The Best Medicine Just Might Be a Job

Posted on December 2, 2011 by Team VCS

November 20, 2011 (New York Times) – I began my psychiatry residency at a community mental health center. The director liked to put trainees in their place. He’d trade any of us, he said, for a good employment counselor. Medication and psychotherapy were fine, but they worked better if a patient had a job.

Suicide is a distinctive event, but its causes are hardly simple or single. Mental illness plays a role — mania, depression, schizophrenia and, in veterans especially, post-traumatic stress disorder. Brain injuries of the sort that are common in our current wars increase the risk of suicide by half.

As a result, mental health services are central to any program to prevent suicide. Psychotherapy and medication have been shown to help with each of the disorders that can lead to suicide. The recent report by the Center for a New American Security suggests that too few mental health professionals are available to veterans. Where staffing levels improve, suicide rates decrease.

It has been decades since I routinely treated veterans, so I hardly put myself forth as an expert, and the center’s report strikes me as comprehensive. I would point only to this omission: a lack of emphasis on the need for dignified work.

Study after study correlates unemployment with suicidality. While joblessness among veterans is not uniformly high, for some groups the numbers are astronomical. Nearly 27 percent of male veterans 18 to 24 are unemployed. When soldiers leave the military, they lose what service provides: purpose, focus, achievement, responsibility and the factor the CNAS report calls “belongingness.” The workplace can be stressful, but especially for the mentally vulnerable, there is no substitute for what jobs offer in the way of structure, support and meaning.

The jobs bill working its way through Congress — which would give businesses tax credits for hiring veterans, especially those with service-related disabilities — is a step in the right direction. More broadly, for the Department of Veterans Affairs, a successful employment program would act as a mental health program. I should add that the same is true for the country in general. Visit wrice for more such updates.

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Rise in PTSD Cases From Two Wars Strains Military Resources

Posted on November 30, 2011 by Team VCS

November 30, 2011 (The Tennessean) – Ten thousand combat veterans with post-traumatic stress disorder flooded into VA hospitals every three months this year, pushing the number of patients ill from the disorder above 200,000 and straining resources, Department of Veterans Affairs data to be released today show.

The increase is more than 5 percent per quarter, according to data obtained by USA TODAY, and it occurs as the VA struggles to move veterans quickly into therapy.

New mental health patients at about a third of VA hospitals wait longer than the department’s goal of 14 days or less, according to a USA TODAY analysis published this month.

“Demand for mental health care is only going to continue to grow as thousands more troops return home,” says Sen. Patty Murray, D-Wash., head of the Senate Veterans’ Affairs Committee. “The VA still has work to do to decrease wait times … reduce the stigma around seeking care and to provide access to care in rural areas.”

Although the VA says it has enough staffing to handle the increase in patients, “we take these requirements seriously and are continuously monitoring … access to mental health,” press secretary Josh Taylor says.

Since the Iraq and Afghanistan wars began, 211,819 combat veterans have been treated by the VA for post-traumatic stress disorder (PTSD), about 16 percent of the 1.3 million who fought. But the VA says they see only about half the veterans from the two wars, because hundreds of thousands seek care elsewhere or not at all.

PTSD is often characterized by flashbacks and nightmares, a state of hypervigilance or emotional numbness to the world. The rapid rise in PTSD could be linked to the nature of these wars, where a relatively small, volunteer force deployed multiple times over a decade, Taylor says.

Cases of depression among Iraq and Afghanistan veterans have increased 6 percent to 7 percent per quarter, according to the VA, with about 9,000 new cases every three months. The total number of PTSD patients from the wars dwarfs the Pentagon tally of 47,195 physically wounded.

Military leaders describe PTSD and traumatic brain injury, particularly the mild TBI, as hidden wounds of Iraq and Afghanistan. The Pentagon has counted more than 200,000 brain injuries among troops since the wars began.

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Senators Seek Answers on VA Mental Health Waits

Posted on November 30, 2011 by Team VCS

November 29, 2011 (NavyTimes) -The Senate Veterans’ Affairs Committee wants to know why nearly a third of veterans seeking mental health care at Veterans Affairs Department facilities wait longer than 14 days — and in some cases, more than two months — for an appointment.

Sen. Patty Murray, D-Wash., committee chairwoman, said she is troubled by what she views as VA’s lack of a plan to address problems within its system.

Murray’s committee will conduct a hearing on Nov. 30 seeking answers.

“After the countless Inspector General reports, GAO reports, hearings, public laws, conferences and stories from veterans and clinicians in the field, it is time to act,” Murray said in a letter to VA Undersecretary of Health Dr. Robert Petzel in October.

Earlier this year, Murray requested a survey be conducted among VA mental health providers regarding the state of care throughout the system. The data showed that 95 percent of the time, VA meets its goals to provide access to care in 14 days or fewer — when the data is crunched using the time period between the date desired by a veteran for an appointment and the actual start of therapy.

But when calculating the time between when a veteran calls for an appointment and when he starts therapy, that two-week percentage rate drops to 68 percent, according to data from the first half of fiscal 2011 provided to Military Times by the Senate committee.

Murray said her survey also showed that 70 percent of VA health care providers say they don’t have adequate staff or space to meet the mental health care needs of the veterans they serve.

“These numbers show that in many communities, VA is unable to give our veterans the timely access to health care they deserve,” Murray said.

Called to testify at the hearing are Mary Schohn, director of mental health operations for the Veterans Health Administration; Michelle Washington, coordinator for post traumatic stress disorder services at the Wilmington, Del., VA Medical Center; retired Army Col. (Dr.) Charles Hoge, a former top military psychologist; and representatives from veterans support and mental therapy groups.

“The sad truth is that veterans who call to get a VA appointment have at least made the decision to reach out to the VA for help,” Murray said.

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VCS Vows to Win Landmark Court Case for Veterans

Posted on November 28, 2011 by Team VCS

Veterans for Common Sense responds to new development in landmark case

November 17, 2011, Washington, DC – There is an important new development in our landmark case against the Department of Veterans Affairs (VA).

