Is Trump Trying To Screw Over Veterans With VA Privatization Again?

Yesterday, according to Erica Werner at the Washington Post, Señor Trumpanzee signed "a sweeping new law... aimed at expanding veterans' access to private-sector health care. But behind the scenes his administration is fighting a bipartisan Senate effort to fund the legislation."

The bill passed the Senate on May 23, 92-5, only Bob Corker (R-TN), Jeff Merkley (D-OR), Mike Rounds (R-SD), Bernie Sanders (I-VT) and Brian Schatz (D-HI) objecting.

The legislation would open up access to private doctors for veterans who don't feel they are getting the care they expect within the VA-- with the approval of a VA health care provider. This would include situations where roadblocks to care exist, such as lengthy wait times or VA medical centers that lack services required by a particular patient.

The VA Mission Act authorizes new health care programs for veterans, but the bill does not reserve federal money to pay for those programs. A group of powerful Senate committee chairmen aims to remedy that by amending a separate measure to pay for the new $50 billion law… But the White House has engaged in a quiet effort to thwart the senators’ plan, encouraging lawmakers to vote it down and instead asking Congress to pay for the veterans programs by cutting spending elsewhere.”

But the White House has engaged in a quiet effort to thwart the senators' plan, encouraging lawmakers to vote it down and instead asking Congress to pay for the veterans programs by cutting spending elsewhere.

White House officials are circulating a memo on Capitol Hill this week that slams the senators' proposal as "anathema to responsible spending" and predicts it would lead to ballooning costs and "virtually unlimited increases" in veterans' spending on private health care.

"Without subjecting the program to any budgetary constraint, there is no incentive to continue to serve veterans with innovative, streamlined and efficient quality of care," the administration says in the memo, which was obtained by the Washington Post.

Sen. Richard Shelby (R-AL), head of the Senate Appropriations Committee, argued that if Congress does not ratify his proposal, the alternative could be to cut $10 billion a year for five years from existing programs, including initiatives within the Veterans Affairs' Department.

"If we don't get on it we're going to have a hole of $10 billion in our approps," Shelby said Tuesday, predicting "some real trouble."

Shelby is joined in his effort by the top Appropriations Committee Democrat, Patrick J. Leahy (D-VT) as well as the leaders of the Veterans Affairs Committee, Chairman Johnny Isakson (R-GA) and Sen. Jon Tester (D-MT). Their coalition reflects a renewed commitment in the Senate to completing spending bills on a bipartisan basis after years of budget dysfunction.

Their effort has run into stringent opposition from a White House still reeling from conservative backlash to the $1.3 trillion government-wide spending bill Trump signed in March. The deal broke through previous spending caps with huge increases in domestic spending Democrats demanded in exchange for military spending sought by Republicans.

Conservatives, including close Trump allies, publicly slammed the spending package and criticized Trump for signing it, and the administration has subsequently dug in against new spending and worked to claw existing spending back.

Trump frequently touts his support of veterans and members of the armed services, promising during the campaign to fix the VA and give more veterans access to private health care. Aiming to keep those promises, veterans programs are one of the few areas aside from the military where Trump has encouraged new spending.

But the White House says it won't accept new spending on the veterans' bill above the agency budget levels already negotiated with Congress, arguing enough money can be found to fund it within existing budget limits.

"We have a responsibility to provide our Veterans with the care they deserve, while also being good stewards of the taxpayer dollar," the administration said in a statement.

The VA spending fight could come to a head as soon as this week, as lawmakers prepare to take up a military construction and VA appropriations bill that the bipartisan group of chairmen want to use to fund the VA Mission Act's program.

It could be a preview of spending fights to come, with the next government shutdown deadline looming on Sept. 30, just ahead of the November midterm elections. Trump has already issued demands for more money for his border wall, something likely to meet resistance in the Senate, setting up the possibility of a shutdown showdown weeks before elections that will decide control of Congress.

The tension over how to pay for the legislation is part of a larger debate over private care for veterans. The Mission Act revamps a private-care program Congress approved in 2014 after a scandal over fudged patient wait lists for medical appointments. The new, bipartisan measure consolidates numerous private-care programs that were fragmented and inefficient and drew support from disparate veterans groups that often disagree. It also expands stipends for a popular program that pays family caregivers of veterans who served in Vietnam and later wars, for example, a priority for advocates.

The legislation's biggest costs, though, will come in new doctor's appointments outside the VA system, which now sends roughly a third of veterans to private doctors. The Congressional Budget Office estimated the increase at 640,000 veterans each year, particularly with new authorization for VA to negotiate a contract for care at private walk-in clinics.

But the shift to greater outsourcing-- arguably the top White House priority for veterans-- has been controversial. It was a key reason the president fired former VA secretary David Shulkin in March after the White House suspected that he was not pushing so-called "Choice" aggressively enough. Many Democrats, traditional veterans' service organizations and federal employee unions adamantly oppose the goal of giving veterans unfettered options to choose private doctors, arguing that such a change would starve VA's vast system of government health care, the country's largest.

Another sticking point is cost. There is no reliable estimate and little research to determine how much taxpayers pay for a private medical appointment versus one inside VA's system of 1,300 clinics and hospitals. Conservatives and liberals agree that outsourcing tends to cost more because VA care has economies of scale, but how much more is a question that will affect the spending debate between the senators and the White House.

... [Traditional veterans groups, which oppose what they are suspicious is a White House strategy to privatize VA, were adamant Tuesday that if the spending caps aren't raised, the agency could be forced to take money from other valuable veterans' benefits to ensure that veterans have access to health care.

"Some degree of community care is necessary, because no one should have to wait three months or drive 200 miles to get a flu shot," said John Hoellworth, communications director for AMVETS. "But it is not the most cost effective way to take care of our veterans."

He added, "You shouldn't have to ask Congress every year for money to take care of veterans."

Merkley pointed out to his constituents that it was tough for him to vote against the bill, noting it has lots in it that he agrees with, "most notably a significant expansion of the VA caregivers program that has successfully helped many veterans stay in their homes while enabling their family members to provide the care that they need. Our veterans deserve the very best care we can provide, and when we have a popular and effective program like this one, we should enable as many veterans as possible to use that program. Unfortunately, the positive aspects of this bill were paired with provisions that I simply could not support. First, the bill invests billions of dollars to support private health care for veterans, but doesn’t put a single dollar into filling 30,000 vacancies in the VA health system. This bias for privatization is extremely troubling. In addition, this bill fundamentally changes the funding stream for the VA system, subjecting the VA’s future funding to unnecessary uncertainty and politicization. That’s unacceptable. Veterans," he wrote, "rely on having a VA system that focuses specifically on the unique needs of veterans, and our veterans need that focus and expertise to be there for them today, tomorrow, and generations to come."

