Military Procurement Process: Changes on the Way?

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There are few things more complicated than the Military Procurement Process.  No doubt, rigorous controls are required for certain mission critical functions, but it seems that bureaucratic roadblocks exists at almost every phase of the military procurement process.

military procurement process

On the eve of the release of a new framework to improve the military procurement process, Chairman of the Armed Services Committee, Republican Rep. Mac Thornberry, vented his frustration with the following explanation:

The Army decided in 2005 it needed a replacement for its M9 Beretta pistol and then spent 10 years writing and rewriting requirements.

The final request to gunmakers was 350 pages with 23 attachments and added $15 million to the cost. After a decade, the Army still had not decided what caliber the gun would be or what ammunition it would use.

Meanwhile, U.S. small arms companies make more handguns in a month than the Army will buy in 25 years, the Armed Services panel found.

“So a commercially available revolver or handgun would be just fine. Maybe it’s OK to get our handguns in a commercially available way in the future,” Thornberry said.

An advisory panel – Section 309 – has recommended the following framework needed for acquisition reform in the military procurement process:

1.  Adapt at the Speed of a Changing World
The United States is operating in a global environment that is more fluid, more interconnected, and faster evolving than at any point in history. To adapt to this reality, the acquisition process must be agile enough to respond to rapidly evolving threats, and fast enough to develop and deliver new capabilities within the arc of emerging threats.

2.  Leverage the Dynamic Defense Marketplace
The defense industrial base has changed, and to maintain technological advantage, DoD increasingly must leverage the commercial marketplace. To be successful in this broader marketplace requires a fundamental change in the DoD–commercial relationship. DoD must become an attractive customer with which commercial firms want to do business. This need requires DoD to be a more sophisticated buyer that is responsive to market dynamics, company interests, and the greater economic landscape.

3.  Allocate Resources Effectively
The U.S. military faces multiple threats posed by increasingly capable adversaries and uncertain domains of warfare. It also contends with constrained defense budgets. To more effectively and efficiently allocate resources, DoD must better align and coordinate how it budgets, sets requirements, and acquires what it needs, to include not only major weapon systems, but also the services and low‐dollar items that make up more than half of DoD contract spending.

4.  Simplify Regulations
Some of the regulations and statutes governing defense acquisition are outdated or no longer applicable and should be amended or repealed to make the system more effective and efficient, and expand the number of companies willing to do business with DoD.

5.  Enable the Workforce
The current acquisition laws and regulations are overly complex, difficult to understand and implement, and contain requirements that result in people making suboptimal decisions and being risk‐averse. DoD needs an acquisition system that is simple, understandable, and executable by people operating in an environment that empowers and incentivizes them to make decisions that lead to positive outcomes.

Frankly, the same “reform” recommendations could be issued for the Department of Veterans Affairs.  There is no need to enlist the services of an “independent” panel to make such self-evident recommendations.  In fact, all 5 recommendations could be summed up rather easily:  “Use common sense!”

Clearly, complex weapon systems require a rigorous system of controls and due diligence.  In most other cases, procurement through an “unregulated” market is probably a far more efficient way to source products at a reasonable cost.

For instance, the Beretta M9 which has been standard issue for the last 35 years has now been replaced by the P320 of German origin.  With only 20% of US Army personnel issued “combat arms,” presumably far less require sidearms.  Does it really take this long to “upgrade” our firearm capability when drones seem the weapon of choice.

Wouldn’t it be far more efficient for the US Army (and presumably other arms of the military) to provide a “recommended” handgun to those servicemembers who need them but provide others with the option to bring their own weapon as long as it is duly registered and approved by unit officials?

Clearly, lethal weapons require additional controls, but there are many budget items that receive the same level of controls and regulations that are probably not required.

Bureaucratic procurement controls tends to lead to fraud and abuse as we have seen in the recent scandal regarding parts for Humvees.

The only way to improve the procurement process is to identify those areas which require disciplined oversight, but endeavor to open the playing field to more reputable suppliers.

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SFTT Military News: Week Ending May 19, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Secretary of Defense Weighs In on War with North Korea
U.S. Defense Secretary Jim Mattis said on Friday that any military solution to the North Korea crisis would be “tragic on an unbelievable scale” and Washington was working internationally to find a diplomatic solution. North Korea has defied all calls to rein in its nuclear and missile programs, even from China, its lone major ally, calling them legitimate self-defense.  Read more . . .

