July 27, 2007

The Iraq Accountability Project - A Wrap-Up of this Week's Senate Oversight in Iraq

This week Senate Democrats continued holding oversight on the President’s conduct of the war.  Senate Democrats are united in their determination to hold the President accountable for his failed strategy in Iraq and guarantee veterans receive the care they earned, and deserve.

Tuesday, July 24th

Senate Committee on Foreign Relations
“Nomination: The Honorable Henrietta Holsman Fore to be Administrator of the United States Agency for International Development”

The Administration’s actions have not matched their words on the resettlement of Iraqis in the United States.

SEN. HAGEL: Speaking of passports, as you no doubt saw in Sunday's Washington Post a rather significant story about a report that our ambassador to Iraq, Ambassador Crocker – if I have this correct – sent you a cable, and, according to the paper, the cable urged the United States to offer U.S. immigrant visas to all Iraqi employees who worked for the United States government in Iraq. You may know that this is part of a Kennedy-Hagel bill that is larger and more substantial than just the visas but deals with Iraqi resettlement here in the United States – those who have assisted the United States government over the last five years. I think this committee would be interested in your response to that story. What is the current status of Ambassador Crocker's cable? And anything else you can tell us about that issue?

HENRIETTA HOLSMAN FORE, undersecretary of State for management, Department of State: Thank you, Senator Hagel. We think this is a very important issue. There is a special responsibility that we bear for those brave Iraqi nationals who've been working by our side. And we feel it most acutely in USAID [United States Agency for International Development] and Department of State and Department of Defense because they are often by our sides. As you know, there is some legislation which allows us to have special immigrant visas for translators. And we certainly welcome legislation which would allow this to be broader so that it could cover more of the Iraqi nationals who would like to be covered under the special immigrant visas.

There is a second route that Assistant Secretary Ellen Sauerbrey has spoken about quite frequently and well, which is that of the refugee status. Our Bureau for Population, Refugees and Migration has processed and looked at a number of opportunities and ways where Iraqi nationals can come to the United States. And there is a third area that we have worked on, which is for internally displaced persons, and ways that we – whether it's United States Agency for International Development can help with Iraqi nationals who are in – who have moved to either the borders along Jordan or other countries, and ways that we can help in education or with humanitarian assistance for those individuals. But we do feel that there is a responsibility and would certainly like to encourage legislation that would help these individuals.

SEN. HAGEL: Well, if I read that story correctly – I've not seen the cables, incidentally – Ambassador Crocker is putting some rather significant urgency on this issue. And if I interpret at least the story correctly, without having read the cables – and by the way, this is an issue he brought before this committee last week and it's an issue he has discussed with me privately. I definitely got the sense that he felt that the State Department should be making this as high a priority as there is and doing something about it. So what are we doing about it?

SECRETARY HOLSMAN FORE: Well, we in the State Department can't do everything alone. We just don't have enough authorities. So all of the chief of mission authorities that he can exercise he has, because we agree with him that he should have those authorities. So he has those. We are looking if there are any additional authorities which he might be able to have, and we do not have a full answer on that as yet.

SEN. HAGEL: When will we have an answer?

SECRETARY HOLSMAN FORE: I would think shortly.

SEN. HAGEL: Well, I would like for you to get back to the committee on that. My vote may well hinge on that.

I would like to know, also, how many Iraqis have we resettled in the United States?

SECRETARY HOLSMAN FORE: I don't know the answer to that question, sir.

SEN. HAGEL: Well, the answer's about 60 or 70. Now, if this administration is putting this kind of urgency on this issue and we are saying all the things, from the president on down, that we owe, just as you have said, Madame Secretary – we owe this to these good, faithful Iraqis who have supported us at great risk, to your point, it seems we're not matching our words with our actions. And I would like a better answer to this question. And I would expect that. And certainly, my vote would very much depend on that because there's a disconnect in my mind somewhere.

Senator Casey insisted that the U.S. Agency for International Development increase transparency and learn from our failed early assistance efforts in Iraq.

