Everyone wants to throat-punch ISIS, right? Right!
But what is ISIS…really? And who attacked the World Trade Center? And what’s the deal with Syria?
Keeping track of terrorist groups can be confusing, so here’s the quick and dirty on three hard-hitting groups the U.S. is currently fighting:
1. Al Qaeda
Al Qaeda is a Sunni Islamic militant organization founded by Osama bin Laden circa 1988 and is responsible for the attacks against the United States on Sept. 11, 2001.
Originally organized to fight the Soviet Union during the Afghan War, al Qaeda continues to resist entities considered corrupt to its leaders, including differing Islamic interpretations and foreign (read: U.S.) occupation of their lands.
Al Qaeda operates under the belief that it is their duty to kill non-believers, including civilians.
After 9/11, a U.S.-led coalition launched an attack in Afghanistan to target al Qaeda, which had been operating under the protection of the Taliban government in the country. Operation Enduring Freedom successfully toppled the Taliban and dispersed al Qaeda throughout the region, but U.S. forces remain unable to fully eradicate the group.
From 1979-1989, the Soviet Union invaded and occupied Afghanistan. Afghan fighters known as the mujahedeen resisted, finally forcing the Soviet Union to withdraw from the country. In the aftermath, there was a power vacuum, with fighting among the mujahedeen until the Taliban was established in 1994.
The Taliban seized control of Afghanistan and imposed strict Islamic laws on the Afghan people. A Sunni Islamic fundamentalist political movement, the Taliban harbored al Qaeda operations, including bin Laden’s stronghold, which led to the U.S. invasion Afghanistan after the September 11 attacks.
Today, largely funded by opium production, the Taliban fights to regain control of Afghanistan, engaging with military forces in-country and claiming responsibility for terrorist attacks in the region.
The Islamic State of Iraq and Syria, also known as the Islamic State of Iraq and the Levant, or just the Islamic State, is a Salafi jihadist Sunni Islamic militant group established in 1999 with the intention of establishing their God’s rule on earth and destroying those who threaten it.
They are known for being exceptionally brutal, utilizing publicity and the social media to broadcast mass executions, beheadings, and crucifixions.
They once pledged allegiance to al Qaeda, but separated from it in 2014 and concentrated their attention on Syria and Iraq.
In January 2014, ISIS captured the city of Raqqa, Syria. For the next six months, the group overtook major Iraqi cities like Mosul and Tikrit before self-declaring a caliphate, an Islamic State with authority over the global Muslim population.
In August 2014, President Barack Obama approved airstrikes against ISIS.
Videos on social media appear to show Russia’s Su-57, a prototype of a new, fifth-generation fighter jet, operating in Syria — and it could be a direct threat to US stealth aircraft like the F-22.
Justin Bronk, a combat aircraft expert at the Royal United Services Institute, told Business Insider that initial attempts to geolocate Su-57s shown in the video indicated the deployment may be authentic.
He also said any deployment could be a cynical move to boost Russia’s military sales while gaining valuable intelligence on the F-22.
“Russia has deployed pretty much everything in its arsenal in Syria, whether they’re prototypes or heavy strategic bombers in absurdly inefficient strike paths all around Western Europe and through the Mediterranean” to strike targets in Syria, Bronk said.
Indeed, Russia often uses Syria as a showroom for its military exports.
It has deployed advanced, complicated systems like submarine-launched cruise missiles, which are designed for high-end naval warfighting, against unsophisticated, basically defenseless targets in Syria.
On more regular bomb runs, Russia simply drops unguided munitions from Cold War-era fighter jets, which are frequently accused of killing civilians in places like hospitals.
Bronk assessed that Russia wanted to boost its position in the export market and that by deploying the Su-57, a prototype without its proper engines or stealth configuration, it could advertise the platform as “combat-proven.”
Though Bronk said the Su-57 was “certainly not combat-proven in the sense of showing it can take on Western fighters,” which is its intended purpose, the plane technically will have participated in combat.
But while the Su-57 poses no real air-to-air threat to Western fighters in its current, unrefined state, it has a diverse array of powerful radars Russia could use to perfect anti-stealth techniques and battle plans against the US’s F-22.
The Su-57 can’t yet fight, but it can spy
According to Bronk, one of the main challenges for the Su-57 is integrating the plane’s “really quite innovative radar arrangement.” He said it would be a great opportunity to test the configuration in Syria, where a large number of F-22 stealth jets operate.
“The skies over Iraq and specifically Syria have really just been a treasure trove for them to see how we operate,” Lt. Gen. VeraLinn “Dash” Jamieson said at an Air Force Association briefing hosted by the Mitchell Institute for Aerospace Studies in January 2018.
“Our adversaries are watching us — they’re learning from us,” Jamieson said. With the apparent deployment of the Su-57, Russia may be teaching its best pilots in its newest plane how to stalk and fight F-22s, which would rely on stealth as their major advantage in combat with more maneuverable Russian jets.
But Bronk said deploying Su-57s in Syria would be a “double-edged sword” for Russia. That, Bronk said, is because not only would Russia be able to scope out the US’s stealth fighters, but their presence in Syria would “give the US a chance to see how the F-22s respond” to Russia’s new jet and “allow Western aircraft time to collect signals intelligence on what those radars are doings.”
Marketing ploy for a prestige plane?
Overall, if Russia does have Su-57s in Syria, it’s most likely a marketing ploy to increase exports as Russia’s economy flags under weak oil prices. Though Russia often hypes the Su-57, it has ordered only 12 of them for its own use and “desperately” needs an investment from India to bump up production, Bronk said.
“They’re ordering 12 of them,” Bronk said. “How can you sustain a genuine program when your order book is so tiny? In a state that has huge budget problems and a massive military bill,” the Su-57 functions as a prestige item, Bronk said.
So while the Syrian civil war rages on, and hundreds of civilians fall victim to airstrikes from the Russian-allied Syrian government, Moscow may be using the opportunity to show off shiny new hardware and gain a military edge against its US competitor.
Military working dogs go through lives of intense national service, trained from near birth to mind human commands and either fight bad guys or hunt for dangerous substances and contraband. But they’re still living creatures, and they are allowed to retire and live out their days after their service is done.
And, since this is the military, there’s a ceremony involved. But when you do retirement ceremonies with healthy, eager dogs, it’s actually a pretty adorable experience.
In this video from Fort Benning, the 904th Military Working Dog Police Detachment held a ceremony to retire two of their working dogs. Max is a Belgian Malinois with 10 years of service and Grisha is a Malinois who had spent four years at Fort Benning. Both dogs received Army Commendation Medals and were slated to live out their days in the civilian world.
Military working dogs serve in a variety of roles. The most visible is likely the dogs trained to detect improvised explosive devices and similar threats like mines and suicide vehicles. These animals are employed across the world, especially at forward bases and combat outposts.
But the military also has dogs that detect drugs to aid law enforcement agencies on military installations, as well as cadaver dogs which are unfortunately required to help find bodies after disasters.
But the animals also serve on the front lines or in raids. Special operators like Navy SEALs now take dogs on some missions to help keep curious onlookers back or even to take direct action against enemy fighters, using their teeth to harm foes or just to pin people down so the SEALs can sort hostages and civilians from fighters in relative safety.
One of the newer ways for animals to serve is in emotional support roles, a job which hearkens back to some of the earliest animals in military units. Animal mascots have been common to military units for centuries, and troops have long looked to the mascots for companionship.
In other words, Mattis wants a full examination of all the hours of burdensome, irrelevant training service members have to undergo before deployment.
“I want to verify that our military policies also support and enhance warfighting readiness and force lethality,” Mattis said.
Mattis also asked for a review into what should be done about permanently non-deployable service members.
The memo states that the review will be headed by a working group under the Pentagon’s undersecretary for personnel and readiness, a position currently occupied by Anthony M. Kurta. While President Donald Trump recently tapped Robert Wilkie for the job, Wilkie has not yet been confirmed by the Senate.
Mattis has recently involved himself in various personnel issues, particularly by encouraging Congress to block an amendment by GOP Rep. Vicky Hartzler to the annual defense budget bill that would have prevented Department of Defense funds from being used to pay for transgender medical treatments. Hartzler’s amendment failed after 24 Republicans voted against it.
Recommendations from the new review Mattis has set in motion are due by Dec. 1, 2018.
“But you’re right, we have a politically correct military and it’s getting more and more politically correct every day. And a lot of the great people in this room don’t even understand how it’s possible to do that.” he said.
The US has deployed three B-2 Spirit bombers and 200 airmen to Joint Base Pearl Harbor-Hickam in Hawaii for training in the Pacific, Pacific Air Forces Public Affairs revealed Jan. 11, 2019.
The stealth aircraft from Whiteman Air Force Base were deployed to the Pacific to support US Strategic Command’s Bomber Task Force mission, a deterrence mission intended to reassure allies and send a clear message to any country that would threaten regional peace and security.
“Deploying to Hawaii enables us to showcase to a large American and international audience that the B-2 is on watch 24 hours a day, seven days a week ready to protect our country and its allies,” Lt. Col. Joshua Dorr, the director of operations for the 393rd Bomber Squadron, explained in a statement.
U.S. Air Force B-2 Spirit deployed from Whiteman Air Force Base, Missouri, takes off from Wake Island Airfield Sept. 14, 2018.
(Photo by Staff Sgt. Danielle Quilla)
“This training is crucial to maintaining our regional interoperability. It affords us the opportunity to work with our allies in joint exercises and validates our always-ready global strike capability,” he added.
The latest deployment marks the second time B-2 Spirit bombers, which are capable of carrying both conventional and nuclear weapons payloads, have been deployed to Hawaii. During the first deployment, the bombers trained alongside F-22s flown by members of the Hawaii Air National Guard 199th Fighter Squadron.
“The B-2 Spirits’ first deployment to [Pearl Harbor] highlights its strategic flexibility to project power from anywhere in the world,” Maj. Gen. Stephen Williams, the director of air and cyberspace operations at the Pacific Air Forces headquarters, said in a statement in October. 2018
The major general added that the deployment “helped ensure a free and open Indo-Pacific,” rhetoric the US uses regularly to describe moves meant to counter Chinese actions perceived as aggressive or coercive.
A B-2 Spirit bomber deployed from Whiteman Air Force Base, Missouri, lands at Joint Base Pearl Harbor-Hickam, Hawaii, Jan. 10, 2019.
(Photo by Senior Airman Thomas Barley)
The second deployment comes at a time of heightened tension between the US and China, especially in contested waterways like the South China Sea where China is expanding its military footprint and the US armed forces are responding in kind.
China has reacted aggressively to US military activities in the region, sharply criticizing the US and even threatening US military vessels.
A US Air Force B-2 Spirit deployed from Whiteman Air Force Base, Missouri, to Joint Base Pearl Harbor-Hickam, Hawaii.
(US Air Force photo by Staff Sgt. Danielle Quilla)
The Chinese mainland is protected by an integrated air defense system, and Chinese-occupied territories in the South China Sea are defended by a so-called “wall of SAMs [surface-to-air missiles].”
Despite its large size, the B-2’s low-observable characteristics “give it the ability to penetrate an enemy’s most sophisticated defenses and put at risk their most valuable targets,” Pacific Air Forces noted in their statement on the recent deployment. “Its presence in the Hawaiian Islands stands as a testament to enhanced regional security.”
B-2 bombers deployed to the Pacific in 2017, specifically to Andersen Air Force Base on Guam, to reassure allies and partners during a period defined by alarm over North Korea.
This article originally appeared on Business Insider. Follow @BusinessInsider on Twitter.
A situation that started with students protesting the government evolved into a failed coup d’etat and, consequently, the decimation of a once-thriving tourism industry. Protesters, feeling powerless in the face of violence, turned to the dark side for help, accepting aid from narco-terrorists sponsored by oligarchs.
The Sandinista Government, also known as the Sandinista National Liberation Front (FSLN), is a revolutionary ideology and organization that was created on July 19, 1961, to overthrow the Somoza dictatorship. From an outside perspective, it looks like the government has come full circle in becoming what it was created to destroy.
U.S. Sanctions have influenced the Sandinista Government to change their strategy in restoring law and order to what was once known as the “safest country in Latin America.” Disregarding warnings from the embassy, I boarded a plane leaving the U.S. to Nicaragua to see it for myself.
No sh*t, there I was…
Did someone say, “communism?”
A History of Distrust
Historically, Nicaragua and the United States have not have an outstanding relationship due several political scandals, including the Iran-Contra affair. Long story short: We sold weapons to Iran through Israel in order to negotiate the release of U.S. hostages. The funds from the weapons sale were going to benefit the Contras, a guerrilla terrorist organization that opposed the Sandinistas. Needless to say, they weren’t so thrilled about it.
Today, the people of Nicaragua don’t treat U.S. citizens negatively because of our nations’ histories, but they do harbor a general distrust of American diplomats and government officials — this is especially true among the top brass.
It is important to note these specific examples of the past because there are similar accusations heading our way once again.
Not your best pitch, Don.
The Reason for the Sanctions
In Nicaragua, a country that has served as a physical barrier in our ongoing War On Drugs in Central America, was developing all the telltale signs of an impending coup.
Local police responded with extreme force against what they believed was a new arm of the criminal underground created to overthrow the government. Their aggressive pushback was interpreted by outside news outlets as a wanton wave of human rights violations. The ‘shoot first, ask questions later’ approach backfired — as it tends to.
Jacinto Saurez, the International Secretary of the FSLN, told the Havana Times of a conspiracy theory of a U.S.-sponsored coup. Oldtimers were quick to believe this because of our nations’ turbulent recent history.
As capitalists, we would never take a metaphorical cow producing milk behind a barn and shoot it, so the idea of a U.S. coup doesn’t hold water against facts.
The harsh reality is, sadly, that Nicaragua killed that cow themselves. The entire economy is reliant on the United States but old revolutionaries in power, blinded by pride, resent that the U.S. is essential to the country’s stability. The old, stubborn leadership resents any foreign influence — even if it is beneficial.
Taxes? No habla ingles.
U.S. sanctions aimed towards the Sandinista government have hit the tourism industry hard and they’ve hit the private sector even harder, yet the upper class has felt nothing. Investors have almost completely pulled out of the country and major corporations tied to the government have fired half their staff.
Mom-and-pop shops are running at max capacity to fill the void left behind by the departure of major department stores, restaurants, and franchises. Larger businesses have to raise their prices to keep up with taxes that the smaller businesses dodge. In short, we’re seeing a great dying of big business but an exploding entrepreneur market.
Small businesses are unaffected by the sanctions because they do not report their income. Hell, most small businesses down here don’t even have the proper licenses to operate legally.
The moment the new national strategy was implemented.
According to the Institute of Nicaraguan Tourism (Intur), U.S. tourism makes up a 24% market share in the country. A new national strategy has been implemented to try and regain American confidence and ensure visitors’ safety. They have increased police presence day and night, all barricades have been removed, and criminals have either been arrested or have fled the country. Regardless, I would highly recommend against traveling here without a guide or prior experience until the political situation improves.
Despite safety precautions, there are more ‘demonstrations’ planned for the near future that pose a security risk. It is unknown if the anti-government forces are going to return en masse.
A deflationary trend has developed for the Nicaraguan Cordoba (NIO) from 32.24 to 31.70 (at the time of writing). This may not seem like much at first glance, but it’s actually a pretty severe drop. The exchange rate is currently id=”listicle-2598140554″ USD to C.70 and, though the jump in U.S. buying power is good news for us, it has had devastating consequences for the local population.
Adam Hayes of Investopedia does a great job of explaining it:
“Deflation typically occurs in and after periods of economic crisis. When an economy experiences a severe recession or depression, economic output slows as demand for consumption and investment drop.
This leads to an overall decline in asset prices as producers are forced to liquidate inventories that people no longer want to buy. Consumers and investors alike begin holding onto liquid money reserves to cushion against further financial loss. As more money is saved, less money is spent, further decreasing aggregate demand.”
Normally, Nicaraguans are paid in U.S. dollars on a monthly or bi-monthly basis. The employees prefer to be paid this way because the dollar is less volatile. Corporations are lobbying for a new law that changes the payout to workers to Cordobas instead of dollars because of deflation. So, now that the local currency has deflated, the prices on everything have gone up. Unfortunately, corporations want to pay people “technically” the same amount — but by that logic, when the economy recovers, they’re “technically” paying people less.
These colors don’t run.
Americans living in Nicaragua
So, what’s the situation like for Americans in the country?
Many foreigners have left, but one thing is for certain among Americans who have remained: They will not be intimidated. Surprisingly, the Americans give no f*cks. They have stockpiled supplies, ammo, and alcohol. Those who have property out in the countryside have opted to weather the storm away from the cities. Those living within the cities have installed electric fences, cameras, and are even flying personal drones when things get hairy.
Nicaragua may be dangerous at the moment, but I can tell you that it’s no Afghanistan. Fortunes are made in times of chaos and it’s a buyers market. Right now, residential and commercial properties are practically being given away.
Americans aren’t turning tail. When I attended a bullfighting competition in the city of Juigalpa, a city saturated with Sandinista loyalists, I took a picture of this warrior:
It’s no secret that this year is super strange for parents. Still reeling from months in quarantine, working from home and homeschooling, parents everywhere are now staring down the barrel of summer vacations with far fewer options than they had in previous years. Parents are navigating uncharted territory, and there’s no doubt it’s putting their parenting skills, their patience, their sanity to the test. But here’s the thing, you’re not alone, parents. We’re all in this together. All you can do is take it one day at a time, power through and find a way to cope. Someday this will all be a distant memory. In the meantime, they say laughter is good medicine, so here are a few parenting memes that will make you feel seen and perhaps LOL just a little. Enjoy!
In a piece written for The Cipher Brief, Michael Eisenstadt of the Washington Institute details Iran’s weapon of choice for imposing its will on domestic and foreign threats alike — cyber attacks.
Eisenstadt, as well as experts contacted by Business Insider, say that Iran has a weak conventional military that couldn’t possibly hope to push around stronger countries. For that reason, cyber attacks represent the perfect weapon.
Cyber attacks are cheap, ambiguous, hard to pin on any one actor, and almost completely without precedent when it comes to gauging a military response.
Cyber attacks allow Iran “to strike at adversaries globally, instantaneously, and on a sustained basis, and to potentially achieve strategic effects in ways it cannot in the physical domain,” writes Eisenstadt.
Unlike the US, which wields nuclear weapons and the world’s finest military, Iran relies on its ability to potentially wreak havoc in the Strait of Hormuz, one of the world’s busiest oil shipping routes, its funding of terrorist organizations, and its arsenal of ballistic missiles to deter attacks, according to Eisenstadt.
“Hack those guys over there.” | Creative Commons photo by Mohammad Sadegh Heydari
However, Tehran cannot hold the Strait of Hormuz in an outright confrontation, its terrorist allies have become increasingly vulnerable and targetable by world powers, and if Iran ever used a ballistic missile, it would soon find itself on the receiving end of a blistering counter attack.
Therefore cyber attacks give Iran a fourth kind of deterrence, one which the US has repeatedly failed to punish. Indeed, cyber attacks are new territory, and the US still hasn’t found an appropriate and consistent way to deal with cyber attacks, whether those attacks come in the form of Russian meddling in the US election, North Korea’s hack of Sony, or China’s stealing valuable defense data.
Eisenstadt addresses this lack of US response as a “credibility gap,” which the US must somehow fill.
While nuclear-powered carriers and submarines are all the rage in the U.S. Navy today, the sea-going service used to have a much wider nuclear portfolio with nuclear-powered destroyers and cruisers that could sail around the world with no need to refuel, protecting carrier and projecting American power ashore with missiles and guns.
The first nuclear surface combatant in the world wasn’t a carrier, it was the USS Long Beach, a cruiser launched in 1959. That ship was followed by eight other nuclear cruisers, Truxtun, California, South Carolina, Virginia, Texas, Mississippi, and Arkansas. The Arkansas was the last nuclear-powered cruiser launched, coming to sea in 1980.
During the same period, a nuclear-powered destroyer, the USS Bainbridge, took to the seas as well. Due to changes in ship nomenclature over the period, it was a frigate when designed, a destroyer when launched, but would be classified as a cruiser by the time the ship retired.
The big advantage of nuclear vessels, which required many more highly trained personnel as well as a lot of hull space for the reactor, was that they could sail forever at their top speed. The speed thing was a big advantage. They weren’t necessarily faster than their conventionally fueled counterparts, but gas and diesel ships had to time their sprints for maximum effect since going fast churned through fuel.
That meant conventional vessels couldn’t sail too fast for submarines to catch them, couldn’t sprint from one side of the ocean to the other during contingency operations, and relied on tankers to remain on station for extended periods of time.
Nuclear vessels got around all these problems, but their great speed and endurance only really helped them if they weren’t accompanied by conventional ships. After all, the cruisers and destroyer can’t sprint across the ocean if that means they are outrunning the rest of the fleet in dangerous waters.
That’s why Rickover wanted a full nuclear battle group. It could move as a single unit and enjoy its numerous advantages without being slowed down by other ships.
And the ships were quite lethal when they arrived. Nuclear carriers at the time were similar to those today, sailing at a decent clip of about 39 mph (33.6 knots) while carrying interceptor aircraft and bombers.
The 10 nuclear cruisers (counting the Bainbridge as a cruiser), were guided-missile cruisers. Four ships were Virginia-Class ships focused on air defense but also featuring weapons needed to attack enemy submarines and ships as well as to bombard enemy shores.
The other most common nuclear cruiser was the California Class with three ships. The California Class was focused on offensive weaponry, capable of taking the fight to enemy ships with Harpoon missiles, subs with anti-submarine rockets and torpedoes, and enemy shores with missiles and guns. But, it could defend itself and its fleet with surface-to-air missiles and other weapons.
But the nuclear fleet had one crippling problem: expense. Rickover knew that to ensure that the larger Navy and America would continue to embrace nuclear power at sea, the ships had to be extremely dependable and secure. To do this, ships needed good shielding and a highly capable, highly trained crew.
Also, the reactors took up a lot of space within the hull, requiring larger ships than conventional ones with the same battle capabilities. So, when budget constraints came up in the 1990s, the nuclear fleet was sent to mothballs except for the carriers.
And even at that stage, the nuclear cruisers cost more than their counterparts. Conventional cruisers can be sold to allied navies, commercial interests, or sent to common scrap yards after their service. Nuclear cruisers require expensive decommissioning and specially trained personnel to deal with the reactors and irradiated steel.
While the week-long exercise also featured anti-submarine warfare and other naval operations, most of the news coverage was of the Marines hitting the island. (In their defense, getting good footage of submarine battles is kinda tough).
Sure, pundits wrung their hands about the ramifications of a China and Russia conducting joint operations. But the fear may have been a bit overblown. After all, China participates in a lot of naval exercises with the U.S. as well.
The location and the activities in the exercise are important, though. Portions of the hotly contested South China Sea are claimed by a few nations, including the Philippines, China, Malaysia, Brunei, and Taiwan. If China were to try to edge other countries off their claims by force, this is the exact exercise they would need to do to get ready.
And the Chinese marines do look good in the video below, working with landing craft, tanks, and air assets to quickly take and hold the island alongside their Russian counterparts in green. See more footage of them in the full video from War Leaks below:
For years, conservatives have assailed the U.S. Department of Veterans Affairs as a dysfunctional bureaucracy. They said private enterprise would mean better, easier-to-access health care for veterans. President Donald Trump embraced that position, enthusiastically moving to expand the private sector’s role.
Here’s what has actually happened in the four years since the government began sending more veterans to private care: longer waits for appointments and, a new analysis of VA claims data by ProPublica and PolitiFact shows, higher costs for taxpayers.
Since 2014, 1.9 million former service members have received private medical care through a program called Veterans Choice. It was supposed to give veterans a way around long wait times in the VA. But their average waits using the Choice Program were still longer than allowed by law, according to examinations by the VA inspector general and the Government Accountability Office. The watchdogs also found widespread blunders, such as booking a veteran in Idaho with a doctor in New York and telling a Florida veteran to see a specialist in California. Once, the VA referred a veteran to the Choice Program to see a urologist, but instead he got an appointment with a neurologist.
The winners have been two private companies hired to run the program, which began under the Obama administration and is poised to grow significantly under Trump. ProPublica and PolitiFact obtained VA data showing how much the agency has paid in medical claims and administrative fees for the Choice program. Since 2014, the two companies have been paid nearly billion for overhead, including profit. That’s about 24 percent of the companies’ total program expenses — a rate that would exceed the federal cap that governs how much most insurance plans can spend on administration in the private sector.
According to the agency’s inspector general, the VA was paying the contractors at least 5 every time it authorized private care for a veteran. The fee was so high because the VA hurriedly launched the Choice Program as a short-term response to a crisis. Four years later, the fee never subsided — it went up to as much as 8 per referral.
“This is what happens when people try and privatize the VA,” Sen. Jon Tester of Montana, the ranking Democrat on the Senate veterans committee, said in a statement responding to these findings. “The VA has an obligation to taxpayers to spend its limited resources on caring for veterans, not paying excessive fees to a government contractor. When VA does need the help of a middleman, it needs to do a better job of holding contractors accountable for missing the mark.”
The Affordable Care Act prohibits large group insurance plans from spending more than 15 percent of their revenue on administration, including marketing and profit. The private sector standard is 10 percent to 12 percent, according to Andrew Naugle, who advises health insurers on administrative operations as a consultant at Milliman, one of the world’s largest actuarial firms. Overhead is even lower in the Defense Department’s Tricare health benefits program: only 8 percent in 2017.
Even excluding the costs of setting up the new program, the Choice contractors’ overhead still amounts to 21 percent of revenue.
“That’s just unacceptable,” Rick Weidman, the policy director of Vietnam Veterans of America, said in response to the figures. “There are people constantly banging on the VA, but this was the private sector that made a total muck of it.”
A spokesman for the VA, Curt Cashour, declined to provide an interview with key officials and declined to answer a detailed list of written questions.
One of the contractors, Health Net, stopped working on the program in September 2018. Health Net didn’t respond to requests for comment.
The other contractor, TriWest Healthcare Alliance, said it has worked closely with the VA to improve the program and has made major investments of its own. “We believe supporting VA in ensuring the delivery of quality care to our nation’s veterans is a moral responsibility, even while others have avoided making these investments or have withdrawn from the market,” the company said in a statement.
TriWest did not dispute ProPublica and PolitiFact’s estimated overhead rate, which used total costs, but suggested an alternate calculation, using an average cost, that yielded a rate of 13 percent to 15 percent. The company defended the 5-plus fee by saying it covers “highly manual” services such as scheduling appointments and coordinating medical files. Such functions are not typically part of the contracts for other programs, such as the military’s Tricare. But Tricare’s contractors perform other duties, such as adjudicating claims and monitoring quality, that Health Net and TriWest do not. In a recent study comparing the programs, researchers from the Rand Corporation concluded that the role of the Choice Program’s contractors is “much narrower than in the private sector or in Tricare.”
Before the Choice Program, TriWest and Health Net performed essentially the same functions for about a sixth of the price, according to the VA inspector general. TriWest declined to break down how much of the fee goes to each service it provides.
Because of what the GAO called the contractors’ “inadequate” performance, the VA increasingly took over doing the Choice Program’s referrals and claims itself.
In many cases, the contractors’ 5-plus processing fee for every referral was bigger than the doctor’s bill for services rendered, the analysis of agency data showed. In the three months ending Jan. 31, 2018, the Choice Program made 49,144 referrals for primary care totaling .9 million in medical costs, for an average cost per referral of 1.16. A few other types of care also cost less on average than the handling fee: chiropractic care (6.32 per referral) and optometry (9.25). There were certainly other instances where the medical services cost much more than the handling fee: TriWest said its average cost per referral was about ,100 in the past six months.
Beyond what the contractors were entitled to, audits by the VA inspector general found that they overcharged the government by 0 million from November 2014 to March 2017. Both companies are now under federal investigation arising from these overpayments. Health Net’s parent company, Centene, disclosed a Justice Department civil investigation into “excessive, duplicative or otherwise improper claims.” A federal grand jury in Arizona is investigating TriWest for “wire fraud and misused government funds,” according to a court decision on a subpoena connected to the case. Both companies said they are cooperating with the inquiries.
Despite the criminal investigation into TriWest’s management of the Choice Program, the Trump administration recently expanded the company’s contract without competitive bidding. Now, TriWest stands to collect even more fees as the administration prepares to fulfill Trump’s campaign promise to send more veterans to private doctors.
(US Air Force photo by Kemberly Groue)
Senate veterans committee chairman Johnny Isakson, R-Ga., said he expects VA Secretary Robert Wilkie to discuss the agency’s plans for the future of private care when he testifies at a hearing on Dec. 19, 2018. A spokeswoman for the outgoing chairman of the House veterans committee, Phil Roe, R-Tenn., didn’t respond to requests for comment.
“The last thing we need is to have funding for VA’s core mission get wasted,” Rep. Mark Takano, a California Democrat who will become the House panel’s chairman in January 2019, said in a statement. “I will make sure Congress conducts comprehensive oversight to ensure that our veterans receive the care they deserve while being good stewards of taxpayer dollars.”
Many of the Choice Program’s defects trace back to its hasty launch.
In 2014, the Republican chairman of the House veterans committee alleged that 40 veterans died waiting for care at the VA hospital in Phoenix. The inspector general eventually concluded that no deaths were attributable to the delays. But it was true that officials at the Phoenix VA were covering up long wait times, and critics seized on this scandal to demand that veterans get access to private medical care.
One of the loudest voices demanding changes was John McCain’s. “Make no mistake: This is an emergency,” the Arizona senator, who died in August 2018, said at the time. McCain struck a compromise with Democrats to open up private care for veterans who lived at least 40 miles from a VA facility or would have to wait at least 30 days to get an appointment.
In the heat of the scandal, Congress gave the VA only 90 days to launch Choice. The VA reached out to 57 companies about administering the new program, but the companies said they couldn’t get the program off the ground in just three months, according to contracting records. So the VA tacked the Choice Program onto existing contracts with Health Net and TriWest to run a much smaller program for buying private care. “There is simply insufficient time to solicit, evaluate, negotiate and award competitive contracts and then allow for some form of ramp-up time for a new contractor,” the VA said in a formal justification for bypassing competitive bidding.
But that was a shaky foundation on which to build a much larger program, since those earlier contracts were themselves flawed. In a 2016 report, the VA inspector general said officials hadn’t followed the rules “to ensure services acquired are based on need and at fair and reasonable prices.” The report criticized the VA for awarding higher rates than one of the vendors proposed.
The new contract with the VA was a lifeline for TriWest. Its president and CEO, David J. McIntyre Jr., was a senior aide to McCain in the mid-1990s before starting the company, based in Phoenix, to handle health benefits for the military’s Tricare program. In 2013, TriWest lost its Tricare contract and was on the verge of shutting down. Thanks to the VA contract, TriWest went from laying off more than a thousand employees to hiring hundreds.
Senator John McCain.
(Photo by Gage Skidmore)
McIntyre’s annual compensation, according to federal contracting disclosures, is .36 million. He declined to be interviewed. In a statement, TriWest noted that the original contract, for the much smaller private care program, had been competitively awarded.
The VA paid TriWest and Health Net 0 million upfront to set up the new Choice program, according to the inspector general’s audit. But that was dwarfed by the fees that the contractors would collect. Previously, the VA paid the companies between and 3 for every referral, according to the inspector general. But for the Choice Program, TriWest and Health Net raised their fee to between 5 and 0 to do essentially the same work on a larger scale, the inspector general said.
The price hike was a direct result of the time pressure, according to Greg Giddens, a former VA contracting executive who dealt with the Choice Program. “If we had two years to stand up the program, we would have been at a different price structure,” he said.
Even though the whole point of the Choice Program was to avoid 30-day waits in the VA, a convoluted process made it hard for veterans to see private doctors any faster. Getting care through the Choice Program took longer than 30 days 41 percent of the time, according to the inspector general’s estimate. The GAO found that in 2016 using the Choice Program could take as long as 70 days, with an average of 50 days.
Sometimes the contractors failed to make appointments at all. Over a three-month period in 2018, Health Net sent back between 9 percent and 13 percent of its referrals, according to agency data. TriWest failed to make appointments on 5 percent to 8 percent of referrals, the data shows.
Many veterans had frustrating experiences with the contractors.
Richard Camacho in Los Angeles said he got a call from TriWest to make an appointment for a sleep test, but he then received a letter from TriWest with different dates. He had to call the doctor to confirm when he was supposed to show up. When he got there, the doctor had received no information about what the appointment was for, Camacho said.
John Moen, a Vietnam veteran in Plano, Texas, tried to use the Choice Program for physical therapy in 2018 rather than travel to Dallas, where the VA had a six-week wait. But it took 10 weeks for him to get an appointment with a private provider.
“The Choice Program for me has completely failed to meet my needs,” Moen said.
Curtis Thompson, of Kirkland, Washington, said he’s been told the Choice Program had a 30-day wait just to process referrals, never mind to book an appointment. “Bottom line: Wait for the nearly 60 days to see the rheumatologist at the VA rather than opt for an unknown delay through Veterans Choice,” he said.
(Flickr photo by Rob Bixby)
After Thompson used the Choice Program in 2018 for a sinus surgery that the VA couldn’t perform within 30 days, the private provider came after him to collect payment, according to documentation he provided.
Thousands of veterans have had to contend with bill collectors and credit bureaus because the contractors failed to pay providers on time, according to the inspector general. Doctors have been frustrated with the Choice Program, too. The inspector general found that 15 providers in North Carolina stopped accepting patients from the VA because Health Net wasn’t paying them on time.
The VA shares the blame, since it fell behind in paying the contractors, the inspector general said. TriWest claimed the VA at one point owed the company 0 million. According to the inspector general, the VA’s pile of unpaid claims peaked at almost 180,000 in 2016 and was virtually eliminated by the end of the year.
The VA tried to tackle the backlog of unpaid doctors, but it had a problem: The agency didn’t know who was performing the services arranged by the contractors. That’s because Health Net and TriWest controlled the provider networks, and the medical claims they submit to the VA do not include any provider information.