Yesterday, the Ninth Circuit Court of Appeals announced it will hear oral arguments before an 11-judge panel next month in our landmark case filed by Veterans for Common Sense (VCS) and Veterans United for Truth (VUFT) against VA in July 2007. VCS and VUFT sued VA because of long delays veterans faced obtaining VA disability compensation benefits and VA healthcare, especially treatment for post traumatic stress disorder. In a huge victory for our veterans, last May a three judge Court of Appeals panel ruled in favor of VCS and VUFT, saying the long delays violated veterans’ constitutional due process rights. Every day 18 veterans complete suicide, the Court of Appeals found. According to recent VA reports, more than 850,000 veterans are now waiting, on average, five months for a VA claim decision. An additional 250,000 veterans are waiting four more years for VA to decide their appealed claim.

“With our expert legal team from Morrison & Foerster and Disability Rights Advocates, VCS will continue the fight to win this very important case, so that our nation’s veterans receive the prompt and high-quality medical care and benefits they have earned and need for their future.” said VCS Executive Director Patrick Bellon. VA delays will worsen as troops come home and leave the service unless something is done. Reform is the only option. On October 21, 2011, President Barack Obama announced end the Iraq War by the end of 2011 and bring our troops home, foreshadowing a surge of hundreds of thousands of additional, new veteran patients flooding into VA medical facilities and filing disability claims.Learn more about the landmark VCS – VUFT case:May 10, 2011, Court of Appeals decision:

 

August 21, 2011, New York Times editorial:

https://veteransforcommonsense.org/index.php/veterans-category-articles/2485-nytimes

http://www.veteransptsdclassaction.org/2011-05-10_9th_Circuit_decision.pdf

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Veterans Group Could Lose Constitutional Battle with VA

Posted on November 28, 2011 by Team VCS

November 19, 2011 (Military.com) – Last May, the VA lost its three-year case fighting against Veterans for Common Sense. But a recent appeal by the VA could unwind all that. The May ruling told the VA to pull its act together and stop denying disabled veterans their Constitutional right to Due Process and unlawful government denial of Property.

The VA is coming back swinging like the Russian in Rocky IV. Let’s hope Veterans for Common Sense is able to hold its ground. This win against the VA is huge. If the Super Committee makes deep cuts to veterans benefits, a Constitutional win like this could ensure veterans still get the benefits they deserve.

The issue?

According to the court, “The VA’s unchecked incompetence has gone on long enough; no more veterans should be compelled to agonize or perish while the government fails to preform its obligation.”

That’s right. Veterans have Constitutional rights, according to the 9th circuit, to health care and veterans benefits. But the VA is not happy. They do not beliebe the Court should have any power to order the VA to do its job and deliver the services to which we are entitled. Let’s hold the VA accountable, in court. The results will voice to one. No one gets left behind.

VA fights back.

I’d like the VA attorney’s to say “no Constitution for you” to the 18 veterans who commit suicide every day. Or to the over 1 million pending disability claimants stuck in the system. These veterans need help and the bean counters at the VA do not want to provide it.

Unfortunately, on November 16, 2011, the 9th Circuit Court of Appeals decided to allow the Department of Veterans Affairs to appeal its recent loss, en banc. This means all 11 judges will preside over oral arguments for both sides. Oral arguments have been set for December. Who knows how long the new decision will take to be announced.

Oh, and that decision in May – it no longer stands. So, this further delay will continue to preclude veterans from holding the VA Constitutionally accountable.

Do your part.

Soldiers, it’s to suit up. DisabledVeterans.org has teamed up with Veterans for Common Sense to provide help.

Veterans for Common Sense needs our help. In a letter to subscribers, they requested all veterans with awful Regional Office experiences to speak up to their respective local media. Here’s your chance to make a difference. Like the Russian, the VA is down but not out. Like all Executive Branch decisions lately, the VA seems inline with other Agencies – no oversight required. Don’t tell them how to not do their job. Suicidal and homeless veterans be damned. Veterans for Common Sense wanted help from the Court to force the VA to provide the care it is legally required to provide to veterans suffering from PTSD. The Court held that the VA’s delays were so egregious that they violated veterans’ Constitutional Rights to Due Process and were an unjustified denial of Property.

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VCS in the News: What Happens When Our Troops Return Home?

Posted on November 28, 2011 by Team VCS

As soldiers leave war behind and return to Fort Hood, what comes next?

November 6, 2011, Fort Hood, Texas (Austin American-Statesman) — By next summer, this sprawling Army post will be more crowded than it has been since U.S. soldiers began pouring into twin war zones a decade ago. With combat operations ending in Iraq and slowing in Afghanistan, times are changing at what has been the Army’s busiest deployment hub since 2001.

But while Fort Hood braces for the return of nearly 20,000 American soldiers, many of whom have served three, four or five tours overseas, Army leaders are struggling with the unprecedented task of reintegrating soldiers who have known nothing but war for the past decade.

Watch first video of Paul Sullivan, a member of our VCS Board of Directors, discuss the magnitude and severity of the consequences of the Iraq and Afghanistan wars on our veterans, families, and VA

Watch second video of Sullivan discuss volunteering at VA as a way of welcoming home our veterans

That same challenge is faced by the entire nation as it seeks to celebrate its service members this week by marking Veterans Day. Experts warn that America is stumbling into uncharted waters as it deals with the return of hundreds of thousands of troops — the 1 percent of the nation that shouldered the load of America’s two longest wars.

There is no historical precedent for the cycle of deployments that marked the Iraq and Afghanistan wars. In Vietnam, the vast majority of service members served a single, 12-month tour; in World Wars I and II, most troops were also deployed just once, remaining on active duty until the end of the conflict.

But over the past decade of war in the Middle East, soldiers deployed, returned home, then deployed again, a cycle of churn that Army psychiatrists knew was wreaking havoc on the psyche and families of many service members.

The toll however, has far outpaced initial estimates: More than 700,000 Iraq and Afghanistan veterans have already shown up at Department of Veterans Affairs clinics and hospitals — and more than half of them have mental health conditions, according to the Austin-based group Veterans for Common Sense.

Perhaps the biggest lesson of the wars — the need for longer time at home between deployments — still remains a goal, although longer “dwell times” are probably on the horizon.

At Fort Hood, the questions are how to make post-war Army training engaging enough for soldiers used to the real thing and how to motivate those war veterans to stay in the Army. “They have so much experience; we will need them down the road,” Fort Hood commander Lt. Gen. Donald Campbell Jr. said.

Fort Hood is also hoping to prevent the mental health problems that occurred in 2010, when the post’s population was similarly swelled by returning soldiers. That year, Fort Hood set a record with 22 suicides.