Trump Tries Smearing Tester

Señor Trumpanzee has never been one for nuance, so when Putin's moron disguised as a president tweeted to his equality stupid supporters that Jon Tester should resign... well what more could anyone expect. He's un-nuanced and he's a more... but he has an instinct for savagery... and he senses what he perceives as blood in the water. He was bellowing on Saturday morning that the "great people of Montana will not stand for this kind of slander when talking of a great human being. Admiral Jackson is the kind of man that those in Montana would most respect and admire, and now, for no reason whatsoever, his reputation has been shattered."

So why doesn't Trumpanzee renominate him to be head of the Veterans' Administration? Sam Stein made the same argument:

Johnny Isakson of Georgia is chairman of the veterans’ affairs committee and a pretty right wing Republican. On Saturday, while Trump was smearing Tester and demanding he resign, Isakson was voicing support for Tester. Trump won Montana 279,240 (56.2%) to 177,709% (35.7%). In 2012 Tester was barely reelected-- 236,123 (48.6%) to 218,051 (44.6%) against Republican Denny Rehberg. He originally defeated Republican incumbent Conrad Burns in 2006 even more narrowly, 198,302 votes (49%) to 195,455 (48%). Trump's goal Saturday was to fire up the Republican base in Montana so they would come out and vote against Tester in November.

In fact, right-wing groups allied with Trump have already been smearing Tester with misleading ads, like this one:



Isakson may or may not have found out that Trump was spreading his poison by tweet when his office said he didn't have a problem with how Tester had handled the Ronny Jackson affair.

“Senator Isakson has a great relationship with Senator Tester,” a spokeswoman for Isakson told CNN following Trump's tweets on Saturday. “He doesn’t have a problem with how things were handled. I don’t know for sure but highly doubt he’s seen the president’s tweets this morning.”

Tester’s staff compiled a report on the allegations against Jackson, which cited claims made by more than 20 people, including an accusation that Jackson "wrecked" a government vehicle after becoming intoxicated at a Secret Service going-away party, and a claim that he drunkenly banged on the hotel door of a female staffer during an official overseas trip during the Obama administration.

Trump, of course, is trying to imply the allegations against Jackson were made by Tester. They weren't-- and Tester made that clear at every point. They testimony against Johnson were made by men and women who worked under him and they were being investigated by the committee. "Tester, against Trump's criticism and backlash from other GOP lawmakers, has maintained that his actions are 'not political.' ...I am focused on making sure that we have the best person possible to run the VA,' he told Politico. 'It’s a very, very important agency.'"

The Kakistocracy Project Moves Forward-- With Speed

Nancy Ohanian feels Trump is an albatross around the neck of the GOP

On Saturday, Philip Rucker and Robert Costa, writing for the Washington Post, reported on Trump’s breakout. The lunatic is trying to run the asylum on his own… well, with the help of a few imbeciles and misfits he still has faith in: Corey Lewandowski, David Bossie, Brad Parscal, and Kushner-in-law. This is the garbage that, in effect, is left “running” America. The best investment Putin could have ever made! Over the weekend, crooked boxing promoter and Trump crony, Don King, joined them. “Nowhere to be seen was John F. Kelly, the beleaguered White House chief of staff and overall disciplinarian-- nor were the handful of advisers regarded as moderating forces eager to restrain the president from acting impulsively, who have resigned or been fired.”

“The gatherings neatly illustrated an inflection point for the Trump presidency. Fourteen months into the job, Trump is increasingly defiant and singularly directing his administration with the same rapid and brutal style he honed leading his real estate and branding empire.”

“Trump is making hasty decisions that jolt markets and shock leaders and experts-- including those on his own staff. Some confidants expressed concern about the situation, while others, unworried, characterized him as unleashed.”

The president is replacing aides who have tended toward caution and consensus with figures far more likely to encourage his rash instincts and act upon them, and he is frequently soliciting advice from loyalists outside the government. As he shakes up his administration, Trump is prioritizing personal chemistry above all else, as evidenced by his controversial selection of Navy Rear Adm. Ronny L. Jackson, the White House physician, to lead the Department of Veterans Affairs.

“The president is in an action mood and doesn’t want to slow-roll things, from trade to the border to staffing changes,” White House press secretary Sarah Huckabee Sanders said. “He wants to make things that he’s been discussing for a while happen. He’s tired of the wait game.”

On policy, Trump is making sudden decisions without much staff consultation, wagering that they will pay dividends-- accepting North Korean leader Kim Jong Un’s invitation for a face-to-face meeting and threatening to veto before ultimately signing the most recent government spending bill.

On the stump, Trump is an improvisational showman. He swooped into the working-class Ohio town of Richfield on Thursday to pitch his infrastructure plan but diverged from his script to deliver surprise commentary on a medley of issues. He threatened to delay a newly renegotiated trade deal with South Korea and announced that the United States may soon withdraw troops from Syria.

…Rudolph W. Giuliani, a former New York mayor and longtime Trump friend, said the president is entering a new phase: “It took time for the president to discover how far he could move things and find the pieces that fit. Now, he sees he has an open field.”

To many beyond the White House, the Trump White House appears dangerously dysfunctional. Theodore B. Olson, a Republican former solicitor general, declined to join Trump’s legal team in the Russia matter.

“I think everybody would agree this is turmoil, it’s chaos, it’s confusion, it’s not good for anything,” Olson recently told anchor Andrea Mitchell on MSNBC. “We always believe that there should be an orderly process, and of course government is not clean or orderly-- ever. But this seems to be beyond normal.”

…“This is now a president a little bit alone, isolated and without any moderating influences-- and, if anything, a president who is being encouraged and goaded on by people around him,” one Trump confidant said. “It really is a president unhinged.”

Other than Defense Secretary Jim Mattis, the lone remaining enforcer is Kelly. But his power as chief of staff has been diminished. Officials said the days of Kelly hovering in the Oval Office morning to night and screening the president’s calls are over. Trump is largely circumventing Kelly’s strict protocols.

The president recently reached out to some people Kelly had sought to excommunicate, calling former communications director Anthony Scaramucci to banter about politics and inviting Lewandowski and Bossie to dinner in the residence.

“He’s rotating back to the people who actually like him and is more willing to take advice from those people,” Scaramucci said. “They’re more honest with him, and he’s more comfortable with them.”