The contractors’ role as middlemen created the opportunity for payment errors, according to the inspector general’s audit. The inspector general found 77,700 cases where the contractors billed the VA for more than they paid providers and pocketed the difference, totaling about million. The inspector general also identified .9 million in duplicate payments and .5 million in other errors.
TriWest said it has worked with the VA to correct the payment errors and set aside money to pay back. The company said it’s waiting for the VA to provide a way to refund the confirmed overpayments. “We remain ready to complete the necessary reconciliations as soon as that process is formally approved,” TriWest said.
The grand jury proceedings involving TriWest are secret, but the investigation became public because prosecutors sought to obtain the identities of anonymous commenters on the jobs website Glassdoor.com who accused TriWest of “mak[ing] money unethically off of veterans/VA.” Glassdoor fought the subpoena but lost, in November 2017. The court’s opinion doesn’t name TriWest, but it describes the subject of the investigation as “a government contractor that administers veterans’ healthcare programs” and quotes the Glassdoor reviews about TriWest. The federal prosecutor’s office in Arizona declined to comment.
“TriWest has cooperated with many government inquiries regarding VA’s community care programs and will continue to do so,” the company said in its statement. “TriWest must respect the government’s right to keep those inquiries confidential until such time as the government decides to conclude the inquiry or take any actions or adjust VA programs as deemed appropriate.”
The VA tried to make the Choice Program run more smoothly and efficiently. Because the contractors were failing to find participating doctors to treat veterans, the VA in mid-2015 launched a full-court press to sign up private providers directly, according to the inspector general. In some states, the VA also took over scheduling from the contractors.
“We were making adjustments on the fly trying to get it to work,” said David Shulkin, who led the VA’s health division starting in 2015. “There needed to be a more holistic solution.”
Officials decided in 2016 to design new contracts that would change the fee structure and reabsorb some of the services that the VA had outsourced to Health Net and TriWest. The department secretary at the time, Bob McDonald, concluded the VA needed to handle its own customer service, since the agency’s reputation was suffering from TriWest’s and Health Net’s mistakes. Reclaiming those functions would have the side effect of reducing overhead.
“Tell me a great customer service company in the world that outsources its customer service,” McDonald, who previously ran Procter Gamble, said in an interview. “I wanted to have the administrative functions within our medical centers so we took control of the care of the veterans. That would have brought that fee down or eliminated it entirely.”
The new contracts, called the Community Care Network, also aimed to reduce overhead by paying the contractors based on the number of veterans they served per month, rather than a flat fee for every referral. To prevent payment errors like the ones the inspector general found, the new contracts sought to increase information-sharing between the VA and the contractors. The VA opened bidding for the new Community Care Network contracts in December 2016.
But until those new contracts were in place, the VA was still stuck paying Health Net and TriWest at least 5 for every referral. So VA officials came up with a workaround: they could cut out the middleman and refer veterans to private providers directly. Claims going through the contractors declined by 47 percent from May to December in 2017.
TriWest’s CEO, McIntyre, objected to this workaround and blamed the VA for hurting his bottom line.
In a Feb. 26, 2018, email with the subject line “Heads Up… Likely Massive and Regrettable Train Wreck Coming!” McIntyre warned Shulkin, then the department secretary, that “long unresolved matters with VA and current behavior patterns will result in a projected million loss in 2019. This is on top of the losses that we have amassed over the last couple years.”
Officials were puzzled that, despite all the VA was paying TriWest, McIntyre was claiming he couldn’t make ends meet, according to agency emails provided to ProPublica and PolitiFact. McIntyre explained that he wanted the VA to waive penalties for claims that lacked adequate documentation and to pay TriWest an administrative fee on canceled referrals and no-show appointments, even though the VA read the contract to require a fee only on completed claims. In a March 2018 letter to key lawmakers, McIntyre said the VA’s practice of bypassing the contractors and referring patients directly to providers “has resulted in a significant drop in the volume of work and is causing the company irreparable financial harm.”
McIntyre claimed the VA owed TriWest million and warned of a “negative impact on VA and veterans that will follow” if the agency didn’t pay. Any disruptions at TriWest, he said, would rebound onto the VA, “given how much we are relied on by VA at the moment and the very public nature of this work.”
But when the VA asked to see TriWest’s financial records to substantiate McIntyre’s claims, the numbers didn’t add up, according to agency emails.
McIntyre’s distress escalated in March 2018, as the Choice Program was running out of money and lawmakers were locked in tense negotiations over its future. McIntyre began sending daily emails to the VA officials in charge of the Choice Program seeking updates and warning of impending disaster. “I don’t think the storm could get more difficult or challenging,” he wrote in one of the messages. “However, I know that I am not alone nor that the impact will be confined to us.”
McIntyre lobbied for a bill to permanently replace Choice with a new program consolidating all of the VA’s methods of buying private care. TriWest even offered to pay veterans organizations to run ads supporting the legislation, according to emails discussing the proposal. Congress overwhelmingly passed the law (named after McCain) in May 2018.
“In the campaign, I also promised that we would fight for Veterans Choice,” Trump said at the signing ceremony in June 2018. “And before I knew that much about it, it just seemed to be common sense. It seemed like if they’re waiting on line for nine days and they can’t see a doctor, why aren’t they going outside to see a doctor and take care of themselves, and we pay the bill? It’s less expensive for us, it works out much better, and it’s immediate care.”
The new permanent program for buying private care will take effect in June 2019. The VA’s new and improved Community Care Network contracts were supposed to be in place by then. But the agency repeatedly missed deadlines for these new contracts and has yet to award them.
The VA has said it’s aiming to pick the contractors for the new program in January and February 2019. Yet even if the VA meets this latest deadline, the contracts include a one-year ramp-up period, so they won’t be ready to start in June 2019.
