Dr. No's Last Rounds

A Political Cartoon, author's information included, on Tumblr, fair use claimed

Greetings All:

Author's note:  This is a particularly long and decidedly political post.  It also touches on suicide.  Not exactly a "be of good cheer" post.  I understand if you might want to skip reading it, especially at this time of year.  I have been working on it for the past week and am posting this in large part to selfishly satisfy my need to vent on a subject that matters to me.  You may not agree with me in part or think I'm dead wrong.  If so, please leave a comment.  Now that you've been "warned" about this post, :) please read on if you like, thanks.

Friends, I'm angry.  I am angry that one Senator, out of a legislative body of 535, decided that he would block a bill.  This bill would have provided much-needed mental health care for Veterans.  I have been working on this post for a while and if you've stopped by my Facebook wall, you'll notice that I've weighed in on this issue.  

The issue in question is The Clay Hunt Clay Hunt Suicide Prevention for America’s Veterans (SAV) Act.  It is named for a Marine.  Clay Hunt served our nation with honor and earned the Purple Heart for wounds sustained in combat in Iraq.  When he had recovered, he trained as a sniper.  Once again, headed off to war.  This time, Afghanistan.  

After he concluded his military service, he returned home.  Clay was a thoughtful, passionate advocate for veterans, especially of America's most recent wars.  

Clay Hunt, photo credit- Iraq and Afghanistan Veterans of America (IAVA), fair use claimed.

Then the darkness came.  Ravaged by PTSD (post traumatic stress disorder) Clay found himself in a very bad place.  His marriage ended.  He lost his job.  He took his own life.

Here's what Clay's Mom said:

"Susan Selke, Hunt’s mother testified before a Senate hearing this month (December, 2014) saying, 'Despite his proactive and open approach to seeking care to address his injuries, the VA system did not adequately address his needs. Even today, we continue to hear about both individual and systemic failures by the VA to provide adequate care and address the needs of veterans.'” 

(Citing to both The Fayetteville Observer and The Washington Post, full cites in sources.)

Out of this tragic loss, friends of Clay, the Veterans' Community, and elected leaders came together to sponsor the Clay Hunt Suicide Prevention for American Veterans Act or the "Clay Hunt SAV Act."  I have provided a link to the bill in its entirety in the sources.  The highlights of the bill are, according to Congressman Tim Walz, Democrat, Minnesota, 1st Congressional District's webite & press release:

"The Clay Hunt SAV Act will help address the veteran suicide epidemic in our nation by:
Increasing Access to Mental Health Care:

• Amends the requirements for reviewing potentially improper discharge characterizations of individuals diagnosed with PTSD or TBI so that vets can get full access to the care they have earned—this language is similar to a Walz bill, HR 975, the Servicemembers Mental Health Review Act.
• Requires the VA to create a one-stop, interactive website to serve as a centralized source of information regarding all mental health services for veterans.

Increasing Capacity to Meet the Demand for Mental Health Care:

• Addresses the shortage of mental health care professionals by authorizing the VA to conduct a student loan repayment pilot program aimed at recruiting and retaining psychiatrists.
• Requires the DoD and National Guard to review the staffing requirements for Directors of Psychological Health in each state. 

Improving the Quality of Care for Troops and Veterans:

• Requires a yearly evaluation, conducted by a third party, of all mental health care and suicide prevention practices and programs at the DoD and VA to find out what’s working and what’s not working and make recommendations to improve care.

Providing Continuous, Seamless Care to Troops and Veterans: 

• Establishes a strategic relationship between the VA and the National Guard to facilitate a greater continuity of care between the National Guard and the VA. 
• Authorizes a Government Accountability Office (GAO) report on the transition of care for PTSD and TBI between the DoD and the VA.  

Developing Community Support for Veterans: 

• Establishes a peer support and community outreach pilot program to assist transitioning servicemembers with accessing VA mental health care services.

This legislation had overwhelming support.  It passed the House unanimously.  When's the last time that happened?  Can't remember?  Me neither.  It also had broad, bipartisan support in the Senate.  

According to Bryant Jordan, reporting for military.com, (full cite below) here's a "who's who" of supporting organizations and elected leaders supporting the Clay Hunt SAV Act:

"The House passed the bill with bipartisan support. The bill picked up 21 co-sponsors -- 11 Republicans and 10 Democrats -- including GOP lawmakers Richard Burr of North Carolina, ranking member of the Senate Veterans Affairs Committee; Roy Blunt of Missouri; Lisa Murkowski of Alaska; Dean Heller of Nevada; Jerry Moran of Kansas; Mike Johanns of Nebraska; Kelly Ayotte of New Hampshire; Mark Kirk of Illinois; John Cornyn of Texas; Jeff Flake of Arizona; and Jeff Sessions of Alabama.