Allies said Trump is reverting to the way he led the Trump Organization from his 26th-floor office suite at Trump Tower in Manhattan. There, staffers were functionaries or lawyers, and many of his advisers were outside the company-- rival business leaders, media figures and bankers. Back then, Trump controlled his orbit himself from behind his cluttered desk, relying on assistant Rhona Graff to field calls.

Trump has welcomed friends to the White House recently, including former House speaker Newt Gingrich, who visited Tuesday and met with Bolton, among others. And the president has turned to outside surrogates to carry his messages. After consulting with Trump, Newsmax chief executive Christopher Ruddy went on ABC’s “This Week” on March 25 and revealed that Veterans Affairs Secretary David Shulkin was expected to be removed. Trump fired him three days later.

“It was the direction [Trump] was always bound to take,” said Michael Caputo, a former Trump campaign official. “The phone book at the White House was filled by complete strangers. . .  But now he knows how the White House operates, and he’ll operate it himself.”

Ascendant in the West Wing are advisers who play to Trump’s gut: Kudlow on tax cuts and deregulation, Bolton on a muscular approach to foreign affairs, Peter Navarro on protectionist trade policies, Stephen Miller on crackdowns on undocumented immigrants and Kellyanne Conway on an open press strategy and tangling with reporters.

Like Conway, Bolton and Kudlow are seasoned cable news commentators who share Trump’s hard-charging instincts and have no illusions about his governing style. Officials said they are expected to cater to the president’s wishes and seek to avoid the internal knife fights that have befallen many a Trump aide.

Kudlow has told Cohn’s top deputies that he would like them to stay on in their posts, a gesture that West Wing aides described as a reflection of Kudlow’s respect for Cohn’s operation as well as his understanding of the difficulties he would probably encounter if he attempted an overhaul.

Kudlow, 70, is a generational peer of Trump and a staple of the New York business elite to which Trump has long aspired. Kudlow has privately told associates that the president has asked him to be an energetic salesman on television-- by acting as a principal, with speeches and road trips-- for the Republican-authored tax law ahead of the midterm elections, as opposed to functioning as a behind-the-scenes manager, according to people who have spoken with him.

“He’s squaring up his economic policy with the right adviser for him,” Giuliani said. “Gary was really good, but I don’t know if Gary ever embraced the Trump economic ideas. He was more of a traditional Democrat or moderate Republican. Kudlow is a real cheerleader for the tax cuts in a way Gary never was, although he helped get them passed.”

Bolton, meanwhile, has told allies that he may make major changes on the National Security Council staff but has been careful not to reveal his plans until he formally takes over later this month. He has been working to appear as a team player-- touting his bond with Pompeo and lunching Tuesday with McMaster-- despite his reputation as a sharp-elbowed bureaucratic brawler, officials said.

Ohanian sees an applecart overturning in November

Trump has been frustrated by news stories of White House tumult and has ordered aides to contest the notion that there is chaos. He also has vented frequently about the $1.3 trillion omnibus spending bill, griping that Congress did not fully fund his promised U.S.-Mexico border wall and labeling Republican congressional leaders “weak negotiators.”

Adding to this weekend’s chaos, was the White House lie that Shulkin left as Veterans Afffairs Secretary on his own, even though everyone knows Trump forced him out-- and even though Shulkin, who hasn’t submitted a resignation letter and even though he himself confirmed that he was fired on NBC and in an NY Times OpEd that he penned the day after Trump unceremoniously ousted him. Lawyers say Trump needs to rewrite history to make Shulkin’s departure voluntary in order to temporarily fill the post with whomever he wants. He picked a right-wing crazy person, Robert Wilkie, instead of anyone from the Veterans Affairs Department. Trump didn’t want to appoint Shulkin’s number 2, Deputy Secretary Thomas Bowman, because he opposes Trump’s plans to privatize the V.A., something Wilkie is fine with. This week Blue America is asking for contributions for progressive military veterans running for Congress and committed to preventing Trump from privatizing the V.A. To see their names and contributing to their campaigns, please click on the ActBlue thermometer on the right.

The Koch Brothers Are Coming For Veterans’ Healthcare

After publicly humiliating VA Secretary David Shulkin and letting him twist in the wind for a week or two, as rumors swirled that he's on the way out-- just like Trump is doing to John Kelly and Ben Carson right now-- Señor T finally tweeted Wednesday that Shulkin, the only Trump cabinet appointee who had been confirmed by the Senate 100-0, was out. A worst case scenario would have been the appointment of Pete Hegseth, the non-veteran Koch brothers' cutout long tasked with destroying the V.A.

It has been a longterm goal of the Koch brothers, through their phony-baloney Concerned Veterans for America, headed by Hegseth, to privatize the V.A. and cut services. The Kochs and their conservative congressional allies could care less that vets have been promised healthcare as part of their reward for serving the country. Their privatization plans are meant to cut and cap healthcare services. The Kochs are demanding Trump do it NOW, before the Democrats win back Congress in November.

Many in Congress-- on both sides of the aisle-- understand that there's a problem that has to be addressed but that offering veterans unrestricted choice between the public healthcare system and private medical providers is not the solution and that it would quickly tank the whole system, exactly what the Koch network wants. Shulkin and most legitimate veterans groups prefer a program that offers private care when wait times get too long or if veterans live too far away from the facility they need.

Bernie Sanders cut right to the chase: "Republicans talk a good game about veterans, but when it came time to put money on the line for veterans, they were not there... There are people, the Koch brothers among others, who have a group called Concerned Veterans of America. Koch brothers, by the way, want to destroy Social Security, Medicare, Medicaid, every governmental program passed since the 1930s."

In his NY Times OpEd on Wednesday night, Shulkin wrote that Trump fired him as Veterans Affairs Secretary because he opposed the Regime's push to privatize health care for veterans. He contended that "successes within the department have intensified the ambitions of people who want to put V.A. health care in the hands of the private sector. I believe differences in philosophy deserve robust debate, and solutions should be determined based on the merits of the arguments. The advocates within the administration for privatizing V.A. health services, however, reject this approach. They saw me as an obstacle to privatization who had to be removed. That is because I am convinced that privatization is a political issue aimed at rewarding select people and companies with profits, even if it undermines care for veterans.

I have fought to stand up for this great department and all that it embodies. In recent months, though, the environment in Washington has turned so toxic, chaotic, disrespectful and subversive that it became impossible for me to accomplish the important work that our veterans need and deserve. I can assure you that I will continue to speak out against those who seek to harm the V.A. by putting their personal agendas in front of the well-being of our veterans.