SEN. CASEY: But here's something else that I think is very important with regard to transparency, and this is a challenge for you not just in the context of going forward but, of course, even in the context of your confirmation. It says that – and I'm picking up in the middle of the line – "one opaque system has replaced another," and then it follows with these words, which I should have read before: "with a small" – quote, "with a small group of people deciding how aid dollars are divvied up, what countries they reach, and who controls them," unquote.

That's a recipe for not just a disaster and the erosion of confidence that the American people feel and the Congress would feel in the work that you're doing and will continue to do if you're confirmed, but I think that would be the wrong path to take, to have a small group of people who may be driven by ideology or, even if they're not, they're driven by narrow interests, to make these decisions. So I would urge you to be a leader in the transparency which I think people have a right to expect, and I think that's going to be a key indicator of your stewardship if you were to be confirmed.

The poor security environment in Iraq has hampered our ability to deliver foreign aid effectively.

SEN. CORKER: Moving back to Iraq, when you – looking at some of the difficulties that have been sustained, if you will, in trying to have appropriate personnel in place in civilian positions, has it been more of the different types of responsibilities that are being taken on in Iraq, or has it been more the security, if you will, of the people – or the perceived security – in going to serve in that way?

SECRETARY HOLSMAN FORE: Well, our resources, more of them go toward security than I think any of us had originally planned. And security becomes such an overwhelming need for us to be able to plan for so that people can do their work. But in identifying individuals, we base this on their technical expertise. So whether it is agriculture or whether it is municipal election systems or whether it is some other part of civil society, it is those technical skills that are the ones that we look for – engineering capacity, for instance. And that's how we then fill these positions in the PRTs [Provincial Reconstruction Teams]. Once they are there, it is then our responsibility and our mission to be sure that they are able to do their jobs and that they have the tools that they need to do their jobs. But it is a constant challenge in many of these posts to have a secure enough environment to get their work done to the maximum extent possible. 

Wednesday, July 25

 Committee on Veterans Affairs
“Hearing on VA Health Care Funding Issues”

The wars in Iraq and Afghanistan are likely to be the most costly wars to date from the perspective of veteran’s health care.

KENNETH W. KIZER, M.D., M.P.H.: From a veteran's health care perspective, the war in Iraq is likely to be the most expensive of any war to date.

…

JOSEPH A. VIOLANTE, NATIONAL LEGISLATIVE DIRECTOR, DISABLED AMERICAN VETERANS, ON BEHALF OF THE PARTNERSHIP FOR VETERANS HEALTH CARE BUDGET REFORM: The wars in Iraq and Afghanistan are producing a new generation of wounded, sick and disabled veterans, and some severe types at a poly-trauma level never seen before in warfare. A young American wounded in Central Asia today with brain injury, limb loss, or blindness will need the VA [Veterans Administration] health care system for the remainder of their lives.

…

UWE E. REINHARDT, PH.D., JAMES MADISON PROFESSOR OF ECONOMICS AND PUBLIC AFFAIRS, WOODROW WILSON SCHOOL OF PUBLIC AND INTERNATIONAL AFFAIRS AND DEPARTMENT OF ECONOMICS, PRINCETON UNIVERSITY: …in the future cost of health care for veterans and of yet other deferred expenses associated with the Iraq war, Nobel Laureate economist Joseph Stiglitz and his co-author Linda Bilmes of Harvard University have estimated that the properly counted cost of that war may already have reached $2 trillion. Although, like all estimates about future spending, these authors' estimate depends on a number of assumptions, including the duration of hostilities, it is safe to say that the properly calculated, true cost of the wars in Iraq and Afghanistan far exceed the $500 billion…. 

Senators and witnesses decried as shameful the current state of the VA health care funding and its treatment of the families of soldiers and National Guardsmen sent to war.

