Ancient Rome is credited with major contributions to modern day language, religion, law, art, and government. Indeed, the Roman Empire was filled with breathtaking architecture and an intricate and fascinating socio-economic culture. But it was also full of drama.
Most people know at least a few key facts about Julius Caesar and his infamous assassination on the Ides of March. But as the Roman Republic crumbled with him and the Roman Empire rose in its place, the rulers that came after him were no less controversial. Extravagance, executions, and extreme religious persecution stand at the forefront of many Roman emperor’s legacies. And that’s not mentioning the sex scandals.
So here’s a list of the absolute worst Roman emperors, in order from the mildly incompetent to the devastatingly unstable.
Diocletian, 284-305 CE
Emperor Diocletian deserves some credit, as his rule marked the end of the Crisis of the Third Century. His governmental reforms are cited as being one of the main contributors to the Roman Empire’s longevity for the next millennium. Diocletian regained control over a wild military force, suppressed enemy threats along the Empire’s borders, and revised the tax system in a broken economy.
However, he’s also credited with one of the most brutal attempts to purge Christianity in history, which definitely resides in the “cons” column. Diocletian revoked the legal rights of Christians, trying to encourage his citizens back to a more traditional worship of the old Roman gods. He razed churches and destroyed religious scriptures, and went even further to prohibit Christian’s from even gathering to worship. After a suspicious fire within the imperial palace, Diocletian’s belief in a Christian conspiracy led to a spree of scourging, torture, and beheading.
In 305 CE, after becoming greatly weakened by a severe illness, Diocletian resigned from his rule, passing the torch to someone with the strength to bear the Empire’s burdens. The first person to willingly abdicate from the role, the former Emperor spent the rest of his days tending a vegetable garden—sounds like a pretty fulfilling retirement.
Elagabalus, 218-222 CE
Elagabalus became Emperor at the tender age of 14, kicking off a reign that would be known for sex scandals and religious controversy—not exactly the sort of things you expect from someone fresh out of puberty.
Emperor Elagabalus started out in life as a high priest serving the Syrian sun god he shared a name with. When he came to rule over Rome, his devotion to the god drove him to try and elevate him to the same status as Jupiter, a move which greatly displeased the Empire. He even insisted upon marrying a Vestal Virgin, Aquilia Severa, which was in direct opposition to not only Roman tradition, but to the law.
On the more salacious side, it’s said that Elagabalus prostituted himself throughout the palace. He was married to five different women, and took on countless lovers of all sexes. He sent servants out into the city to procure lovers for him, and even opened the imperial baths up to the public to enjoy the spectacle of watching others bathe.
Some historians say that Elagabalus might have been one of the first transgender historical figures, offering large amounts of money to any physician who would be able to successfully administer gender reassignment surgery. This was regarded as wholly scandalous by the people of Rome, casting him in a negative light he couldn’t hope to overcome.
Elagabalus’s general incompetence on the throne led to the devaluation of the Roman currency. Showing his immaturity further, he began appointing lovers to crucial political positions. So while history tends to be unfavorable towards him for his personal choices, it does seem likely that he was unfit as an emperor mostly due to the fact that he was a literal child.
The Emperor’s youth did him no favors in the end, however. At 18 years old, Elagabalus and his eccentric behavior were brought to an end by the Praetorian Guard. After Elagabalus stripped his cousin’s titles and wealth, the Guard, who much preferred said cousin, rebelled against Elagabalus, killing both him and his mother in the violence.
Tiberius, 13-37 CE
There were plenty of things that Emperor Tiberius did right. He avoided needless and financially draining military campaigns and instead relied heavily on diplomacy. He reinforced the borders of the Empire. He even kept the Empire’s treasury generously stocked.
However, Tiberius never really wanted to rule as emperor, and that was very apparent. He left many responsibilities to the Senate and was otherwise distant and reclusive. He left Rome in the middle of his reign—a decision widely regarded as the worst one he could possibly make—and opened himself up to a reputation fully up to interpretation.
Whether these claims are rooted in truth or based fully in fabrication is impossible to know at this point, but either way, Tiberius was hated enough to get tongues wagging with the most vicious of talk. During his stay on the island of Capri, Tiberius was accused of flinging people off of cliffs for minor slights and engaging in disturbing sexual acts with very young boys. While that doesn’t have very much to do with governing an empire, it’s pretty much the last thing you want out of a ruler.
Tiberius earned a reputation as a bloodthirsty emperor after a mess grew out of a man named Sejanus making a grab for power. Sejanus tried to set himself up as Tiberius’s next heir by assassinating Tiberius’s son. Tiberius, of course, called for the death of not only Sejanus, but of those who were associated with him—including his children.
It seems likely, too, that much of his bad reputation comes from his connection to Caligula, who you’ll hear much more of later.
Caracalla, 211-217 CE
For the first 13 years of his reign, Caracalla ruled as a co-emperor alongside first his father, Septimius Severus, and then his brother, Geta. In 211 CE, he had his brother assassinated by the loyal members of his Praetorian Guard. Not satisfied, Caracalla went a step further to slaughter most of his brother’s supporters as well. In a further act of insult, Caracalla removed Geta’s image from paintings, coins, and statues, struck him from record, and made it an actual crime to utter his name.
On top of being generally regarded as a tyrannical and cruel emperor, Caracalla wasn’t all that effective in other aspects of his rule. He put into effect an edict which declared all free inhabitants of the Empire to be official citizens… so he could collect taxes from a wider base of people. He depleted much of the Empire’s funds trying to keep his army happy and often engaged in ruthless and unnecessary military campaigns.
Caracalla had an obsession with Alexander the Great, and in a fit of erratic behavior went on to persecute those philosophers of the Aristotelian school based solely off the legend that Aristotle poisoned Alexander. His behavior only got worse when, after discovering a play mocking him in the city of Alexandria, he dispatched his troops to massacre, loot, and plunder the city.
In 217 AD, Caracalla was stabbed to death by a defected soldier—an almost ironic end, considering his adoration for his own army.
Maximinus Thrax, 235-238 CE
Emperor Maximinus Thrax was a very large man, and he was also largely hated. In direct contrast to Emperor Diocletian, he’s often considered to be the ruler who caused the Crisis of the Third Century. He brought Rome to near ruin with his exhaustive military campaigns, overextending his soldiers by dispatching them to multiple fronts at once.
His distrust and distaste for anyone apart from his army did him no favors and caused social instability. Maximinus even had members of his own family put to death. He was a man who preferred to rule by conquest rather than favor and became known for wrecking public property and setting fires to any village he passed through.
His short three-year rule ended in 238 CE, when members of the Imperial Roman army assassinated him alongside his son and advisors.
Nero, 54-68 CE
Nero’s 14-year reign had some significant successes, including the negotiation of peace with the Parthian Empire and the quelling of Boudica’s revolt. While the upper class considered him overly extravagant and undignified, the lower classes of Rome actually had a strong positive opinion towards their ruler. This was true despite the fact that some of his methods leaned toward tyrannical madness. Seeing as he was only 16 years old when he took the throne, that’s not all that surprising—adolescence is hard.
In the beginning of his reign, Nero’s rule was closely guided by his mother, Agrippina the Younger, much as she had orchestrated Nero’s rise as emperor. Agrippina married his great-uncle and previous emperor, Claudius, and arranged for Nero to marry his new stepsister, Octavia. By 59 CE, an unexplained falling out caused Nero to order his troops to have her killed. This wouldn’t be the last time he organized a death.
In 62 CE, Nero divorced Octavia, citing that she was incapable of producing an heir. When his subjects looked negatively at this decision, he had Octavia exiled. Not long after that—either to further change public opinion or to solidify his claim to the throne—he accused her of adultery and had her put to death. His second wife, Poppaea Sabina, died in 65 CE. Some writers of ancient times say that Nero was responsible for this death, too, though others disagree.
Nero’s legacy as a madman is most closely tied to the Great Fire of Rome in 64 CE, which completely destroyed three of Rome’s 14 districts, leaving another seven heavily damaged. Many myths surround the terrible tragedy which killed hundreds of citizens, including the dramatically evil story of Nero fiddling as Rome fell to ashes.
In actuality, the fiddle wasn’t even in existence at the time. While some classical sources cite that Nero was on the roof of his palace singing from “The Sack of Ilium,” others place him dozens of miles away from the flames.
While it’s impossible to know the truth of the fire’s origins, many people blamed Nero directly for the destruction. It was believed that he was intentionally making way for a new city aesthetic. Whether out of genuine belief or a desperate attempt at scapegoating, Nero blamed the fire on followers of the growing Christian religion.
Nero set out to cruelly persecute the Christians, implementing an array of creative tortures and deaths, including wrapping them in animal skins to be torn apart by dogs.
