampshire, President Obama made the following statement:

“We have the AARP onboard because they know this is a good deal for our seniors…AARP would not be endorsing a bill if it was undermining Medicare.”

However, the AARP has not made such a commitment as of yet. The White House said the president misspoke, but that’s a pretty major blunder. While most are wondering if this was a deliberate attempt to mislead the people, I’m wondering if there is an endorsement in the works and he spoke too soon. It was a bad week for the White House on health care reform.

#2 – Military Spouses Get Federal Job Preference

Here is something that should have happened years ago. A no brainer change in the hiring guidelines issued by the Office of Personnel Management regarding federal employment makes it easier and faster for military spouses to obtain federal jobs. This is an absolute necessity when you consider how many relocation orders have been issued in the past decade and will hopefully help ease deployment stress.

#1 – The Strange Journey of the Arctic Sea

After disappearing after it left the English Channel, the Russian flagged cargo ship the Arctic Sea has been missing for 2 weeks. The U.S. Navy is not involved, but the Russians sent a small flotilla including two submarines after the cargo ship, leading many sources to wonder why. There are rumors of piracy and of ransom, but an alleged attack happened off the coast of Finland before it passed through the channel. An actual pirate attack in European waters would be a historic event. Now word comes that there has been a ransom demand from the ship, but details are sketchy. The ship is carrying timber to Algeria, but rumors abound that there is something more than timber involved. The Russian Navy has seen some increased show of force incidents lately, so their involvement for propaganda reasons can’t really be ruled out. We’ll see how it develops.

Add your voice

In addition to sending in nominations for the Top 5 each week, feel free to post your own musings below and rank what your most interesting/frustrating/angering story of the week was. Posts are not held for moderation so your comment will appear immediately, but may be modified if it violates our Community Standards.

Clearing the Air

With the national health care debate in the new headlines and a multitude of emails flying around a concerned nation, we often receive inquiries regarding our stance on the debate. In response to these inquiries, MOAA members were sent the following message from our president. I am happy to report that no bilge has been found in this message.

Official Message Regarding Health Care

As Congress enters its month-long August recess, I want to clarify MOAA’s perspective on national health care reform and its possible implications for you and all members of the military and veterans’ community and their families and survivors.

Many MOAA members have strong opinions on the politicians involved, strong preferences for one political party or the other, and strong views on both the principle and the specific details of national health care reform.

From MOAA’s standpoint, our tax-exempt, nonprofit status precludes us from taking partisan stands for or against any politician or political party.

We take positions on issues. And in the interest of delivering our members the most bang for their membership buck, we devote our limited resources to addressing issues that directly affect our national defense and the military and veterans’ community.

For these reasons, our primary focus is on the aspects of the draft health care legislation that will affect you and the military community – military and VA health care, TRICARE, Medicare and TRICARE For Life.

Our research and advocacy efforts on national health care reform are targeted at six primary goals:

• Safeguarding military and VA beneficiaries’ health benefits;
• Ensuring military and VA beneficiaries can choose other insurance;
• Ensuring military and VA beneficiaries aren’t taxed on the value of those health benefits;
• Preserving and improving military and VA beneficiaries’ access to providers of quality health care;
• Ensuring long-term sustainment of Medicare (and TRICARE For Life) – and a fix for the broken Medicare payment formula that now poses annual threats of significant cuts that would erode providers’ willingness to see Medicare and TRICARE beneficiaries; and
• Keeping our members apprised of how pending legislation could affect them and encouraging grassroots communications to their elected representatives to protect their interests.

We’ve sent a Military Coalition letter to every member of Congress, and thus far MOAA members have generated over 35,000 e-mails to their legislators using our alert. Every indication we’ve received from the Administration and congressional leaders of both political parties is that they share the goals listed above (read MOAA’s Aug. 7 legislative update for the latest specifics).

But there’s a long way to go in the legislative process, and hard experience tells us severe budget pressures can undermine the best intentions.

The bottom line: The entire MOAA staff and I are here to serve you. We will continue communicating with you, so we can let you know what we are working on and you can tell us what your concerns are. Please make sure you are signed up for our weekly Legislative Update and check our Health Care Happenings blog for the most up-to-date information.

I want to assure you MOAA will continue to be extraordinarily vigilant on this front. I encourage you to use MOAA’s national health reform alert to keep pressure on Congress to protect your interests. And please visit with your elected officials during this August recess.

Thank you for your continuing support and membership in MOAA.

All the best,

VADM Norb Ryan Jr., USN (Ret)
President

Related Battle of the Bilge Posts

TFL CBO Emails Resurface
TFL on Chopping Block?
TFL on Chopping Block – Update
Sarah Palin’s Befuddling Comments Highlight Health Care Circus

Discussion

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Please Note: The commentary in this article is not necessarily the position of MOAA, except where specified near the bottom.

‘Three minutes thought would suffice to find this out; but thought is irksome and three minutes is a long time.’ – A.E. Houseman

Update

After Palin’s statements detailed below and the public outcry that followed, she has done a complete about face and is now calling for ‘civil’ discussions on the subject.

Her statement according to MSNBC, from today:

Palin now says there are many disturbing details in the bill. But she says people must stick to discussion of the issues “and not get sidetracked by tactics that can be accused of leading to intimidation or harassment.”

Amazing. A weekend of facepalms can have a strong affect on our political outlooks.

From August 8th

Wait, what?

Yesterday, the world was treated to an exceptionally uninformed statement via Sarah Palin’s facebook page:

Segment from Sarah Palin’s Statement on Health Care Debate
The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

For the entire statement, go here.

