Time for a Dose of Reality
9:35 AM, Jun 19, 2014 • By KEVIN NICHOLSON
The events of the last few weeks have been gut wrenching for many active duty members of the military and veterans. We have watched the Veterans Affairs (VA) health care scandal unfold, the absurdly lopsided trade of Sergeant Bowe Bergdahl in exchange for five top-level Taliban commanders, and now the loss of hard-won Iraqi cities to ISIS (the Islamic State of Iraq and Syria) following the premature withdrawal of all U.S. troops from that country.
Through these events, the gaping disconnect between the would-be world inhabited by President Obama and his allies in the media and academia, and the reality that actually governs the world, has been laid bare. Perhaps it is no coincidence that the recent failures that have engulfed the Obama administration are all related to the military. Reality hits home quickly in military matters; military affairs are not an area where you can play, as the leadership and elected officials of the left have long been playing, an elaborate game of pretend. This game has allowed them to extol the virtues of a fundamentally flawed VA in pursuit of healthcare-related political victories, and to trade Taliban commanders for AWOL privates against the advice of military professionals. The same attitude enables President Obama and his allies to conclude that, since they never supported the war in Iraq in the first place, they therefore had no responsibility to make sure that the conflict was resolved responsibly.
In stark contrast to the actions of the Obama administration, most Americans take on the problems they face through the lens of reality. They deal with the world as it is, before attempting to change or improve it. They expect to encounter some level of complication with any plan that they put into motion, and they adjust accordingly when problems appear. Any of these common sense measures would have helped to avert the Obama administration’s failures as they relate to the VA, the release of top-level Taliban commanders, and the unraveling situation in Iraq.
Fudging the Numbers
The fundamental problems exhibited in the VA scandal have been hiding in plain sight of everyone who has had access to the Internet since about 2007. These details have been willfully and purposefully ignored by left-of-center commentators and leaders. In 2007, then Washington Post columnist Ezra Klein stated that “the VA's lead in care quality isn't disputed.” The New York Times’s Paul Krugman promoted the VA as a model to be “emulated by the rest of our health care system” in 2011.
Yet from 2007 to 2009, published news reports highlighted multiple cases of major VA failures. To name a few: 19 veterans died due to substandard care at a Marion, Illinois, VA hospital; 100 veterans received botched radiation treatments at a VA hospital in Pennsylvania; 10,000 veterans were exposed to AIDS and hepatitis at multiple facilities; and all of this while vets across the nation faced significantly longer wait times for service than reported and advertised by the VA.
Hardly a model to emulate, the VA’s health care system is a system in need of an overhaul. But instead of calling attention to this reality, the leading lights of the Democratic party’s brain trust held up the VA as a model for aspects of the Affordable Care Act (ACA). As a graduate student just a few years ago, I sat through lectures from renowned experts at Harvard and Dartmouth as they extolled the virtues of everything from the vaunted electronic records system of the VA to the system’s purported ability to reduce costs, all while producing superior health results.
In his blog, Krugman has even gone so far as to state, “Integrated care — and effective use of electronic records — delivered rising quality of care [at the VA] even as it reduced costs.” Krugman continued, “Yes, I know, someone will chime in with a VA horror story, because any large health system will make errors. But the VA clearly delivers care as good or better than most civilians receive, at sharply lower cost.”
Leave aside the fact that veterans are civilians (active duty military receive care from the military’s separate medical system). A system that effectively kills people due to its administrative failures does not provide “good or better” care than most “civilians” receive. The severity of mistakes made in a command and control environment like the VA, and the immediate and unforgiving impact of those mistakes on many veterans’ lives, makes it tough to hide the ridiculousness of Krugman’s argument.
In reality, the VA’s electronic record system is a hodge-podge of roughly 100 different software systems. The infrastructure of some of those systems dates back to the 1980s, and many components of the overall system are incompatible with others. Every veteran who visits the VA knows to bring with them a photocopy of their medical record, and knows that when they turn their record over to a doc, it will promptly disappear. (This is why well-prepared VA patients always keep an original paper copy of their record at home.)
Furthermore, the VA’s ability to produce superior health outcomes is dubious. A 2009 report by the Congressional Budget Office confirmed that it is difficult to gauge the quality of VA care against other providers, given that many veterans receive their health care from multiple sources. Of Medicare-eligible patients age 66 and older who had also been enrolled in the VA for one year or more, only about three percent chose to seek in-patient hospital care from only the VA. Seventy-six percent avoided the VA completely, with 19 percent seeking care solely from Medicare, while roughly one percent sought care from both the VA and Medicare. Yet proponents of the VA as a model healthcare system have ignored this mix of providers in an attempt to ascribe all successful health outcomes to the VA.