I came to government with an understanding that Washington can be ugly, but I assumed that I could avoid all of the ugliness by staying true to my values. I have been falsely accused of things by people who wanted me out of the way. But despite these politically-based attacks on me and my family’s character, I am proud of my record and know that I acted with the utmost integrity. As I prepare to leave government. I am struck by a recurring thought: It should not be this hard to serve your country.

Randy Bryce's campaign in southeast Wisconsin is so strong that a day doesn't pass that doesn't see more speculation that incumbent Paul Ryan is planning a graceful exit for himself. One thing he doesn't want to see on his public resume is that he was beaten by an everyman and iron worker. And @IronStache stands strong with fellow veterans. "When I returned home after serving our country," he told us, "I worked alongside the government to help Milwaukee’s homeless veterans. I saw the real struggles facing our community and the real opportunities our government has to assist. Over my dead body will i let a draft dodger and a couple of profiteering crooks try and privatize our V.A."

Jim Thompson is running a strong grassroots campaign in a very red Kansas district and making tremendous headway. Issues like the Republicans privatizing the V.A. draws more and more people to check him out. "As a veteran myself," he told us, "this apparent move toward the privatization of the V.A. is not just horribly concerning, it is flat out wrong. Our government, through the V.A., owes this nation's soldiers every bit of care and help they need. Our soldiers sign up to serve their country knowing they may have to make the ultimate sacrifice, the V.A. must not use them and their care as pawns for rewarding the people and companies who would profit from this move. If we have enough money to send soldiers to war, we sure as hell have enough to take care of them when they get back. Privatization just cannot be an option for our protectors because putting profits over people is unacceptable and our troops deserve better."

DuWayne Gregory, the Chief Executive of the Suffolk County Legislature and an Army veteran currently running for the Long Island seat held by Peter King, was incensed when we spoke about Trump's plans to privatize the V.A.-- and not in the mood for compromising. "As a veteran who has served our great country I fully understand the sacrifice our veterans make to fulfill their commitment. It would be a cold day in hell before I allow Trump’s and Peter King’s corporate agenda to exceed the needs of our veterans. Suffolk County has one of the largest populations of veterans in the country. These men and women served our country bravely and deserve to remain humanized and not become a data point for a corporate profit motivated agenda. In my opinion, we can not do enough to demonstrate our respect for our veterans, the least of which, should be quality-focused not profit-driven healthcare."

The Blue America-backed progressive Democrat running for the seat in Maine's second district, Jared Golden, was marine who served in both Afghanistan and Iraq. The incumbent there is Republican Bruce Poliquin, who serves on the House Veterans Affairs Committee and already voted in committee to privatize V.A. healthcare. This morning, Golden said, "I will never support the privatization of V.A. healthcare because I know first hand how important it is to veterans like myself and the people I served alongside. Older generations of veterans have fought so hard to improve the V.A. and it’s disgusting to think that some members of Congress want to turn it into a for profit business. Can you imagine the Black Water equivalent of a private health care system? Not on my watch."

Ryan, Pence And Price Have A Problem: Even Republicans Want Health Care

Yesterday, Greg Sargent started the news cycle rolling at the Washington Post with a simple question: Will Donald Trump really go through with all of it?. Like many of us, Sargent is rightfully worried that Trump, Pence, Ryan and McConnell "may soon be going forward with an agenda that could inflict radical, disruptive change on millions of people," especially in regard to gutting the Affordable Care Act and destroying Medicare. "We don’t know," he wrote, "how far Trump will actually go. It’s also true that Republicans are taking steps to mitigate the short-term impact of some of the changes being mulled, and are struggling internally with the details in ways that suggest their best laid plans could conceivably go bust. But is there any particular reason not to anticipate the worst at this point?"

Los Angeles Congressman Ted Lieu is thinking along similar lines but he focused on another GOP threat to healthcare-- V.A. privatization. "As the Member of Congress representing the nation’s largest VA hospital," Lieu told the media, "I oppose any effort to privatize VA healthcare.  My opposition to privatization is guided by the voices of veterans and advocates in my district, who understand that we can improve service delivery to our veterans without tearing the VA down brick by brick.  On average, our veteran population is older and sicker than the rest of America-- they have earned and deserve a world-class healthcare system designed to meet their unique needs. Finally, as a veteran myself who served on active duty, I humbly believe that a veteran should be at the helm of the VA.  Our nation’s warriors deserve a leader with a profound understanding of their service and sacrifice.  They deserve a leader dedicated to guaranteeing timely access to the highest quality care."

A poll taken between Nov 15 and 21 by the the nonpartisan Kaiser Family Foundation found that only 1 in 4 Americans want the Republicans to repeal Obamacare. 52% of Republicans would like that to happen, significantly less than the 69% would said they wanted that to happened before the election, but majorities across party lines support many Obamacare provisions-- though not the mandate-- which basically pays for the goodies they all want. This is what the vast majority of Democrats, Republicans and Independents all support from the Affordable Care Act:

• allowing young adults to stay on a parent's insurance until age 26.
• no copayments for many preventive services.
• closing the Medicare prescription drug coverage gap known as the "doughnut hole."
• financial help for low- and moderate-income people to pay their insurance premiums.
• a state option to expand Medicaid to cover more low-income adults.
• barring insurance companies from denying coverage because of a person's medical history.
• increased Medicare payroll taxes for upper-income earners.

Some Republicans are getting nervous about moving from demagoguery to actually taking away people's-- voters'-- healthcare. But not all. Ryan, Pence and Tom Price are all willing to set themselves aflame on a pyre that burns up Obamacare, Medicare, Medicaid and Social Security if it comes to that. Trump... perhaps not so much-- not that anyone knows what Trump thinks about any policies. In his column yesterday, Paul Krugman asserted that Trump is about to betray the white working class voters in Ohio, Michigan, Indiana, Wisconsin and Pennsylvania who made him the electoral college winner.

The evidence of that coming betrayal is obvious in the choice of an array of pro-corporate, anti-labor figures for key positions. In particular, the most important story of the week-- seriously, people, stop focusing on Trump Twitter-- was the selection of Tom Price, an ardent opponent of Obamacare and advocate of Medicare privatization, as secretary of health and human services. This choice probably means that the Affordable Care Act is doomed-- and Mr. Trump’s most enthusiastic supporters will be among the biggest losers.

The first thing you need to understand here is that Republican talk of “repeal and replace” has always been a fraud. The G.O.P. has spent six years claiming that it will come up with a replacement for Obamacare any day now; the reason it hasn’t delivered is that it can’t.

Obamacare looks the way it does because it has to: You can’t cover Americans with pre-existing conditions without requiring healthy people to sign up, and you can’t do that without subsidies to make insurance affordable.