After that, Nero’s rule started to crumble. Reconstruction efforts had stretched the Roman currency thin, and Nero’s indecision in dealing with further revolts caused widespread instability. In 68, his Praetorian Guard renounced their loyalty and declared Nero an enemy of the people. In one last dramatic flair, Nero committed suicide before he could be executed.
Caligula, 37-41 CE
There aren’t many reliable surviving accounts of Caligula’s reign. Even if the myriad stories surrounding him are fabrications, he’d have to be pretty unpopular to generate that kind of libel in the first place.
To be fair, Caligula had a bit of a rough start in life. He was the sole survivor after his entire family perished either in imprisonment or directly at the hands of Emperor Tiberius. He was then taken in by the emperor and indulged in all of his worst whims, until Tiberius passed and Caligula took to the throne at 25 years old.
In the first six months of his rule, things actually went pretty well. He cut unfair taxes, recalled those sentenced to exile, and granted military bonuses to soldiers. However, after a strange illness overtook him, his recovery was shrouded in a madness that gave way to sadistic and perverse tendencies. He became known for uttering the phrase, “Remember that I have the right to do anything to anybody.”
Any perceived mockery from his subjects was met with the punishment of death. In fact, in his infinite paranoia, Caligula began sending those closest to him off to exile or death—including his adopted son. His cruelty led to him gaining a sense of satisfaction out of making parents watch as their children were killed.
His arrogance rose to new heights as he declared that he was an actual living god. Caligula even had the heads of statues of gods and goddesses replaced with his own.
Further accounts of his insanity include throwing an entire section of a gladiatorial audience into the arena to be eaten by beasts for his own amusement, planning to appoint his horse as a consul, and turning the palace into a veritable brothel.
Caligula was assassinated by the Praetorian Guard after only four years as emperor. The man was so hated by the Senate that they even rallied to have him erased from the record of Roman history. Thanks to this campaign, it remains unclear to this day what is fact and what is fiction in the Caligulan reign.
Commodus, 180-192 CE
Commodus was appointed as a co-ruler by his father, Emperor Marcus Aurelius, in 177 CE. Marcus Aurelius died in 180 CE, leaving his narcissistic and self-indulgent son as the sole Emperor of Rome.
Because Caligula couldn’t be the only one to have all the fun, Commodus also thought himself to be a god, referring to himself as Hercules reborn and forcing others to follow suit. He swanned around the city in lion skins and participated in gladiatorial events—an act in which was considered scandalous for a ruler to partake.
What’s worse: He often chose to compete against weak soldiers who were sickly or maimed from the war, sometimes tying two of them together to club them to death with a single strike. To add insult to the already grave injury, he also exorbitantly charged Rome for his arena appearances.
Commodus’s self-love knew no bounds. He changed the calendar months to reflect his own self-bestowed epithets. He shamelessly exiled and executed his wife and proudly kept a harem of hundreds. He forced his advisors to take the fall for political blunders and had entire families slaughtered on suspicion of conspiracy.
US Air Force Global Strike Command, which oversees the entire Air Force bomber fleet, ordered a safety stand down for its B-1B Lancer bombers on June 7, 2018, following an emergency landing by a Lancer in Texas in May 2018.
“During the safety investigation process following an emergency landing of a B-1B in Midland, Texas, an issue with ejection seat components was discovered that necessitated the stand-down,” the command said in a release. “As issues are resolved aircraft will return to flight.”
A B-1B bomber from Dyess Air Force Base in Texas made an emergency landing at Midland International Airport in western Texas on May 1, 2018, after an in-flight emergency. Emergency responders made it to the runway before the plane landed, and none of the four crew members onboard were injured.
It was not clear what caused the emergency, though fire crews that responded used foam on the plane.
Photos that emerged of the bomber involved showed that at least one of its four cockpit escape hatches had been blown, but the ejection seat did not deploy.
(U.S. Air Force photo by Master Sgt. JT May III)
The B-1’s four-man crew includes a pilot, copilot, and two weapons officers seated behind them. All four sit in ejection seats and each seat has an escape hatch above it, according to Air Force Times. Pulling the ejection handle starts an automatic sequence in which the hatch blows off and a STAPAC rocket motor launches the seats from the aircraft. The entire process takes only seconds.
It was not clear at the time of the incident whether the blown hatch or hatches had been recovered or whether the ejection seats had failed to deploy.
A Safety Investigation Board, a panel made up of experts who investigate incidents and recommend responses, is looking into the incident at Midland, the Global Strike Command release said.
The Global Strike Command stand-down order comes about a month after the Air Force ordered a day-long, fleet-wide stand-down while it conducted a safety review following a series of deadly accidents. At the time, the Air Force said it was seeing fewer accidents but that 18 pilots and crew members had been killed since October 1, 2018.
This article originally appeared on Business Insider. Follow @BusinessInsider on Twitter.
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 308th Fighter Squadron was reactivated in a ceremony at Luke Air Force Base, Nov. 30, 2018. The squadron will house the Royal Netherlands Air Force’s and the Royal Danish Air Force’s F-35A Lightning IIs, in a training partnership.
With Lt. Col. Robert Miller assuming command, the fighter squadron is scheduled to begin operations in December 2018.
“It’s bittersweet to leave the 62nd FS, but fortunately I’ll continue to fly and instruct at the 308th FS,” Miller said.
Throughout the next two years, the Dutch and the Danish air forces will be sending their jets to populate the squadron and help Luke AFB’s mission of training the world’s greatest fighter pilots.
“The 308th FS is the fourth F-35 squadron at Luke, but the most important part of this activation is that we will be with two partner nations,” said Miller. “In a few weeks, the Dutch will start their F-35 training followed by the Danes.”
Col. Mathew Renbarger, 56th Operations Group commander, passes the 308th Fighter Squadron guidon to Lt. Col. Robert Miller, 308th FS commander, during an assumption of command ceremony, Nov. 30, 2018, at Luke Air Force Base.
(U.S. Air Force photo by Airman 1st Class Aspen Reid)
Before final arrangements were made, Lt. Gen. Dennis Luyt, Royal Netherlands Air Force commander, paid Luke AFB a visit. During the visit he was given a tour of the base and of the Academic Training Center where all of the F-35 pilots learn how to fly.
After thorough examination of the training facilities, Dutch air force members were given a walk-through of the new fighter squadron building.
Under Miller’s watch, the 308th FS’s goal is to train as efficiently as the rest of Luke AFB’s fighter squadrons.
“As we stand up the 308th FS we will emulate the 62nd FS nation to the best of our ability,” said Miller. “In time, we’ll challenge to be the best F-35 organization.”
Miller said challenging the status quo is the mindset at Luke AFB.
“The trust that we build at Luke with our partners is critical to our success on the battle field. The opportunity to train, learn and be together is unparalleled elsewhere,” said Miller. “We are changing the way our Air Force and other nations prepare for war.”
Brig. Gen. Edward L. Vaughan is the Air National Guard Special Assistant to Maj. Gen. Scott F. Smith, the Director of Training and Readiness, Deputy Chief of Staff for Operations, Headquarters U.S. Air Force, Arlington, Va. The directorate, encompassing seven divisions and the Air Force Agency for Modeling and Simulation, is responsible for policy, guidance and oversight of Air Force operations.
General Vaughan also serves as the lead for the Air Force Physiological Episodes Action Team (AF-PEAT) and co-leads the ad hoc Joint-PEAT, along with Navy Rear Adm. Fredrick R. Luchtman.
General Vaughan completed Reserve Officer Training Corps at Rensselaer Polytechnic Institute and received his commission as honor graduate from ANG’s Academy of Military Science. He previously served in leadership roles at the squadron, group, wing and higher headquarters levels in both the mobility and combat air forces. General Vaughan commanded the 156th Airlift Wing, Puerto Rico, and Detachment 1 of the 13th Air Expeditionary Group (formerly the 13th Expeditionary Support Squadron), Antarctica.
During an interview with Airman Magazine, Gen. Vaughan discussed his new post leading the joint investigation of Unexplained Physiological Episodes (UPEs) and his experiences as a mobility and combat airman and safety officer.
Airman Magazine: Please tell us about your new job investigating Unexplained Physiological Episodes.
Brig. Gen. Vaughan: As part of my role working in A3T, I’ve been tasked by the A3 Lt. Gen. Mark Kelly to lead the Physiological Episodes Action Team, also known as the PEAT.
PE stands for physiological episode or event. Essentially it’s any anomaly in the interaction among the aircrew, equipment, and environment that causes adverse physical or cognitive symptoms, which may impede the ability to fly..
What we’ve done across the Air Force and all aircraft, but most recently with the T-6 fleet, is to investigate what causes PEs. In some cases an Unknown PE will immediately reveal to us what happened. Maybe there was some sort of contamination in the cockpit due to an oil leak or some other fumes, so we’re able to identify it as a known physiological event.