I suppose that none of this really matters when you’re trying to win a political argument. A recent audit of 731 VA hospitals and outpatient clinics may have discovered that more than 57,000 veterans have been waiting more than 90 days for an initial appointment, while 64,000 veterans never even received an initial appointment after requesting one. But these numbers reflect more of those inconvenient horror stories that Krugman would prefer not to be bothered with.
Why make the argument of the VA as a model system in the first case? Because, to admit the VA’s many fatal flaws, is to admit that socialized medicine (to use Ezra Klein’s one-time description of the VA’s health care network) doesn’t work very well. And that’s an uncomfortable reality for the Obama administration and its supporters. If the VA can’t really provide better outcomes at reduced costs, what are we to think of the ACA’s chances of doing the same?
In reality, the VA hospital system should likely be phased out and replaced with insurance coverage for qualified veterans. Retirees and injured veterans, many of whom already have insurance coverage provided by the military known as TRICARE, should retain or gain that coverage. This coverage should then be made eligible for use at private hospitals across the country, and supplemented by a system of regional military-run trauma centers (specializing in providing the brain, burn, prosthetic, and psychological treatments required by many injured veterans).
This is a practical and reality-based solution to a real problem that affects the health and well-being of Americans who have sacrificed a great deal for their country. It’s certainly not the only answer to the problem, and may not be the best. But it’s an honest start in the right direction that doesn’t depend on an elaborate game of pretend.
A Convenient Excuse for a Bad Decision
What can you say about a White House that made the conscious decision to release five top-level Taliban commanders in exchange for an (at best) AWOL soldier under a scenario that will likely see those combatants return to the battlefield in one way, shape, or form?
The Obama administration and its supporters in the media have obviously received their talking points, and all are reciting the fact that the United States “leaves no one behind” on the battlefield. Ergo, anyone who disagrees with their decision to release five top-level Taliban commanders must not care about the welfare of Prisoners of War. This trope has been shouted from the rooftop by the president and his supporters in the media with the hope that the argument closes the case.
To call this a hyperbolic response to a straw man is too kind. The United States does not leave its own on the battlefield. Enough said. Those of us who have served in the military have lived this creed and do not need to hear it regurgitated by the likes of Susan Rice, the national security advisor and former United Nations ambassador. Rice’s further description of Bergdahl as having served the United States with “honor and distinction” – powerful words whose meaning apparently escape her – only underscores the disconnect between the administration and the rest of us.
I, along with many veterans, believe that a serious attempt should have been made to recover Bergdahl, but not at any price. The exchange of five Taliban commanders for Bergdahl should have never even been an option, regardless of the circumstances of his disappearance. Those who say otherwise should be asked the question of whether President Franklin Roosevelt would have exchanged five of Hitler’s divisional commanders for an AWOL private in 1944. Think that’s an extreme analogy? Ask the families of U.S. troops killed by Taliban thugs, or the families of thousands of Shiites massacred at the order of Mohammad Fazl.
There was a wide set of options available to President Obama and his staff when it came to the method employed to recover Bergdahl. In fact, all indicators point toward the likelihood that the exchange of Bergdahl was a convenient excuse to release the five detainees as a precursor to further “peace” talks with the Taliban (to meet a pre-condition imposed by the Taliban). Bergdahl was likely a convenient excuse to achieve an incredibly naïve and perverse goal. This is hardly an unrealistic view of the scenario. The decision on the part of the White House and the New York Times to malign the members of Bergdahl’s unit who’ve had the temerity to speak up regarding his likely desertion, should just make Americans all the more suspicious of what it is that the administration and its allies are trying to do.
And though it’s not politically correct to say so, there’s maybe no greater sign of detachment from reality than assuming that one can engage in peace talks with a group of men known by their penchant for cutting off the heads, noses, and ears of those with whom they have disagreements. After seven months of leading a team designed to fight the enormous IED threat in Maiwand, Afghanistan, I speak from personal experience when I say that one cannot engage in peace talks with a group of fanatical murderers. If you do, they will use the opportunity to try and kill you and your allies at some point in the future.
Iraq: Heartbreaking but Predictable
Afghanistan, President Obama always assured us, was a worthwhile war from which he wanted no distractions. His lack of leadership on Afghanistan since his first election, his use of politicized and publicized drawdowns, and his decision to summarily release five top-level Taliban commanders, should all call that claim into question.
And if that’s how he treats what he deemed a worthwhile effort in Afghanistan, his treatment of a war he disdained in Iraq should come as no surprise. For all intents and purposes, President Obama has thrown his hands in the air from the beginning of his administration and declared Iraq to be a conflict for which he was not responsible, and in which he had no interest in securing a lasting peace.
But in the real world, he is responsible for Iraq. He was responsible from the moment he took office. While he may not have created the problems he assumed, he assumed them nonetheless. That’s the price of leadership, and if one doesn’t like it, they should not run for president.
Many public and private sector leaders inherit serious problems from their predecessors; few have had such complicit support from professional onlookers (the media, in this case) as they have willfully ignored their obligation to successfully solve those problems.