Any replacement will either look a lot like Obamacare, or take insurance away from millions who desperately need it.

What the choice of Mr. Price suggests is that the Trump administration is, in fact, ready to see millions lose insurance. And many of those losers will be Trump supporters.

You can see why by looking at Census data from 2013 to 2015, which show the impact of the full implementation of Obamacare. Over that period, the number of uninsured Americans dropped by 13 million; whites without a college degree, who voted Trump by around two to one, accounted for about eight million of that decline. So we’re probably looking at more than five million Trump supporters, many of whom have chronic health problems and recently got health insurance for the first time, who just voted to make their lives nastier, more brutish, and shorter.

Why did they do it? They may not have realized that their coverage was at stake-- over the course of the campaign, the news media barely covered policy at all. Or they may have believed Mr. Trump’s assurances that he would replace Obamacare with something great.

Either way, they’re about to receive a rude awakening, which will get even worse once Republicans push ahead with their plans to end Medicare as we know it, which seem to be on even though the president-elect had promised specifically that he would do no such thing.

As Krugman pointed out, during the campaign, Trump solemnly swore to not cut Medicare (and reassured his fans that he would replace Obamacare with something "great." So how did Pence talk him into an extremist crackpot like Tom Price as Health Secretary?

TalkingPointsMemo provided a handy reminder and roadmap to Ryan's plans to assault and destroy Medicare, his life's dream. Will Trump be able to-- or even want to-- stop him?

Ryan has been pushing his privatization plan-- or what he calls "premium support"-- for years. It's been part of his annual budget blueprints, and it has evolved over time. The basic idea is that Ryan would give the elderly a set amount of money to buy health insurance rather than Medicare's fee-for-service system where the government pays doctors and hospitals based on the services they provide.

How much money the elderly would receive to buy insurance, the quality of the plans available, how the government would regulate them and the rate at which the benefits would increase have varied over the years and sometimes have been unclear.

As Medicare is currently configured, American workers and employers contribute equally to the public insurance program via the Medicare payroll tax. When people turn 65, they become eligible for Medicare's guaranteed coverage, pay premiums and receive a robust package of benefits.

Looming as the biggest unknown is whether Medicare-- in its current form as a single-payer, guaranteed-coverage, fee-for-service system-- will remain intact.

Will Medicare be eliminated explicitly, as it has in past Ryan plans? Will it be changed so substantially that the long-term effect will be to weaken it so that phasing out it out is inevitable? Or will Ryan seek to change Medicare in fundamental ways while still preserving its most important protections?

How committed President-elect Trump and Rep. Tom Price (R-GA), his nominee as secretary of Health and Human Services, are to Medicare privatization is another wild card in the mix.

"It is quite clear at this point that Ryan and Price would say they are retaining traditional Medicare as an option, but the question is under what terms. Is it provided under terms that would allow traditional Medicare to continue and flourish? Or is it conversely under terms that would cause it to wither and perish?" said Paul Van de Water, a senior fellow at the Center on Budget and Policy Priorities.

Over the years, Ryan's plans have evolved, in part because of pressure from his own members. Ryan told the New Yorker in 2012 that he recognized his plan needed to be accepted by more than just a few conservatives in the House. He needed to develop a plan that met the vision for the broader Republican conference.

...[T]he underlying principle for Ryan's plans comes from the conservative idea that private businesses are more efficient at managing health care than the government would be. That, some experts argue just isn't true. Medicare, by and large, is a fairly efficient program. Seniors manage to get a lot of health care they are happy with for a decent price.

"Medicare is more efficient than private insurance for two main reasons. One it is able to pay providers less and second it also because of its size, it has lower administrative costs as well," Van de Water said.

Health care experts who have spent years analyzing Ryan's plans note that there are still a lot of questions to be answered. Here's what we do know:

Ryan's 2008 Plan On Medicare: Ending Medicare

In 2008 when he was the ranking member of the House Budget Committee, Ryan proposed that traditional Medicare should be replaced with a voucher program. The idea was that individuals would get a set amount of money from the government to purchase health insurance and eventually Medicare would be phased out.

...Ryan's 2011 Budget: Ryan Works To Phase Out Medicare

In 2011-- after months of listening sessions with his Republican colleagues-- Ryan released his budget, titled Path to Prosperity, which again proposed a major overhaul to Medicare, but had greater support in the wake of Tea Party takeover of the House of Representatives by Republicans who ran on cutting the federal deficit. It left Medicare intact for existing beneficiaires but newly eligible participants would be funneled to an exchange where private insurers competed and individuals could choose private plans. This was Ryan's phaseout plan.

...Experts argued that the plan would put more cost on individuals than they would incur under traditional Medicare and that administrative costs associated with the plans actually eradicated any savings to the government.

"The Congressional Budget Office estimates that under the Ryan plan the cost-increasing effects would swamp the cost-reducing effects, so much so that by 2030 the overall cost of care for the Medicare population would be at least 41 percent higher than it would be under Medicare and the amount that enrollees would have to pay directly would more than double," Henry Aaron – a Brookings Institution fellow who co-wrote his own premium support plan in the 1990s– wrote in a paper on premium support. Ryan claimed in numerous interviews that his proposed changes to Medicare actually were based on the plan that he and Rivlin developed together. “Alice Rivlin and I designed these Medicare and Medicaid reforms,” Paul Ryan said at the time, according to the Washington Post. Rivlin, however, fully rejected Ryan's revised "premium support" plan.

...Ryan's Plan Has Evolved To Leave Some Form Of Traditional Medicare In Place

In more recent years, Ryan's plan has evolved. The idea is still the same. Senior citizens would get a set dollar amount to buy health insurance. Yet, instead of giving voucher recipients only the option to buy private insurance on a health insurance marketplace, the elderly could choose to use their subsidy to buy traditional Medicare.

...[S]ome health care policy experts argue that traditional Medicare could still be jeopardized under Ryan's later privatization plans. Here's the issue. Under Ryan's privatization plan, it's understood that the government will give a set amount of money for individuals to buy insurance, but that dollar amount would be determined by a bidding process of private insurers. Experts are not convinced that quality protections would be strong enough so they worry that the competitive bids could be far cheaper than traditional Medicare in many places, but not be near the quality of the coverage. In that case, individuals who might be interested in going with traditional Medicare to ensure they had more protections may have to pay out of pocket.

"They might have to pay more and they might have to pay a considerable amount more depending on where they are," said Stuart Guterman, a senior scholar at the Commonwealth Fund. "It’s not overtly phasing out Medicare, but it does clearly put pressure on some folks in some areas."