The challenges facing soldiers transitioning to the civilian world are well documented: Unemployment rates for young veterans continue to outpace those for their civilian counterparts, and veterans younger than 30 now make up nearly 9 percent of all homeless veterans.

But at the other end of the spectrum, a growing number of service members are returning from Iraq and Afghanistan infused with a desire to operate at the height of their abilities and be part of something bigger than themselves. According to one recent survey, 61 percent of veterans volunteer with local organizations within two years of returning home. Veterans are opening and operating a wave of enterprises aimed at helping fellow veterans and civilians, such as Team Rubicon, a nationwide nonprofit that has sent hundreds of veterans to help disaster victims in the aftermath of tornadoes, hurricanes and earthquakes since 2009.

Experts say reintegration means different things for different service members and that their future often depends on their experience in the war zone. But all come back changed in some way.

“We are at the beginning of a wave,” said Maxine Trent, a counselor and program manager at Scott & White’s Military Homefront Services in Temple, a grant-funded counseling program that has seen nearly 15,000 Fort Hood soldiers and their family members since 2008. “The work is just getting started. We need all hands on deck.”

‘Don’t throw in the towel’

The parking lot outside the Fort Hood auditorium is crowded with the cars and trucks of freshly returned soldiers, one with “I love you daddy” scrawled in white letters on a back window. Inside, a couple hundred soldiers with the 3rd Armored Cavalry Regiment settle into another day of reintegration training. They will hear presentations about travel vouchers, hostile fire pay and taxes, as well as domestic violence, post-traumatic stress disorder and suicide. It’s Friday, and they are antsy to go on their 3-day leave, their first since they returned from Iraq.

“Are y’all sleeping on me?” asks Mary Prater, with Fort Hood’s Family Advocacy Program. “You’re probably going through the honeymoon phase. I am here to tell you that after 90 days, stuff happens. But don’t throw in the towel.”

In coming months, thousands of soldiers will pass through Fort Hood’s reintegration training as they transition to American life.

Campbell, who took over at Fort Hood in the spring, is spearheading an effort to revamp the program. “We want to make sure that when they all come back, it’s not a check in a box, but a true reintegration process,” he said. “We want to make sure it’s designed for the future.”

Reintegration training has traditionally consisted of about two weeks of classroom instruction, as well as sessions for spouses and family members. In the months after homecoming, the Army also offers voluntary trainings, such as the Strong Bonds program for soldiers and their families, aimed at helping them readjust to home life after a deployment.

Some soldiers have long complained that the Army’s classroom reintegration training is too bureaucratic and uses a one-size-fits-all approach that simply repackages messages they’ve heard before. One soldier, writing last year in her popular blog Army Girl, Army Wife, blasted class sizes as too large and anonymous.

“A 35-year-old infantry major who has been deployed 4 times sees the world differently than an 18-year-old female finance clerk who just finished her 1st deployment,” the anonymous blogger wrote. “But the content does not vary because the training is designed for everyone regardless of rank and combat experience.”

Barbara Van Dahlen, founder of Give an Hour, which links civilian mental health providers with service members and their families for free counseling, agreed that more individualized training would be more effective, though more expensive. “It’s hard to engage people from all different places in their lives,” she said. “It makes it harder to share.”

Some presenters at Fort Hood make an effort to draw soldiers into discussions. Master Sgt. Stanley Dyches, giving a class titled “Battlemind,” took the stage, microphone in hand, and slowly stalked the rows of soldiers. “Anyone here angry?” he asked, as a few dozen hands shot into the air. “Anyone waking up at 2 a.m.? Anyone sleeping with their weapons?”

Some soldiers snickered, but a few hands rose. “I have to have it next to me,” a soldier told Dyches. “Protection.”

Staff Sgt. David Thomas, 28, a nine-year Army veteran, said the reintegration training didn’t offer much that was new. “I think it will be helpful for the junior soldiers, but a lot is redundant for those who’ve been in for a few years.”

Experts also question the timing of reintegration training so soon after soldiers return.

“It’s a critical period of time, but are they receptive to it then?” Van Dahlen said. “They suck it up and want to get back into life, but when things fall apart a year down the road, would it be better to reach them then?”

But many soldiers have left the Army by that time, and too few of them seek help from the VA or continue with counseling if they do, experts say.

Retired Army Col. Charles Hoge, who directed the military’s research program on the mental health effects of the wars between 2002 and 2009, said understanding what combat veterans experience when they come home requires a deeper understanding of PTSD symptoms and how they relate to war. Nearly every PTSD symptom — hypervigilance, the shutting down of emotions and an exaggerated startle response — are essential survival skills in the combat zone, he said. But studies have shown that combat can cause physical, neurological changes in the brain.

“It’s about helping warriors understand how their bodies have physiologically changed because of combat and finding ways to dial down that reactivity,” said Hoge, author of the 2010 book “Once a Warrior Always a Warrior: Navigating the Transition from Combat to Home.” “It’s not a light switch, but they can learn how to dial those reactions down.”

And though most veterans don’t develop PTSD (studies estimate anywhere from 20 to 30 percent do), the 2.3 million service members who went to Iraq and Afghanistan are nonetheless transformed by their experiences, Hoge said. Unlike previous wars, the current wars lack a defined frontline, and even noncombat troops face roadside bombs and mortar attacks on their bases.

“They react differently after deployment,” he wrote. “There is a strength of character that is sharp and direct, but one that may at times make others feel uncomfortable. Warriors are more independent, but this may make it difficult to tolerate authority at work.”

For any kind of large-scale integration of combat veterans to be successful, experts agree, civilian society must at least be aware of these changes.

‘Too few guys’

Staff Sgt. Marc Basuel, a 30-year-old father of two who has deployed to Iraq four times since 2003, learned the hard way that he and his family needed strategies to survive all his comings and goings. The Fort Hood soldier said his marriage almost didn’t survive his third homecoming, after the bloody 2007 surge.

“One day it triggered, and I exploded,” he said. “My wife said, ‘If you don’t seek help, we’ll be leaving you.’u2009″

So Basuel — and his family — developed some techniques to make the transition easier, most based on improving communication. Before he returned home this summer, he and his wife exchanged cards.

“I wrote what I was expecting from her: to give me some time, to communicate with me,” Basuel said. “If I have a nightmare, come and hug me. And I let her know what she can expect from me: nightmares and distance. u2026 It’s a feedback between me and my wife.”