In 2011, as President Obama geared up for his last campaign, the Status of Forces Agreement (SOFA) that allowed U.S. troops to operate within Iraq was drawing to a close. For an extended period, the Obama administration had been “working” on establishing a new agreement with Iraqi prime minister Nouri al Maliki. But in Al Maliki, the president had the perfect foil: someone who was a Bush ally, a problematic figure to be sure, and a reason to engineer a crisis over the agreement and walk away. And thus, the vacuum of power was created that has now allowed ISIS to march through the streets where American blood was once shed to secure a new hope for a people’s future.
During much of the time that U.S. troops were on the ground there, Iraqis were briefly lifted from the oppression they had previously felt under the rule of Saddam Hussein; I saw it myself as I led Marines in Al Anbar province. Like all wars, Iraq was imperfect and unclean. Mistakes cost Americans and Iraqis their lives; victories gave both new opportunities.
But none of these mistakes compare to President Obama’s. Now we are faced with the prospective birth of a new terrorist state, and President Obama has assured everyone that the U.S. will not be sending ground troops back to Iraq (beyond those he has already been forced to send to secure the American embassy). Americans are no doubt relieved to hear this, but that’s partly due to the fact that their president has told them that the conflict in Iraq was nothing more than a mistake for the past six years.
Meanwhile, ISIS has taken advantage of President Obama’s desire to avoid responsibility in order to kill its enemies in pursuit of ground, power, wealth and influence. All of these are “nineteenth and twentieth century” tactics that Obama and his allies no doubt find antiquated, off-putting, and unworthy of the international community’s respect.
I’ve seen these tactics employed in Iraq and Afghanistan in the twenty-first century, and the results are gruesome. The impractical elitists who ignored the existential danger of similar threats in the nineteenth and twentieth centuries, and failed to muster an adequate response then, ended up getting millions of people killed. Statements of disapproval are not enough to keep Americans or our allies safe from the threat of determined killers.
Re-establishing Our Tether to Reality
These are the results of the mistakes and scandals that stem from a leader’s fundamental detachment from reality. The Obama administration has made many mistakes, but it’s more difficult for the president and his allies to fudge the result of military-related errors. They hit home in an obvious manner that’s difficult to hide.
During what often seems like another lifetime, at the age of 21, I served as the national president of the College Democrats of America. I worked at the Democratic National Committee, served on the DNC’s executive committee, and spoke at the 2000 Democratic National Convention. I spent one year in that role, and left Washington largely disgusted with what I saw.
In the ensuing years after my time leading the College Dems, I began a journey that took me back home to the heartland, off to a cattle ranch in the mountains of Wyoming, across the battlefields of Iraq and Afghanistan, and through the halls of two Ivy League schools. Along the way, I got married, had three children, kept my drive, dropped my illusions, and came to admit, then embrace, the fact that I am a conservative.
Reality, dished out through raw experience, got the better of me, and I’m thankful for that. I want no part of an elite class of pretenders, who are willing to consistently ignore reality whenever it collides with their ideology. Whatever President Obama, Susan Rice, Paul Krugman, Ezra Klein, and – yes – Hillary Clinton may tell themselves, willful ignorance doesn’t solve problems or help people. Only clear-eyed assessments of problems combined with hard-earned experience, iron will and hard work can do that.
Leaders and commentators may have made good or bad decisions and arguments in the days and months following September 11, 2001. They may have been right or wrong in their assessments of long-term threats.
But I’m willing to bet that in the days following that attack, when everyone’s tether to reality was pretty strong, that none of our nation’s leaders would have considered trading five top-level Taliban commanders for an AWOL private. That’s a decent benchmark to remember when it comes to matters of such importance. Such reality-based decision-making would also have helped to avoid the current situation in Iraq, and would have led to addressing problems at the VA years earlier.
Going forward, my hope is that conservatives will give many more former Democrats like me a good reason to join them in embracing reality en route to providing solutions capable of actually solving problems. I don’t have much hope for converting the would-be aristocracy that sits atop the left’s establishment, but I do believe that a significant chunk of what the Democratic leadership assumes to be their future voting base is tired of their failures, and open to a new way of doing things. They realize that reality, as it always does, is catching up to us all.
Conservatives have only one arrow in our quiver that is fully capable of bringing down the hot air balloon that keeps the would-be aristocracy of the left afloat: reality. Luckily, it’s a powerful arrow. We just need to learn how to aim it better.
Kevin Nicholson, a management consultant living in Wauwatosa, Wisconsin, is a veteran of the U.S. Marine Corps and the wars in Iraq and Afghanistan. He was awarded the Bronze Star for his service in Afghanistan. After leaving the Marine Corps, he completed a joint graduate program at the Harvard Kennedy School of Government and Dartmouth’s Tuck School of Business.
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