Problems at Walter Reed
[Phillip Carter,
Saturday February 17, 2007 at 3:38pm ]
Sunday's Washington Post carries a depressing story about the human cost of the war. (Update: the Post runs Part II of this series in Monday's paper.) According to Dana Priest and Anne Hull, two of the paper's finest reporters, the Walter Reed Army Medical Center is having great difficulty keeping up with the pace of casualties coming home from Iraq and Afghanistan. The results are not good:
But these wounded are not the only warriors who are suffering right now. We have had roughly 1.4 million troops rotate through the Iraq and Afghanistan theaters of operation. Hundreds of thousands of reservists have rotated through mobilizations since Sept. 11, 2001. Our military will likely remain engaged in these wars for the foreseeable future, and hundreds of thousands more will rotate through these two theaters. Yet despite these operational facts, the VA budget continues to atrophy. Veterans seeking disability ratings must wait between 6-12 months to receive an adjudication. Veterans without a service-connected disability rating who do not meet a stringent "means test" may be excluded from the system entirely. Although the VA has been rated as the nation's finest medical system, it increasingly cannot deliver that care to the population it exists to serve. Why?
On the side of the Department of Veterans Affairs in Washington, there is a quote from President Lincoln's Second Inaugural Address:
This makes me angry; it ought to make you mad too. But don't just get mad — do something about it. Contact your Senator or Representative to let them know you feel strongly about this issue, and that you support full funding for the VA which will enable to them to follow through on President Lincoln's promise.
The common perception of Walter Reed is of a surgical hospital that shines as the crown jewel of military medicine. But 5 1/2 years of sustained combat have transformed the venerable 113-acre institution into something else entirely — a holding ground for physically and psychologically damaged outpatients. Almost 700 of them — the majority soldiers, with some Marines — have been released from hospital beds but still need treatment or are awaiting bureaucratic decisions before being discharged or returned to active duty.This is the tip of the iceberg. The Walter Reed hospital sees the most seriously wounded military personnel who come home. These personnel often require significant medical, mental-health, and rehabilitative care, and this is a mammoth undertaking. I am extremely disturbed to see these problems at the military's flagship hospital. We owe our wounded sons and daughters more.
They suffer from brain injuries, severed arms and legs, organ and back damage, and various degrees of post-traumatic stress. Their legions have grown so exponentially — they outnumber hospital patients at Walter Reed 17 to 1 — that they take up every available bed on post and spill into dozens of nearby hotels and apartments leased by the Army. The average stay is 10 months, but some have been stuck there for as long as two years.
Not all of the quarters are as bleak as Duncan's, but the despair of Building 18 symbolizes a larger problem in Walter Reed's treatment of the wounded, according to dozens of soldiers, family members, veterans aid groups, and current and former Walter Reed staff members interviewed by two Washington Post reporters, who spent more than four months visiting the outpatient world without the knowledge or permission of Walter Reed officials. Many agreed to be quoted by name; others said they feared Army retribution if they complained publicly.
While the hospital is a place of scrubbed-down order and daily miracles, with medical advances saving more soldiers than ever, the outpatients in the Other Walter Reed encounter a messy bureaucratic battlefield nearly as chaotic as the real battlefields they faced overseas.
On the worst days, soldiers say they feel like they are living a chapter of "Catch-22." The wounded manage other wounded. Soldiers dealing with psychological disorders of their own have been put in charge of others at risk of suicide.
Disengaged clerks, unqualified platoon sergeants and overworked case managers fumble with simple needs: feeding soldiers' families who are close to poverty, replacing a uniform ripped off by medics in the desert sand or helping a brain-damaged soldier remember his next appointment.
"We've done our duty. We fought the war. We came home wounded. Fine. But whoever the people are back here who are supposed to give us the easy transition should be doing it," said Marine Sgt. Ryan Groves, 26, an amputee who lived at Walter Reed for 16 months. "We don't know what to do. The people who are supposed to know don't have the answers. It's a nonstop process of stalling."
But these wounded are not the only warriors who are suffering right now. We have had roughly 1.4 million troops rotate through the Iraq and Afghanistan theaters of operation. Hundreds of thousands of reservists have rotated through mobilizations since Sept. 11, 2001. Our military will likely remain engaged in these wars for the foreseeable future, and hundreds of thousands more will rotate through these two theaters. Yet despite these operational facts, the VA budget continues to atrophy. Veterans seeking disability ratings must wait between 6-12 months to receive an adjudication. Veterans without a service-connected disability rating who do not meet a stringent "means test" may be excluded from the system entirely. Although the VA has been rated as the nation's finest medical system, it increasingly cannot deliver that care to the population it exists to serve. Why?
On the side of the Department of Veterans Affairs in Washington, there is a quote from President Lincoln's Second Inaugural Address:
". . . to care for him who shall have borne the battle and for his widow, and his orphan . . ."This is the motto of the VA. It sets a very high bar for the VA, one which does not allow for means testing or bureaucratic excuses or resource constraints. It simply acknowledges the debt that we owe to the men and women in our armed forces: that we will care for them, and their families, after they serve us. We are not living up to that promise today.
This makes me angry; it ought to make you mad too. But don't just get mad — do something about it. Contact your Senator or Representative to let them know you feel strongly about this issue, and that you support full funding for the VA which will enable to them to follow through on President Lincoln's promise.
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I think it makes it pretty clear how the entire debacle has been politicized by the Congress, the media, and certain individuals within the Justice department.
This is certainly the case, given that Richard Armitage has effectively been let "off the hook" for his willing lack of forthrightness to the Bush administration about his role in the initial leak.
Diogenes
It's amazing, that despite the crushing patient load - which exceeded all forecasts - the Army is still planning on closing the place in 2011 and consolidating all DC care to Bethesda. It's shortsighted and foolhardy.
Just like the rosy "Post Saddam" projections, the Army is erroneously forecasting a reduced demand for definitive-care services in the midst of a war.
Walter Reed is being bled dry in anticipation of its closure in 4 years. Both the imminenet closure and criminal witholding of overdue capital funds are tragically short-sighted mistakes.
FWIW, anyone when in DC should visit Walter Reed. You can get in with photo ID and the food is pretty good. The Cafeteria has the human costs of Iraq on full display - at breakfast, lunch and dinner.
The issues af race and class in today's all volunteer force are hit home at Walter Reed - most especially in the faces of the parents of the wounded who maintain a constant vigil.
> the VA budget continues to atrophy.
Interesting choice to use the passive voice for this sentence.
Cranky
It wasn't up to either the Army or Navy.
The decision came from BRAC and was accepted by Congress and the President, on the submission from the Secretary of Defense. It was the least controversial closing because there was a sense that WRAH had outgrown itself and it was ultimately cheaper (and better) to expand the Naval facilities.
At some point, someone will say something about the goods of "Jointness." If they don't, I will add that the hamburgers at Balboa (a Navy joint that serves mostly USMC and a few Army idiots like me when we come back from Iraq) are the best I've ever had.
Maybe food at the military hospitals tastes better because it beats MREs or souk mystery meat kebab. Maybe it's just because our civilian leaders wisely have spared no expense on our chow at the hospital DFACs (and I'm really eating sirloin, not hamburger).
I'd opt for the former, not the latter.
I've been frankly disgusted by VFW's efforts in this area, not to mention the organization's pro-Republican PAC.
It has made me strongly question why I should remain a member.
You raise some excellent points re: the lack urgency/advocacy on the part of veterans service groups. I agree with you, the VFW and American Legion have essentially become pro-GOP pacs. The tenor of the American Legion magazine has taken an extreme-rightward tilt over the last decade.
It's not just the VFW and American legion either. The Reserve Officers Asociation, of which I'm a member, is doing nothing while its member's lives are being ripped apart with an unsustainable OPTEMPO and crushing personnel shortages (e.g the Army Reserve currently has 53% of its authorized O-3s and 58% of authorized E-7s). The ROA has even gne into a partnership with the Heritage Foundation. I too question why I remain a member of this organization.
Well, in DC they are close to each other geographically. Perhaps that led to them being linked ideologically.
I've always thought the ROA's property was one of the best in DC.
I ended up staying in the Army. Started enlisted and retired as an RA officer. Lesson learned over the years: every Army officer has to be, in addition to his normal duties, a personnel officer as well. Both for his own preservation and for his troops. One thing I learned: keep a copy of everything. They lose what you give them. They don't care. Other lessons: the generals do not care. This became clear early on. They're too busy doing whatever it is that the "system" demands. And they always take care of their own. When was the last time you heard of a general not being well taken care of? The troops, meaning everybody lieutenant colonel and below (full colonels are potential generals, so they're almost in the club), just have to live with the "system" and fend for themselves. I always knew this and I did well in the "system" because I always understood the true nature of my service. Cynical? You bet. We don't have that old saw that ends with, "and the government's here to help you" for no reason.
WRT to Phil's excellent capture of this shameful article, I will spend tomorrow writing my congressman and senators as well as the chairmen of the House and Senate armed services committees to ask them what they intend to do. I will also write the president of the Military Officers Association, of which I am a member, suggesting that MOAA focus on this. In this regard, I have to tell you folks who are members of the American Legion and VFW that I would never, ever be a member of either organization. I was a member of VFW years ago, but left them because of their politics. American Legion? Always been like this. They are pure and simple a right-wing lobbying group. I don't know much about ROA—was only a reserve officer for three years and am not now eligible—but I would suggest that reserve officers take a hard look at their affiliations.
Write those letters, is what I say. And I will also say that I'm sorry Phil is boring Diogenes, who doesn't care about this kind of issue. Don't worry, Diogenes. I'm sure we'll get back to topics more suited to the likes of you.
Also, Cranky, I like your observation about passive voice. Kind of like, "mistakes were made," eh?
We have seen that criminal prosecutions of most misdeeds have come to be not for the original crime, but for the act of trying to cover it up. A lot of people have commented about the irony of this "it's not the crime, but the coverup mentality", but it is where we are.
About the original crime, as I understand it, a decision was made by some within the Bush administration to cause Ms Plame to be outed. They didn't do this directly, but spread partial information in the hopes that someone who didn't understand the implications would leak it to the press. That hapless individual happened to be Armitage, who claims it was only fairly recently that he even realized he was the source. I would make the case that it should be the plotters, rather than those they manipulated into making the
actual leak who should bear the legal responsibility. Intentions should be more important than the actual deed.
Sound advice on making copies of everything. They lose records all the time, and as noted above, "they" don't care. The requiremtn for proof is with the individual.
Still sickening, though.
They should all be very ashamed. As should the rest of us for not demanding better.
They were hilarious because they frankly said that the only reason they joined the National Guard was to avoid Vietnam. Instead, they spent a year there.
There wasn't all of that false patriotism crap. They distrusted everyone. Ironically, they formed that VFW because they didn't feel welcomed by the old WWI and WWII dudes at the other VFW in town. And when those of us from Desert Storm came back, we didn't feel all that welcome in the Vietnam joint.
Why? Wasn't a "real war," the same thing their dads and grandpas told them!
I haven't been back to the post since my two deployments to Iraq, but I have the feeling they wouldn't be so difficult about a "real war" now.
Easy. Because today's Republicans simply aren't very smart people.
Dumb people do dumb things, like start dumb wars for dumb reasons and continue to support dumb leaders who get them into said dumb wars.
This isn't hard stuff. No need to overanalyze.
America needs smarter people in charge. Period.
Off topic: WTF!!???
Quote George Bush jr : /snip/``On the field of battle, Washington's forces were facing a mighty empire, and the odds against them were overwhelming. The ragged Continental Army lost more battles than it won, suffered waves of desertions, and stood on the brink of disaster many times. Yet George Washington's calm hand and determination kept the cause of independence and the principles of our Declaration alive./snip/ (source, the Guardian )
lol.
Where is someone like the Chairman of the Joint Chiefs when the troops need them.
Nothing is going to change until there is a sense of public outrage.
I have been reading an online book, _The Authoritarians_ by Dr Bob Altemeyer. The book is the result of many years of research by Dr Altemeyer into what he calls an "authoritarian follower". AFs do not want or seek power, rather they seek a strong leader to tell them what and how to think. AFs in the US who are politically engaged are almost entirely Republicans, AFs in the former USSR were almost entirely Communist party members or fellow travellers.
It turns out that AFs are almost impervious to facts and logic once they have an idea in their head. This is due to the fact that they are able to compartmentalize various conflicting ideas in their minds to a degree which most non AFs would find astonishing.
I strongly urge anyone who is interested in the political process here in the US to read this book to get an understanding of the thought processes of that thirty percent of the American public that still stands behind Bush and his policies.
The Authoritarians
No, I certainly don't mean the Democrats, most of whom provided supine oversight of the war, including the titular chief opponent to the president in the previous presidential election, the man who voted for the resolution authorizing war before he really voted against it, or whatever it was.
Rather, I'm thinking of McCain, Shays, Hagel, et al. Normally, one would assume these GOP zombies, apparently behaving like Stalinesque stooges, mouth bland talking points devoid of any "conflicting ideas" that the rest of us would find "astonishing."
Have we really come so far in our nation that we can't even concede honorable opponents in the political process might be competent, thoughtful people?
This is almost as bad as MK's ludicrous persistence in calling Americans "facist" or the ideas Charles has about the US Army "war crime machine" and its similarity to "the Nazis."
Beyond the hyperbole, George W Bush is still an American committed to public service to benefit a democracy. John Forbes Kerry is still an American committed to public service to benefit a democracy. Ralph Nader is still an American committed to public service to benefit a democracy. And even I'm an American committed to public service to benefit a democracy.
He's a software engineer, but in his own way Charles is an American committed to public service to benefit a democracy.
These are not dishonorable men, nor is their work -- although sometimes disagreeable to many people -- facist or insane or inherently venal.
Quit the useless distortion, the tired invectives impugning people's loyalty and the facist tropes in lieu of real discussion.
"Beyond the hyperbole, George W Bush is still an American committed to public service to benefit a democracy. "
I'm sorry, but can I see some evidence of this assertion ?
A starting point would be any significant expenditure of political capital by GWB for purposes other than (a) political power, (b) rewarding campaign contributors, (c) rewarding the base of the Republican Party or (d) self-indulgence.
'Social security reform' is an obvious example - once it got hard, he stopped spending political capital.
Ian Whitchurch
That is where you and I disagree, sir. I would say that level evidence proves that the GWB-administration has consequently tried to sap powers from the democratic institutions and shifted them to the executive branch. He has abolished Habeas Corpus, fer chrissakes, sir.
I do not imply that the US army is in any way comparable to the nazis, nor do I mean to Hitlerize the discourse. However, a fascistic system does not necessarily need to be insane, it is merely a description of a form of authocratic country. With all due respect, sir.
I'm with Ian Whitchurch and MK, (and I suspect most of the world) on this one.
All the evidence so far clearly indicates that Bush &Associates are committed to Big Business, and Self Interest Inc., and, naturally, the power that comes with it.
I would be fascinated to see any new evidence that proves otherwise.
"Quit the useless distortion, the tired invectives impugning people's loyalty and the facist tropes in lieu of real discussion."
1. You would need to prove first that it is distortion.
2. No real discussion can take place unless the nature of any problem, and its component parts is understood. I suggest that it is clear to most of the world that one of the biggest problem components currently is Bush &Associates.
What you are suggesting is to continue the discussion and ignore one of the root causes of the very problem that is being discussed.
Did you even go and look at the book I linked to?
If the Republicans are so competent and thoughtful how then do you explain the incredibly bad job that has been done in prosecuting the war in Iraq?
How do you explain the 363 tons of hundred dollar bills that simply disappeared in Iraq?
How do you explain that Rumsfeld forbade his planning staff even mentioning planning for the occupation to him?
"HE WOULD FIRE THE NEXT PERSON THAT SAID THAT"
it occurs to me that if Bush &Associates were really "committed to public service", this thread probably wouldn't have happened. For example, just maybe some of the 363 tons of moolah, or some of the countless millions handed over (apparently with little oversight) to Halliburton, might have funded worthwhile causes, such as Walter Reed and US veterans (like yourself) who have committed themselves to public service.
MSR,
Tireless or not, the truth remains as it is whether it appeals to your sensibilities or not. The primary use of past examples to explain current personalities is based, not on similar displays of actions, but of motivations. To wit, Hitler was a very committed German, though born an Austrian, and thus he viewed his purpose with the highest moral authority he believed existed: that as divine right to the supremacy of the German State over all non-german actors. To his vision and his reasoning, either you were for him or against him. For him, he was friend, against him, he was an implaccable enemy.
Thus, I would submit to your sensitivities, that your pigeon holing of Hitler falls within your definition of "impugning people's loyalty and the facist tropes in lieu of real discussion."
Not to be sophist about this whole subject, but to show that their are shades, nuances to the comparisons people use. Often people will grasp onto the larger image, ignoring the transitional natures of the individual being used for the linkage and all the accompanying baggage.
Either way, even though the methodology of the two, Hitler to Bush, are a bit of a stretch, the fear of a similar end result is what has people drumming their fingers on their teeth.
Stop it.
Now, for another tutorial for the laypeople who seem to know nothing about the U.S. military.
The roots of the system that shut down Walter Reed are hardly dug into Republican soil. It all goes back to the Defense Base Closure and Realignment Act of 1990. The point of the statute was to authorize an ad hoc non-partisan committee that would examine bases that no longer were cost worthy.
At the end of the Cold War, it was found that a large number of bases were redundant, didn't function jointly with other services or were too cost-prohibitive to remain functioning operations. Because many of these bases hire a lot of locals, however, Congressional leaders wanted to make themselves one step removed from the closure process.
Voila, BRAC. At the time, this was the creation of a Democratically controlled Congress and a Republican president, George H.W. Bush.
In 2002, the Democratic Senate and the Republican House reauthorized BRAC for another round of closures. The committee returned with a list of bases earmarked for the wrecking ball, delaying until 2005 most of the activity to actually close them.
Public hearings were held by the BRAC committee, and several operations were spared. But not Walter Reed. Also in the DC area, BRAC proposed to shutter the Potomac Annex.
Before everyone gets their tits in a pincher, the hospital isn't expected to cease operations until 2011.
Again, that's 2011. The reason? The site was landlocked and couldn't be easily expanded, unlike the larger facility staffed for the Navy in Bethesda.
For those of us who have been in the military for awhile, the question of medical care for veterans and our families always dominates discussions.
If you believe that we're just discovering how inadequate the rickety VA and DoD hospitals are, you need to start actually talking to a few soldiers, sailors, airmen or marines. Congressional hearings about the state of our nation's VA and military health systems go back well into the Reagan administration.
Am I now supposed to believe that every Congress or president, Democratic or Republican, since 1981 has been a mindless GOP-driven hater of democracy, cheerleader for facism and didn't give a damn about the troops?
Give me a break. Questions about the dwindling budget for VA now could be mimeographed and put alongside the same arguments being made in 1995 at Congressional hearings. Was Clinton really that devoid of love for the troops?
Hardly.
Personally, I believe that our hospital system for returning wounded personnel should be the best available anywhere in the world. This is completely self-serving because I'm currently being treated for wounds sustained in my second deployment to OIF (third, however, to Iraq, counting Desert Shield/Storm).
The military medical system is horrendous. Guess what? It was horrendous under Clinton, too. Had we been involved in a regional conflict under Clinton (say, if the Balkans had exploded, or if we had remained in Somalia), the very same problems would have surfaced for the public to see.
It's not as if the problems were not always there.
Now you can blame "fascists" or "Hitler Bush" or "Halliburton," or you could just spend the time to read some past Congressional testimony, pick up a GAO report or a VA IG finding, and read up on the topic.
I get the feeling that for most of you, that's too hard. Nor is it nearly as satisfying as calling Americans "facists" or Republicans "mindless."
But this site is called "Intel-Dump," not "Take a Dump on Intelligence."
MK apparently doesn't realize that the executive branch is a democratic institution.
"He has abolished Habeas Corpus, fer chrissakes, sir."
Actually, he and the Congress together -- i.e., the democratically elected branches of our government -- voted to limit access to habeas corpus (and did so in a manner completely consistent with historical treatment of prisoners).
With all due respect, sir.
Your treatise re: BRAC is informative at the 50,000 foot level. At the practical level, it's less useful. The fact is that the services have a tremendous amount of "wiggle room" to guide the process towards the findings they seek. The most glaring case of this happened during BRAC 2005 when the USAF deliberately omitted key information regarding the facilities at Youngstown, OH and Niagara Falls, NY - they were busted. I was at the hearing in Buffalo when it happened.
Also in BRAC 2005, against all logic and financial evidence to the contratry, the Navy charged full speed ahead to convince the BRAC commission to close Naval Sub Base New London. Thankfully, in that instance, the BRAC folks got it right.
I have no doubt in my mind that the Army wanted WRAMC closed before the BRAC panel was assembled. I question the way material facts regarding the facilities capabilities and mission were presented. Simply put: BRAC would have spared WRAMC if the Army presented an even half-hearted effort to change their opinions. They punted. WRAMC will close. Who was there to defend WRAMC? Eleanor Holmes Norton? Mayor Williams? Hardly any defense at all when the "sharks" of Maryland and Virginia were circling in the water for miltary construction dollars and new federal FTEs.
A few points re: WRAMC ...
1. It's "land locked". Technically, yes. It's also 128 acres (not counting the Forest Glen Annex)! This is bigger than many world-class academic medical centers with several times the patient load. You never hear anyone referring to NYU Medical Center or Brigham and Women's in Boston as "land locked."
2. There is not a shred of evidence to suggest that the Army and USMC will require LESS definitive care services in 2011. In fact, we could possibly need more. Halving the bed capacity in the National Capital Region while we are attempting to increase the Army and don't know what tomorrow will bring is just foolish.
The bottom line is that you can't just wash your hands and blithely say that BRAC is a non-political process. It sure as hell is a political process. It was no secret that Rumsfeld sought a "purple" combined service Medical Corps. It looks like that dream is dead (Thank God), but to suggest that service cheifs and service Surgeon Generals weren't encouraged in 2004 amd 2005 to present data in a less than flattering manner re: Walter Reed and Wilford Hall is just naive.
Because the end-process was open, however, public hearings were held, and, like I said before, several bases were spared. I particularly recall reading about a USAF reserve base that was saved.
Why? Because the citizens affected pointed out that the USAF neglected to mention the actual length of the runway, which DoD said was "too short." It was one of the longest in the world, more than capable of handling the air freight.
Walter Reed went through the same process. You and I both know that it uniquely was considered lacking by BRAC. Are you imputing partisan political motives to that? On what evidence?
I can believe that the USAF and Navy surgeons general, the deputy surgeon general of the Army, the chief medical officer for the Marine Corps, the Joint Staff surgeon and the chief financial officer from the Office of the Assistant Secretary of Defense for Health Affairs were all on the fix.
So where is the GAO report or the DoD IG filing that I can read telling me that the cost savings from the 2011 closing aren't what the civilian and uniformed presenters to BRAC say they are? The way the BRAC report reads, the shift of Walter Reed to Maryland and the other medical reforms will cause $2.4 billion in direct reinvestment in better facilities that will save $5 billion dollars by 2031.
Before you begin impugning Rumsfeld or Bush for the closure at Walter Reed, remember that it has long been on BRAC's radar in other administrations.
I don't think I'm being naive by believing that a larger, better joint center will, in the long run, be the best thing for the military. And they're also building the Ft Belvoir wing, don't forget that.
I also should point out, from some personal experience, that DoD has not been the heartless ogres many in here would make them out to be. Although I'm no big fan of George W Bush, I thank everyone connected with the revamping of Brooke Army Medical Center, and if the president or his civilian appointees get some of that thanks, so be it.
I have a very dear enlisted comrade of mine there who is recovering from some of the worst wounds possible (his leg was burned off because of an RPG explosion; he nevertheless fought on while his lieutenant bled to death next to him). I can't say enough good things about the facilities and the personnel treating him.
Full disclosure: I'm a huge fan of "jointness." This is hardly political. Just a quirk of my nature. If there can be savings AND overall better care by building newer, more cost-effective facilities, than I'm for it.
If you don't like BRAC, however, don't blame Donald Rumsfeld, George W Bush or the surgeon generals of the services.
Blame every member of Congress since 1992 who has passed the buck on it.
Personally, I believe every decision like that should go before ALL of Congress, rather than a non-partisan committee hearing from a bunch of uniforms and community suits. But I don't get to make laws.
> blame Donald Rumsfeld, George W Bush or
> the surgeon generals of the services.
The discussion seems to be getting detoured into BRAC, whereas I believe the overall issue is the inadequate funding and executive oversight of the VA's rehabilitation service since, perhaps, 2003. When the United States launched a war - an event which would tend to raise the rehabilitaton requirements far above those when the previous President was in office.
Cranky
I also could relate some real doozies about the brilliant Clinton oversight of Operation Restore Hope. That was a winner.
Do I blame Republicans for their poor civilian oversight over Iraq? No. I blame individuals because I know some of the CPA who were decent, competent people.
Some of the most jackassed incompetents I've met over the past two decades in the military have been Democrats.
Some of the most jackassed incompetents I've met over the pst two decades in the military have been Republicans.
Were most of the CPA jackasses I met competent? No. Should they have been sent to Baghdad? No.
Were many of them there because of political fealty to the president? Yes.
Were many of them there because State or DoD or Name Your Alphabet Agency thought they were the most competent they had to send?
Yes.
Did the jackassery of these supposedly competent incompetents make you wonder, sometimes, about the rest of the civilian or uniformed federal government?
Profoundly.
But for all that, I blame mostly the previous SecDef and the Congress with oversight of DoD. I also, to some extent, blame the military officer and enlisted non-commissioned officer leadership, most especially in the Army, and anything I say about them would only make Fiasco redundant.
Part of the problem stemmed from an inability at the highest levels of the civilian State and DoD leadership --BOTH political appointees and longtime civilian service staffers -- to agree on a workable, joint plan to handle Phase IV issues.
Also a huge problem that never was adequately addressed: The idiotic dispute over JCS troop numbers and what the civilian leadership thought the generals should want.
But similar shortsighted planning also marked the latter stages of Operation Restore Hope, albeit to lesser harm because we could simply leave Somalia. Not so easy to leave Iraq.
Trust me when I say that the very fine military planning I saw in Desert Storm/Shield didn't really carry over to Restore Hope after IMARDIV pulled out.
To put it politely. I hear there was a book and a movie that mentions some of these issues.
No comment.
The biggest critic Donald Rumsfeld ever had in the Senate was NOT a Democrat. SecDef Snowflake had to worry most about John McCain, who continues to savage the former DoD leader's rule at every turn.
Perhaps John McCain, someone who could teach the hapless Manitoba professor a thing or two about real systems of authoritarian political coercion, or Chuck Hagel are really not as conservative as they seem. Instead, they're mindlessly fixated on authoritarians such as W or Rummie and blandly mouth GOP talking points.
I get the feeling that's not exactly true. Maybe the good professor can find someone to publish a real book about real research involving real ideas. Perhaps his first field study will be on people on threads who are convinced by conspiracy theories that a third of the American people are democracy-hatin' rednecks.
Or maybe they'll just fall back and blame the Jews like Walt. That's been found to work in a pinch, too.
Personally, I don't much like conspiracy theories. I don't like to impugn people's motives simply because of their political allegience. And I even try hard not to judge those who call people who don't agree with them "prolific and despicable war criminals."
I seem to remember getting the t-shirt for a war that started in 2001. The health care system that was inherited six months previously came from a different administration.
If you wish to make this a thread about all that Bush or Congress or the military or voters could have down over the last three years to magically improve the VA and military health system, then please go forth.
It will nevertheless be incomplete, lacking in any intellectual rigor, and masturbatorily antagonistic toward only the most recent president.
I'll give everyone a simple series of tests.
First, drive down to the nearest military base near you. Walk into the barracks of the first company you see. Ask to see all of their married personnel. Then stare at them and say one word. One word only.
"Tricare."
Seventeen hours later, when they're done, walk down to the nearest senior citizen center. Look for all the aging gentlemen from the "Greatest Generation." Sit them down and mention two syllables. Only two.
"VA."
Having now expended a full 24 hours enjoying all the discussion about the military and VA health systems, see if you can still cook up a theory about a Bush conspiracy to screw with the troops.
I suggest that you might get an earful from people who don't exactly recall the halcyon days under Carter, Reagan, Bush I, Clinton and Bush II, not to mention the Congressmen they've written to, the aides they yelled at, and the VFW dues they've paid.
Just try it.
But this thread isn't about BRAC. It's about WRAMC. The reason WRAMC is a shit-hole is because it's a shit-hole. The Army's shit-hole. Not BRAC's. The Army's. Let's not forget that. What leaps out in the Post's articles (there have been follow-ups) is that WRAMC is a very poorly managed MILITARY facility, run by unqualified, unmotivated and uncaring administrators who seem to have embaraced the primary mission of making seriously wounded junior enlisted personnel and their famililies as miserable as possible. Hup-one, hup-two, hobble on out to that early AM formation there, snuffy. You're in the Army, boy. Good order and discipline trumps all. I'm surprised they don't have the ambulatory patients out painting rocks or in the motor pool. Where would the Army be without chickenshit?
Note there is no mention of wounded officers in these articles. They're there. But officers don't have to put up with this shit. They know the system and they know people.
One striking thing is that once a troop or his/her family actually learns a little bit about the system and maybe contacts a congressional staffer, things change. For example, disability ratings are "reviewed" and then revised upward. Really a fair system run by all of those caring docs, eh? You know, the Army has always been the ultimate "frog" system—we all know how to make a frog jump, right?—but that the medical system jumps right in tune with the rest of the system is really shameful.
More great publicity for the recruiters. Of course, maybe those with criminal records don't read the newspapers.
I'm not saying that "politics," in the Greek/office/inter- and intraservice rivalry sort of way isn't what's going on. Any base closure is going to be political.
What I don't like, however, is when people point to the BRAC process and say it's partisan politics, because it's a lot of things but it ain't that.
No one can seriously point to Bush and say, "See. The military medical system is screwed up. VA is screwed up. They're closing Walter Reed. Bush's fault!"
The military medical system has been screwed up as long as I remember. VA has been the armpit of medicine for as long as I've been a veteran (albeit not in need of their services).
Bush deserves some blame for not rallying the services, Congress and the American people to do something about all of this.
But he's not the only one to blame.
And while I'm disgusted with the way the Post portrayed medical care at Walter Reed, I'm equally impressed with the outstanding and compassionate care I've watched a friend undergo at Brooke Army Medical Center.
I also should mention that I was a big fan of the Presidio installation. I would go to SF when I was on leave because my brother lived there, and I loved to run through what used to be a base. I went back on last year and found it was just a yuppie place now, but the military cemetery was still there.
Was it selfish to keep Presidio (a base that had outgrown its usefulness, but was drop-dead gorgeous)? Probably. It would have been hard to justify to taxpayers keeping a base that had dwindled to an outmoded USCG station.
I've been deployed to a lot of places over the years. Some of the facilities were craptacularly bad (Ft Knox). Others were wonderful (Torii Station, Okinawa).
Hospitals should be the gemstones in the entire freakin' DoD and VA. Had this ethos ever existed for our wounded servicemen and -women, we wouldn't be reading the story in the Post.
But I could point to a thousand other stories in everything from the NY Times to VFW Magazine talking about the sorry state of the VA hospitals, too.
I don't blame BRAC or Bush for those.
Ok. How about we start with what we knew in early 2004? Not even a full year into the Iraq War and Bush had begun making decisions that damaged the effectiveness of the VA to complete its mission.
Veterans Groups Critical of Bush's VA Budget
The VA didn't originate in the Bush administration, but he sure as hell hasn't done it any favors.
Interesting turn of phrase here as well. Are you disgusted with the coverage of Walter Reed, or by the actual level of care provided at Walter Reed?
MSR, I disagree. Bush says that he is a war president and that we are at war yet in this instance he doesn't act like we are at war. Whatever the shortcomings of the hospital system before Bush came into office he has had ample time to fix them. In fact, he had the positive duty to fix those shortcomings when we invaded Iraq and Afghanistan. That he hasn't fixed those shortcomings and yet continues to strut around and call himself a war president is inexcusable.
Bush compares the GWOT to the Second World War and other major wars. I can't imagine Roosevelt or Lincoln shortchanging the military health care system during WWII or the Civil War.
But to single out the last two years of VA budgeting and then say, "See, Bush doesn't care about veterans" -- I think that's unfair. It lets too many other politicians AND voters off the hook.
And, no, I'm not discouraged by the way the Post covered the story, only that what the Post found to be true still exists. It's sickening.
But you also must truncate VA from the military medical system. They really are not connected. Two different agencies, two different budgets that manage to spend a combined $40 billion annually.
What you also must remember is that presidents don't make budgets in a vacuum. Congress is the ultimate political test for any budget. Although I'm not a Republican, I can say that it was a Democratic president who, alongside Congress, cut VA funding in real dollars from FY94-97. In dollars inflation-benchmarked at 1996 levels, VA did not rebound to previous funding until 2001.
Those years of decline in VA funding occured during the Clinton administration.
But it would be unfair to also malign Clinton completely.
The reason? Bipartisan agreement that a military drawdown AND the (let's just say it) dying off of a large generation of WWII vets would ultimately mean fewer services to be provided.
That said, even during the debate over the 2001 VA budget (how long ago that seems now), the House felt they needed to add $2.1 billion, including $350 million "to repair rundown, substandard and unsafe hospitals."
Now, somehow those hospitals got to be "rundown" and "substandard" and "unsafe" before George W. Bush ever took office.
I shall now await a chorus of people screaming that William Jefferson Clinton "hated the troops" because he, too, sought to privatize large aspects of VA care and knew that on his watch there existed too many "substandard" and "unsafe" and "rundown" hospitals.
And even during that time of peace, VA had a backlog of nearly 500,000 cases!
Like I said before, plenty of blame can go around for both Republican AND Democratic legislators and executives.
One of the most frustrating -- but perhaps ultimately rewarding -- aspects of this forum is that so many people seem to have discovered the military for the first time when the US went to war in Afghanistan and Iraq.
So when you read a story about dysmal care for our veterans or wounded servicepeople, you think it's novel.
Hardly. And that's what is so disgusting about it.
I can't imagine Lincoln or FDR unleashing the cruelty of Tricare onto the American serviceman. What is Gettysburg or The Bulge to compare to an angry wife's telephone call home from the front about Tricare!
By the way, some of us are old enough to remember when Tricare was called Champus. It didn't become "Tricare" until 1994.
It all started during the Eisenhower administration as "Military Medicare" and was for dependents only.
So if you see a parade of grizzled vets coming in here to curse the sorry state of the military medical service from Eisenhower to Bush II, you'll understand the glossary.
And who exactly controlled Congress from 94 to 97? I think I'm starting to see a pattern here. Republican control of Congress = cuts in the VA budget.
If it was in fact debated in 2001 then why hasn't Bush or the Republican controlled Congess done anything about it since then? Oh right, they did do something, cut their budget.
You keep trying to compare apples to oranges. There are no metrics available to compare what may or may not have happened during the '90's to the path this administration has chosen.
Lincoln's Congress (not really Lincoln) created what we now know as the federal welfare state by extending veterans benefits to Union troops honorably discharged from service. But I can assure you that the care given to the soldier in the field was only slightly better than that which would await them after their release from Army hospital.
I'm not exactly sure anyone would make the point that voters were overwhelmingly generous to the American military veteran in 1865 -- only that by 1866 the sheer number of veterans and their families made it difficult for Congress to deny their political power.
And, as I mentioned before, FDR might have been a great war president, but he hadn't created the widespread medical system for dependents that exists today. In fact, conscription in 1943 caught FDR and the War Department off guard. No one had expected so many MARRIED soldiers (they had always been unmarried in the most junior ranks before the draft), and so Congress had to create a special fund to provide maternity care.
It was administered by states, not the federal government. The first real federal role in widespread health care for servicemen's families came with "Military Medicare," when Congress realized that the Korean War had exacerbated the military's health system (hmmmmm, another two presidents who failed to plan and didn't care about the troops! Truman and Eisenhower!).
If you want a Tricare expert, I'll have to turn the keyboard over to my wife.
Democrat, Republican... what a crock: you're nothing but a fascist, Mr. CYA Overkill.
Then what do you make of the increase in VA funding from 2001-2006? That VA funding only really increases in significant amounts when there is a president AND a Congress who are GOP?
Because by your logic, that's how it works out, and I'm not buying it.
The 2001 increase by the House, by the way, was bipartisan (the funding legislation was signed unanimously and was drafted by the staffs of both the Democratic and Republican chairs), and it was responding to a previous budget presented by Clinton.
What typically has happened is low balling on the VA budget by the president, and then reaction by the House and Senate, no matter the party, to raise the funding (although not to an amount they likely would have liked to have seen).
In 2004, this sort of annual theater took on a political cast because it was an election year. It should be noted that for all the mock horror from the VFW prez about the proposed budget, VFW did just about everything but Swiftboat Kerry's hamster to get W elected.
The major problem I've had with Congressional oversight has NOT been the funding. It's been the oversight.
Why is Walter Reed where it is today? That just didn't happen over the last few years. It happened over decades. Perhaps it looks worse because there are more troops streaming in, but I can't believe that this is anything new.
If San Antonio can get it right, why not DC? Especially because Congress is only a short taxi fare from the joint. How many lawmakers have taken the trip? Or, more importantly, how many of their staffers who actually do all the work gone out to visit the troops?
I know one who has, John Murtha. I don't always like a lot of his policies, and think some of his proposals for OIF are misguided. But I never have doubted his longterm, quietly passionate concern for wounded men at Walter Reed.
He's there. He doesn't talk about it, but he goes every week and has been doing so long before he became outspoken in his concern.
I can name another. John McCain.
They're not alone, but they're a minority in Congress. Maybe that's the problem.
I don't know. I can think of several days in Somalia that were as bad as some of the worst days I've experienced in Iraq.
It depends on where you are, who is shooting at you, and what's at stake.
I have a friend who had a machinegun bullet saw off his knees in Somalia. Go tell him that Operation Restore Hope wasn't a real war compared to Operation Iraqi Freedom.
If he could still kick your ass out of his house, I bet he would.
"IAVA has been leading the charge for action in response to recent media reports of drastically inadequate care for outpatients at Walter Reed Army Medical Center in Washington, D.C."
The "reports" have been out there for awhile. If I can scold VFW, American Legion and other groups for failing to properly investigate and speak up for the wounded veteran, then the same goes for IAVA.
Where were you a year ago on this issue?
Actually, MSR, you often seem to be just that. In fact, you often come across as the stalwart defender of all that it is just and good in government, the military, and in particular, the Bush Administration. My impression is that you really are a "book" guy, as was highlighted by your savaging of poor Watada—you and drill sergeant Henderson—and your refusal to even consider the role conscience might play in one's decision process. I even gave you a provocative post on conscience and just war; you wouldn't come out to play. Kept repeating the talking points.
I have no animosity towards you. In fact, I respect you and I like your input here. I also know your circumstances and I suspect you might come across differently in different circumstances. For now, however, you do come across as the defender of the status quo. Which is, lest we forget, the year 2007, some six years into the Bush Administration. Which also means he and his apologists can no longer blame Clinton. I recall our current president campaigning and directing this message to the military: "help is on the way." This is the president who was going to rescue the military from the depredations of the Clinton era and make all things right and good in the military universe.
Well, how's this president done for the troops, MSR? You can't answer, so I'll do it for you. As a retired Army officer, I stay very well wired into things military. I have to, for no other reason than self-interest. You get a pay raise, I get a pay raise. I get the same medical care you get. You suffer for lack of needed support from your system, I suffer with you. Not necessarily from self-interest in this case, but because I care. And, WRT the Bush Administration, I'm hard-pressed to find anything it may have done for you or me other than to place you (not me) into harm's way in a needless and futile combat exercise and then fail to provision you or support you in a proper manner. So you've gotten the shitty end of the stick. All I've gotten is profound distrust of my government, which claims the right to wiretap me whenever it pleases and refuses to pay for the wars in which it wishes to engage. So you may pay the ultimate price. Me, I just get great sorrow and fear for the future of our nation.