In other cases, pilots will experience symptoms, come down and land, report them and we don’t know exactly what the cause is until we investigate further.
Members of the Navy Physiological Episodes Action Team and Air Force PEAT listen to a discussion between Rear Adm. Fredrick R. “Lucky” Luchtman (left) and Air Force Brig. Gen. Edward L. “Hertz” Vaughan (right) as they lay the ground work for the Joint Physiological Episodes Action Team, or J-PEAT.
(Photo by Scot Cregan)
Airman Magazine: Tell me about the PEAT. What is the structure and objective of the team?
Brig. Gen. Vaughan: The AF-PEAT is Air Force Physiological Episodes Action Team. Now, previously this has been known as the UPE IT or Unexplained Physiological Events Integration Team. We’re working very closely with our Navy partners and they came up with a pretty good name – Physiological Episodes Action Team. In the interest of both jointness and keeping it simple for all the flying community, we’ve aligned names with the Navy.
Of course, that’s not the only thing we’ve learned from the Navy. The Navy’s had some great success in exploring what happens in physiological episodes, what happens to aviators, and we’ve been able to learn a lot from them and they’ve learned from us as well.
Airman Magazine: How does the PEAT operate?
Brig. Gen. Vaughan: We have two meetings per week. Every Friday the Air Force PEAT meets. Who is on this action team? The answer is those people who are required for that particular meeting.
We’ll have the topics of the week, sometimes we’re looking at specific incidents with airplanes, specific episodes, and other times we may be investigating new equipment that’s coming out, new procedures, new training or maybe there’s the results of an investigation that we’ll need to review. We have standing members of the team, about half a dozen, that are there at every meeting.
Then we have another kind of a second layer of folks, which gets us up closer to 20 people, who come in as needed. That second layer includes folks from the acquisition community or the 711th Human Performance Wing. We don’t necessarily need to have them come to every meeting, but there’s times we really need somebody from human performance wing present. That’s one meeting.
Then immediately following that meeting, we have, what I call the Joint-PEAT. It’s really an ad hoc Joint Physiological Episodes Action Team with the Navy. It is very much a joint effort in that we work closely together and meet weekly to keep a steady battle rhythm so as things come up during the week, if they’re not an emergency or if it’s not something that we’ve got to address right at that minute, we’ll be able to put it together on Friday. We know that once a week we’re going to have a meeting where we can sit down face-to-face and hash these things out.
My Navy counterpart is Rear Adm. Frederick Luckman, he goes by “Lucky”. My call sign is “Hertz”. We immediately got to a Hertz-Lucky professional friendly demeanor. We go through an awful lot of coffee. He and I meet as often as we can to share data. Like I said, we cannot share the information fast enough.
The Navy is doing a lot of good work. They had a series of issues with physiology not only in the F-18, but T-45s, and they’ve had very good success in their T-6 fleet. They have a T-6 fleet that’s about half the size of the Air Force’s. They have slightly different models, some of theirs are newer models, but the oxygen systems are very similar.
The Navy adopted early on, in response to some of the lessons they learned from other airframes, significant maintenance practices in their T-6 oxygen system that we found very useful. We watched the Navy adopt those, saw the results of it and in those cases we’ve been able to adopt it exactly the same way that they have.
Brig. Gen. Edward L. Vaughan, head of the Air Force Unexplained Physiological Events Integration Team, and Rear Adm. Fredrick R. Luchtman, Navy Physiological Episodes Action Team lead, discuss ongoing efforts to minimize the risk of Physiological Episodes.
(U.S. Navy photo by Cmdr. Scot Cregan)
Airman Magazine: How does the timely resolution of PEs, affect training and readiness?
Brig. Gen. Vaughan: Looking at the National Defense Strategy, lethality is the primary objective and, for the Air Force, that equates to readiness. Are we ready to fight? You know, the question is readiness for what? Ready to do what? It’s ready to prosecute the war, ready to fight. In some cases, being ready to go out and influence and be that presence where we need to be.
If we’re having equipment struggles, delays in our programs, or we’re having to stand-down aircraft or cancel missions because of physiological episodes that will get in the way of us being ready. It will get in the way of us executing any plans we may have out there. So it’s important for us to get the information back, put the fixes in, get those funded, fielded and executed as quickly as possible. Once we do that, we’re going to enhance readiness and capability as we grow toward the Air Force We Need.
It also eliminates a distraction. Anytime you have aircraft mishaps of any kind, anytime you have a cluster of these PEs, it’s going to create a distraction, not just for the frontline airman, but for their families, and anybody else associated with it. Anybody involved with the operation and maintenance will have a distraction. That distraction takes our eye off the readiness ball. That’s one of the reasons that you’ll see the PEAT, Physiological Episodes Acting Team, embedded right in A3T. A3T’s tasking is training and readiness.
Airman Magazine: What types of symptoms are commonly associated with PEs?
Brig. Gen. Vaughan: Symptoms span the spectrum of what can happen to people on airplanes. I’ll caveat this with Air Force aviators receive extensive training in physiology and what may happen to them in tactical aviation. All pilots and other aircrew going through their initial training, experience the hypobaric chamber, we call it the altitude chamber. They get used to what it’s like to operate at high altitudes and what happens during decompression. They also have routine refresher training in all aspects of aviation physiology.
One of the main reasons for doing that training is so that each aviator can learn what their individual symptoms will be. No two people will react the same to an aircraft or environmental stimulus and, in fact, the same person may have different reactions on different days based on fatigue, fitness, nutrition, or other personal factors.
It’s important for each aviator to have a sense of what symptoms they might have, especially the early onset symptoms, so they can take early appropriate action to safely recover the aircraft or get out of the environment that’s causing the problem.
Some of these symptoms can range from things like tingling in the extremities, fingers and toes, headaches or nausea. There are actually cases of folks having euphoria, while other folks may become belligerent. They know if you’re flying along and all of a sudden you just feel a little irritated for no particular reason it may be time to check your oxygen system, look at the environment you’re in or determine if that’s caused by something else. Then take appropriate action to mitigate the risk.
Airman Magazine: You have said that when investigating and mitigating PEs, “We can’t share information fast enough.” Describe what you mean and how that process can be improved?
Brig. Gen. Vaughan: Sharing the right information and then making sense of the information is very important in dealing with this phenomenon. What we do right now in the Air Force is we listen to the pilots. Pilots will land and give us a debrief – What happened? When did it happen? What types of conditions were going on in the airplane?
You’ll find that in the Air Force fleet, and the Navy fleet as well, most of the aircraft have pretty sophisticated sensors when it comes to their engines and other aircraft systems. When they land that information is downloaded, aggregated, and acted upon. Much of the critical data is available real time and available to the pilot for immediate action. Each aircraft is slightly different as technology improves, but the amount of data that we’re able to download from a given flight is enormous. But hard data on the human weapon system is slim to none.
This gets into right into some of the themes of Secretary of the Air Force has talked about going into artificial intelligence, big data analytics. How do we deal with all this data, make some sense of it and not run down the wrong path to get a wrong conclusion?
I will tell you one area though, where we’re still struggling, not only the Air Force, but also the Navy and our colleagues at NASA, is collecting data from the actual human weapon system.
We want to know things like pulse rate, oxygen content in the blood, cognitive functions, any anomalies with eyesight, but these are very hard things to sense independently without interfering with the aviators while they conduct their mission.
That’s a fascinating area of research that’s happening out at the 711th Human Performance Wing at Wright Patterson Air Force Base in conjunction with the Navy Medical Research Unit Dayton. What they’ve started to do, both those labs working together and along with some NASA support, is fielding some prototypes, such as sensors that might go, for example, in the (oxygen) mask or on the pilot’s helmet.
We actually know real-time information about the oxygen system in an airplane. We have sensors on the actual system to know the content of oxygen and other gases that might be presented to the aviator. What we don’t know is what happens in system losses; what happens between the actual oxygen production or the oxygen source and the pilot’s breathing. Furthermore, we don’t know the pilot’s ability to uptake that oxygen. There’s a lot of medical and physiological processes that we need to monitor better.
A technique called Hybrid 3D Printing, developed by AFRL researchers in collaboration with the Wyss Institute at Harvard University, uses additive manufacturing to integrate soft, conductive inks with material substrates to create stretchable electronic devices.
(Wyss Institute photo)
Airman Magazine: What does the end state of this research look like? Are you talking about monitoring physiological responses of pilots during missions in real time?
Brig. Gen. Vaughan: That’s absolutely correct. We’d like to get to an end state where the human weapon system is instrumented in such a way that’s noninvasive and nonintrusive. The aviators won’t feel the sensors and it doesn’t interfere with their duties at all, but that that data is available just like you would read all the instruments on an engine. We’re trying to figure out, is that five years from now, two years from now or 20 years from now?