Guterman also worries that even if traditional Medicare were an option, it might be strained if enough younger, healthier beneficiaries opted for private plans, older, sicker individuals stayed with Medicare. It could result in Medicare slowly losing it's power to set competitive prices for services.

“I think it’s a legitimate concern if the mix shifts so that fewer and fewer Medicare beneficiaries are enrolled in traditional Medicare. Then it would be harder for them to set prices effectively," said Guterman.

2016: Ryan Blames Medicare Overhaul On Obamacare

On the campaign trail, Trump boldly declared that Medicare would remain the same for seniors. He argued that the program was not going to be touched. But as soon as Trump won, Ryan appeared on Fox News and argued that something had to be done about Medicare and hinted that it might come as part of the repeal to the Affordable Care Act.

"Because of Obamacare, Medicare is going broke," Ryan said in an interview. "So you have to deal with those issues if you're going to repeal and replace Obamacare."

The reality is that changes to Medicare made by Obamacare actually made the program more solvent, not less. The Medicare trustees wrote in 2010 that "the financial status of the Hospital Insurance trust fund is substantially improved by the lower expenditures and additional tax revenues instituted by the Affordable Care Act. These changes are estimated to postpone the exhaustion of HI trust fund assets from 2017 under the prior law to 2029."

Frogs Legs, Anyone?

Last night I went to dinner with state Rep. Kaniela Saito Ing (D-Maui). Now state Senator Stanley Chang, once a Blue America congressional candidate, introduced us and told me he's one of the smartest and most progressive political leaders in Hawaii. At age 27, he's also the youngest chairperson in Hawaii's legislative history, heading up the Ocean, Marine Resources, and Hawaiian Affairs committee in the state legislature. His newborn son's middle name is Kekipi, which means "the rebel" in Hawaiian. We ate at chef Josef Centeno's new vegetarian restaurant, PYT. Here's the menu. It's nothing like Jean-Georges in New York, where Trump brought Romney Tuesday night. Their website announces that ties are not required. Here's the menu. I don't know what Romney or Reince ate-- the terminally nasty Mike Huckabee told Fox viewers yesterday that "On Mitt Romney’s plate there was a big, big slice of crow"-- but Trump ate Egg Caviar; Diver Scallops, Caramelized Cauliflower and Caper-Raisin Emulsion; Young Garlic Soup with Thyme and Sautéed Frog Legs; Turbot with Château Chalon Sauce; Lobster Tartine, Lemongrass and Fenugreek Broth, Pea Shoots; Broiled Squab, Onion Compote, Corn Pancake with Foie Gras; along with a Chocolate Dessert Tasting. I don't know if they went Dutch or not but Trump's portion costs $218. Romney looked awkward. God only knows what's going on in his head.

I wonder if making Romney eat frogs legs at the decadent Jean-Georges was part of Trump's public humiliation of the man who did everything he could to defeat him for the better part of the last two years.

NEWT GINGRICH: There's a scene in Pretty Women where Richard Gere goes up to the salesman on Rodeo Drive and says: "We need a little sucking up here."

You have never, ever, in your career seen a wealthy adult who is independent, has been a presidential candidate, suck up at the rate that Mitt Romney is sucking up.

I am confident that he thinks now that he and Donald Trump are the best of friends, they have so many things in common. That they're both such wise, brilliant people. And I'm sure last night at an elegant three-star restaurant, he was happy to share his version of populism, which involve a little fois gras, a certain amount of superb cooking, but put that in a populist happy manner.

LAURA INGRAHAM: I was trying to figure out what the frog legs on the menu meant.

GINGRICH: The frog legs are very elegant. Callista and I both had fathers who ate frog legs. I did notice that Reince Priebus of Kenosha, Wisconsin decided not to have frog legs. I can't wait to talk to Reince and find out exactly how a guy of his background worked his way through the menu.

Luckily for them, Mitt speaks French fluently. So he could help them with the menu. He could say: "Ahh, Mr. President-elect. This would be the perfect meal for you."

Something like maybe escargot, maybe pheasant. God, I'd love to have been there as a fly on the wall...

They know that every day that goes by the opposition to Romney grows...

Every day they let this thing hang out there it becomes harder and more expensive to pick Romney.

Romney isn't the only candidate for Secretary of Trump State being put through his paces. Rudy Giuliani, Gen. David Petraeus (ret.), Marine Corps General John Kelly (ret.), Gen. Keith Kellogg (ret.) and Sen. Bob Corker of Tennessee are all still in the running, according to ringmaster Trumpanzee. Kelly had a TV dinner last night with the many-chinned Trump in his Trump Tower aerie. Do they have frog leg TV dinners now? My dad once brought me to the original Nathan's on Coney Island-- Trump will have been there; the housing development where Woody Guthrie lived and wrote the song about Trump, Sr. being a racist slob was nearby-- and I noticed they had frog's legs on the menu. When I told him that's what I wanted he advised me against it but I insisted-- and then puked when I took a bite and imagined I was eating a slimy frog. Rep. Dana Rohrabacher claims Trump is also interested in him being Secretary of State but no one but the slightly crazy-- and more than slightly delusional-- Rohrabacher thinks so. Unless Putin is telling Trump to go with Rohrabacher.

Trump has turned the process into an undignified pageant. I only wish there was a televised swim suit competition as part of the spectacle. But none of that seems nearly as amusing as the ABC News report yesterday that His Trumpiness is seriously considering Sarah Palin as Secretary of Veteran's Affairs. He must really hate the vets. Palin-- ala Rudy Giuliani-- is opening lobbing for the gig. One of the guys who impregnated a Palin daughter and who served in the military is pumping for her. Trump probably wants to have her mud-wrestle Scott Brown for the job, although... Trumpy the Clown is also reported to be looking at Rick Perry and former Congressman Jeff Miller (R-FL). Palin's pitch to the transition team:

"Stop blaming the victim and wake up, Mr. President. While Christians bow our heads to pray for you, radical Islamists want to cut off your head. The only thing standing between us and savages, it’s the red white and blue, it's the United States military! And if you love freedom, thank a vet! Thank them. Honor them."

Palin hasn't been invited to Trump Tower for frogs legs or a TV dinner but she loudly reminded everyone who would take her call that she was an early Trump supporter when no one knew who he was except people who watched his TV show. She says if she doesn't get the Veterans gig, she'll take Energy, reminding everyone that the "drill, baby, drill" slogan was hers.

“NOW is the time to shut off the Saudi oil cartel flow valve and develop our own God-given natural resources. The only excuse not to become energy independent is a political excuse,” she wrote.