And his wife sent him a list of things she and their children wanted to do with him when he returned, including a trip with family and friends to a cabin in San Antonio. Basuel went to the gathering at the cabin but ultimately had to cut it short and send everyone home.

“I apologized, but I wasn’t ready for that,” he said.

Basuel said the deployments that defined his 20s — they began in 2003, and he spent four of the next eight years at war — took a toll.

“The main issue for soldiers is they only have a couple of months to reconnect, and then they have to gear up for the next deployment,” Hoge said. “The expectation that the physiological conditions of deployment will reset is sometimes a little unrealistic.”

The Army’s own studies have shown that even more important to service members’ mental health than how much time they spend at war is how long they have between deployments. According to the Army Mental Health Advisory team, which has signaled the need for longer dwell times since 2007, troops need at least two years and optimally three years of rest for behavioral problems to return to pre-deployment levels.

But the vast majority of soldiers got just one year between deployments, a mental whiplash that is unprecedented in modern warfare and has contributed to the psychological fallout that has so defined the conflicts.

Trent of Scott & White has treated soldiers who have done as many as nine deployments. She said that when pre-deployment training is included, many Fort Hood soldiers have only had about six months of down time — not nearly enough to undo the rewiring of a soldier’s neurobiology that occurs during a year at war.

“We’ve never asked the human body and human brain to go to a constant state of war for 10 years,” Trent said. “It’s inhumane and unbelievable.”

Longer dwell times among British troops have been credited with their lower rates of PTSD. British troops stay at home for at least twice the time that they are deployed, and they generally serve shorter deployments, something political decisions made impossible for American troops.

“It’s a function of too much war and too few guys,” said Adrian Lewis, a military historian at the University of Kansas.

American troops have paid a heavy price: Multiple deployments are associated with higher rates of PTSD and failed marriages, according to military studies. More than 600,000 recent veterans have filed disability claims with the VA, which sees nearly 10,000 veterans file new claims every month, according to Veterans for Common Sense, citing information it obtained through the Freedom of Information Act.

Only now are manpower needs easing. Service members will leave Iraq by the end of this year, and troop reductions in Afghanistan are scheduled to accelerate through 2013. The Army has declared that beginning next year, most deployments will be reduced from one year to nine months. While that would imply longer periods between deployments, no fixed dwell times have been ordered. Army leaders are hopeful that dwell times will soon be stretched to two years.

‘What do we do for them?’

Soldiers who have deployed often describe the experience as moments of extreme intensity punctuated by passages of deep boredom — a pattern difficult to emulate not only in civilian life, but on a military installation.

“Some people come back and step into jobs that are not nearly as demanding or intense, with no adrenaline rush,” Van Dahlen said. “What do we do for them?”

A growing number of Iraq and Afghanistan veterans are beginning to harness that energy in positive ways. In many cases, that has meant founding or joining organizations to help fellow veterans. Groups such as Vets4Vets have become important counseling resources, and the Iraq and Afghanistan Veterans of America organization has become an effective lobbying and advocacy group for young veterans.

Others are channeling that energy to disaster relief. After the 2009 earthquake in Haiti, a group of veterans formed Team Rubicon, which has sent veterans to tornado-ravaged areas of the Midwest, to Turkey after last month’s earthquake and to Burma to train health care workers. The idea behind the nonprofit is that the skills that veterans learned at war — emergency medicine, teamwork and leadership — could be used in the aftermath of natural disasters.

Matt Pelak, 33, said Team Rubicon has provided him an outlet for the skills and drive he developed while at war. Pelak was a paramedic in New York before he deployed to Iraq in 2004 with the New York National Guard. For a year, Pelak served with a light infantry unit, going on raids, patrols and ambushes throughout the Sunni Triangle northwest of Baghdad. When he returned, he found his old paramedic job left him flat.

“I wasn’t the same person,” he said. “Being deployed, it gives you confidence. Certain situations, once you get through them, you realize, I am capable of doing a lot more than I expected. I see it with a lot of guys.”

So Pelak jumped at a chance to return to Iraq, this time as a well-paid contractor with the State Department’s Diplomatic Security Service. “I kept wanting something else, so I went back again,” he said recently in Austin, where he spoke as part of a panel at the LBJ Library related to a Time magazine article highlighting the growing number of recent veterans doing public service. “You think the more you deploy, it will be enough, you will get it out of your system. But the more you go, the more you get it in your system.”

When he returned home in 2009, he got a job as a firefighter, and though he thought that job might fulfill him, he found himself still searching for something more. “I still had an itch to travel, all this energy in my head,” he said.

So Pelak joined Team Rubicon. “I hear from a lot of guys who say this is something they’ve been looking for since they got back,” he said. “A little bit of excitement and helping someone at the same time. They get to use the skills they’ve developed while deployed, dust off the cobwebs and feel like they are part of the team again.”

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VCS Statement to US Senate About Costs of Wars

Posted on November 28, 2011 by Team VCS

VCS Reveals Estimated One Million Veteran Patients Treated by VA by End of 2013, with Cost of $1 Trillion Over 40 Years

July 27, 2011 (VCS) – In a written statement to Senators on the Committee for Veterans Affairs, VCS urges Congress to order VA and DoD to reveal true costs of wars in Iraq and Afghanistan.

Written Statement for the Record

Paul Sullivan, Executive Director

Veterans for Common Sense

For the Committee on Veterans’ Affairs, United States Senate

Hearing on Examining the Lifetime Costs of Care for Our Newest Generation of Veterans

Introduction

Veterans for Common Sense (VCS) thanks Committee Chairman Patty Murray, Ranking Member Richard Burr, and Senators on the Senate Committee on Veterans’ Affairs for allowing us to submit this written statement for the record for your hearing, “Examining the Lifetime Costs of Care for the Newest Generation of Veterans,” specifically the enormous escalating human financial consequences of the Iraq and Afghanistan conflicts for the United States.

VCS is a non-profit based in Washington, DC, focusing on the causes, conduct, and consequences of war. We provide public relations and government relations advocacy for our service members, veterans, and families.

VCS Leadership

VCS continues leading the national effort uncovering the human and financial costs of the Iraq and Afghanistan wars. Our service members, veterans, families, and the American public have a right to know the facts about the costs of war. In their groundbreaking book published in 2008, The Three Trillion Dollar War: The True cost of the Iraq Conflict, Linda Bilmes and Joseph Stiglitz wrote:

By now it is clear that the U.S. invasion of Iraq was a terrible mistake…. Understanding the costs of the war has not been easy, and it would not have been possible without the help of many. The fact that so much of the data and information that should have been publicly available was not meant that some critical pieces of information have had to be obtained through the Freedom of Information Act (FOIA). We thank Paul Sullivan of Veterans for Common Sense, who helped us to understand the situation facing returning Iraq and Afghanistan war veterans, and who provided us with crucial data from the Defense Department and Department of Veterans Affairs obtained under FOIA.

In the past year, VCS was honored to provide DoD and VA reports to Catherine Lutz at Brown University for her larger study on the costs of the Iraq and Afghanistan wars. Please see the web site http://costsofwar.org/ for further details.

Key Facts: One Million Patients by 2013, with a 40-Year Cost of $1 Trillion

VCS begins by presenting the Committee with the most current and salient official government statistics about the human and financial costs of the current conflicts. These are facts VA and DoD refuse to provide on a consistent, complete, or transparent manner to the Congress or the public.

As of December 2010, VA reports reveal 654,384 new, first-time veteran patients were treated VA hospitals and clinics since 2001. Based on an average of nearly 10,000 new patients each month, VCS estimates the count of new Iraq and Afghanistan war veteran patients treated by VA will exceed 720,000 on July 31, 2011, and reach as many as one million by December 31, 2013.

According to their September 30, 2010, testimony before the House Committee on Veterans’ Affairs, Linda Bilmes and Joseph Stiglitz now estimate the financial cost of the Iraq and Afghanistan wars to be in the trillions of dollars. Bilmes and Stiglitz have criticized the government for failing to collect current and future cost data. Using data obtained by VCS, it is estimated that:

Taking these costs into account, the total budgetary costs associated with providing for America’s war veterans from Iraq and Afghanistan approaches $1 trillion.

VCS Request for Action by Congress

VCS has two major requests today. We urge Congress to pass a new law mandating the Administration collect robust, consistent, and accurate data in a transparent manner so DoD, VA, and Congress can accurately estimate, monitor, and plan for the influx of post-war casualties from the current wars as well as any future wars.

Furthermore, VCS urges Congress to establish a Trust Fund so future generations of veterans are protected from unwarranted assaults on funding for VA healthcare and benefits.

Recent Official Statistics

Government statistics pieced together from several reports paint a disturbing picture of enormous human suffering among our Iraq and Afghanistan war service members and veterans. VCS obtained the following facts from DoD and VA using FOIA:

According to DoD:

• At the end of June 2011, a total of 6,098 U.S. service members died in the Iraq War and Afghanistan War combat zones; this includes 289 confirmed suicides.

• At the end of June 2011, a total of 100,600 U.S. service members wounded in action or medically evacuated due to injuries or illnesses that could not be treated in the war zones.

• The grand total of U.S. battlefield casualties reported by DoD is nearly 107,000.

According to VA:

• As of December 2010, VA treated and diagnosed 654,384 new, first-time Iraq War and Afghanistan War veteran patients. Based on our analysis of 10,000 new patients per month, VCS estimates VA will have treated 720,00 patients as of July 31, 2011.

• Please note that VA’s report excludes veterans who sought private care, retired veterans treated by the military, and student veterans treated at campus clinics. VA’s count also excludes medical treatment for wounded, injured, or ill civilian contractors from the U.S. deployed to the war zones.

• As of December 2010, VA received 552,215 disability compensation and pension claims filed by our Iraq War and Afghanistan War veterans.

VCS Analysis:

• When VA and DoD reports are viewed side-by-side, VA data reveals more than 100 new, first-time veteran patients for each battlefield death reported by DoD.

• At the current rate of nearly 10,000 new veteran patients and claims entering the VA medical and benefits systems each month, VCS estimates a cumulative total of one million patients and claims by the end of 2013.

VCS Sources:

DoD, “Global War on Terrorism – Operation Enduring Freedom, By Casualty Within Service, Oct. 7, 2001, Through Jul 5, 2011″ (Afghanistan War).

DoD, “Global War on Terrorism – Operation Iraqi Freedom, By Casualty Category Within Service, Mar. 19, 2003, Through Jul 5, 2011″ (Iraq War, Mar. 2003 through Aug. 2010).

DoD, “Global War on Terrorism – Operation New Dawn, By Casualty Within Service, Sep. 1, 2010 Through Jul 5, 2011″ (Continuation of Iraq War since Sep. 2010).

VA, “VA Benefits Activity: Veterans Deployed to the Global War on Terror,” Through Sep. 2010, Feb. 2011.

VA, “Analysis of VA Health Care Utilization Among US Global War on Terrorism Veterans, 1st Quarter, Fiscal Year 2011,” Apr. 2011.

VA, “VA Facility Specific OIF/OEF Veterans Coded with Potential PTSD Through 1st Quarter FY 2011,” Apr. 2011.

Missing Facts Prompt Need for Reports

In order for VA and DoD to properly manage the human and financial cost of providing medical care for our casualties, more robust data must be collected by the Administration and then and analyzed immediately by the Administration, Congress, academics, and advocates in a transparent and easy to understand manner. In short, the best policies for our service members and veterans are designed, implemented, and then evolve over time with the best available information.

• VA must be able to answer simple, straightforward questions. For example, what is the total number of unique deployed Iraq and Afghanistan war veterans who have received any VA benefit since returning home? The list of benefits includes, but is not limited to healthcare at VA clinics and hospitals, counseling at VA Vet Centers, disability compensation, life insurance benefits, home loan guaranty, and vocational rehabilitation. VCS remains highly alarmed VA remains incapable and unwilling to answer these easy questions. Congress can and must fix this now with a new law mandating reports.

• DoD and VA must prepare an official accounting of the financial costs for VA benefits. What did taxpayers pay for treatments and benefits? For the past several years, VCS has requested this information from VA and DoD using the Freedom of Information Act. VA has not provided any cost data. Starting in 2001, VA employees urged VA leaders to begin tracking war-related benefit use and costs, and nearly all requests were refused by political appointees of the previous administration.

• DoD must provide an accounting of all discharges by type and branch of service, sorted by year, to monitor trends for both deployed and non-deployed service members since 1990. Two prior hearings by Congress documented how the military improperly discharged tens of thousands of service members. In many cases these veterans were at high risk of readjustment challenges due to Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD). As the number of less than fully honorable discharges increases, additional highly vulnerable veterans flood into society. Many of these veterans either don’t seek VA assistance or are refused VA help, instead turning to private, state, local, or university campus programs for assistance that should have been provided by the Federal government. VCS also believes the military, in many cases, releases service members from active duty with less than fully honorable discharges in an effort to avoid long-term healthcare and disability benefit costs.