We’ve scoured the health care proposals and nothing contains mention of ‘Obama’s death panel’, or even a remote euphemistic example. One proposal (and remember that this process is a long one and there is nothing close to a consensus on what the final reform bill will contain) that might be the basis for her claim that the reform is ‘evil’ and would result in bureaucrats deciding who would live or die based on ‘level of productivity in society’ is the proposed ‘Health Care Commission’ that would evaluate public and private options to ensure consumers are getting the proper benefits and coverage for the price they are paying. To help describe the proposal, Politifact enlisted Jennifer Tolbert, an independent analyst from the non-partisan Kaiser Family Foundation, who said “This is designed to protect consumers from plans that have outrageous cost-sharing or really limited benefits”.

Regardless of where the former governor received her misinformation, this type of language is dangerous and extraordinarily non-productive. When your base of followers interprets the concept of evil as a tangible enemy, it only adds to the possibility of violence.

Town Hall Disruptions, Violence

All across the nation this month, as Congress is in recess and representatives and senators head home for vacation, the plan on both sides of the aisle was to hold town hall meetings on health care reform. The intent of each member of Congress was to discuss the virtues and problems with the multiple competing bills that will eventually converge to form the health care reform program. But other people had different plans. There have already been disruptions of speeches, threats against elected officials and physical altercations at several forums.

Part of these disruptions are, I can only assume, from well intentioned and passionate people that may be misinformed about what health care reform is (like anyone receiving the email outlined here) actually going to look like. But there is evidence that these disruptions are being organized and whipped up by partisan forces. FreedomWorks, an organization that was also heavily behind the ‘tea parties’ movement, had an internal memo leaked (pdf format) which showed how much of an effort was being made to disrupt the meetings.

Following a list of instructions on how protestors can meet up and how they should proceed to the town hall meetings, the memo outlines what they should do at the event:

Inside the Hall
Spread out in the hall and try to be in the front half. The objective is to put the Rep on the defensive with our questions and follow-up. The Rep should be made to feel that a majority, and if not, a significant portion of at least the audience, opposes the socialist agenda of Washington. They need to leave the hall with some doubts about their agenda. The other objective is to illustrate for the balance of the audience that the national leadership is acting against our founders’ principles which are on the other side of the debate – and show them that there are a lot of solid citizens in the district who oppose the socialist approach to the nation’s challenges. We want the independent thinkers to leave the hall with doubts about the Democrat solutions continually proposed by the national leadership.

You need to rock-the-boat early in the Rep’s presentation, Watch for an opportunity to yell out and challenge the Rep’s statements early. If he blames Bush for something or offers other excuses — call him on it, yell back and have someone else follow-up with a shout-out. Don’t carry on and make a scene – just short intermittent shout outs. The purpose is to make him uneasy early on and set
the tone for the hall as clearly informal, and free-wheeling. It will also embolden others who agree with us to call out and challenge with tough questions. The goal is to rattle him and get him off his prepared script and agenda. If he says something outrageous, stand up and shout out and sit right down. Look for these opportunities before he even takes questions.

When the formal Q&A session begins get all your hands up and keep up – be persistent through the entire session. Keep body language neutral and positive to improve chances of being selected. When called on, ask a specific prepared question that puts the onus on him to answer. It can be a long question including lots of statistics/facts. You will not be interrupted from readin a solid question. If you ramble on too long without a focus, you will be stopped. After the Rep answers, or more likely diverts or dodges, be prepared with a follow-up – take the initiative and you will be able to follow-up. The balance of the group should applaud when the question is asked, further putting the Rep on the defensive. If the Rep tries a particularly odious diversion, someone from the group should yell out to answer the question. These tactics will Clearly rattle the Rep and illustrate some degree of his ineptness to the balance of the audience.

Note: Emphasis added

The point of town meetings is to discuss issues and for reps to get the true feelings from their constituents on major issues. Attempting to coordinate a disruption of this process is an attempt to undermine representative democracy, an ironic twist to an already strange situation. But the question keeps coming up – why? What is FreedomWorks connection (besides being a right wing group opposed to President Obama)? ThinkProgress has a disturbing peace on the corporate lobbyist ties to all of this that can be viewed here.

What This Means for TRICARE, VA, TFL and Medicare

As I’ve stated before, for true non-partisan, realistic and experienced analysis of legislative issues, look no further than MOAA’s Government Relations department. The President has given assurances that whatever the bill ends up as, TRICARE and VA funding/benefits will be protected. This week’s Legislative Update goes in to the subject of health care reform in depth and explains the process well.

The seasoned Government Relations team also provides a ‘bottom line’ for members of the military:

• Congress is not going to “kill Medicare” or “kill TFL”
• Seniors are the most powerful voting bloc in America, and legislators aren’t going to flagrantly disregard their interests
• Many things in the health care reform legislation are positive for Medicare/TRICARE beneficiaries and seek reasonable cost constraints that minimize impact on beneficiaries
• There also are some things that cause justifiable concern, such as (a) the risk of putting significant power in the hands of a commission or set of administrators who would be empowered to take action that might or might not be draconian at some point in the future, (b) the potential for extending means-tested premiums ever-further down the income scale, and (c) using some Medicare savings to fund universal health care, but applying cost-constraint “hammers” (e.g., a future commission) only to Medicare
• There’s no denying that something has to be done to constrain Medicare cost growth, as the alternative (much higher taxes) won’t fly, and that will almost certainly necessitate some “lesser of the evils” choices
• There’s no free lunch, especially coming into a new decade in which the country faces massive economic challenges and rising deficits. If something isn’t done now, the task will only get tougher later
• Part of the challenge to understanding is that some in both parties and their supporters use rhetoric aimed more at scoring political points than providing factual perspectives
• MOAA will keep vigilant to protect members’ legitimate interests, and MOAA members need to respond with grassroots action when those interests come under attack

Discussion

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