That same day, she wrote about her family’s connection to native Alaskans, a relationship covered by the interior secretary position. Palin’s husband Todd is part-native Alaskan.

Steve Bannon, Trump’s campaign CEO and the president-elect's pick for chief strategist, is close with Palin. In 2011, he made a documentary about her titled The Undefeated.

After ABC News reported on Palin being under consideration for the VA secretary position, she posted a message on Facebook, which she then tweeted, writing in part, "We should be grateful we'll soon have a commander-in-chief who will champion our vets and honor the promises our nation made."

In a November Ballot Initiative, California Voters Take On Big Pharma & Sky-High Drug Prices

What drug company CEOs are doing to patients for a few dollars more (source)

by Gaius Publius

Sky-high drug prices are a scandal, but everyone knows that, even those responsible for the prices. They're also a source of enormous profit and wealth, which is the problem. The drug companies, acting alone and through their lobbying arm, Pharmaceutical Research and Manufacturers of America (PhRMA), are literally sending people to their deaths in order to drain others of a few dollars more. It would not be out of line to call this behavior murderous and psychopathic — in a Martin Shkreli sense — though most would settle for a term from economics. Something related to capitalism, perhaps.

Drug companies and their wealth have captured the national legislative and regulatory process and even some of the national patient advocacy groups (see below for more). How to crack the nut of deadly high drug prices and bring them down to an affordable level? Activists in California are making a very credible attempt at the state level with a November ballot initiative called the Drug Prices Relief Act, or Proposition 61.

Fran Quigley, writing in Truth-Out, first describes the scale of the problem (my emphasis throughout):

It is hard to overstate the level of dysfunction in the US medicines system. The headline-producing greed of "pharma bro" Martin Shkreli was just the most dramatic example of a pharmaceutical industry whose patent monopolies grant it immunity from market forces while its political clout shields it from government regulation. Taking full advantage of taxpayer-funded research, drug corporations make record profits, even by Fortune 500 standards, and pay their CEOs as much as $180 million a year. Those corporations spend far more on incessant marketing to consumers and physicians than they do on research -- part of the reason they have largely failed to develop new medicines that address the most deadly illnesses and diseases.

As for the patients who rely on those medicines, pharma lobbying has ensured that the US Medicare program is alone among industrialized nations' government health plans in not negotiating down the price it pays for medicines, causing US patients to pay far and away the highest global price for necessary drugs. One in every five US cancer patients can't afford to fill their prescriptions, and many seniors on Medicare are forced to cut their pills in half to stretch their supply. ...

The industry's US trade organization, the Pharmaceutical Research and Manufacturers of America, known as PhRMA, has an annual budget exceeding $200 million, which it directs to the promotion of the image and interests of its 57 member companies. The industry's US lobbying expenses for 2015 were $238 million, and its campaign contributions have reached as high as $50.7 million in a year. That money has been well-spent.

Even those in government who say they're trying to help aren't helping:

Not that the Obama administration has always been a champion of medicine access: the Affordable Care Act enshrined a huge guaranteed market for pharmaceutical companies, and the National Institutes of Health (NIH) recently flat-out refused to exercise its legal right to address huge corporate mark-ups on cancer medicines the NIH helped develop.

I'm shocked about the NIH not using authority it already has to provide relief. That's a good indication of the extent to which all of national government is captured by this industry.

Only the Veterans Administration, unlike Medicare, negotiates down drug prices. Medicare is forbidden by law to do so. Which makes the prices paid by the VA for prescription drugs an interesting benchmark.

Proposition 61: Marking California Drug Prices to the VA Benchmark

In a nutshell here's what Prop 61 would do:

The initiative, recently certified by the California Secretary of State as Proposition 61, calls for state agencies to be blocked from paying more for a prescription drug than the price paid by the US Department of Veterans Affairs. Unlike the Medicare program, the VA is free to negotiate the price it pays for drugs and as a result, pays as much as 42 percent less than Medicare and usually significantly lower than state Medicaid programs. The primary force behind the ballot measure, the AIDS Healthcare Foundation, says the law could save Californians hundreds of millions of dollars a year in lower government costs and lower individual co-payments.

Are you a California resident? Imagine a 42% cut in drug prices. (It's not hard to predict prescription prices falling throughout California if state agencies become the go-to source for low-cost drugs.) That alone, I think, makes Prop 61 worth your active and vigorous support. It would literally change lives, including your own.

Are you a resident of any other state with a ballot initiative option? If Prop 61 passes in California, it will be exported, perhaps to a state near you. Another reason to give Prop 61 your active and vigorous support.

Quigley's piece has much more information, including some he said-she said about whether Big Pharma is worried about this initiative passing (count on it, regardless of what they say) and whether the ballot measure will deliver the change it advertises (again, count on it, regardless of what its opponents say). I recommend reading it through if this effort interests you at all. It looks very promising to me.

I do want to leave you with one more quote from the article, however, related to those patient advocacy groups who are opposed to Prop 61.

Some Patient Advocacy Groups Are Opposed; Guess Why

The opposition is quoting some patient advocacy groups that are opposed to the measure. For example:

While the pharmaceutical industry opposition to the measure is predictable, some patient-connected advocacy organizations have raised concerns as well. Anne Donnelly, policy director for the San Francisco-based HIV and Hepatitis C advocacy group Project Inform, has been widely quoted by the opposition campaign and in media reports questioning the wisdom of the ballot initiative. Donnelly says her group is officially neutral on the referendum and points out that Project Inform supports a drug price transparency bill that is pending at the California state legislature. "We are supportive of the goal of lowering drug prices, but the drug pricing system is so complex that I am not sure this simplistic (ballot) measure is the best approach," she said in an interview.

But...

Project Inform's lack of support was highlighted in a July New York Times article on the referendum. But the referendum's supporters have in turn questioned Project Inform's motivations, noting that the organization -- like many patient advocacy groups -- is funded in significant part by pharmaceutical company donations. "When you look at who is speaking out against the initiative, you have to ask what it is in it for them," says Burger of the CNA. Donnelly confirms that industry donations make up between 20-36 percent of Project Inform's budget, but says the organization takes precautions to ensure that the industry does not influence its positions.

Money doesn't talk, it swears. Or so I hear. Though maybe Ms. Donnelly hears it sing a different tune.

GP

Are You Surprised That None Of The Republicans Who Sabotaged The V.A. Have Resigned In Disgrace Yet?