Military Handgun M-9 handguns

Could the US Military Purchase Handguns Online?
The Defense Department may start doing a whole lot more online shopping in 2018, if Republican Rep. Mac Thornberry has his way. The Texas chairman of the Armed Services Committee unveiled new legislation Thursday that aims to cut costly bureaucratic red tape at the Pentagon by allowing the military to buy everything from pens to treadmills from business-to-business sites such as Staples and Amazon. That would free the federal government’s biggest bureaucracy from using its current “expensive” and “onerous” contracting and scheduling process to buy its commercial goods, according to Thornberry.  Read more . . .

Large Number of Troops Separated for Misconduct had PTSD
Nearly two-thirds of the 91,764 U.S. troops who were separated from the military for misconduct in a recent four-year period had been diagnosed with post-traumatic stress, a traumatic brain injury or another condition that can lead to misconduct, according to a report released Tuesday, raising questions about the Pentagon’s treatment of combat veterans. The Government Accountability Office found that the Defense Department needs to take action to make sure that commanders appropriately consider medical conditions when weighing what to do with service members facing misconduct allegations. Some 57,141 troops were separated from the service despite a potentially relevant diagnosis between 2011 and 2015, and 13,283 of them received other-than-honorable discharges that could prevent them from receiving care from the Department of Veterans Affairs, the report said.  Read more . . .

Improper Payments at VA Continue to Grow
The Department of Veterans Affairs cost taxpayers $5.5 billion dollars in improper payments last year, according to a new report by the Veterans Affairs Office of Inspector General published Monday. An improper payment is any payment that “should not have been made or that was made in an incorrect amount under statutory, contractual, administrative, or other legally applicable requirements,” according to the report. The findings, published on May 15, reported an increase in improper payments from $5 billion in 2015 to $5.5 billion in 2016. It also found that two VA programs failed to keep their rate of mistaken payments below 10%, and six of its programs failed to meet reduction targets set last year.  Read more . . .

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops

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Meet David Cox: Dr. “No” of VA Reform

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Meet J. David Cox, who many consider “Dr. No” of badly needed reforms within the Department of Veterans Affairs (“the VA’).

J. David Cox

J. David Cox

J. David Cox is President of the American Federation of Government Employees and is the person most likely to block any meaningful reform within the VA.  SFTT has had an eye on Mr. Cox who in the run-up to last year’s Presidential election, threatened the previous secretary of the VA with physical violence:

Cox was “prepared to whoop Bob McDonald’s a – -,” he said. “He’s going to start treating us as the labor partner … or we will whoop his a – -, I promise you,”

The new VA Secretary, Dr. David Shulkin, is rightly receiving favorable media coverage and support from both parties in Congress on his forceful new leadership.  In fact, the New York Times recently referred to Dr. Shulkin as a “Hands On, Risk-Taking ‘Standout.'”

The New York Times reports the following example of Dr. Shulkin’s responsiveness (and common sense):

After he first took the job, he grew concerned that the agency was not doing enough to prevent suicide after a news report showed high rates among young combat veterans. Suicide prevention leaders told him that they would put together a summit meeting to respond, adding that it would take 10 months.

Dr. Shulkin told them to get it done in one month. When his staff members pushed back, he pulled out a calculator and began quietly tapping, then showed them that during the delay, nearly 6,000 veterans would kill themselves. They got it done in a month.

“For me it was a very important day,” he said, remembering the meeting. “It taught our people you can act with urgency, and you can resist the temptation to say we work in a system that you can’t get to move faster. I think they learned that you can.”

Indeed, SFTT has greatly admired the decisiveness with which Dr. Shulkin has attacked two chronic problems with the VA:  A bloated infrastructure and the lack of authority to manage the VA’s large workforce.

While Congressional Republicans and Democrats have largely agreed on an “accountability” bill to support the firing of VA employees, J. David Cox argues that:

“Trampling on the rights of honest, hard-working public-sector employees is not the solution to holding bad employees accountable for their actions,” American Federation of Government Employees National President J. David Cox said. He said the bill would set up different standards for VA employees and other federal workers.

In fact, just recently it was reported that “a federal appellate court overturned the firing of Sharon Helman, who presided over a Phoenix VA Health Care System that left veterans waiting for weeks or even months for care while phony records were kept to show the agency was meeting its wait-time goals.”

Dr. David Shulkin, VA Secretary

While I hope that Dr. Shulkin has the fortitude to implement the bold changes he has outlined, the entrenched bureaucracy represented by David Cox and others, such as David Cifu, will continue to undermine his efforts.

The VA has simply grown too large to manage effectively.  Dr. Shulkin is right in arguing that the lives and well-being of Veterans are far more important than defending the rights of a few “bad apples” within the VA.  David Cox should embrace the vision of Dr. Shulkin and act in a manner which reflects well on the work ethic of the vast majority of VA employees.

Veterans, Veteran organizations and our elected officials should provide Dr. Shulkin with a clear mandate to bring about the much needed reform within the VA. Our Veterans, their family and friends and an appreciate public deserve no less.

J. David Cox would do well to join forces with Dr. Shulkin in this effort rather than taunt him.

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SFTT Military News: Week Ending May 12, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Military Code-Breaking Project Inadvertently Compromised
In early December 2016, an NYU student came across a server inside New York University’s famed Institute for Mathematics and Advanced Supercomputing, headed by the brilliant Chudnovsky brothers, David and Gregory. The server appeared to be an internet-connected backup drive. But instead of being filled with family photos and spreadsheets, this drive held confidential information on an advanced code-breaking machine that had never before been described in public. Dozens of documents spanning hundreds of pages detailed the project, a joint supercomputing initiative administered by NYU, the Department of Defense, and IBM. And they were available for the entire world to download.  Read more . . .

cyber warfare

Large Russian Military Exercise on Western Border with Latvia
The Russian exercise, known as Zapad, or West, occurs every four years and will take place this year in western Russia, including Belarus and the Russian enclave of Kaliningrad. The U.S. military estimates that 70,000 to 100,000 Russian troops could take part in the exercise, the officials said, adding that the Russian military could also take the opportunity to upgrade certain equipment permanently stationed in the region. Specifically, the officials said that they expect the Russian missile defenses in Kaliningrad to be permanently upgraded with nuclear-capable Iskander ballistic missile systems.  Read more . . .

Vet Groups Back Bill to Support VA Firings 
Major veterans service organizations have rallied behind proposed legislation to speed up the firing process at the Department of Veterans Affairs, but a government union charges it would be a gross violation of workers’ rights. “Trampling on the rights of honest, hard-working public-sector employees is not the solution to holding bad employees accountable for their actions,” American Federation of Government Employees National President J. David Cox said. He said the bill would set up different standards for VA employees and other federal workers.  Read more . . .

US Army Small-Arms Program Explained
U.S. Army small-arms experts recently laid out a blueprint of future small-arms goals that would equip infantry units with several new weapons, ranging from a new squad automatic rifle to a new shoulder-fired, anti-armor weapon. Four months after the Army selected a replacement for its M9 service pistol, the service has started to talk openly about plans to equip infantry squads with lighter, more effective small arms.  Read more . . .

Use of Antidepressants to Treat PTSD Linked to Dementia
Experiencing an exceptionally traumatic event can lead to mental health issues. It can result in flashbacks, nightmares, and severe anxiety that affects the quality of life of the individual and their overall well-being. The most serious of the trauma-inducing mental disorder is post-traumatic stress disorder (PTSD), which can last for months or even years after the inciting incident, interfering with day to day functioning. New research suggests that this disorder is a significant risk factor for developing dementia, a leading cause of serious illness, disability, and death.  Read more . . .

Psychedelic Drug and Therapy Show Promise in Treating PTSD
According to a story by Scientific American, researchers presented results from trial treatments that used psychotherapy and MDMA (3,4-Methylenedioxymethamphetamine otherwise known as ecstasy) as a means of combatting major side-effects of PTSD, such as frequent nightmares and heightened anxiety levels. It was found that 67% of patients who received two or three sessions of MDMA-assisted therapy had completely overcome the illness roughly a year later. This number, as compared to the 23% of patients who got the same result after receiving psychotherapy and a placebo drug, could be the catalyst for an increased number of trials involving psychedelic drugs in the future.  Read more . . .

Bipartisan Support in Senate for VA Accountability Bill?
Congressional Republicans and Democrats have reached agreement on a long-stalled bill to make it easier for the Department of Veterans Affairs to fire its employees, part of an accountability effort touted by President Donald Trump. The deal announced Thursday could smooth the way for final passage on an issue that had been in limbo since the 2014 wait-time scandal at the Phoenix VA medical center. As many as 40 veterans died while waiting months for appointments as VA employees created secret waiting lists and other falsehoods to cover up delays.  Read more . . .

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops

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Search for Secretary of the Army Continues

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Yet another Trump nominee for Secretary of the Army, Mark E. Green, has withdrawn his name from consideration citing “false and misleading attacks against him.”

According to the Washington Post, “the opposition to Green centers on his past comments about Islam, evolution and gender issues, including suggestions that being transgender is a disease.”

Earlier this year, Vincent Viola also withdrew his name for consideration for the same position claiming that he would have difficulty separating his private interests from the responsibilities of the office.

Never one to back the wrong horse, SFTT is delighted to learn that Mr. Viola is 50% owner of Always Dreaming, the winner of this year’s Kentucky Derby.

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First Steps to Overhaul the Department of Veterans Affairs

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Dr. David Shulkin continues to impress by tackling some rather entrenched “special interest” groups within the Department of Veterans Affairs (“the VA”):

– Personnel;

– Infrastructure

Earlier this week, VA Secretary Shulkin informed a Congress that he was considering closing some 1,100 underutilized VA facilities.  The Associated Press reports that:

Shulkin said the VA had identified more than 430 vacant buildings and 735 that he described as underutilized, costing the federal government $25 million a year. He said the VA would work with Congress in prioritizing buildings for closure and was considering whether to follow a process the Pentagon had used in recent decades to decide which of its underused military bases to shutter, known as Base Realignment and Closure, or BRAC.

“Whether BRAC is a model that we should take a look, we’re beginning that discussion with members of Congress,” Shulkin told a House appropriations subcommittee. “We want to stop supporting our use of maintenance of buildings we don’t need, and we want to reinvest that in buildings we know have capital needs.”

Last week, President Trump signed an Executive Order protecting VA whistleblowers from retaliation in a quest by the VA to shed incompetent employees.

Department of Veterans Affairs

While these measures may seem rather insignificant given the overall size and reach of the VA, they could mark an important change in the direction of the VA to help respond to the needs of Veterans.

The VA has evolved into a mammoth organization intent on serving the needs of all Veterans and their families.  Roughly 60% of the VA’s $180 billion budget (2017 budget) is allocated to mandatory benefits programs.

The VA’s discretionary budget of $78.7 billion is allocated to a variety of Veteran services,  but by far, is the the $65 billion allocated to medical care facilities.   Despite regular reports of shortcomings at VA facilities, the Rand Corporation recently (2016) reported that “the Veterans Affairs health care system generally performs better than or similar to other health care systems on providing safe and effective care to patients.”

While it appears that many Veterans – quite possibly the vast majority – receive quality health services from the VA, many Veterans complain about the timeliness and quality of service provided to them.

Like other healthcare providers in the private sector, the VA has determined what health events are covered, the type of coverage provided and where the health services are administered.

One program that has come under particular attack is the Choice Program, which gives Veterans access to medical services in the private sector if the VA can’t dispense services within 30 days or a VA facility is not located within 40 miles of the Veteran.

At his confirmation hearings, now VA Secretary David Shulkin, requested that Congress expand the coverage of the Choice program and eliminate many of its administrative constraints.  Needless to say, changes in the Choice program would certainly provide a greater number of Veterans with access to private sector care.

In cases of emergency, even minor improvements to the Choice program could be of major benefits to Veterans.

Nevertheless, these changes do not provide Veterans with access to alternative therapy programs not currently approved by the VA.  As SFTT has reported on numerous occasions, PTSD is currently treated with demonstrably ineffective “approved” treatment procedures while far better and less-intrusive programs like hyperbaric oxygen therapy (HBOT) are widely used with success throughout the world.

In effect, there are a number of activities within the VA that can best be performed by third-party services.  In fact, integrating these services with community resources may prove to be more of a long term benefit to the Veteran and his or her family.

Stand for the Troops remains hopeful that Secretary Shulkin and the dedicated employees of the VA will find the right balance in helping Veterans recover their lives.