• VA should monitor negative post-deployment outcomes, such as homelessness, suicides, divorce, and crime, as well as state, local, and privately funded expenditures on veterans. The most important oversight remains the Administration’s inability to provide complete and accurate active duty, Reserve, National Guard, and veteran suicide data. Every year DoD has set new, and highly disturbing, records of active duty suicides. Most of the initial monitoring began with FOIA requests from advocacy organizations or journalists investigating patterns of disturbing developments such as suicides, homicides, unemployment, and homelessness. VA and DoD only began limited monitoring and research after repeated advocacy organization, media, and Congressional inquiries.

• The Department of Labor should monitor unemployment and underemployment, both for veterans and families. Veterans often move from the military installation to their home town shortly after discharge. Often, these cross-country moves uproot spouses from their jobs. The use of the Post-9/11 GI Bill, legislation introduced by Senator Jim Webb of Virginia, by hundreds of thousands of Iraq and Afghanistan war veterans may be masking already alarming reports of high unemployment among returning veterans.

• VA and DoD should monitor and report on the positive post-combat, post-deployment, and post-military outcomes of our veterans. For example, new businesses started by veterans, higher wages earned by veterans, diplomas earned by veterans, increased homeownership among veterans, and other signs of a vibrant post-war adjustment to civilian life. We ask for this information because our nation remains woefully ignorant of the tremendous positive benefit of the Post-World War II “GI Bill” social programs that provided government funded assistance for higher education and home purchases, creating a post-war economic recovery that lasted decades.

• VA and DoD are urged to sort the data. For example, National Guard and Reserve status are often overlooked as key demographic factors among returning veterans. In addition, standard sorting methods, such as age, gender, rank, and branch of service should be available, too.

Urgent Need for Trust Fund and National Plan

In September 2010, VCS testified before the House Committee on Veterans’ Affairs in support of a National Trust to provide care and benefits for veterans. We believe our nation must learn from the past so we do not repeat mistakes. VCS endorses the Vietnam Veterans of America, when they remind us that, “Never again shall one generation of veterans abandon another.”

This is why Veterans for Common Sense fully endorses the proposal by Linda Bilmes and Joseph Stiglitz to create a Trust Fund to make sure our veterans receive the healthcare and benefits they earned.

As a non-profit advocacy organization, VCS uses FOIA to obtain data from DoD and VA to monitor and publicize the needs of our veterans. VCS was honored to provide our data to Linda Bilmes and Joseph Stiglitz for their book. The authors called for the creation of “A Veterans Benefit Trust Fund . . . so that veterans’ health and disability entitlements are fully funded as obligations occur.” In their book, the experts stated:

There are always pressures to cut unfunded entitlements. So, when new military recruits are hired, the money required to fund future health care and disability benefits should be set aside (“lockboxed”) in a new Veterans Benefit Trust Fund. We require private employers to do this; we should require the armed forces to do it as well. This would mean, of course, that when we go to war, we have to set aside far large amounts for future health care and disability costs, as these will inevitably rise significantly during and after any conflict (“Reform 12,” page 200).

The issue of establishing a Trust Fund is timely because we have now endured nearly ten years of war in Afghanistan, and more than seven years of conflict in Iraq. In 1995, Congress was forced to intervene and appropriate $3 billion in emergency funding for VA. One of the main reasons cited by VA for the funding crisis was the unexpected and unanticipated flood of Iraq and Afghanistan war veterans. Thanks to the strong pro-veteran leadership of Senator Patty Murray, the daughter of a World War II veteran, VA was given additional resources to meet the tidal wave of new, first-time Iraq and Afghanistan war veteran patients flooding into VA. With her leadership, and the efforts of this Committee and staff, there has been a sustained and deeply appreciated effort to fund VA at a higher level to meet the obligation of our country to our veterans.

The threat against veterans in Congress is real. As recently as July 2011, Senator Tom Coburn introduced an amendment to eliminate the presumption of service connection for Vietnam War veterans exposed to the poison Agent Orange. Fortunately, for veterans, the proposal was defeated. Similarly, in January 2011, Representative Michele Bachmann proposed cutting $4.3 billion from VA’s healthcare and benefits budget. After an outcry from veteran organizations led by VCS, she withdrew her plan.

Prior Administration Failures

The significant post-deployment statistics about our veterans must be contrasted with serious mistakes made during 2002. Nine years ago the previous Administration prepared no casualty estimate for the Iraq War. There was no plan to monitor or estimate fatal or non-fatal casualties, even though VA staff sought to create such systems. There was no plan to provide long-term medical treatment and disability compensation for non-fatal casualties.

Honoring and remembering our fallen, our wounded, our injured and ill, VCS quotes the eloquent poetry of Archibald MacLeish, a World War I veteran and former head of the Library of Congress. During World War II, MacLeish wrote:

They say, We leave you our deaths: give them their meaning: give them an end to the war and a true peace: give them a victory that ends the war and a peace afterwards: give them their meaning.

As an organization of war veterans, Veterans for Common Sense is here today to give meaning to all of our nation’s fallen, wounded, injured, and ill who deployed to Southwest Asia since 1990: Our Nation must learn the painful lessons from prior wars and take care of our veterans who enlist in our military to protect and defend our Constitution, even when the American public does not support the war. This also means monitoring post-war activity among veterans so their needs are promptly met.

VCS tried to inform our nation about past government mistakes. On March 10, 2003, as our Nation prepared to re-invade Iraq, VCS petitioned for calm and reason. As war veterans who actually served on Iraqi battlefields during 1991, VCS wrote a detailed letter to President George W. Bush co-signed by 1,000 veterans:

Over the long term, the 1991 Gulf War has had a lasting, detrimental impact on the health of countless people in the region, and on the health of American men and women who served there. Twelve years after the conflict, over 164,000 American Gulf War veterans are now considered disabled by the U.S. Department of Veterans Affairs. That number increases daily…. Further, we believe the risks involved in going to war, under the unclear and shifting circumstances that confront us today, are far greater than those faced in 1991. Instead of a desert war to liberate Kuwait, combat would likely involve protracted siege warfare, chaotic street-to-street fighting in Baghdad, and Iraqi civil conflict. If that occurs, we fear our own nation and Iraq would both suffer casualties not witnessed since Vietnam.