Bernie Sanders (I-VT), chairman of the Senate Veteran's Affairs Committee, and one of the most persistent and effective advocates for veterans anywhere in government, was on Face The Nation this morning. He was more constrained in his response to the V.A. scandal that Ken was in his report Friday evening after Shinseki had been forced to fall on his sword. Ken speculated that we'll probably never know how responsible Shinseki really was for the mess because, in his words, "the psychotic lying scumbags who have been leading the assault on him not only are incapable of speaking a word of truth but have now effectively substituted their psychotic lying scumbag agenda for any possible consideration of discovery of truth and fixing it… [T]heir historic and amply documented hatred of America's heroes is kind of hard to understand, even remembering that we're dealing with psychotic lying scumbags.

For sheer gall, you have to stand back and admire the right-wing screech assault on the VA. I had a fleeting thought to suggest that all the unaccountably uncaged right-wing beasts who are now having fake-orgasmic follies over the VA scandals be asked to pause in their lying orgy or right-wing scumbaggery to chronicle their history of support for veterans' affairs. Then I realized that it would serve no purpose, since gathering that chronicle would take literally no time at all, since the lying scumbags of the Right have a combined history of absolutely no support of any kind at any time for veterans' affairs.

It's as if right-wingers hate veterans worse than the enemies those veterans had been sent into combat to protect us from.

For a country that has allowed warmongering to be stitched into the center of its psyche, one of the strangest phenomena is the depth of contempt and loathing our warmongering party has shown toward the Americans who are sent off to fight those wars.

Right-wingers love war. They worship war. You get the feeling it's what they do instead of sex, at least when there are no abusable friends or family, or hookers, or dishy callboys readily available and they would otherwise have to satisfy themselves with their vast reserves of porn. (What would right-wingers do without their vast reserves of porn?)

BUT RIGHT-WINGERS DON'T LOVE THE PEOPLE
THEY SEND SO JOYFULLY TO FIGHT THEIR WARS

There's never any limit to how much money the right-wing psychotic lying scumbags are prepared to spend on war-- on budget, off budget, around budget. And the mantra is always "Support Our Troops." You can be tarred and feathered for Not Supporting Our Troops. We sure heard plenty of that during the Bush regime's orgy or warmaking.

But of course the right-wing psychotic lying scumbags never give a damn about Supporting Our Troops, only about Supporting Our Wars. Do we really not remember how ineptly armed, or even unarmed, Our Troops were sent into Iraq? Even though a war in Iraq was clearly at or near the top of the agenda of everyone in the Bush regime who had input into the making of foreign policy.

And when those Not Supported Troops, having lacked the good grace to die, are turned from troops into veterans, then they become the warmongers' enemy.

Partly, of course, it's about money, and the role of government, which is basically to provide right-wing scumbags with the opportunity to steal as much of it as they can lay their grubby paws on-- and of course to provide the money itself for them to hijack.

And when right-wing psychotic lying scumbags get on their Gov't Is the Enemy mechanical horse, intoning that Gov't Spending Is Wasteful Spending, then of course it's the rest of us who have to live with the consequences. Whenever Congress was called on to provide adequate financial support for veterans' care, it was the right-wing psychotic lying scumbags who led the shrieking chorus of "Chuck you, Farley."

And when right-wing psychotic lying scumbags inflected mandatory automatic spending cuts, and a government shutdown, pretending in the depths of their devoid-of-realtiy delusions that these idiotic, dangerous actions in fact had no consequences, how were they allowed to sustain those vicious delusions?

Yesterday on the radio I heard one of the psychotic lying scumbags intoning-- in that mandatory tone of high dudgeon and high outrage-- about how it's not about politics or lack of public support and I assumed the earth must surely have promptly opened up and swallowed the slimepod, because as anyone with a working brain has known all through the scandals, those are the only things it has been about.

It's the right-wing psychotic lying scumbags who caused the crisis, and naturally they lie about it. Well, what would you expect them to do?

Bernie took a slightly different tact this morning. As he told Bob Schieffer, he plans to propose short-term legislation tomorrow or Tuesday and then go for the systemic fixes in a committee meeting this coming Thursday. “There must be a culture of honesty and accountability within the VA," he wrote, "and people who have lied or manipulated data must be punished. But we also have to get to the root causes of the problems that have been exposed. The simple truth is that with 2 million more veterans coming into the system in recent years there are many facilities within the VA that do not have the doctors, nurses and other personnel that they need to provide quality care in a timely way.”

His Restoring Veterans’ Trust Act of 2014 aims to give the V.A. authority to immediately remove senior executives based on poor job performance while preventing wholesale political firings. It would provide veterans who can’t get timely appointments with VA doctors the option of going to community health centers, military hospitals or private doctors. It would authorize V.A. to lease 27 new health facilities in 18 states. It would authorize emergency funding to hire new doctors, nurses and other providers in order to address system-wide health care provider shortages and to take other steps necessary to ensure timely access to care. To address primary care doctor shortage for the long-term, the bill would authorize the National Health Service Corps to award scholarships to medical school students and to forgive college loans for doctors and nurses who go to work at the V.A.

Other provisions in Sanders’ legislative package would:

• Upgrade VA’s antiquated scheduling systems.

• Require President Obama to establish a commission on VA health care access and recommend, within 90 days, actions to bolster capacity.

• Extend comprehensive services and benefits to the most severely injured pre-9/11 veterans; standardize the process for sending patients to community health centers, military hospitals or other health care providers; and extend from five to 10 years access to VA health care for all recently-separated veterans.

• Provide help for veterans who suffered significant spinal cord, reproductive and urinary tract injuries and who now want to have children.

• Bolster the VA’s ongoing effort to eliminate shrinking but still unacceptable backlogs in processing claims for disability benefits.

• Make certain that all veterans get in-state tuition rates for college costs covered by the Post-9/11 GI Bill.

• Improve the delivery of care and benefits to veterans who experienced sexual trauma while in the military.

• Remove the VA from annual budget battles by adopting so-called “advance appropriations” to protect veterans in case of a government shutdown.

• Restore a 1 percent cut in retirement cost-of-living adjustments that Congress enacted for current military service members.

The Republicans, always eager to sabotage the V.A. and push it towards privatization on behalf of their avaricious, wealthy donors, filibustered S. 1982, the Comprehensive Veterans Health and Benefits and Military Retirement Pay Restoration Act of 2014 and managed to kill it even though 56 senators voted for it. How obvious is it that the 41 GOP scumbags-- to quote Ken-- should have all resigned along with Shinseki… or maybe instead of Shinseki, since he seems to have at least been trying to ameliorate a bad situation, while they were busy making it worse and making it untenable. None have resigned and no will resign. It's up to the voters. These are the 41 senators who murdered our veterans: