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May 11th, 2008 • No Comments
Contractors are raking in billions of U.S. tax dollars in Iraq, but when it comes to giving some of that lovin’ back to the sugar daddy who’s been so good to them, turn out to be total players:

Congress is finally moving to shut one of the more egregious forms of Iraq war profiteering: defense contractors using offshore shell companies to avoid paying their fair share of payroll taxes. The practice is widespread and Congressional investigators have been dispatched to one of the prime tax refuges, the Cayman Islands, to seek a firsthand estimate of how much the Treasury is being shorted.

You might not find it surprising that the center of the world’s booming private defense market happens to be the Caribbean. Who knew? The AP looks at one company in particular, Combat Support Associates, which although vital to our national security, and privy to top secret information about our strategy for fighting the War on Terror, houses its headquarters in the Cayman Islands:

Also, company officials maintain the subsidiary is outside the jurisdiction of U.S. courts, so federal labor rules and anti-discrimination laws don’t apply either.

In fact, there’s scant evidence that CSA Ltd. exists - at least physically. There’s no listed office address or phone number in the Cayman Islands. Records show the corporation is registered with Close Brothers, an investment house that serves as its shallow footprint in the Caymans.

Close Brothers operates out of a five-story, blue-windowed office building across the street from the docks used by cruise ships visiting this island paradise. There’s no sign of CSA Ltd., however. ”We can’t make any comments in regards to our clients,” Close Brothers director Roger Priaulx said by telephone.

The biggest offender? The one who has profited the most from no-bid contracts from the Federal government, KBR, formerly of Dick Cheney’s Haliburton. Somehow, I think Cheney would approve.

Responding to the problem, John Kerry, Barack Obama and Brad Ellsworth has introduced the Fair Share Act of 2008 (S.2775), which would increase accountability and transparency of our tax system by closing a tax loophole to prevent Federal contractors from using foreign affiliates or tax shelters to avoid paying payroll taxes (I have yet to find out where McCain stands on this bill).

Presumptive Dem. nominee Barack Obama has said the whole scheme “turns the idea of patriotism on it’s head.” Here’s Barack Obama’s statement.

(From The Mercenary's Cookbook)

There is a central question those of us who follow the media closely tend to ask: Are the DC elites with the magaphone getting duped, or just playing dumb? Well, we may have finally found our answer.

Consider this interesting part of an exchange between Hillary Clinton and George Stephanopoulos on This Week :

The interview took another unpleasant turn when Stephanopoulos tried to pin down Clinton over her position on NAFTA, a trade program introduced by her husband during his presidency. Clinton has come out against the plan saying it was not good for American workers. Stephanopoulos said, “The Clinton administration didn’t do enough to address the downside of globalization and therefore failed the workers in Indiana and the workers of the West?”

Clinton clearly took offense to the tone of the question and while answering, decided to take a jab at the host.

“Well I believe, George, in the 1990s we had a booming economy that created nearly 23 million new jobs, more people were lifted out of poverty in any time in our near history. It was an economy that worked for everyone, not just the rich, the wealthy and the well connected, but there were underlying issues that we didn’t understan fully. Now, you remember this, because George did work in that ‘92 campaign - George and I actually were against NAFTA - I’m talking about him in his previous life, before he was an objective journalist,” Clinton said to a visibly annoyed Stephanopoulos.

Now, David Gergen, who is about as earnest a commentator there is (a Republican who worked for the Clinton Administration), said this to Jake Tapper of ABC, who is less reliable, but gets it right in this case:

“The was considerable division within the White House about whether NAFTA was right on the merits,” says Gergen, “and I always associate her with those who had questions about it on the merits.”

This is where it gets interesting. “Arguments about policy are always before a decision is made. Once the president makes a decision everybody falls in line. I feel like she was among those who leaned against it on the merits. I do not remember her at a meeting arguing it out, I just felt she always had reservations.”

Then the decision was made and the first lady fell in line, along with the rest of the administration, Gergen says, to help get NAFTA passed.

About the Nov. 10, 1993 meeting, Gergen says, “she was not suddenly a convert to NAFTA. It’s just that when the president decides something, people around him are going to support that decision. I thought she was a good soldier on that.”

I saw Gergen answer this question in another interview where he said pretty much the same thing: Hillary didn’t think NAFTA was worth spending a lot of political capital on. Now here’s the thing: George Stephanopoulos was there. George knows what Hillary’s position on NAFTA was because George saw it with his own eyes. And according Hillary, he was her ally in leading the charge against it.

Like Hillary, once the decision was made, he fell in line. Yet, Stephanopoulos tries to pin her down, suggesting to the audience that, as someone who was there behind the scenes, in his journalistic judgement there is some doubt about where Hillary stood on this issue.

So no, when George spent a lot of time asking Obama about flagpins or questions raised during his stop on Sean Hannity’s radio program, he hasn’t been tricked, or played for a fool, he’s playing dumb. When they hand him these questions (or he comes up with them himself), it doesn’t matter that he was there when Hillary opposed pushing NAFTA.

Consider what this says about our chattering class: they feel absolutely no obligation to inform viewers, and what’s worse, do feel an obligation to pass on accusations they know are false. There is what he knows, and what he tells you, and the two don’t have to agree.

So, how is this different from lying, exactly?

This comes from my blog, The Mercenary's Cookbook.

The Houston Press does a story on what a family claims is the hospital’s efforts to end their daughter’s life. Fourteen-year-old Sabrina Martin went to the hospital for what doctors at first thought was a brain tumor, then determined was a abscess from a sinus infection. After a surgery to drain some fluid from her brain, she went into cardiac arrest from two strokes that left her in a coma. The family was then told that if she ever came out of it, she would be a mental vegetable, and immediately started getting pressure, they claim, to end her life.

This is not as clear cut as it might at first seem. I come at this issue with some personal experience, as I have a sister on disability and a niece who has lost 60% of her brain due to a severe seizure. Legally, once you put in a feeding tube, it becomes very hard to end a person’s life – it is deeply imbedded in our genes and our law that not intervening to save a person is more acceptable than intervening to end a person’s life. In my experience, however, despite the fact that my sister is on disability and Medicaid, the powers that be in Arizona have done nothing to try to circumvent my sister's wishes. Yet, I can see why it would be better for everyone involved if they had.

In my case, my niece is not quite as bad off as Terri Schiavo, yet it is beyond doubt that my niece will never have any quality of life, let alone even be able to swallow by herself. Even if her brain were fully functional, she has been unconscious for the most important period of child development, that recent research shows can only be patched, not repaired. She could live as a vegetable for decades, at taxpayer’s expense. And I don't feel I have the right to make that decision for her.

No matter how you feel about situations like these, the laws in Texas are terrifying:

Memorial Hermann was one of a host of hospitals across the state that along with doctors and right-to-life groups endorsed the Texas Advance Directives Act, which the Legislature passed in 1999 and which was signed into law by then-Governor George W. Bush. (The right-to-life groups have now backed off their support of the Advance Directives Act and say the law is unfair and gives too much power to ­doctors.)

In essence, the law gives doctors the ability to either continue or withhold life-sustaining treatment against the wishes of the patient or the patient's legal guardian. To do so, the doctor presents his case before the family and an ethics committee, and if the committee agrees with the doctor's decision, the family is given ten days to find another facility that will comply with their wishes before treatment is either continued or withdrawn. Families are given a list of lawyers and organizations to help facilitate a transfer.

Now I can totally empathize with Michael Schiavo’s decision to end Terri’s life, and I found the smear campaigns against him (alleging attempted murder, among other things) disgusting and invasive. There is little that offends me more than politicians grand standing and bringing their considerable power and media manipulation to bear on average citizens.

To this day, I think nothing defines the character of President Bush more than the fact that after signing the above law, it was not receiving a memo on “Bin Laden determined to Strike U.S.”, or Katrina, but Terri Schiavo that got Bush to cut his vacation short for the first time of his Presidency, to prevent a family from making the decision he placed in the hands of Insurance companies and hospital administration.

The family claims that after the surgery, they started finding DNR orders (Do Not Resuscitate) orders clandestinely slipped into Sabrina’s file.

"Hospitals routinely do that," says. "In another case at Memorial Hermann, we were participating in an ethics committee process and the neurologist who had done brain surgery... he said that he put a DNR in the file. We asked, 'Did you consult with the patient's mother? Did you have any indication this is what the patient wanted?' And he said, "No, we do it all the time.' The doctor just decided to put a DNR on this patient. And I can think of two others right off the top of my head. And mind you, for all of this, these are only the ones who call us for help. There could be countless others."

Fine says that orders not to attempt resuscitation are almost always done in collaboration and with consent of the patient's family.

"I'd say it's that way 99.999 percent of the time," he says. However, "A doctor can write a order on a patient if they feel that it is appropriate for the patient. No law prohibits that."

The head reels. Again, in my case (Arizona is apparently sane in comparison) the family was consulted and their wishes adhered to. Let’s remember, though, that Texas is the model from which conservatives would like to base national healthcare “reform”. What’s more, because of tort "reform", medical malpractice is not profitable, and typically only desperate lawyers would attempt to bring such a case. There’s simply no money in it, which means there’s no consequence for hospitals who do this.

Sabrina’s immediate family also claims the doctors in this case pulled other family members aside and convinced them to pull the plug. This doesn’t offend me. Terri Schiavo is not atypical (Tom DeLay decided to pull the plug on his father). Loved ones often understandably want to hold on longer than what most anyone else would find is reasonable. Which again, is why I had such sympathy for Michael Schiavo, who had held out hope for years. When a loved one decides to let go, you better believe all avenues have closed down.

That doesn’t mean a doctor can’t give advice. What I found most infuriating is that the doctors I dealt with saw their job as providing comfort without imparting information. As they showed me X-rays of the black void showing dead tissue where my niece’s brain used to be, you’d ask if it was possible to recover, or want percentages, or some idea of what sort of life was possible in this situation. The doctor would parry, “I don’t like to use percentages”, “You never know, each case is different”, “She will improve, we don’t know how much”. Finally, I just asked, “Should I be investing in a college fund for her?” He refused to speculate.

The doctor does have a better idea of a patient’s chances, and the family unrealistic expectations of recovery. But slipping in DNRs? You can’t blame the family for suspecting this might be used as a way around convening the ethics board to cover up malpractice.

When there’s no accountability, and profit becomes the one factor determining decisions like this, we know how discretion gets used by the cynical. I see no reason why doctors would be immune. This doctor, responding in comments, does offend me:

As a practicing physician I can assure you that convening an ethics board (containing physicians, nurses and laypeople) to review every aspect of a case in great detail is the last thing a physician who had made a mistake would want to do.

The laws in Texas are a blessing and exist so that physicians and nurses have the right to NOT continue painful and unnessesary treatments even if the family wants to continue. This is to protect the patient from unrealistic family members and the staff from doing things they find morally and profesionally wrong. They must continue full treatment until an independent group makes a decision.

A DNR order is usually approved by the family, but is a decision made by a physician that advanced recusitation on a patient would not be benificial and would cause suffering for no reason.

Crickey. The point made in the article is that DNRs can be used by doctors, at their discretion, to circumvent the ethics board that might determine if “advanced resuscitation on a patient would not be beneficial.” A blessing, indeed. For the hospital.

I hate to ask what the staff finds “morally and professionally wrong”. From this statement, it appears to be allowing a family to keep a loved one alive, based on their moral principles, which apparently may be overridden by moral judgment of the staff, without oversight. If someone really has a moral problem, they don’t have to be compelled to change the IV bags. Let someone on staff do it who is not going to object to complying with the family’s wishes.

Here’s another comment, which I feel encapsulates the whole rationale for the conservative approach to healthcare

Many people are patients at Hermann hospital and never pay their bills. It is a huge place that handles most of the local trauma . Many lives are saved at Hermann. For the ones that will not make it, the DNR is a kind way to let nature take its place. The story of that child is a sad one but things happen that are out of the control of all parties concerned. A reality check is needed here. The child appears to be in a vegetative state and no doubt, if she were able to communicate she would prefer to be set free. Often times parents suffer from guilt, selfishness in terms of wanting to hold on to their children even though they should let go. In this case, these people are determined to get money to satisfy their point of view and greed. They are wrong for doing so. They will not win. Hospitals try their best and not all will end up satisfied. We have to face reality that all things do not end up the way we expect.

I am empathetic to those who say it is a waste of resources to keep some of these patients alive, with no chance of any quality of life. And Terri’s parents (and my sister) certainly demonstrate how love can blind us, and how easy it is to convince yourself random facial expressions or ticks are conscious responses. But if the abortion and euthanasia debate have taught us nothing, it is that life – when it begins, and when it ends – is a very personal, spiritual question that ought not to be answered by anyone but the families.

I’m pro-choice, but I couldn’t, in good conscience, support a law that forced a mother to have an abortion to save her life. I couldn’t force a Christian Scientist to get medical treatment (for their children – a more difficult call). The point is, these are matters of the soul, and as such belong to the most personal, religious beliefs a person can have. If we are to save money, why not save it by allowing those like Michael to make the decision without the Federal government staging a media event on the outside lawn?

In fact, Bush is being consistent here, not in matters of life, but matters of power: the decision of when life ends should be left up to hospital bureaucracies and the government, based on dollars and cents rather than God and family. All they need to know is the hospital pulled the plug, and they assume the family will not pay, and the hospital, given total discretion, will make the best moral decision. This is the rationale used for an imperial Presidency as well – our leader needs no checks, no balances, no accountability, only the freedom to decide what he feels is best. Selfishness is not possible. They are good. The victims of those decisions deserve it.

The articlesays Sabrina remembers everything up until her second surgery and helps her younger sister with math now, and is in special ed. The perceptions of the family are highly suspect, but this is a few steps beyond following a balloon with your eyes on videotape. In my case, my niece is unable to swallow, bed ridden, in foster care, having cost millions of dollars. What is true about the Schiavo case and Sabrina’s – and mine – is that it was not the families who made the decision. And in all these cases, I see no evidence that the government and hospital bureaucrats are making better decisions than the families.