A project for Congressman Turner: give the VA the tools they need

The half a hammer award to congress for failing to give the VA the tools to do the job

Our congress is willing to give our military weapons they don’t want, but won’t give our VA the tools they need to treat our vets. For this- here’s the half a $600 hammer award.

I’m writing this from room 124A, on 3-S of the Dayton VA.

I came here Monday night with a severe case of kidney stones. As a veteran with a service connected health issue, I’m guaranteed health care. I’ve only used the VA for the last 7 or so years- despite having coverage via my partner, Teresa who works for Elsevier. She even reminded me that she could take me to MVH- which is five blocks away instead of to the VA which is five miles away. When you are in serious pain- the idea of closer counts.

I told her I preferred the VA- because all my medical records are there (electronic)- that the people at the VA care about me and that I trust them. 24 hours later- I know I made the right decision. Partially, because instead of being sent home after the stones were removed (less than 14 hours after arrival) I’m still here- taking it easy, with a catheter still in place. At the Valley- they would have been sending me home- because the insurance company said to.

The doctors that worked on me were all fantastic, from the experienced calm hands of Dr. Potts in ER, to the follow up twin geek residents who stepped in after to assess, to the Johns Hopkins trained urologist who ultimately put in a stent, removed the stones and made sure that I wouldn’t be waiting the next two weeks for a very big stone to pass.

But, despite all this stellar work- and support from nurses, anesthesiologists, social workers and even the legal guy who helped fill out the directives before surgery, there is one small issue that needs to be addressed, now, not later.

The urologist is part of a husband and wife team- he wrote the textbook on non-invasive surgery for urological (I don’t remember the rest of it… and my phone was dead, so no picture to show) – and she was the one who answered all the questions and discussed my options. They came here two years ago to help straighten out the department, which apparently was in trouble. I didn’t know this, but there is an international shortage of urologists. They are getting ready to leave Dayton- for points elsewhere. She talked about wanting to be working on troops suffering from extreme pelvic trauma in the first 4 hours after getting hit by an IED- but that the Army won’t take her at 51, she also talked about the fact that military medical system doesn’t integrate as well with the VA as they could- or should, but that’s not the real sticking point.

The fact is, while they can put my stent in- when it’s due to come out in a few (a) weeks– they don’t have the technology to take it out. In fact, they haven’t had it for the entire two years they’ve been here. It seems the VA only bought one machine– and didn’t buy the service contract that guarantees a replacement when this one needs fixed. Apparently, they also don’t have the money to fix it, so instead, they are going to send me to a private physician to remove it- and have the VA pay. She’s worked in for-profit hospitals and said that she always had the tools she needed because she made them a lot of money. Apparently, to our congressman, it’s more important to write laws that guarantee business for the insurance companies that would have sent me home this afternoon- or to the defense contractors that sell us weapons systems that the services don’t need or want like the C-27J or the M1 Abrams tank. Yep, defense contractors and insurance companies get preference over taking care of your veterans because defense contractors and health insurance companies donate lots of money to our congressman’s campaign- and the VA docs don’t.

If Congressman Turner really wanted to do something to help the VA- instead of creating a media circus over some missing records or a senile dentist gone bad- he’d be asking the docs what tools they need to do their jobs and making sure they had them.

We’ve all heard of $600 hammers- well, in this case, they’ve given my urological heroes half a hammer- the one to pound the nail in, but not the one to pull it out. With election time coming up- and 2 weeks before my stent needs to come out- let’s see if our congressman can work for the people who used to work for the base that he swears his candidacy on.

Photo of David Esrati in VA hospital bed recovering from kidney stone removal surgery

Have iPhone, internet access will publish.

And to all my champions at the VA- if there are other stories like this- where you aren’t given the tools to do your job for our veterans properly, now’s the time to speak up. Please go to a public computer- like at a library, or use a friends home computer or a mobile device at a non-government hot spot- and leave a comment on this post. You don’t have to use your real name or email address, just be honest. Tell us about what Congress isn’t getting for our vets- and let’s let our congress earn their jobs back by getting it to you – before November 6.

Thank you for all you do. Despite not having the proper tools– you have the heart that’s missing in the cold world of corporate medicine- and that’s why I choose you first. Because when most of you say “Thank you for your service” I can say the same thing back.

And, special thanks to Director Costie, who even made a bed side visit and is currently investigating this situation as well. My bet is that he gets the stent remover back in service before our congressmen does.


29 aug 10:12 am The head of surgery stopped by with an update- the post is getting read. They have three of the scopes they need- 2 are out for repair. The docs don’t like working without a spare. They also have plenty of a different kind of scope- a cytoscope, which will work to take my stent out. No need to go to private practice. The surgeons want a more expensive type of equipment- that isn’t in the budget- and there are some disagreements on brand- but this is internal politics. All of the equipment was bought within the last 2 years and most of it was put in service last August. They are being careful stewards of our tax dollars. I had this update done once with the right names- but lost my internet connection- via my phone, so it got lost. They still are hoping to add wi-fi to the rooms, but that isn’t crucial to the provision of health care.

Grand theft taxdollars

Aaron Sorkin writes television shows that force me to have an emotional response. I remember scenes and monologues from his shows, from others, I’m lucky to remember a good line or two. He speaks about things that are seemingly obvious, but in a way that makes them seem like an epiphany of the surreal. The only problem is that they are plain hard cold facts.

An old one from the West Wing, delivered by Dayton’s own, Martin Sheen:

And a recent one, from Newsroom, delivered by Jeff Daniels:

And from the latest Newsroom, where he poses the idea of a political debate where the politicians should actually be held accountable for their answers:

All of these political discussions go deeper than what most are willing to admit in this country- that we have real problems, and no real answers. We refuse to challenge, to poke, to prod, to ask the questions why?

So, I think to myself, what would Aaron Sorkin do with material from Dayton Ohio? Stories that on the surface would seem ludicrous to any intelligent person, but seem to pass for standard operating procedure in Dayton. I wonder why I even care to continue to write about them. And, I wonder why you continue to read. This community seems entirely OK with allowing its tax dollars to be given away to anyone any politician chooses, with little chance of questioning, never mind liability.

I guess I should go back to my very first campaign pieces, that I still have quite a few of. 20 years later, the questions I tried to address are still questions today. Why do we stand for such a racially divided and economically divided city? How do we accept tax dollar giveaways of epic proportion, while being told we’re broke? Oh, if I were only Aaron Sorkin and could tell the stories with the veracity of a Martin Sheen or a Jeff Bridges.

Photo of the SW corner of the Arcade complex with the windows fallen out

The arcade is losing windows- long after millions of tax dollars were poured into it.

Where else does a private businessman hand a check over to the Chief of Police for $100,000 to get him to resign? Where else does the same businessman get to buy a landmark that the city poured millions into – only to board it up and let it rot?

Now, we’re sitting by laughing at a naive man from outside our community who had a dream and bought it- and is now having to deal with windows popping out and falling on the sidewalks, while we are still telling him that his bad investment is still worth a fortune in taxes?

This was the first time I saw public money invested into a project, being handed over to a private company, without a fair and open bidding process. Unfortunately, it wasn’t the last. And, despite huge investments in tax dollars, the price the city settled on was a paltry $36,000. Somehow, to anyone observing this transaction, it would seem that this would become the taxable value- but, somehow that’s not the way things work.

Now, we’re looking at the building and thinking- how much will it cost us to tear it down?

When it comes to livability, cities are often evaluated by their schools, their libraries and their parks. In Oakwood, they do an amazing job- being the only community to do all three. In Dayton, we can’t claim our schools or our libraries- and we’ve been backpedaling away from our parks as fast as possible.

The former Bomberger center- now the Ahiska Turkish American Community Center

The former Bomberger center- now the Ahiska Turkish American Community Center

I drove down I-75 S today, and looked at the ball fields on the old McCook field site. At least they still look like ball fields unlike the one at the end of my street visible from u35. The only thing missing- not a soul was playing. I have an old friend from college who used to work for the city in parks and rec- and I remember going to see her there and at the Burkhardt Center- and they used to always be packed. Now, Burkhardt center, much like many others is growing weeds and graffiti. The former “Bomberger Center” which belonged to the taxpayers- and had an outdoor pool- was handed over to some immigrants. Not that I’m against immigrants, but, this was ours for us. We paid for it. I don’t recall ever seeing a “for sale” sign posted- or a request for proposals so it could be offered for the highest and best use.

Just last week, the City Commission voted to spend $450,000 to buy a private piece of real estate. Did they have a public use? Was there a question? We can’t keep our pools open, or our rec centers, but can by a building that a business needs to unload so they can buy another one.

For years, we’ve paid through the nose to support Sinclair Community College. A grand asset to our community. It’s the only institution of higher ed owned by the public in the State of Ohio with zero debt. For years it’s tuition was so low that it made sense to move into Montgomery County and become a resident just for the savings. As the costs of other schools have skyrocketed, Sinclair is still a great deal- however, a few years ago, they decided to start a branch campus in Warren County. Why did we invest so heavily in Sinclair as citizens of Montgomery County- only to see our investment in a competitive advantage shared with a county that hasn’t paid a dime in tax toward it? And, yes, Sinclair’s tuition has gone up for those who paid for it.

IRG scrapping the fuel farm at DAY

Our tax dollars helped build this fuel farm, now we’re paying a vulture to scrap it and steal our money

Out at the airport we had a sure thing- a lease with UPS until 2019 for the old Emery Air Freight hub. They had to keep it secured, operable and in tip top shape. They also had to pay the city around $2 million a year in lease payments above the cost of keeping the building intact. For some odd reason, our former airport director went out and actively sought a deal to give away the building and the continuing income of millions of dollars- to IRG of California. A local business that had been working on a plan to use the building was shut out, and the city took about $7 million from UPS to let them out of their lease early and turned around and handed half of it to IRG. What did IRG have to guarantee or invest? Not a dime. Sounds like a crazy deal? Nope- it’s just Dayton as usual. They started by selling off 4 huge diesel backup generators that we gave them- clearing a few million more. Then, they started scrapping the $20 million  conveyor system in the building and last Thursday, a backhoe started to tear up a multimillion dollar stainless steel fuel storage facility. In scrap value alone we’re talking a few more million.

The former airport director left for New Orleans after writing the contract to do the deal, and his lover, the former financial controller for the Airport left to follow him a few days after the deal was completed with IRG.

Millions in tax dollars given away. Not much left to put nets up on the baskets at parks throughout the city. What’s left of our tax base is now being shuffled around in the name of “economic development.” We’ve seen at least 3 major businesses move from one tax supported deal to another tax supported deal down at Austin Landing- where they have a dual tax structure, something that may not exist anywhere else in America. Yes, here in Montgomery County, we have the people who work at Kohl’s paying 2.25% in income tax on their minimum-wage jobs- while the big donors to the political elite who work at Teradata and Thompson Hine a stones throw from Kohls- are income tax exempt. Why even try to hide the graft and corruption anymore? We’ve been doing it out in the open for so long we don’t even know to scream STOP when we see it happening right in front of our eyes.

If you break into our county prosecutor’s home and steal a few things you will get five years in prison. If you break into my office- and cause $8K in damage as well as kill three days of productivity- you get a slap on the wrist.

To those who know about what really goes on in Dayton Ohio, it would make great story lines for Aaron Sorkin, but when told by me, it’s just me being a complainer.

I call it grand theft tax dollars because that’s what it is. The question is, when will you start to realize it?

2000 and counting

There has been a war of some sort going on in Afghanistan since the dark ages. Before George W. Bush decided that Afghanistan was the cause of 9/11 (despite the terrorists all being Saudis) the Russians had spent their time in hell trying to win over the “hearts and minds” of a people who have no use for our Western ways or political beliefs.

After spending trillions of our tax dollars to “rebuild” a country that was never built in the first place, we find our country falling apart at the seams. Cities going into bankruptcy, tens of millions of under-employed or unemployed Americans, and a middle class that is suffering the most in 70 years. Bin Laden is dead, and we still have more people die every year in domestic gun violence and because of drunk driving than died on 9/11, but haven’t waged a multi-trillion-dollar war on gun nuts gone bad or booze hounds behind the wheel.

Watch this touching video of a man on a mission in Texas, trying to paint a portrait of every Texan who has died in our wars of choice.

Let’s put our country back to work, and put painter Ken “the dauber” Pridgeon and his Portrait of a Warrior Memorial Art Gallery out of the hero painting business.

2000 dead American soldiers is too many. There is no reason to continue occupying Afghanistan. Bring our troops home now.

How to cut the cost of Medicare and save tax dollars

Medicare is a major financial driver for healthcare in Ohio; the government insurance program for the elderly and disabled younger people paid for 41 percent of all medical services at Ohio hospitals last year, according to the Ohio Hospital Association.

via Hospitals’ Medicare funding cut over readmissions | www.daytondailynews.com.

There is no arguing that America pays more for health care than any other nation, and gets less. In the same breath, you can also hear that independent physicians are going as far as leaving medicine, despite shortages of physicians, because they claim that they can’t make money accepting the reimbursements from both Medicare and private insurers.

Republicans talk about spending cuts all the time. Paul Ryan is under attack for wanting to transform Medicare by turning it over to private insurers (which is exactly what we’ve done in Ohio and specifically with a major business that’s been propping up Dayton- CareSource).

CareSource has been in hyper-growth mode as a manager of Medicare/Medicaid dollars, getting more government money for every citizen that enrolls in their managed care program. They then sit between the government and the health care providers and try to ration and manage tax dollars to provide the “highest quality care” for their clients.

But here’s the rub. All of these private companies that count on government tax dollars for large parts of their income, 41% for hospitals, and 100% for companies like CareSource aren’t subject to any effective cost controls. How do we know this? The CEO of Premier Health Partners, makes $4 million a year, and most of his top staff makes a seven-figure salary. The CEO of CareSource makes $3 million a year. Her salary is set by, get this, a board made up of her customers- the hospitals.

Congressmen often make fun of the proverbial $650 toilet seat or the $700 hammer, but, with Medicare/Medicaid paying 41% of hospitals’ revenue, and 100% of CareSource, why don’t we have wage controls on these government contractors? The same can be said of defense contractors, although the main difference is that no defense contractor is pretending to be a non-profit.

In NY there is currently legislation being discussed to cap non-profit executive pay at $199,999 and it’s already in place in NJ. I remember outrage over 20 years ago when the CEO of the Red Cross was toppled for a salary over $1.5M but can’t find the reference right now. Adjusted for today’s dollars it would dwarf the salary being paid to our local chiefs.

Government contractors over a certain size are even told how much they have to pay each worker in a specific position. A secretary is proscribed to be paid $21.08 an hour in one package I looked at. How come we don’t have maximums required as well? Part of the reason politicians refuse to address this, is that without being able to make over a million a year for running a “non-profit” health-care  operation, many of these emperors without clothes wouldn’t be able to make huge contributions to their campaign funds. According to open secrets, health-care professionals were the 5th largest donors to political campaigns in the 2008 election.

Of course if we eliminated private money from political campaigns we might get the politicians we need instead of the best money can buy.

Access to affordable health care in this country is a farce. Any major illness almost always comes with bankruptcy as a side-effect. Small businesses struggle with insurance costs that climb between 20% and 40% annually, without offering better coverage. It’s a small step, but ending the exorbitant salaries of semi-public employees (those who make 40% of their income from our tax dollars is a good starting point.

Chutzpah alert: as a small business owner, who is also a community activist, I’m publishing this piece at the same time as I’ve requested a meeting with Premier Health Partners President and CEO James Pancoast to discuss the benefits of a real bike-share program in Dayton and the environmental, economic and health benefits to the community. A first class system could be bought and paid for with 75% of his annual income, leaving him a cool million to still keep food on his table and gas in his tank.

I’m betting that he won’t be willing to meet with me, blaming my criticism of the system that makes him a very rich man, with our tax dollars. This is the America we have. Unfortunately, because our leaders apparently don’t read history, they are ignoring what inevitably happens with all republics that allow the gap between the haves and the have nots to get too wide.


Who are school test scores for?

We picked up our kids’ OAA test scores at our school the day they came out. The news wasn’t so good. Our kids who had routinely scored in the top percentiles in previous years were now just scoring slightly above state averages, but still above those of their peers at their current school.

This made us consider moving our kids to a different school. In fact, as I understand the school scores, if the school is under performing, you have the option to ask for reassignment or even a voucher to apply to private schools.

In the wake of an attendance “scandal”- some districts have un-enrolled and re-enrolled students who were not showing up, the State Board of Education seemingly has zero interest in attending to parents needs to assess their school choice this year- while they work out who scammed the system in a few school districts:

In an unprecedented move, the State Board of Education on Monday voted unanimously to postpone the release of 2011-2012 Ohio school report cards until questions are answered about the accuracy of attendance data reported by local school districts.

The annual report card release had been slated for Aug. 29 but Acting Superintendent Michael Sawyers recommended it be delayed because of the state auditor’s ongoing investigation into alleged irregularities in reporting student attendance in some districts, including Columbus and Toledo.

The delay also means the new Performance Index rankings for each district, charter school and STEM school will not be released on Sept. 1.

Ohio Department of Education spokesman John Charlton said the state board will revisit the issue when it meets on Sept. 10-11, but it’s unclear when the data may be released

via Ohio delays release of school district report cards | www.daytondailynews.com.

Considering Dayton Public Schools opened last week and many schools are open this week, I question what good these numbers do for parents mid-September? Apparently, districts also receive funding based on test scores which is also throwing a monkey wrench into some district hiring:

Springfield City Schools Superintendent David Estrop said the delay nearly caused the district to have difficulty hiring 50 new employees because that federal funding is tied to the results of the district’s annual report card….

An agreement between ODE and the Springfield district allows it to fill those 50 positions. It will use the “20 percent set aside” – federal funds dedicated to interventions for struggling students – to pay the salaries of 41 tutors and nine academic coaches for the beginning of the school year. ibid

By the time the state releases this year’s scores, they will be absolutely useless to taxpayers to use as a metric for making enrollment decisions (never mind that better performing schools locally, like Stivers, DECA etc. already have waiting lists.

To penalize the whole state, due to a few districts monkeying with attendance figures is wrong. Penalize those districts with fines or firing local superintendents or even criminal prosecutions, but holding back data for school evaluation from the citizens who pay for this testing is wrong.

Full disclosures: my firm, The Next Wave, does some work for Dayton Public Schools. One of the things we produce is a school comparator- listing all the Dayton Public Schools, with their addresses, bell times, uniform requirements, extra-curricular activities, enrollment zones and- scores and attendance rates. This year’s literature is on hold thanks to the state.