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SFTT Military News: Week Ending May 5, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Is China Reconsidering Its Relationship with North Korea?
When North Korea’s founder Kim Il-Sung visited Beijing to sign a mutual defense pact with China in 1961, he was comforted by the military protection promised by his fellow communist neighbors. But half a century and a few North Korean nuclear tests later, the agreement is beginning to look like a musty Cold War relic that China would rather forget. Despite their alliance in the 1950 – 1953 Korean War, analysts questioned whether Beijing would now rush to Pyongyang’s defense in a military confrontation with the US and South Korea.  Read more . . .

Questions on Efficacy of “MOAB” bombing in Afghanistan
But a new investigation by independent analysts casts doubt on the efficiency of the bomb, suggesting it inflicted far less damage than initially reported – and raising questions again over why the bomb was dropped. Using satellite imagery, ground footage and 3D visualization, Alcis, an institute for geographical analysis, surveyed the targeted area in Nangarhar province. It found 38 buildings and 69 trees destroyed within a 150-metee radius, challenging statements from locals who told reporters the bomb had damaged houses up to two miles away. Alcis was also skeptical of the Afghan government’s assessment that the bomb killed 94 Isis militants. “I’m staggered by that,” said Richard Brittan, the institute’s managing director. “I simply don’t understand where they can get that number from.”  Read more . . .

Pituitary gland

Can Brain Concussion Injury be Properly Evaluated?
In an effort to fill that technology gap, Timothy Bentley, and his team at the Office of Naval Research’s Warfighter Performance Department in Arlington, Virginia, have engineered new sensor technology that could give medics on the battlefield a clearer idea of whether or not an injury actually occurred after a blast. The coin-sized sensors, placed in service members’ helmets and tactical gear, detect the impact of a blast wave—which moves faster than the speed of sound—and assign it a number, a measure of blast strength. The number is then run through an algorithm that computes how a service member was hit by a blast, which sensors were activated based on their placement, and then tells medics if the service member needs to get off the field immediately or not.   Read more . . .

Can Putin and Trump “Broker” Syrian Deal with No-Fly Zone?
Once again it appears Vladimir Putin has seized the strategic high ground and initiative in Syria, as he declared yesterday that he has broad agreement for humanitarian safe zones across Syria after discussions with Donald Trump, Turkey and Iran. He claims he can enable the ceasefire brokered in Astana some weeks ago, which currently is an abject failure, by creating no-fly zones with the Russian, Turkish, Iranian and US militaries protecting safe zones on the ground. He also, thankfully, acknowledges that UN troops might be required.  Read more . . .

Antibiotic Doxycycline May Reduce the Risk of Developing PTSD
Doxycycline, a common antibiotic, appears to disrupt the formation of negative memories in the brain. According to a study in the journal Molecular Psychiatry, this could help prevent post traumatic stress (PTSD). The study suggests blocking matrix enzymes—proteins located outside nerve cells—may interfere with the ability to form memories. Doxycycline blocks these enzymes.  Read more . . .

VA Secretary Ponders Closing Up to 1,000 VA Facilities
Veterans Affairs Secretary David Shulkin says his department is seeking to close perhaps more than 1,100 VA facilities nationwide as it develops plans to allow more veterans to receive medical care in the private sector. At a House hearing Wednesday, Shulkin said the VA had identified more than 430 vacant buildings and 735 that he described as underutilized, costing the federal government $25 million a year. He said the VA would work with Congress in prioritizing buildings for closure and was considering whether to follow a process the Pentagon had used in recent decades to decide which of its underused military bases to shutter, known as Base Realignment and Closure, or BRAC.  Read more . . .

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops

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Whistleblowers and the Department of Veterans Affairs

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On April 27th, President Trump signed an Executive Order to create the Office of Accountability and Whistleblower Protection within the Department of Veterans Affairs (“the VA”).

According to the AP, VA Secretary David Shulkin said the office will help identify “barriers” that make it difficult for the department to fire or reassign bad employees. Another function of the office will be to help shield whistleblowers from retaliation.

To many, it may seem surprising that a new office within the VA is required to protect “whistleblowers,” since private and public whistleblowers have long been afforded protection under the Whistleblower Protection Act of 1989.