That means TriWest will by default become the sole contractor for the new program. The VA declined to renew Health Net’s contract when it expired in September 2018. The VA was planning to deal directly with private providers in the regions that Health Net had covered. But the VA changed course and announced that TriWest would take over Health Net’s half of the country. The agency said TriWest would be the sole contractor for the entire Choice Program until it awards the Community Care Network contracts.
“There’s still not a clear timeline moving forward,” said Giddens, the former VA contracting executive. “They need to move forward with the next program. The longer they stay with the current one, and now that it’s down to TriWest, that’s not the best model.”
Meanwhile, TriWest will continue receiving a fee for every referral. And the number of referrals is poised to grow as the administration plans to shift more veterans to the private sector.
This story was produced in collaboration with PolitiFact.
This article originally appeared on ProPublica. Follow @ProPublica on Twitter.
The USS Ronald Reagan (CVN 76), USS Nimitz (CVN 68), and USS Theodore Roosevelt (CVN 71) are in the Western Pacific on operational deployments. They have full air wings and carrier escorts.
The USS Carl Vinson (CVN 70) and USS John C. Stennis (CVN 74) are in the Eastern Pacific, while the USS Abraham Lincoln (CVN 72) and the brand-new USS Gerald R. Ford (CVN 78) are in the Atlantic. Those four carriers are on training missions or doing workups before deployments.
All the carriers — including the ones converging on the Western Pacific — are on planned operations amid President Donald Trump’s 12-day trip to Asia.
Here’s what each carrier is up to.
The USS Ronald Reagan just finished a three-day drill in the Sea of Japan with a Japanese destroyer and two Indian warships.
The USS Theodore Roosevelt visited the US territory of Guam on Oct. 31, the first time the carrier has ever done so.
The USS Theodore Roosevelt visited the US territory of Guam on Oct. 31, the first time the carrier has ever done so. (Image via @PacificCommand Twitter)
Three months earlier, the North Korean leader Kim Jong Un threatened to launch missiles near the island. More recently, China reportedly practiced bombing runs targeting Guam with H-6K “Badger” bombers.
The USS Carl Vinson recently conducted training exercises off the coast of Southern California and is now doing a planned sustainment exercise and flight tests with the F-35C Lightning II fighter.
F/A-18 Hornets and Super Hornets assigned to Carrier Air Wing (CVW) 2 fly over the Nimitz-class aircraft carrier USS Carl Vinson (CVN 70), front. (Navy photo by Mass Communication Specialist 2nd Class Sean M. Castellano)
The USS Gerald R. Ford, the first of its class, is the largest and most advanced ship in the US fleet. It was commissioned in July and is undergoing trials and exercises before it fully joins the fleet.
The competition allowed Marines stationed in Japan to test and enhance their shooting abilities.
“The concept of every Marine a rifleman goes back to our basics,” said Sgt. Christian Lee Burdette, an ordinance maintenance chief with Marine Corps Installations Pacific. “We learn basic infantry skills before we learn our military occupational specialty. Every Marine in general has the capabilities to engage any threat with a weapon. With this training, it provides that confidence for a Marine to engage effectively.”
The first day of the competition included a brief morning class to brush the competitors up on their marksmanship knowledge followed by competitors zeroing their rifles. Zeroing is the process of calibrating the rifle combat optic, so the weapon is accurate to where the shooter is aiming. The shooters’ zero is essential, as a faulty zero can disrupt a shooters’ ability to hit their target.
The following week allowed the shooters to practice the various courses of fire. To complete certain courses, the shooters were forced to shoot with their off-hand and eye.
U.S. Marines competing in the Far East Marksmanship Competition engage targets at Range 18 on Camp Hansen, Okinawa, Japan Dec. 13, 2018.
(Photo by Pfc. Brennan Beauton)
“It puts you into unknown situations, instead of just shooting on a flat range and known distances,” said Sgt. Shane Holum, an emergency service crew chief with MCIPAC. “You have multiple targets and you are shooting and moving. You have to work through problems and malfunctions.”
The final week was for score. All of the shooters’ shots were marked and recorded. Marines were able to compete as an individual, a team, or both. Each shooter had to complete the standard Marine Corps rifle and pistol qualification course along with other courses. The additional courses required shooters to fire and maneuver obstacles, and switch weapons while engaging targets at different distances.
Sixteen teams competed on Dec. 13, 2018, in a rifle and pistol competition. To enter and compete as a team, each team must include four shooters. A team must have an officer and a first time shooter. The first time shooter must be at least a noncommissioned officer.
A U.S. Marine shooter and spotters assess the target in the Team Pistol Match finals at Range 1 on Camp Hansen, Okinawa, Japan Dec. 13, 2018.
(Photo by Pfc. Brennan Beauton)
“Any command that is stationed on Okinawa or mainland Japan can come out to the competition,” said Staff Sgt. Stephen Ferguson, an instructor and competitor for the Marine Corps Shooting Team. “You can bring as large as a team as you want, or bring a single shooter. Either way, you can come out and compete.”
The Marine Corps Base Camp Butler’s team won the team rifle competition. The Communication Strategy and Operations Company on Camp Hansen won the team pistol competition, the same day the unit became officially activated. On Dec. 14, 2018, the MCB rifle team was presented with the Calvin A. Lloyd Memorial Trophy, and the CommStrat pistol team was presented with the Shively Trophy.
“Annual qualification is once a year,” said Sgt. Cameron Patrick, an instructor and competitor for the Marine Corps Shooting Team. “Shooting is a very perishable skill so we want you to not just do the qualification, but to try and get out and practice on your own time. Actually refine your skills by yourself. Don’t wait for that one year to come around.”
The top 10 percent of shooters are invited to participate in the United States Marine Corps Marksmanship Championship Competition in Quantico, Virginia, in April 2019. From there they will be evaluated to see if the individual has the qualities of becoming a member of the Marine Corps Shooting Team, according to Patrick.
The Far East Competition is held annually on Okinawa. Marines that want to participate are encouraged to sign up early as slots fill up quickly.