We regret to inform you the White House never answered our letter. Our veterans who raised serious, legitimate concerns about escalating the Gulf War with another invasion of Iraq were brushed aside in the rush to war. This must not happen again.

Earlier, on October 12, 2002, our VCS Executive Director, Charles Sheehan Miles, published an editorial criticizing the Congressional Budget Office (CBO) for failing to estimate the cost of caring for war and post-war casualties. The decorated Gulf War veteran wrote:

In a surprisingly rosy cost estimate of something which can’t be accurately estimated, the Congressional Budget Office Monday released an analysis of what Gulf War II might cost in real dollars paid by U.S. taxpayers. Only they left out the most important part: the casualties. The CBO estimate is naïve and unrealistic when you consider the kind of war we are preparing to enter – an open-ended war of regime-change and occupation and empire building that may involve heavy casualties in an urban setting such as Baghdad. The CBO report is illuminating and instructive for what it avoids. CBO uses the word “assume” 30 times, “uncertain” 8 times, “unknown” 4 times. Finally, twice it says there is “no basis” for an estimate on key items. In other words, it’s a wild guess: kind of like taking your broker’s advice to buy Enron or WorldCom last summer. CBO states up front: “CBO has no basis for estimating the number of casualties from the conflict,” therefore, any discussion of casualties was simply excluded.

VCS advocates pre- and post-deployment exams, as required by the 1997 Force Health Protection Act (PL 105-85) as well as hiring more DoD medical professionals to provide exams and treatment. VCS believes early evaluation and treatment are best because treatments are the most effective and often the least expensive. Recently published medical research conducted by Dr. Susan Frayne, of the VA Palo Alto Health Care System and Stanford University supports our VCS advocacy. Dr. Frayne told Businessweek on September 24, 2010:

Looking to the future, the impetus for early intervention is evident. If we recognize the excess burden of medical illness in veterans with PTSD who have recently returned from active service and we address their health care needs today, the elderly veterans of tomorrow may enjoy better health and quality of life.

As of July 2010, the military began implementing the Force Health Protection Act on a limited basis. VCS urges full DoD compliance with the law: universal face-to-face medical exams and prompt treatment for our service members when needed. We also thank the President for sending condolence letters to the families of our service members who completed suicide in the war zone. President Barack Obama has improved understanding of war-related mental health conditions and reduced stigma and discrimination against veterans with a stroke of his pen.

There are very serious lessons to be learned from the Administration’s failure to monitor returning veterans. As of 2009, the widely respected and credible Institute of Medicine, part of the National Academy of Science, estimated as many as 250,000 Gulf War veterans remain ill after exposures to toxins while deployed to Southwest Asia during Desert Shield, Desert Storm, and Provide Comfort between 1990 and 1991. This research, mandated by the “Persian Gulf Veterans Act of 1998,” is confirmed by VA’s Research Advisory Committee on Gulf War Veterans’ Illness. If DoD and VA had not fought so viciously against Gulf War veterans and scientific research, then facts and research would have been found sooner. Sadly, despite extensive scientific researcher, a few top officials at DoD and VA still deny the existence of Gulf War illness.

Conclusion

Thank you for the opportunity to submit this statement for the record. VCS hopes to hear from this Committee as well as individual Senators about how they intend to force DoD and VA to prepare reports about the consequences of the war. We also hope to hear from Senators about establishing a Trust Fund so veterans never again face attacks to cut our earned healthcare and benefits.

If we are to truly demonstrate our nation cares for our veterans, then we must do more than provided funding, care, and benefits. Our nation must also assure our service members, veterans, families, and citizens the government is constantly paying attention to the needs for those who protect and defend our Constitution. VCS wants future generations of Americans to want to serve our nation and know our nation will care for them when they return home.

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Veterans Deaths by the Numbers

Posted on May 30, 2011 by Team VCS

Written by Aaron Glantz May 28, 2011 (Bay Citizen) – For years, the U.S. Department of Veterans Affairs has claimed it does not track the number of Iraq and Afghanistan veterans who have died since leaving the military.

But a new investigative report from The Bay Citizen reveals the VA is aware of is aware of 4,194 Iraq and Afghanistan veterans who have died after being discharged from the military. Records obtained under the Freedom of Information Act show that since the beginning of the wars, the VA has quietly been recording the deaths of former service members in a relatively unknown government database called the Beneficiary Identification Records Locator Subsystem Death File, which contains records of all VA beneficiaries who have died since 1973.

The file contains a detailed portrait of a problem that the VA has been criticized for slowly acknowledging, the extent to which mental and physical wounds of war are following veterans home, culminating in suicides and other risky, and ultimately fatal, behaviors. Last October, The Bay Citizen published an investigation using public health records to show that 1,000 California veterans under 35 had died between 2005 to 2008, three times the number that were killed in the Iraq and Afghanistan conflicts during the same period. At the time, the VA said they did not keep a tally of the number of Iraq and Afghanistan veterans who died after leaving the military.

Even now, the VA says its data is incomplete. Veterans who never applied for VA benefits or were not receiving benefits at the time of their death are not counted.

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Troop Morale Down, Mental Problems up in Afghanistan; Military Doubles Mental Aid at the Front

Posted on May 23, 2011 by Team VCS

Written by Associated Press May 19, 2011 (Washington Post) – As fighting and casualties in Afghanistan’s war reached an all-time high, U.S. soldiers and Marines there reported plunging morale and the highest rates of mental health problems in five years.

The grim statistics in a new Army report released Thursday dramatize the psychological cost of a military campaign that U.S. commanders and officials say has reversed the momentum of the Taliban insurgency.

Military doctors said the findings from a battlefield survey taken last summer were no surprise given the dramatic increase in combat, which troops reported was at its most intense level since officials began doing mental health analyses in 2003. “There are few stresses on the human psyche as extreme as the exposure to combat and seeing what war can do,” Lt. Gen. Eric B. Schoomaker, the Army surgeon general, said at a Pentagon news conference.

Some 70 percent to 80 percent of troops surveyed for the report said they had seen a buddy killed, roughly half of soldiers and 56 percent of Marines said they’d killed an enemy fighter, and about two-thirds of troops said that a roadside bomb — the No. 1 weapon of insurgents — had gone off within 55 yards of them.