 SEN. SANDERS: In May of this year, media reports, for example, told us – and I quote – “from 125,000 to 150,000 U.S. troops may have suffered mild, moderate or severe brain injuries in Iraq and Afghanistan,” end of quote. The Defense Department's task force on mental health states that it found, quote, “Thirty-eight percent of soldiers and 31 percent of Marines report psychological concerns such as traumatic brain injury and post-traumatic stress disorder after returning from deployment. Among members of the National Guard, the figure is 49 percent,” end of quote. Does anyone seriously believe that today we have anywhere near the capability of addressing that very serious problem? I would argue we certainly do not. I would also argue that because of lack of money, what we have seen over the last many decades are shameful acts on the part of the United States government. Who in this room can be proud that the Veterans Administration and the government of the United States of America fought as hard as it could against those Vietnam vets who said, “Hey, we came back from Vietnam. We were exposed to Agent Orange. Our people are dying. Our people are getting sick.” And what the United States government has said, “Sorry, that's not the case. You got to go to court to win your rights.” And a lot of that has to do with funding.
…
DR. REINHARDT: So I am convinced, and I'm on record as saying that this entire decade, this war will go down as one of the more shameful segments of American history. I read in the Trenton Times that they had a pancake bake in order to raise money for a pantry for military families – those were National Guardsman. And I asked – and I asked my student what nation would possibly send the wives and the husbands of people who are serving in Iraq to a pantry, essentially, begging for food. That is not true in Germany. I asked there – when a reservist gets called, the company keeps paying their salary and the government reimburses the company. Not here. These families take huge hits on their income.

Many veterans are having trouble even qualifying for access to Veterans Administration health care under the current standards.

SEN. TESTER: Once again, we had the opportunity to hear from a number of Montana vets who said that once they get in the VA, the care they get is very good. The problem is getting in the door.
…

SEN. SANDERS: Four or five years ago, the president of the United States in his wisdom said, “Yes, we have hundreds of billions of dollars in tax breaks for the wealthiest one percent, but if you have a non-service- connected disability – if you don't have a service-connected disability and you make more than $27,000 a year, we're shutting the doors of the VA to you.” That is politics. I happen to disagree with those priorities. The truth of the matter is, is that in my state of Vermont and all over this country today, there are waiting lines for veterans to get the health care that they need. Very often, people have to wait long periods of time to get the care that they are entitled to.

An inefficient funding process has left the Veterans Administration unable to hire the doctors and nurses it needs to provide veterans with adequate health care.

SEN. AKAKA: Could you speak a little bit more on the affects of continuing resolutions and hiring freezes on employee morale and motivation?

J. DAVID COX, NATIONAL SECRETARY-TREASURER, AMERICAN FEDERATION OF GOVERNEMNT EMPLOYEES, AFL-CIO: Every year when we had the continuing resolutions, there was the inability to replace staff that had left, retired or quit, moved to other jobs or moved from one section of the medical center. Medical center directors were told to hold the line, they did not have the budgets to act on. We had to reach out to use agency employees on a fee basis, which costs a whole lot more. And then again, many of the schools of nursing, many of the physicians, many of the health care professionals that were available, that were graduating and eligible and available to be hired, the VA was not able to reach to them and to offer them employment because of continuing resolutions and the lack of funds. And, therefore, it has greatly hampered the ability to recruit and retain. And, obviously, nothing is any more upsetting to a nurse or any health care provider to be there on the front line providing care to veterans and have insufficient staffs to meet those needs.

…

MR. COX: The VA is in desperate need of workforce succession planning, but I fear that it will never be undertaken in a serious manner so long as the discretionary funding process continues to focus on the short term and generate great financial uncertainty. The average age of the VA health care workforce is 48.3 years, and it is going up every year. In five years, 44 percent of the entire VA health care workforce will be eligible to retire. The statistics on VA-registered nurses are frightening, especially in light of the national nursing crisis. According to an American Hospital Association report just cited in USA Today, this country had 118,000 nurse vacancies last year. Can the VA health care system, which has to fight for funding every year, compete for nurses in the face of this national crisis? I'm doubtful. Yet, the VA isn't doing what it can to hold on to its current nurses. Almost 22,000 of the 36,000 registered nurses who work at the VA will be eligible to retire by 2010. That is three years away. And newer nurses are leaving in droves. In fiscal year 2005, nearly 78 percent of all R.N. resignations at the VA occurred within the first five years of employment. A systematic funding methodology goes hand in hand with systematic staffing methodology that counts what needs to be counted, like patient acuity, staffing needs for new health directives, and costs of staying competitive with private sector. Unfortunately, VA's track record for implementing a nurse staffing methodology in a discretionary-funded environment has been dismal.

 

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