If you think of the human on the loop or in the loop going forward, especially in cyber systems and integrating across all-domain operations, it’s going to be more important than ever to make sure that the human weapon system is keeping up and that we’re able to monitor that.
So we’re looking at sensors that might be wearable. A lot of folks out in the community are familiar with wearable fitness monitors and the chips that go in your shoes if you’re going to run a race to keep track of where you are. One of the challenges we have in aviation is the sensors that might be worn in commercial practice that people might buy at a local store are not suitable for the aviation environment, particularly tactical aviation.
Not only do you have the pressure and temperature anomalies that occur as airplanes travel up and down, but in tactical aviation, fighters, bombers and training aircraft, there’s an awful lot of G-loading. There can be anomalies that go from high altitude to low altitude in very short order and that has a lot of wear and tear on the sensors. Some sensors are embedded in clothing and depend on contact with the skin. For example, in order to prepare themselves for a mission, aviators will strap down tighter than you might in an automobile to keep them safe, but that may also cause bulges in the clothing that interferes with sensory contact. There’s a lot of research yet to be done and a lot of development ahead of us.
I’m looking forward to the Air Force potentially investing more in that research. I’m especially impressed with our ability to work with our joint partners with the Navy and the Army, which is coming on board later this month, in this PEAT effort. They’ve got a lot of exciting things happening in their aerospace medicine field and then NASA has been a partner throughout. You really can’t beat, from an intellectual capacity standpoint, having partners like the 711th Human Performance Wing and NASA. We’ve got the best partners in the world.
Airman Magazine: Are there other interagency or commercial partners in the research and investigation of PEs?
Brig. Gen. Vaughan: Absolutely. Some of the companies that produce our aircraft have divisions dedicated to human physiology and enhancing the ability of the human to perform in or on the loop. They provide enhancements such as providing sensors and digital displays. In some cases, even an augmented reality display, which we have in many aircraft, where there’s a lens that comes over one eye and not only can you see your environment, but that lens will produce a heads-up display of images that will help you interpret what you’re seeing on the ground.
Not only do we have industry partners that helping us with this, we also have universities and some international partners. Primarily we’re working through the Navy to access the folks that are doing that work on the outside, but we’re going to start working a little more with our international affairs group here in the Air Force to foster those partnerships.
Airman Magazine: Do you see a time when human sensor capability will be baked in rather than bolted on?
Brig. Gen. Vaughan: I think we’re going to get to that point. Right now, we’ve got to be sensitive to the fact, that if we start utilizing every sensor that’s available commercially, we run the risk of interfering with the mission and maybe causing a distraction. The last thing we want to do is have sensors be the cause of problems. We want the sensors to help us solve those problems.
We’re looking at ways to prototype these things. Edwards Air Force Base, for example, where we do a lot of research and development flight testing, has been very instrumental in working with the 711th Human Performance Wing and the system program offices for the airplanes, to include the T-6, F-15, F-16 and others, in doing some remarkable testing that gives us great foundational data. That foundational data is important to determine where we do the development going forward. Also, we recently shook hands on an agreement with the Civil Air Patrol to help us collect, assess, and sort through the many commercially available wearable sensors.
Airman Magazine: What’s the benefit to the force of being able to process and utilize PE data faster?
Brig. Gen. Vaughan: So for example, right now if we have a physiological event in the aircraft, we typically execute emergency procedures, get to a safe backup source of oxygen if it’s available, descend to an altitude where it’s safe to breathe ambient air and then land as soon as possible at the nearest suitable airfield.
Perhaps what will happen in the future, with sensors on board, you may be able to head off that emergency. Sensors may alert the pilots to the fact that they are entering a phase of flight or a set of activities or an environment, where they’re at higher risk of these kinds of anomalies. By alerting the pilot to that, they may be able to mitigate it or avoid a physiological event.
Furthermore, if there is a situation in flight, the sensors on board that gives them real time readings may enable them to do a better job of assessing what’s going on.
But this is where it gets insidious. With physiological events, one serious possible symptom is an inability to assess the situation.
Now that’s a pretty extreme symptom, but you may have those situations come up. In which case, presenting the data to the pilot as numbers or another traditional data format might not be as useful as, maybe, an alert light. There are some programs out there that cause the oxygen mask to vibrate a little bit. We do this with the control stick in airplanes as well. With such an equipped aircraft if you were to get into a stall, the control stick vibrates, They call it a stick shaker. Applying these proven technologies to other areas are all in prototype and being tested.
Zach Demers, an aerospace engineer, demonstrates the Automatic Ground Collision Avoidance System (Auto GCAS) in an F-16 flight simulator at the Air Force Research Laboratory, Wright-Patterson Air Force Base, Ohio.
(Photo by Master Sgt. Brian Ferguson)
Airman Magazine: Weren’t you involved in the adoption of another pilot safety system?
Brig. Gen. Vaughan: Formerly, I served as the Air National Guard’s national director of safety. Part of our safety portfolio is flight safety and in that we have some advanced fourth and fifth- generation aircraft, but we also have legacy systems out there. Systems that don’t have baked-in ground collision avoidance systems.
We worked very hard with the system program office and the Pilot Physician program in the United States Air Force to bring on board these Auto G-CAS systems (Automatic Ground Collision Avoidance System). We have confirmed saves in situations where the pilot may have lost awareness. It doesn’t have to be a physiological event. It can be task saturation or other things that cause the pilot to lose awareness of proximity to the ground. Traditional GCAS systems will alert the pilot, such as an X symbol in the heads-up display, letting them know they’re near the ground and need to pull back on the stick.
In the Auto G-CAS, the aircraft sensors can actually determine the point where the pilot can no longer recover, due to the limits of human reaction time, and the system takes over the jet and recovers it for the pilot. As soon as the aircraft is in a safe regime, it returns the control back to the pilot. And that’s also had a couple of great saves for us.
Airman Magazine: You mentioned the Pilot Physician program, what is that and are they involved in the J-PEAT and investigating of UPEs?
Brig. Gen. Vaughan:Pilot Physician is a very unique program in the Air Force and its highly specialized. These are individuals are rated aviators of all sorts, but primarily pilots. Then they go to medical school and change their job category. So they’re no longer primarily pilots for the Air Force, they’re now physicians for the Air Force.
They’ve enabled to help us understand what’s going on both operationally and medically and where those two things meet. In other situations, you have pilots who were trying to describe what’s happening to them in the airplane and then you have medical doctors trying to understand that description. There can be things lost in translation between the communities.
The Pilot Physicians speak both aviation and medicine fluently, are able to identify with the pilots and, in many cases, have flown that exact aircraft being investigated.
Lt. Col. Jay Flottmann, pilot physician and 325th Fighter Wing chief of flight safety, explains how a valve in the upper pressure garment and the shape and the size of oxygen delivery hoses and connection points contributed to previously unexplained physiological issues during F-22 flights.
(Photo by Senior Airman Christina Brownlow)
Airman Magazine: Are there specific examples of investigations that benefitted from Pilot Physician experience and expertise?
Brig. Gen. Vaughan: Lt. Col. James “Bones” Flottman was the Pilot Physician directly involved in the F-22 investigation that we did a few years ago. The F-22 had a series of physiological episodes. He was the one that was able, as an F-22 pilot and a physician, to credibly determine that it was a work of breathing issue.
It was a combination of factors, we don’t need to go into all the specifics right here, but he was able to bridge the gap between pilot practices, things they’ve been taught to do and things they did through experience, and what was happening medically. That resulted in improvements in the whole system – improvements in some of the hardware and improvements in the pilot practices. Not only was he able to help the investigation team solve that, he was able to then go back and credibly relate this to the pilots, restoring faith both in the system, in the Air Force process.
There’s another one that is a friend of mine, retired Col. Peter Mapes. Dr. Pete Mapes is a classic Pilot Physician. He was a B-52 pilot and a fantastic doctor, as are all of them. He and I worked closely together on Auto G-CAS, as well as several key people in engineering and operations. He was really the driving force, along with Lt. Col. Kevin Price, at the Air Force and the OSD level to push that development and production through, especially for the legacy aircraft.
He also had a role in many other aviation safety improvements to include helicopters, specifically wire detection. A lot of helicopters have mishaps because they strike power lines. He was instrumental in getting some of those systems put into helicopters and out into the fleet.
He was also instrumental in improving some of the seat designs and some of the pilot-aircraft interface designs as well. Really too many to mention.
Another great a success story for the Air Force, when it comes to the Pilot Physician program is Col. Kathy Hughes, call sign “Fog”. She’s flown the T-38 and A-10, a great flying background, and has been a wonderful physician for the Air Force. She really explored the use, the application and the design of our G-suits and was able to help the Air Force evolve into a full coverage G-suit. So now the G-suits that our fighter aviators fly are more standardized and more effective than the previous generations of flight suits. Thanks, in large part, to her work. I recently met her at aviation safety conference where she is helping commercial interests design better ejection seats.
That’s just three examples. There’s a whole laundry list.
We also have advising both the Navy and Air Force PEAT, Col. William P. Mueller; call sign “Ferris”. Col. Mueller was an F-4 fighter pilot and now one of the top physicians in aerospace medicine. He’s been absolutely invaluable in helping us understand what’s going on with the physiological episodes. He not only sits on the Air Force PEAT, but he also has a permanent membership sitting on the Navy’s PEAT. So he’s part of that joint interaction and offers a fearless perspective on improving training.
Col. Kathryn Hughes, a pilot-physician and director, Human Systems Integration, 711th Human Performance Wing, sits on the stairs of a centrifuge at Wright-Patterson Air Force Base, Ohio, April 22, 2016.
Brig. Gen. Vaughan: I like using the email analogy. So most of us have email. Those that work in an office may have one for work and one for personal use, or maybe even more than that. If you’re like me at all, if you skip checking your emails for even one day, you find yourself in a huge email deficit. Now imagine all the sensors, whether it’s a cyber system, aircraft systems, space system, and each piece of all the data being collected as an email coming to you. Within minutes you would be completely overwhelmed with data. So we’re going to rely on systems to help us sort through the data and present those things that are most important now for decision making.
Those other pieces of information that we might want later for analysis, it will store those and present them at the appropriate time. So that gets after artificial intelligence. We need these systems to work with the human in the loop. We don’t necessarily want it to be standalone. We want it to be integrated with humans and that’s where the real challenge comes in, because as an aviator flying an airplane, the data I want right at that moment to prosecute the fight, may be different than the data a cyber operator working with me in that operation may need at that same moment. Artificial Intelligence or underlying data systems will have to be smart enough to give the data to the operator that’s needed to make the right decision.
I recently spent some time with Satya Nadella, CEO of Microsoft. I asked him about this wicked technology problem of applying artificial intelligence on the tactical edge. His advice about leveraging cloud technology to perform advanced operations on big data, where and when needed, has been invaluable.
Airman Magazine: How does recorded data on individual pilots allow you establish baseline physiology and find relationships between PEs that may occur in aircrew from different units and bases?
Brig. Gen. Vaughan: We’re already finding benefit from that data, so the 711th Human Performance Wing is working very closely, in this case with the T-6 system program office, and some big data analytic gurus. These folks will take large volumes of data and slice and dice it to find where there might be some differences from what would be considered a baseline or normal.
Then they can dig into those differences and see if there is something to learn. They’re finding a lot of great results that help us improve the systems. Because physiological events involve humans and each human has such a different reaction and an individual person will have a different reaction on a different day, it can be difficult to look at a small sample size and draw any big lessons. We need large sample sizes and that’s where you can start to kind of tease out the pieces of the data that are going to move us forward.
As we worked with the Navy on the Physiological Episode Action Team we have found that pilots in the Air Force and the Navy are more informed than ever. They know people in the tech business and the pilots talk amongst themselves and share information and they’re finding these wearable sensors.
Most of the wearable sensors are not suitable for aviation use. They just can’t provide good data under those conditions, but it’s worth exploring. Talking to Admiral Luckman, we wanted to find a way to get these sensors, and most of them are small things like fitness monitors, that just aren’t allowed in our environment right now, into the cockpit just to see how they survive a flight. The Civil Air Patrol, which flies general aviation aircraft, fly with their smart phones and other types of equipment.
They have a tremendous safety record, but they also have a completely different set of rules than we do. They typically just follow the AIM and the FAA civilian flight rules. Most of those flight rules don’t have any prohibitions on bringing equipment in your pocket or your flight bag.
So recently we sat down with some of the leaders of the Civil Air Patrol to work out a memorandum of understanding whereabouts we’ll get these ideas and sensors to our pilots in the fleet. Some of them will appropriately go through Air Force and Navy channels and may end up being something of a program of record in the long term.
Others that we can’t cross that gap and into the system, we’ll offer those to Civil Air Patrol and, at their option, they can start flying those. It’s not official flight test, but they can at least tell us, does this thing survive a flight up to 10,000 feet and back. And that piece of information might be just enough. That then allows our system program office with the labs to start taking a closer look.
Brig. Gen. Vaughan: So that’s a great question and that’s why I think the development of sensors and better understanding of baseline human physiology is so important.
The RPA environment is just the tip of the iceberg. As we look at humans in the loop or on the loop, human physiology, whether it’s in cyber, RPAs, intel, space, any of the other missions that we’re doing, is a very important consideration.
What we don’t have yet is a tremendous amount of baseline data. What’s physiology supposed to look like in those situations? So when it’s different, how would we know it? That’s some of the work that’s going on right now at the labs is base-lining that data.
I will tell you that while the environment of RPAs is uniquely different than the environment in airplanes, but it’s not always easier. You have a lot of folks that are out there engaged in very serious operations, life and death situations, that they are dealing with for hours on end and then go home every night to their families and to would be a normal environment. Most people have coping mechanisms to deal with that. But that’s one of the areas of research that folks are looking at in the labs – how do we better prepare people to go back and forth between these kinds of environments?
Maj. Bishane, an MQ-9 Reaper pilot, controls an aircraft from Creech Air Force Base, Nevada. RPA personnel deal with the stressors of a deployed military service member while trying to maintain the normalcy of a day-to-day life.
(Photo by Staff Sgt. Vernon Young Jr.)
Airman Magazine: Let’s shift gears and talk about your career history. How does leading PEAT differ from your past experiences as a safety officer at a wing or a squadron?
Brig. Gen. Vaughan: Prior to this, I worked for Secretary Mattis in OSD reserve integration. We basically informed OSD policy relative to the seven different reserve components out there to include the Air National Guard.
Before that, I served as commander of the 156th Airlift Wing. As a wing commander, it is a minute-by-minute duty to make risk decisions and it’s very important to realize the consequences of those decisions and understand that whole risk matrix.
In my current position, I’m not a commander of anything. I’m not really in charge of folks specifically. We have a team, but we come together as required. So this job is more informative. One of our primary roles is to inform commanders. As they give us data, we give them back context so they can make better risk decisions.
It also allows the labs to put a focus on their studies enabling the system program offices to acquire and improve systems to support the mission. So this job is very different in that respect.
I think having been a commander previously helps me understand what these commanders they need to hear and how they want to receive that data so it doesn’t overwhelm them.
Airman Magazine: What is it you would like the pilots and aircrew to know about you, the PEAT and their part in preventing and mitigating PEs?
Brig. Gen. Vaughan: I traveled to Randolph Air Force Base and I had the opportunity to meet with some of the higher headquarters staff. I met with the commander of 19th Air Force and I was very encouraged and reassured with everyone’s openness to really solving this problem as aggressively and quickly as possible, talking about physiological episodes, but also, in a broader sense, the sustainment of the T-6 and sustainment of other airframes for which people might be interested.
I feel good about where that’s going. I also had a real eye-opener when I had an opportunity to meet with some of the T-6 pilots. We met off base. We decided to meet in a restaurant in a casual environment. We wanted that format because I wanted to hear really unfiltered what some of these T-6 pilots, who are some of the most experienced pilots in the Air Force flying that mission, that airframe. I was able to learn a lot. They have great faith in their chain of command and leadership. They have valid and serious concerns about physiological episodes, as does the commander all the way up to the chief of staff and the Secretary.
I think being able to hear their perspective, share with them my firsthand knowledge of meeting with senior level commanders in the Air Force bridged some gaps. I also was able to hear some very specific engineering questions and connect some of those pilots directly with some of the engineers at the system program office and some folks within their own chain of command that they just haven’t connected with yet. Just trying to get those dialogues going, because the solutions that the air Force is putting into place, whether it’s T-6 or any other airframe, are usually phased. Some of them require major investment, money and time-wise, and those take a little longer to accomplish.
So how do you bridge the gap between today and when we get to that promised land if some of those bigger fixes and it comes down to some solid risk management? In the case of the T-6, there’s a whole list of maintenance protocols that we handle and emergency procedures for the pilots that don’t necessarily reduce the number of these events, but they can reduce the severity and certainly mitigate the consequences. That’s what we’re trying to do. We don’t want a situation where any physiological episode goes far enough to lead to a permanent injury or harm of an aviator destruction of property. We want to catch those things as early as possible through these mitigation techniques.
Another thing I got to do when I was at Randolph was shadow the maintainers as they did maintenance on a T-6 that had a physiological episode. In the past, when these things would happen, there wasn’t a specific protocol. They would do their very best to look at the oxygen system, but there wasn’t a protocol on how to do that.
T-6 Texans fly in formation over Laughlin AFB, TX.
(Photo by Tech. Sgt. Jeffrey Allen)
Over the last year, with the help of a lot of the pilots, doctors, chain of command folks, human performance wing – a big team effort, when the airplane lands after one of those instances it’s an automatic protocol for that oxygen system.
In most cases it’s removed and a new one is put in and the suspect system then gets this thorough going over at the depot level and not only do we fix that, that particular system and return it to service. We’re able to learn a lot and collect data points. In some cases, we don’t find the specific cause in that system and then we look elsewhere – maybe more pilot interviews, talking to the doctors and trying to piece it together.
The protocols that are out there now not only helped mitigate the consequences of these events until we field new equipment, but they also help us in collecting data that will inform better decisions going forward.
The Trump administration plans to demand that US allies pay the full cost for hosting American troops, plus 50% more for the privilege of hosting them, Bloomberg News reported March 8, 2019, citing a dozen administration officials and people it said had been briefed on the situation.
The plan targets allies such as Germany and Japan but is expected to extend to any country that hosts US military personnel. With the so-called “Cost Plus 50” plan, some countries could wind up paying as much as six times what they pay now to host US troops.
In January 2019, South Korea agreed to pay just shy of id=”listicle-2631065522″ billion, significantly more than the previous 0 million, to host US troops in country. Bloomberg reports that President Donald Trump demanded “cost plus 50” in recent payment negotiations with South Korea and that it nearly derailed talks.
Trump has long railed against allies for not paying what he considers their fair share for US defense.
“We defend Japan. We defend Germany. We defend South Korea. We defend countries. They do not pay us what they should be paying us,” he said during the first presidential debate in September 2016. “We are providing a tremendous service, and we’re losing a fortune.”
President Donal Trump.
(Photo by Gage Skidmore)
“Wealthy, wealthy countries that we’re protecting are all under notice,” the president said at the Pentagon in January 2019. “We cannot be fools for others.”
Since he took office, he has repeatedly pressed NATO countries to spend at least 2% of their gross domestic product on defense as some countries pledged to do by 2024.
The Cost Plus 50 plan, according to Bloomberg, has alarmed both the State Department and the Defense Department, with rising concern that such a move could weaken the alliances at a time when the US is again facing great-power competition from rivals like China and Russia.
Countries such as Japan and Germany are already becoming increasingly resistant to the presence of the US military within their borders, and there are concerns that demands for larger payments could make the host countries even more hostile to the idea of hosting US troops.
“Getting allies to increase their investment in our collective defense and ensure fairer burden-sharing has been a long-standing US goal,” the National Security Council spokesman Garrett Marquis told Bloomberg. “The administration is committed to getting the best deal for the American people,” he added, while refusing to comment on ongoing deliberations.
It remains to be seen whether the Trump administration will announce the Cost Plus 50 plan as is or lessen the steep new demands.
This article originally appeared on Business Insider. Follow @BusinessInsider on Twitter.
The Pentagon’s new report on China’s developing military capabilities exposes the fighting force on the front-line of China’s quest to control the seas.
The Chinese Maritime Militia, a paramilitary force masquerading as a civilian fishing fleet, is a weapon for gray zone aggression that has operated in the shadow of plausible deniability for years. Supported by the People’s Liberation Army Navy “grey hulls” and Chinese Coast Guard “white hulls,” the CMM “blue hulls” constitute China’s third sea force.
“China has used coercive tactics, such as the use of law enforcement vessels and its maritime militia, to enforce maritime claims and advance its interests in ways that are calculated to fall below the threshold of provoking conflict,” the report explains. For instance, after the Permanent Court of Arbitration in The Hague discredited China’s claims to the South China Sea last July, Beijing dispatched the CMM to the territories China aims to control.
“China is building a state-owned fishing fleet for its maritime militia force in the South China Sea,” the Pentagon report introduced.
China presents the CMM as a civilian fishing fleet. “Make no mistake, these are state-organized, -developed, and -controlled forces operating under a direct military chain of command,” Dr. Andrew Erickson, a leading expert on Chinese naval affairs, explained during a House Committee on Armed Services hearing in September.
The maritime militia, according to the Pentagon, is a “subset of China’s national militia, an armed reserve force of civilians available for mobilization to perform basic support duties.” In the disputed South China Sea, “the CMM plays a major role in coercive activities to achieve China’s political goals without fighting, part of broader [People’s Republic of China] military doctrine that states that confrontational operations short of war can be an effective means of accomplishing political objectives.”
The Department of Defense recognizes that the CMM trains alongside the military and the coast guard. A 2016 China Daily article reveals that the maritime militia, a “less-noticed force,” is largely “made up of local fishermen.” The article shows the militia training in military garb and practicing with rifles and bayonets.
“The maritime militia is … a component of China’s ocean defense armed forces [that enjoys] low sensitivity and great leeway in maritime rights protection actions,” explained a Chinese garrison commander.
The CMM is not really a “secret” weapon, as it has made its presence known, yet throughout the Obama administration, government publications failed to acknowledge the existence of the maritime militia. “We have to make it clear that we are wise to Beijing’s game,” Erickson said in his congressional testimony.
The CMM harassed the USNS Impeccable in 2009, engaging in unsafe maneuvers and forcing the U.S. ship to take emergency action to avoid a collision. The maritime militia was also involved in the 2011 sabotage of two Vietnamese hydrographic vessels, 2012 seizure of Scarborough Shoal, 2014 repulsion of Vietnamese vessels near a Chinese oil rig in disputed waters, and 2015 shadowing of the USS Lassen during a freedom-of-navigation operation. China sent 230 fishing vessels, accompanied by several CCG vessels, into disputed waters in the East China Sea last year to advance China’s claims to the Senkaku/Diaoyu Islands administered by Japan.
Commissar of the Hainan Armed Forces Department Xing Jincheng said in January that the members of the Maritime Militia should serve as “mobile sovereignty markers.” He stated that this force is responsible for conducting “militia sovereignty operations” and defending China’s “ancestral seas,” territorial waters “belonging to China since ancient times.”
“I feel that the calm seas are not peaceful for us,” he said. “We have to strengthen our combat readiness.”
While the maritime militia has been mentioned by Navy officials, as well as congressional research and commission reports, the new Department of Defense report is the first high-level government publication to address the third sea force. “The fact is that it is there,” U.S. Pacific Fleet Commander Admiral Scott Swift said in November, “Let’s acknowledge that it is there. Let’s acknowledge how it’s being command-and-controlled.”
Dragging the maritime militia into the light significantly limits its ability operate. “It is strongest—and most effective—when it can lurk in the shadows,” Erickson wrote in the National Interest.
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Imagine signing up to be starved, sleep deprived and trying to fight for survival during a 19-day combat leadership course in the mosquito-, rattlesnake- and wild boar-infested hilly terrain north of San Antonio with 28 other Airmen.
This was the scenario for 29 Airmen who took part in the Ranger Assessment Course at Camp Bullis, Texas, Oct. 29 – Nov. 16. Upon successful completion of RAC, the Airmen would have a chance to enroll in the coveted, yet even more grueling, Army Ranger Course.
Airmen from different career fields challenge themselves in the Ranger Assessment course which is a combat leadership course which can lead to attending Army Ranger School. The 29 Airmen who began the course came from six major commands and represented security forces, tactical air control party, airfield management and battlefield Airmen specialties.
One of the 12 instructors, Tech. Sgt. Gavin Saiz from the 435th Security Forces Squadron at Ramstein Air Base, Germany, said RAC is a combat leadership course emphasizing doctrine that uses a host of tactical and technical procedures to instruct the students, who have to learn and apply a firehose of information in a short period.
Qualified Airmen from any career field can attend the course, which is held twice a year. Efforts are underway to see if the course can be expanded to four times a year in order to conduct them in U.S. Air Forces in Europe and Air Forces Africa and Pacific Air Forces. If the applicant is physically and mentally qualified, they can enroll in the course, but not everyone makes it to the finish line. The course has a 66-percent fail rate.
Since 1955 when the Army began accepting Airmen into its school, nearly 300 Airmen have earned the Ranger tab. The Army Ranger Course is one of the Army’s toughest leadership courses, with a concentration on small-unit tactics and combat leadership. The course seeks to develop proficiency in leading squad and platoon dismounted operations in an around-the-clock, all-climates and terrain atmosphere. RAC is based on the first two weeks of the Army Ranger Course.
The RAC instructors provide this stress-oriented battle school for airmen to develop better leadership and command tools under the mental, emotional and physical strain. They push the students to improve their resiliency and coping mechanisms.
Capt. Nicholas Cunningham, 741st Missile Security Forces Squadron, Malmstrom AFB, Montana, was one of five students selected for the Ranger Training Assessment Course (RTAC) which is a dynamic two-week spin up to acclimate Army and sometimes joint or partner service members to the rigors of Ranger School. If he successfully completes that course, he may be referred to Army Ranger School. “The course taught us tons of lessons about working as a team, pushing past mental limits and mostly leadership,” he said. “Where we as Ranger students at first were acting as individuals, we had to shift toward operating together as a single unit. The more we acted by ourselves, the worse we did as a team. To meet the objective, whether it was packing our clothes within a certain amount of time or assaulting an enemy force, required every Ranger to do their part of the task and then some.”
After the first week of classroom and hands-on training, Sloat said they select students for various leadership positions for the missions and then challenge them to plan, prepare and conduct missions, whether it is a recon or ambush mission. They plan backwards based on a higher headquarters Operation Order.
On the last day of missions, ten tired, hungry and cold Airmen made it to the finish line, having tested their mettle to the extremes. The 29 Airmen who began the course came from six major commands and represented security forces, tactical air control party, airfield management and battlefield Airmen specialties.
The first female to finish the course, 2nd Lt. Chelsey Hibsch from Yokota Air Base, Japan, has also been selected for RTAC. She said she saw more individuals fail as a follower because they didn’t want to go out of their way to help their partners succeed. “Those who were good followers tended to have others follow them with more enthusiasm because they had each other’s backs,” she said. “You learn how you react when everything is against you. Some individuals pressed on and others froze.”
The Air Force Security Forces Center, one of the Air Force Installation and Mission Support Center’s subordinate units, hosted the course. The instructors, all having been through the course and graduated Army Ranger School, put the students through the mind-numbing days and nights. The instructors provide this stress-oriented battle school for Airmen to develop better leadership and command tools under the mental, emotional and physical strain and improve their resiliency and coping mechanisms.
Below are the names of those who successfully met the challenge in the 19-01 Ranger Assessment Course and will be recommended to attend the Army Ranger Course: Staff Sgt. Paul Cdebaca/TACP/3 Air Support Operations Squadron, Joint Base Elmendorf – Richardson, Alaska Staff Sgt. Mark Bunkley/TACP/350 SWTS – Joint Base San Antonio – Lackland, Texas Senior Airman Troy Hicks/TACP/ 7 Air Support Operations Squadron– Ft. Bliss, Texas Senior Airman Aaron Lee/SF/9 Security Forces Squadron, Beale AFB, California Senior Airman Zachary Scott/SF/802 Security Forces Squadron, JBSA – Lackland, Texas
A second group of Airmen recommended for RTAC along with Cunningham and Hibsch: Senior Airman Sage Featherstone/TACP/7 Air Support Operations Squadron, Ft. Bliss, Texas Senior Airman Austin Flores/SF/75 Security Forces Squadron, Hill AFB, Utah Staff Sgt. Brayden Morrow/SF/341 Security Support Squadron, Malmstrom AFB, Montana
The littoral combat ship was intended to carry out a wide variety of missions for the United States Navy in the 21st century. From mine-countermeasures to coastal anti-submarine warfare to combating small and fast enemy surface craft, these vessels are intended to fight and win. But how well would they fare against perhaps the epitome of the small fast surface craft in World War II?
The PT boat was built in very large numbers by the United States during World War II. While its most famous exploits were in the Philippines in late 1941 and early 1942, particularly the evacuation of General Douglas MacArthur, these boats saw action in all theaters of the war. There were two primary versions of the PT boat: The Higgins and the Elco.
These boats had slight variations in a number of sub-classes, but their main armament was four 21-inch torpedoes. In addition to the powerful torpedoes, the PT boats also packed two twin .50-caliber mounts. Other guns, ranging from additional .50-caliber machine guns to a variety of automatic cannons ranging from 20mm Oerlikons to the 37mm guns used on the P-39 Airacobra, to 40mm Bofors also found their way onto PT boats – and the acquisitions may not have been entirely… official.
USS Freedom (LCS 1) is one of the lead ships of the two classes of littoral combat ship in service at present.
(Photo by U.S. Navy)
Now, the littoral combat ships also come in two varieties: The Freedom-class monohull design and the Independence-class trimaran design. Their standard armament consists of a 57mm main gun, a number of .50-caliber machine guns, a launcher for the RIM-116 Rolling Airframe Missile, and two MH-60 helicopters. Modules can add other weapons, including 30mm Bushmaster II chain guns, surface-launched AGM-114 Hellfire missiles, and even the Harpoon or Kongsberg Naval Strike Missile as heavier anti-ship missiles.
This was one of 45 PT boats at the Battle of Surigao Strait in October 1944.
(Photo by U.S. Navy)
Looking at just the paper, you’d think that the littoral combat ship has an easy time blowing away a PT boat. In a one on one fight, you’re correct. But the whole point of the PT boat wasn’t to just have one PT boat – it was to have a couple dozen attacking at once. The classic example of this was the Battle of Surigao Strait, part of the Battle of Leyte Gulf, in October 1944. According to Volume XII of Samuel Eliot Morison’s History of United States Naval Operations in World War II, “Leyte,” the Japanese force heading up Surigao Strait was facing 45 PT boats.
A Mk 13 torpedo is launched from a PT boat. Now imagine that over a hundred have been launched at your force.
(Photo by U.S. Navy)
Never mind the fact that those PT boats were backed by six older battleships, four heavy cruisers, two light cruisers, and 28 destroyers, the sheer number of PT boats had an effect against a force of two Japanese battleships, one heavy cruiser, and two light cruisers. Incidentally, only one Japanese destroyer survived that battle.
USS Independence’s helicopters and onboard weapons would help it put up a good fight, but sheer numbers could overwhelm this vessel.
(Photo by U.S. Navy)
The same situation would apply in a PT boat versus littoral combat ship fight. The littoral combat ship’s MH-60 helicopters would use AGM-114 Hellfires to pick off some of the PT boats, but eventually the numbers would tell. What could make things worse for the littoral combat ship is if those PT boats were modified to fire modern 21-inch torpedoes. Such a hack is not out of the question: North Korea was able to graft a modern anti-ship torpedo onto a very low-end minisub and sink a South Korean corvette.
During the Vietnam War, there was a small group of special operations troops who took the fight to the enemy. Military Assistance Command Vietnam-Studies and Observations Group (MACV-SOG) was a highly secret outfit comprised of Green Berets, Navy SEALs, and Air Commandos who conducted covert cross-border operations deep into Cambodia, Laos, and North Vietnam.
SOG recon teams consisted of a few Special Forces operators and their indigenous troops, or “little people,” as the Americans affectionally called them.
Khanh “Cowboy” Doan, a South Vietnamese commando, was one of them.
In the early 1960s, Cowboy’s father saw that America would have a bigger role in Vietnam’s affairs, and so prompted his son to learn English. And so Cowboy became an interpreter. As American involvement in the Southeast Asian country grew, Cowboy began working for the American forces and soon ended up in SOG.
During his career in SOG, Cowboy participated in scores of missions. He was part of the relief column that went into Lang Vei, a Special Forces A camp that had been overrun by NVA tanks and troops in the early stages of the Siege of Khe Sanh. He also took part in a mission where his nine-man team squared off against 10,000 NVA troops.
While in SOG, Cowboy narrowly escaped death numerous times. In one instance, he didn’t go out with his team for some reason, and the team (ST Alaska) ended up being wiped out save one man who escaped and evaded for two days before getting picked up.
In 1972, after operating in SOG for six years, Cowboy lost his leg during a mission across the fence.
At the end of his career, he had served in numerous recon teams, including ST Alaska, Virginia, Idaho, and Alabama.
After Saigon fell in 1975, Cowboy thought that the cleverest thing to do in order to avoid the wrath of the North Vietnamese was to go North, where they wouldn’t be expecting him. After 11 years and 14 failed escape attempts from the country, he managed to reach the Philippines in 1986 and from there the US.
Recently, Cowboy contracted COVID-19 and had to be hospitalized with serious symptoms. What’s worse, his entire family was also infected, including his wife, son, and grandson. As a consequence, they are hard put to make ends meet. Cowboy was released from the hospital and is back in his home, but he still has to go through dialysis twice a day, totaling nine to ten hours of treatment. The good news, however, is that he is improving by the day.
Some of Cowboy’s SOG buddies, including Special Forces legend John Stryker “Tilt” Meyer, who has written extensively about America’s secret war in Vietnam, have set up a GoFundMe campaign to support their brother-in-arms and his family.
The GoFundMe campaign (you can visit the page by following this link) aims at helping Cowboy and his family during this difficult time. Donations will help pay rent, cover medical expenses not covered by his insurance, and buy food and medicine for Cowboy and his entire family.
So far, hundreds of people have donated.
“Please thank every person who donated to help me [and] my family. I can’t believe it. We [are] amazed. Please tell every person: ‘You have rescued my life,’” Cowboy told Meyer.
Men like Cowboy fought for their country against the Communist tide. But they also fought for their American brothers, with whom they share a bond that only war and adversity can forge.