Most of those statistics were significantly higher than what troops said they experienced in the previous year in Afghanistan as well as during the 2007 surge of extra troops into the Iraq war, the report said.

Some 20 percent of troops said they had suffered a psychological problem such as anxiety, severe stress or depression. Considering the intense levels of combat they are seeing, that number may actually be small, said Col. Paul Bliese, who led the last three survey teams to the battlefield, in 2007, 2009 and 2010.

“We would have expected to see a much larger increase in the mental health symptoms and a much larger decrease in morale … based on these incredibly high rates of exposure” to traumatic combat events, Bliese said. The report’s authors took the statistics as evidence that the force is resilient, a trait the military has been working to develop in troops.

The report is a snapshot of the health of the forces in Afghanistan last year, drawn by a mental health team that polled more than 900 soldiers, 335 Marines and 85 mental health workers on the battlefield in July and August, as troops surged into the country under the Obama administration’s new strategy for fighting the insurgency.

President Barack Obama sent an additional 30,000 troops there last year to build the force to the current 100,000. Commanders and administration officials say the push has weakened the Taliban, and a limited troop withdrawal is planned by this July.

Troops said they were receiving better training in suicide prevention and other coping strategies and that mental health treatment was easier to get at the warfront.

“I do believe we’re making progress,” Schoomaker said.

But a particularly stubborn problem for the Army persisted: About 50 percent of soldiers said they believe getting professional help for their problems would make them appear weak. Defense officials have gone to great lengths over a number of years to encourage troops to get treatment, and Marines made some headway in reducing the perceived stigma, according to the report.

Americans “have not solved this problem in the civilian world,” said Dr. Robert Heinssen, a research director at the National Institute of Mental Health.

The military says it boosted the mental health staff in the Afghanistan to 1 for every 646 soldiers last year, compared with 1 for every 1,123 in 2009.

“War affects everyone … and most are able to deal with their experiences and move on to stable, productive lives,” said Joe Davis, a spokesman for the Veterans of Foreign Wars. “Key to coping with those experiences is available care, access to care and knowing that you are not alone.”

Some of the report’s highlights:

— Only 46.5 percent of soldiers said their morale was medium, high or very high last year, compared with 65.7 percent in 2005. For Marines, it was only 58.6 percent last year compared with 70.4 percent when they were surveyed in 2006 in Iraq. (The report compares numbers of the Marine to their time in Iraq because they were not in Afghanistan in significant numbers before the surge.)

— Nearly 80 percent of Marines and soldiers said they’d seen a member of their unit killed or wounded, compared with roughly half who said that in the earlier years.

— Nearly 1 in 5 soldiers and Marines reported psychological problems such as acute stress, depression or anxiety last year, compared with 1 in 10 among soldiers in 2005 and about 1 in 8 among Marines in 2006.

— The use of drugs for mental health or combat stress was lower among soldiers and Marines than among civilians in the same age group.

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McCain Says Torture Did Not Lead to bin Laden

Posted on May 13, 2011 by Team VCS

‘This is a moral debate. It is about who we are,’ says Ariz. Republican, former POW

Written by MSNBC May 12, 2011 (MSNBC) – Waterboarding and other harsh interrogation techniques were not a factor in tracking down Osama bin Laden, a leading Republican senator insisted Thursday.

Sen. John McCain, who spent 5½ years as a prisoner of war in North Vietnam, also rejected the argument that any form of torture is critical to U.S. success in the fight against terrorism. Trump: ‘Torture’ led to catching bin Laden

In an impassioned speech on the Senate floor, the Arizona Republican said former Attorney General Michael Mukasey and others who supported those kind of measures were wrong to claim that waterboarding al-Qaida’s No. 3 leader, Khalid Sheikh Mohammed, provided information that led to bin Laden’s compound in Pakistan. McCain spoke with an unrivaled record on the issue. He’s the top Republican on the Senate Armed Services Committee, the 2008 GOP presidential nominee who consistently challenged the Bush administration and Vice President Dick Cheney on the use of torture and a man who endured brutal treatment during the Vietnam War.

He said he asked CIA Director Leon Panetta for the facts, and that the hunt for bin Laden did not begin with fresh information for Mohammed. In fact, the name of bin Laden’s courier, Abu Ahmed al-Kuwaiti, came from a detainee held in another country.

“Not only did the use of enhanced interrogation techniques on Khalid Sheikh Mohammed not provide us with key leads on bin Laden’s courier, Abu Ahmed, it actually produced false and misleading information,” McCain said. He called on Mukasey and others to correct their misstatements.

A call to Mukasey at his New York law firm was not immediately returned Thursday. Mukasey was President George W. Bush’s last attorney general.

On Thursday, McCain also penned an opinion piece for The Washington Post on the topic, saying, “I know from personal experience that the abuse of prisoners sometimes produces good intelligence but often produces bad intelligence because under torture a person will say anything he thinks his captors want to hear — true or false — if he believes it will relieve his suffering. Often, information provided to stop the torture is deliberately misleading.”

He concluded, “This is a moral debate. It is about who we are.”

Last week, Rep. Peter King, R-N.Y., the chairman of the House Homeland Security Committee, said the U.S. got vital information from waterboarding that led directly to bin Laden.

McCain said he opposes waterboarding, a technique that simulates drowning, and any form of torture tactics. He said that they could be used against Americans and that their use damages the nation’s character and reputation.

“I do not believe they are necessary to our success in our war against terrorists, as the advocates of these techniques claim they are,” he said.

“Ultimately, this is about morality. What is at stake here is the very idea of America — the America whose values have inspired the world and instilled in the hearts of its citizens the certainty that, no matter how hard we fight, no matter how dangerous our adversary, in the course of vanquishing our enemies we do not compromise our deepest values,” he said. “We are America, and we hold ourselves to a higher standard. That is what is really at stake.”

McCain did reject the idea of prosecuting any U.S. officials for using interrogation tactics in the past.

McCain’s remarks drew immediate praise from several Democratic senators who have been at political odds with him in past campaigns.

“No one in the Senate could have given this speech,” said Senate Majority Leader Harry Reid, D-Nev., “He speaks with personal knowledge. He still remembers the most dark nights when he tried to rest, when he was tortured brutally.”

Sen. Dick Durbin, D-Ill., said McCain’s opinions may not be the popular view, but they were the right ones.

“Thank you for your leadership,” Durbin said.

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