Clearly, additional protection is needed if doctors like Dr. Dale Klein can be relegated to an empty room for bringing VA abuse to the attention of the Inspector General.  Found below is a report for Fox News:

Dr. Dale Klein may be the highest-paid U.S. government employee who literally does nothing while he’s on the clock. A highly rated pain management specialist at the Southeast Missouri John J. Pershing V.A., Klein is paid $250,000 a year to work with veterans, but instead of helping those who served their country, he sits in a small office and does nothing. All day. Every day.

“I sit in a chair and I look at the walls,” the doctor said of his typical workday. “It feels like solitary confinement.”

A double board certified physician and Yale University fellow, Klein said the Department of Veterans Affairs (V.A.) took away his patients and privileges almost a year ago after, he alleges, he blew the whistle on secret wait-lists and wait-time manipulation at the V.A. in Poplar Bluff, Mo., as well as his suspicion that some veterans were reselling their prescriptions on the black market.

While one would like to be optimistic that the new “Whistleblower Office” within the VA would help improved efficiency within the VA, I suspect that there are far too many institutional barriers to be overcome in this mammoth organization.

Department of Veterans Affairs

Size Matters at the Department of Veterans Affairs

The VA’s simple mission laid down by President Abraham Lincoln is “to care for him who shall have borne the battle, and for his widow, and his orphan.”

Needless to say, each person has his or her interpretation of what that VA mission entails, but over time the VA has laid on layers of responsibility to fulfill that mission.   In the military, we often refer to that as “mission creep.”

In effect, the VA – whether pressured by Congress, the President or their own Administration – have taken on responsibilities that may or may not be what was originally intended under President Lincoln’s promise.

More importantly, the VA has centralized most functions under its umbrella to administer to the needs of Veterans.

Employing some 350,000 people and many outside consultants, the VA administers health and benefit programs to millions of Veterans.  In economic terms, one might characterize the VA as a monopoly.

While many of the services provided by the VA are excellent, it would be unrealistic to expect that ALL services are effective.

In fact, the IG, internal VA audits and the IG have reported many irregularities at the VA.  Unmanned Crisis Call Centers, unacceptable patient “wait times” and the heavy reliance on prescription drugs all contribute to public wariness and distrust of the VA.   More importantly, many Veterans reject the services provided by the VA.

SFTT has long argued that the VA is far too large to succeed on every front without compromising their main mission.  Shortly after Dr. David Shulkin was appointed Secretary of the VA, we wrote:

NO AMOUNT OF MONEY or CHANGE IN LEADERSHIP or ENACTMENT OF NEW LEGISLATION will bring about A MORE RESPONSIVE VA.

The VA has become a bureaucracy that answers only to itself and is not responsive to the needs of Veterans.  Frankly, the VA has lost its way and very little will change unless the VA is broken down into far smaller manageable components.

While smaller components of the VA will invariably fail, A SMALLER AND LESS CENTRALIZED VA WON’T COMPROMISE THE FULL MISSION.  

VA Whistleblowers and David Cox

Dr. Shulkin and others clearly realize that there are serious problems of accountability within the VA.  The April 27, 2017 Executive Order is designed to help “weed out” waste and inefficiencies within the VA.

J. David Cox

J. David Cox

Despite much needed reform within the largely ungovernable VA, I suspect that  J. David Cox, President of the American Federation of Government Employees, will continue to run a destabilizing campaign to block any meaningful reform.

We admire the courage of “whistleblowers,” but Veterans shouldn’t expect great changes considering the entrenched positions of David Cox and his henchmen.

It is reassuring to see Dr. Shulkin take action to confront the serious problems within the VA.  We wish him success in his endeavors and hope that he receives much needed support from our elected leaders to bring radical reform to the VA.

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SFTT Military News: Week Ending Apr 28, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Israeli Airstrike at Syrian Airport Confirmed
An Israeli missile strike has caused a large explosion and fire at a military site near Damascus international airport, Syrian state media report. A fuel tank and warehouses were damaged, the Sana news agency said. But Syrian rebel sources said an arms depot run by Lebanon’s Hezbollah movement, which is fighting in Syria as an ally of the government, was hit. Israel said the explosion was “consistent” with its policy to prevent Iran smuggling weapons to Hezbollah.  Read more . . .