“Cowboy is a clearly a legend but also very humble,” Meyer told Sandboxx News.
Check out these awesome facts you probably didn’t know about our beloved holiday.
1. Moment of remembrance at 3 pm
On Dec. 28th, 2000, President Bill Clinton signed the National Moment of Remembrance Act, which asks all Americans to pause on Memorial Day at 3:00 pm local time for a full minute to honor and remember all those who perished protecting our rights and freedoms.
2. Wearing red poppies
You may have noticed people wearing red poppy flowers pinned to their clothing on Memorial Day. This idea was influenced by the sight of poppies growing in a battle-scarred field in WWI which prompted the popular poem “In Flanders Fields” written by former Canadian Col. John McCrae.
The American Legion adopted the tradition of wearing the red poppy flowers along with many allied countries to commemorate troops killed in battle.
3. Flag raising procedures
Americans love to proudly display their flags and let them wave high and free. On Memorial Day, there’s a special protocol to properly raise and exhibit the ensign. Here it is.
When the flag is raised at first light, it’s to be hoisted to the top of the pole, then respectfully lowered to the half-staff position until 12:00 pm when it is re-raised to the top of the pole for the remainder of the day. Details matter.
4. The origin of the holiday
Originally called “Decoration Day” by Gen. John A. Logan of the Grand Army of the Republic, in 1868, the day was intended to honor the estimated 620,000 people who died fighting in the Civil war and was celebrated on May 30th.
But it wasn’t until 1971 that Congress shifted the holiday to the last Monday of May to ensure a three-day weekend and renamed it to what we all know today.
At least five separate cities claim to be the birthplace of “Decoration Day,” including Macon and Columbus, Georgia. Of course, there’s no real written record or D.N.A test to prove who is truly the mom and dad.
California, you are not the father… or mother. (Source: Wikipedia Commons)
The phone call Tom Mattis got from Jim Mattis on Dec. 23, 2018 wasn’t a pleasant one, but he said his younger brother was “unruffled” by President Donald Trump’s decision to force him out early, the elder Mattis told The Seattle Times.
“He was very calm about the whole thing. Very matter of fact. No anger,” Tom Mattis told The Seattle Times. “As I have said many times in other circumstances, Jim knows who he is … many more Americans (now) know his character.”
Jim Mattis announced his resignation as defense secretary on Dec. 20, 2018, reportedly prompted in large part by Trump’s decision to withdraw the roughly 2,000 US troops deployed to Syria.
Mattis went to the White House that day in an effort to get Trump to keep US forces in the war-torn country. Mattis “was rebuffed, and told the president that he was resigning as a result,” The New York Times said at the time.
Trump initially reacted to Mattis’ resignation gracefully, tweeting that the defense chief and retired Marine general would be “retiring, with distinction, at the end of February,” echoing Mattis’ resignation letter.
But Trump reportedly bridled at coverage of Mattis and his letter, which was widely interpreted as a rebuke of Trump and of the president’s worldview.
On Dece. 23, 2018, Trump abruptly announced that Mattis would leave office two months early, sending Secretary of State Mike Pompeo to tell Mattis of the change. Deputy Defense Secretary Patrick Shanahan will take over the top civilian job at the Pentagon in an acting capacity.
Deputy Defense Secretary Patrick Shanahan.
Trump’s sudden move to push Mattis out was reportedly a retaliatory measure, but Mattis evinced no ire over it when he told his older brother on Dec. 23, 2018.
The Mattises are natives of Richland, Washington. Tom, who was also a Marine, still lives there, as does their 96-year-old mother, Lucille.
Tom said his brother was faithful to the Constitution and would always speak truth to power “regardless of the consequences.”
“No one should assume that his service to his country will end. And the manner of his departure is yet another service to the nation. It is the very definition of patriotism and integrity,” Tom Mattis added.
Defense Secretary Jim Mattis.
(DOD photo by Army Sgt. Amber I. Smith)
Jim Mattis — who checks in with their mother almost daily, Tom Mattis said — had no plans to return home from Christmas, according to the elder Mattis, hoping instead to visit troops in the Middle East.
But Trump’s announcement appeared to forestall that trip.
On Dec. 19, 2018, a day before his resignation, Mattis released a holiday message to US service members, telling them “thanks for keeping the faith.”
On Dec. 24, 2018, Mattis signed an order withdrawing US troops from Syria, the Defense Department said, though a timeline and specific details are still being worked on. On Christmas Day, Mattis was reportedly in his office at the Pentagon.
This article originally appeared on Business Insider. Follow @BusinessInsider on Twitter.
There’s a meme that occasionally makes the rounds on social media that claims you’d have to kill 359 people in order to save up enough human blood to get the iron required to make a longsword. Forging a weapon of war from the blood of your enemies? Sign us up.
But that number seemed a little suspect, so we decided to dig deeper.
It’s true, there is iron in red blood cells — mostly in hemoglobin — but trying to extract that iron from someone’s blood is no simple process. And, with a little math, we’ve determined that if you’re somehow able to get the iron out, the number of people you’d need to drain would be way higher than the meme suggests. Let’s explore this bloody question.
Yes, this scene. Side note: This is why they had Mystique inject iron into the blood of the guard — to keep this scene scientifically accurate.
(20th Century Fox)
First of all, there are roughly 5 million red blood cells in a microliter of blood. Accounting for the tiny fractions of iron in red blood cells and the amount of blood in the body, the amount of iron within an average human body totals 4 grams, enough for about eight paperclips. We’re thinking that whoever invented the meme took this number, did the division, and came to the conclusion that you’d need 359 unfortunate souls to complete the diabolical process. But we’re not finished — not by a long shot.
A single molecule of hemoglobin is comprised of 2952 carbon atoms, 4664 hydrogen atoms, 832 oxygen atoms, 812 nitrogen atoms, eight sulfur atoms, and a whopping four iron atoms. You’d have to strip away the rest of the elements in the molecule to get to said iron. So, now we have to talk extraction — and since you’re probably already thinking of that scene from X2, let’s talk magnets.
The quality of the iron in the blood might be tied to the healthiness of each individual — but we’re just going to assume that’ll average out over the several thousand souls required…
(Photo by Tamahagane Arts)
The iron in the metalloprotein hemoglobin isn’t in a metallic state, which is great for anyone who has ever encountered a magnet. This is why you don’t immediately collapse from a clogged artery when a magnet comes close to your veins. Instead, oxygenated hemoglobin is diamagnetic — meaning it repels magnets — at an extremely low level. The blood that travels between the heart and the lungs is deoxygenated, however, making it paramagnetic, so that’s the first place any chaotic-evil blacksmith should begin.
If you could manage to create a machine to pump and deoxygenate large quantities of blood, like a modified, artificial heart, it would then be prepped for a super-magnet to pull the raw iron out of the blood. Take the blood that’s been pulled out by a super magnet and set it on fire to burn away any remaining oxygen and hydrogen and, voila, you have something to work with — in theory, anyway. Nobody’s tested this, probably because they don’t feel like being labelled a mad scientist.
What you’d be left with is something similar to iron sand. You officially have a workable material for first step in the smelting process. But there’s a huge difference between raw materials and iron that’s able to be forged.
In the real world, for every 1 kg of workable iron ingots created, you end up with an average of 3.181 kg of impurities and slag byproduct — and that’s when working with the highest quality iron sand, stuff from Gampo, South Korea. We’ll give our theoretical blood-iron the benefit of the doubt and assume it’s about the same in terms of quality.
So, you’ll need a total of 4.181 kg of blood-iron sand to get 1 kg of workable iron. Now, let’s get back to the math.
At this point, you’d already be considered a monster, so let’s keep going! To get 25 kg of usable blood-steel for a full suit of armor would require a messy 179,376 blood bags — which, surprisingly, is less than the amount of people killed annually by sugary drinks worldwide.
(Bethesda Game Studios)
An average longsword has a finished weight of around 1.5 kg — but typical generates an additional 0.75 kg of waste. That means we’ll need 2.25 kg of workable iron to make the sword. 2,250 grams of workable iron, factoring for the ratio of impurities, means we’ll need 9,407.25 grams of raw material — of blood-iron sand — to start. At 4 grams per person, you’d need at least 2,352 completely drained donors to make a iron longsword out of blood.
But if you’re going that far, why stop at iron? Why not work it into steel, which makes objectively better weapons?
Continuing folding and forging, removing the impurities, and adding carbon (which, presumably, could be found in the garbage shoot after all the work you’ve done so far) can harden that bad boy into something more durable. Granted, you’d need more blood-iron sand at a magnitude of 1 kg of blood-steel ingots to 27.7 kg of waste. That puts you at 64,749.9 grams of blood-iron sand, or a genocidal 16,188 doomed souls to create a single steel blade.
To put that in perspective, you’re looking at killing roughly half as many people as the bubonic plague did in 1625 London.