Democrat senators backing the legislation included Blumenthal; Joe Manchin of West Virginia; Mark Begich of Alaska; Richard Durbin of Illinois; Joe Donnelly of Indiana; Kirsten Gillibrand of New York; Robert Menendez of New Jersey; Amy Klobuchar of Minnesota; John Reed of Rhode Island and Chuck Schumer of New York."

Bryant went on to write about organizations supporting this Act:

"Organizations including The American Legion, Veterans of Foreign Wars and Iraq and Afghanistan Veterans of America, as well as professional military groups such as the Military Officers Association of America, Association of the United States Navy and Air Force Sergeants Association have all endorsed the bill."

Amazing this did not pass.  Yet it did not.  Why, you might ask?  Well, as mentioned above, one Senator blocked it.
 
Enter Senator and Dr. Coburn.  

The Senator opposed the bill.  He claimed the bill was duplicative and would not achieve its aims.  Here's a news report (again, see Bryan from military.com, full cite below) the with quotes from the Senator:

"Coburn argued before the Senate late Monday that 'almost everything that's in this bill has already been authorized and approved with the $10 billion [Veterans Choice Act] that we sent to the VA.  'I object to this bill not because I don't want to help save [veterans], because I don't think this bill's going to do that,' he said.
Coburn also criticized Congress, including himself, for failing to better oversee the VA."

Senator Coburn has prided himself on being a fiscal watchdog, earning the informal title, "Dr. No."  I have no issue with that as a priority.  However, another important priority is taking care of our Veterans.  I respectfully disagree with both the reasoning and actions of Senator Coburn.  As to his claim this bill duplicates current VA efforts, the VA Secretary, Bob McDonald, endorsed it, saying it would compliment current efforts. (Please see the military.com source for the full comments.)

There has been, not surprisingly, a firestorm of anger at Senator Coburn's actions/antics.  I posted something on his Facebook wall and did my best to be respectful, perhaps overly so.

Not everyone has been so charitable.  Montel Williams, a former Marine had these comments:


"Let’s remember that Coburn voted to send young people, like Clay Hunt, to fight two wars that weren’t remotely paid for and exploded the debt he professes to be so concerned about. In my view, it’s the height of hypocrisy, having so thrown fiscal discipline to the wind to fight two wars, to suddenly invoke it in preventing passage of legislation aimed at keeping those who fought those two wars from committing suicide." (Please see cite below in sources for additional comments from Mr. Williams.)

IAVA, the Iraq and Afghanistan Veterans of America, an organization advocating for Veterans of America's longest wars, had this to say:

“'This is why people hate Washington. Senator Coburn is the only person stopping this bill from becoming law,' said IAVA CEO and Founder Paul Rieckhoff. 'If Senator Coburn blocks the Clay Hunt SAV Act, an enduring part of his legacy will be killing an overwhelmingly supported bipartisan suicide prevention bill for our veterans. That has real implications. If it takes 90 days to revisit this issue in the next Congress, the statistics tell us that 1,980 additional veterans will die by suicide. Senator Coburn needs to think carefully about that number in addition to his concerns about the minimal financial costs of this bill.'”

Full disclosure:  I am a member of IAVA and consider Paul Rieckhoff a friend.  Paul helped me years ago obtain a pro bono expert witness for an Army Reserve Soldier I was representing.  We've stayed in touch over the years and I could not be more proud of him for what he's done leading IAVA.

Here's what Clay's Mom and Step-Dad said in a personal appeal to the Senator:

“I understand you are a man of principles, and that you very vehemently and painstakingly watch over our national budget,” said Selke. “Susan and I are conservative Republicans from the state of Texas. I appreciate your vigilance over our budget. The bill we are talking about is projected to cost about $22 million dollars. That’s a lot of money to me. It’s a lot of money to you. But in the context of the value of a human life, it is insignificant.”


So what's the impact of this bill not becoming law?  Another 22 veterans (times 90 days) will kill themselves.  Would this bill save all of them?  I highly doubt it.  It might only save a few.  Yet it is the right thing to do.

While on the subject of the number of suicides of Veterans, consider this:  The number of 22 Veteran suicides a day might be low.  From CNN:

"Every day, 22 veterans take their own lives. That's a suicide every 65 minutes. As shocking as the number is, it may actually be higher.

The figure, released by the Department of Veterans Affairs in February, is based on the agency's own data and numbers reported by 21 states from 1999 through 2011. Those states represent about 40% of the U.S. population. The other states, including the two largest (California and Texas) and the fifth-largest (Illinois), did not make data available."

There is a ton of data out there about why this number is low.  I'd suggest that as our Vietnam and Vietnam-era Veterans age, suicide for their age group will grow.  It may be tempting to lump it into substance abuse or chronic health issues.  However, if we're a nation that honors our Veterans, then we'll look at all the causes of why our heroes choose to stop living, either all at once or bit by bit.  I do have a few additional cites below on this issue and some other information on Senator Coburn's actions.  Out of fairness, I have included the C-SPAN link to his farewell speech in its entirety in the sources.

As I wrap up this "Heaven's Gate" length blog post, I want to comment on precisely what the good Senator from Oklahoma did.  Lest anyone think he just voted no, let the record reflect he did not.  

Nope, he instead utilized an arcane Senate rule to invoke his prerogative to not let the bill have a vote.  This is possible due to the rules of the Senate.  I have the link to the rules below if you're truly suffering from insomnia.  

These rules are not in the Constitution.  It is true that it is from the Constitution that the Senate derives its authority to make its rules.  But please, do not tell me it was the Founders' intent that one person could block the will of the many.  If I recall, the whole reason we shot back at Lexington and Concord was because of one man named George III who was blocking the will of the many.  

Senator, I do not view your actions as being principled.  I view them as being arrogant.  I believe your thinking "I'm doing what I want," is not how a legislator and a leader acts.

I have a link below to Rachel Maddow about some of your previous comments and I have elected not to post it here.  Part of the reason is the length of this post.  The other reason is that I want to end this post by focusing on what I see as the profound problem with the thinking of Senator Coburn.  He does not just vote "no" but he kills the legislation because he thinks he knows best.  He is putting his individualism and self above the group, above the process.

Ayn Rand would be so proud.

Well, in any event, it is too late for this session.  The Clay Hunt Act will have to wait until next session.  I just hope the delay does not cause us to lose other Veterans to suicide.  I'd like to believe that could happen.  Sadly, the data says otherwise.

I understand one of the reasons Senator Coburn is retiring is because his cancer has returned.  If you believe nothing I have written in this post, believe this:  I wish him a full and speedy recovery.  Cancer claimed my Mom's life.  No one, no one's family, should be a victim of this horrid medical condition.  

I hope Senator Coburn gets the best medical care possible and gets it as soon as he needs it.  True, he's got great health insurance.  He's earned it.  He's a U.S. Senator, after all.

Yet what a shame that Clay Hunt, someone who was also suffering from a horrid medical condition, could not get the care he needed.  Clay had certainly earned his care as well.

That, for me, is the best reason why this bill needs to become law.  Notwithstanding that there will be some duplication and yes, even waste (we're talking about the Government after all), it will get care to more Veterans sooner than the status quo.  It will continue to address the wickedly baffling and far too-often lethal nature of PTSD.  It will, I am certain, help stem the tide of the (at least) 22 Veteran suicides everyday.  

For these reasons, it needs to pass.  For these reasons, it deserved a vote.

Regrettably, "Dr. No." in his "last rounds," did not see it that way.  That is a shame.  It's a shame for the reasons mentioned in this post.  And it is a shame because the two-decade career of a good man, doctor, citizen and Senator has been forever tarnished.  History's judgment will be that he failed that most basic test of medicine and government:  "First, do no harm."

Physician, heal thyself.

Be well my friends,
Jeno

Post-script:  The comments in this blog post are those of Jeno M. Berta alone.  They do not represent the official position of any governmental agency, organization, political body, sub-division, any other person or group's (official or voluntary) opinion.  In other words, this post, as with all my posts, are my opinion alone.  Thanks.

Sources:

http://www.fayobserver.com/blogs/news/home_front_operations/home-front-operations-clay-hunt/article_e3d13a74-8567-11e4

http://www.washingtonpost.com/news/checkpoint/wp/2014/11/19/the-legacy-of-clay-hunt-marine-recalled-in-new-suicide-legislation/ 

https://www.congress.gov/bill/113th-congress/house-bill/5059/text 

http://walz.house.gov/media-center/press-releases/walz-miller-duckworth-introduce-comprehensive-legislation-to-tackle 

http://www.military.com/daily-news/2014/12/16/clay-hunt-veteran-suicide-bill-blocked-in-senate-by-coburn.html 

http://www.defenseone.com/ideas/2014/12/coburn-has-gone-too-far-blocking-veterans-suicide-bill/101202/

http://iava.org/press-release/lone-senator-stopping-passage-of-veterans-suicide-prevention-bill/

http://www.military.com/daily-news/2014/12/12/senators-hold-threatens-clay-hunt-veteran-suicide-legislation.html

http://www.huffingtonpost.com/2011/04/16/clay-hunt-iraq-veteran-suicide-_n_850033.html

http://www.huffingtonpost.com/2014/12/15/tom-coburn-veterans-suicide_n_6330582.html

http://www.cnn.com/2013/09/21/us/22-veteran-suicides-a-day/

http://www.nationaljournal.com/defense/why-are-so-many-older-veterans-committing-suicide-20140413

http://crooksandliars.com/2014/12/rachel-maddow-blasts-tom-coburn-putting

http://www.rules.senate.gov/public/index.cfm?p=RulesOfSenateHome

http://blog.heartland.org/2014/12/senator-coburns-farewell-address/

http://www.c-span.org/video/?323252-8/senator-tom-coburn-rok-farewell-speech-senate-tributes

http://www.huffingtonpost.com/tag/tom-coburn-cancer/