Brain Shock Therapy by US DARPA Army Research Group
The US military is working with seven American universities to see if electrically stimulating the brain will increase the ability to learn new skills. The Targeted Neuroplasticity Training (TNT) program is focused on synaptic plasticity, the ability of the brain to build new neural pathways to absorb knowledge. By stimulating the nerves that connect neurons in the brain and spinal cord to organs, skin and muscles, the Defense Advanced Research Projects Agency (DARPA) is hoping that the brain can be trained to learn new skills more quickly.  Read more . . .

Rethinking the US Military Health System
During Operations Enduring Freedom and Iraqi Freedom (2001 – 2014), the United States’ military health system completely transformed its approach to casualty care, achieving the highest rate of survival from battlefield wounds in the history of warfare. It is one of the most remarkable accomplishments in the history of US medicine. Ironically, the same health care system that worked miracles “down range” in Iraq and Afghanistan faces mounting criticism at home. How can this be? In part, it is because the military health system has two distinctive missions: support combat and humanitarian assistance missions overseas and provide comprehensive health services to millions of service members, their families, and military retirees at home.   Read more . . .

North Korean Military Strength Overrated?
North Korea’s soldiers mostly carry fake weapons during their mass-scale parades, a former US intelligence officer has said. Michael Pregent believes many of the arms flaunted by menacing-looking North Korean troops during their displays are dummies, and claims even their sunglasses wouldn’t be fit for combat. Pregent was asked to look at photographs from an April 15 military parade in the North Korean capital of Pyongyang.  Read more . . .

Taliban

 Taliban Announces Spring Offensive
Afghanistan’s Taliban announced the start of their annual spring offensive Friday, promising to build their political base in the country while focusing military assaults on coalition and Afghan security forces. Taliban spokesman Zabihullah Mujahid announced the launch of the offensive in an email statement that boasted Taliban control over more than half of the country, referencing a February report issued by Washington’s special inspector general for Afghan reconstruction. That report said that the Afghan government had control or influence over only 52 percent of Afghanistan’s 407 districts last year, down from 63.4 percent previously.  Read more . . .

Brainwave Study to Help Fight PTSD
The new study was led by researchers at Wake Forest Baptist Medical Center in Winston-Salem, N.C. The investigators sought to tackle PTSD from another angle, through the patients’ own brainwaves. The study involved 18 patients who completed an average of 16 successive, daily sessions of what the researchers called “noninvasive closed-loop acoustic stimulation brainwave technology.” During the sessions, the patients’ brain activity was monitored and certain brain frequencies were translated into acoustic tones that were then relayed back to the patients via earbuds.  Read more . . .

 Whistleblower Protection Executive Order for VA
President Donald Trump, as part of his dash to rack up wins before the end of his first 100 days, signed an executive order Thursday that creates a new office devoted to protecting whistleblowers at the Department of Veterans Affairs.Before signing the order at the Department of Veterans Affairs, Trump said the new office will help provide veterans with the “health care they need and the health care they deserve.””We are not going to let them down,” Trump said, arguing that the order “makes it clear that we will never tolerate substandard care for our great veterans” and ensure that those who report problems at the veterans affairs are protected.  Read more . . .

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops

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Hyperbaric Oxygen Therapy (HBOT) to Treat Veterans with PTSD

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Veterans and casual observers continue to be mystified why the Department of Veterans Affairs (the “VA”) continues to insist on failed therapy programs to treat Veterans with PTSD.

Dr. David Cifu, the senior TBI specialist in the Department of Veterans Affairs’ Veterans Health Administration, argues that Veterans treated with Cognitive Behavioral Therapy and Prolonged Exposure Therapy are receiving the best therapy possible to treat PTSD.   There is no reliable third-party verification to support Dr. Cifu’s bold assertion.

More to the point, Dr. Cifu dismisses  other treatment alternatives arguing that there is no scientific basis to support them.  In particular, Hyperbaric Oxygen Therapy (HBOT) has been singled out for particular disdain by Dr. Cifu.

Specifically, the VA concluded their trial “study” with the following observations:

“To date, there have been nine peer-reviewed publications describing this research,” Dr. David Cifu, VA’s national director for physical medicine and rehabilitation recently told the Oklahoman. “All the research consistently supports that there is no evidence that hyperbaric oxygen has any therapeutic benefit for symptoms resulting from either mild TBI or PTSD.”

Frankly,  there is voluminous scientific evidence that HBOT is both a viable and recommended treatment alternative for Veterans suffering from PTSD and TBI.

Hyperbaric Oxygen Therapy (HBOT)

Hyperbaric Oxygen Therapy or HBOT is available at many privately-owned hospitals in the United States and around the world.  There is compelling scientific evidence that HBOT reverses brain damage.

In fact, HBOT is the preferred therapy of  the Israeli Defense Forces (“IDF”) for service members with head injuries.  Frankly, this assertion alone trumps any argument to the contrary by Dr. Cifu.

In its most simple form, HBOT is a series of “dives” in a decompression chamber (normally 40) where concentrated oxygen is administered under controlled conditions by trained physicians.  There is clear and conclusive evidence that brain function improves through the controlled application of oxygen.  In effect, it stimulates and may, in fact, regenerate brain cells at the molecular level.

HBOT Brain Functionality Over Time

In addition, HBOT is far cheaper to administer than currently approved programs at the VA.   Maj. Ben Richards argues that all Veterans with PTSD and TBI could be treated with HBOT for less than 10% of the VA budget allocated for pharmaceuticals.

More to the point, the annual VA treatment costs for Veterans with PTSD and TBI are roughly $15,000. For this annual expense, many Veterans could receive HBOT.

Dr. Figueroa asks, What are we Waiting For?

Almost 3 years ago, Dr. Xavier A. Figueroa, Ph.D., in an article entitled “What the <#$*&!> Is Wrong with the DoD/VA HBOT Studies?!!” clearly sets forth a compelling scientific argument why Veterans with TBI and PTSD should be treated with HBOT.

Found below is a summary of Dr. Figueroa’s conclusions (footnotes removed):

A large fraction of the current epidemic of military suicides (22+ service members a day take their lives) are more than likely due to misdiagnosed TBI and PTSD. Although the DoD and VA have spent billions (actually, $ 9.2 billion since 2010) trying to diagnose and treat the problem, the epidemic of suicide and mental illness are larger than ever. Drug interventions are woefully inadequate, as more and more studies continue to find that pharmacological interventions are not effective in treating the varied symptoms of TBI or PTSD. In many cases suicide of veterans have been linked through prescribed overmedication.

HBOT is a safe and effective treatment with low-to-no side effects (after all, even the DOD accepted the safety of HBOT back in 2008). Access to HBOT is available within most major metropolitan centers, but the major sticking point is money. Who pays for the treatment?  Those that are willing to pay for it out-of-pocket and state taxpayers picking up the tab for brain-injured service members forced back into society without sufficient care (or forced out on a Chapter 10, when it should have been treated as a medical condition).

The continued reports of studies like the DoD/VA sponsored trials allow denial of coverage and provide adequate cover for public officials to claim that more study needs to be done. As we have seen, the conclusions of the authors of the DoD/VA sponsored studies downplay the results of effectiveness. There are sufficient studies (and growing) showing a strong positive effect of HBOT in TBI. More will be forthcoming.

The cardinal rule of medicine is “First, Do No Harm”. With HBOT, this rule is satisfied. Now, by denying or blocking a treatment that has proven restorative and healing effects, countless physicians and organizations, from the VA to DoD, Congress and the White House, could be accused of causing harm. Never mind how many experiments “fail” to show results (even when they actually show success). Failure to replicate a result is just that…a failure to replicate, not a negation of a treatment or other positive results. You can’t prove a negative and there are many clinical trials that do show the efficacy of HBOT.

The practice of medicine and the use of HBOT should not be dependent on the collective unease of a medical profession and the dilatory nature of risk adverse politicians, but on the evidence-based results that we are seeing. Within the VA, there are hard working physicians that are trying to change the culture of inertia and implement effective treatments for TBI and PTSD, using evidence based medicine. Unfortunately, evidence-based medicine only works when we accept the evidence presented to us and not on mischaracterized conclusions of a single study (or any other study). Our veterans, our citizens and our communities deserve better than what we are currently giving them: bad conclusions, institutions too scared to act in the interests of the people it serves and too many physicians unwilling to look at the accumulated evidence.

Indeed, it is time to for Dr. Shulkin to rid the VA of Dr. Cifu and embrace cost-effective treatment therapies which provide some hope for Veterans with PTSD and TBI.

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