As MSR suggests, military medical care has never been what we'd like it to be. Lots of reasons for that, most of them having to do with the old square peg in the round hole theory, so the Walter Reed story isn't particularly surprising. For those of you haven't encountered the military medical system, let's just say it's blessed by mostly dealing with a young and very healthy population. Unless there's a war. Then its shortcomings come to the forefront. Plus there is the reality that, with each generational war, more guys survive wounds that they wouldn't have in their fathers' wars.
Military medicine will always be what it is. But the problems have been exacerbated in the Bush Administration. The Bush Department of Defense has been led by free-market ideologues preoccupied with the bottom line and with their own quaint libertarian notion that everyone other than certain favored classes, mostly those with money, should pay their "fair share." These people view government benefits, no matter how earned or at what sacrifice, as welfare. So we have a government and DoD dominated by bean-counters, most of whom have never served in the military or (horrors) been anywhere near a war. So, yeah, MSR, Bush has broken his promises to the military. The "help" was in the form of the proverbial onrushing train.
Then there is the VA and Clinton. Unlike MSR, I actually know the VA well. I received medical care from VA from 1995 to last year, when I moved out of the SF Bay area to a locale where access to VA is difficult. Now I am on Tricare and oh, my goodness, what a treat. Under the Clinton Administration, VA was modernized to the extent that it is now held up as a model for commercial systems. Under the Clinton Administration, VA opened local clinics nationwide—which is how I got into the system—to serve veterans everywhere. The clinics then served as feeders into VA hospitals for more serious work. My clinic was in San Jose; my hospital was in Palo Alto. I got what can only be characterized as outstanding care from both facilities. The VA hospital in Palo Alto now has a whole separate center that focuses only on severely brain-damaged veterans of Iraq and Afghanistan. This center is recognized in medical circles as being the best of its kind. I couldn't believe the poor kids I saw there. All of us older dudes did what we could for them, but oh, man.
Why is VA so good now? Well, another Clinton initiative helps a lot. VA is computerized all the way. A VA surgeon wants my medical history? He can go online and get it in a heartbeat, nationwide. This VA system is the envy of every other U.S. medical system. My wife was a nurse with Kaiser, the huge HMO in California and other states; they couldn't get squat from other Kaiser facilities. And, incidentally, VA is now mightily frustrated because DoD refuses to provide their docs, who are caring for severely wounded Iraqi and Afghanistan veterans, online access to those vets' military medical records. Something about security, don't you know.
Tricare. Oh, man. What MSR needs to know about Tricare is what will happen to him (and his family) once he's retired. He thinks it's bad now? Wait. Last year, the DoD arbitrarily decided to treble my Tricare deductible as a cost-saving measure. It was triple for me because I'm an officer; enlisted were only going to have to pay half. Congress stepped in. They reminded DoD that they'd already gotten direction to look for cost-savings elsewhere and had never rendered the required report of same. Guess what? They've done it again. Those increased fees are in FY 08 budget. They still haven't made the report Congress directed. And Congress is pissed. I'm confident the fee increases won't happen. But what this is a prime example of what is essentially a lawless administration. They get congressional direction. And they fart it off.
By its actions, the Bush Administration views itself as an imperial government all to itself, with all Americans, including the Congress and the courts, bound to obey. They clearly do not care about the military or about veterans. They are what they are.
No matter what you think of the missions we execute for you, I'm sure no one will have a problem with given a few bucks to USO or any of the other organizations Phil links to on the lefthand part of your screen.
For those of you in uniform, remember to put these and other worthwhile organizations on your federal form for deductions from your pay.
Non-partisan, non-profit, these organizations help fill in the gaps DoD, VA and other federal and state agencies leave for our fighting men and women.
Don't forget them.
My knowledge of the military helathcare system is second-hand, I only know about it through family members that have had to deal with it.
But, Bush has given 'we are a nation at war' as a reason for many of his more controversial actions over the last six years. Yet here, where no one would disagree with him if he had said that and asked for more money, Bush has done nothing. It wouldn't have cost Bush political capital to fix the problems at Walter Reed or the military health care system in general, it would have only cost money.
It makes me skeptical when he asks for powers to suspend habeas corpus for foreigners or to do warrantless wiretapping. Why are we at war when it comes to those things but not health care for the service men and women wounded in Iraq or Afghanistan?
I will concede that hospitalization was improved. For that, I would credit one of the best appointments any president has ever made at the VA. Kenneth Kizer, who came to VHA (the hospital side of the place) in 1994.
That was just before my detailing to DC and I will never say a bad word about the efforts Kizer made. But don't ever forget that in Congress there was a Senate leader on the issue who was even MORE adamant than Bill Clinton to reform VA.
Bob Dole.
You will never hear me ever say a bad word about VA's computerized records system because it is justifiably envied nationwide.
I will take very strong issue, however, with the notion that all of VA was magically improved overall, because it wasn't.
There remained a number of hospitals that, six years after Kizer's appointment, were "unsafe" and "unacceptable," which is just what the bipartisan leadership of the House called them. And Congress was absolutely right.
So Kizer was a great administrator, but he wasn't a miracle worker. And if you're going to say Bush hasn't done everything he could have done over the last six years of war, then I ask why Clinton couldn't do the same over six years (with Kizer!) of peace?
I agree that VA has led the way with computerized records (something health insurers have been trying to get all doctors to do for years), but never forget that nearly a half-million claims were still unprocessed when Bush took office.
In the middle of two wars, after activating nearly the entire Guard and Reserves at some point over the last few years, it's depressing that there's still nearly 600,000 unprocessed claims, compared to about 500,000 in Clinton's last year?
What do you want me to do? Give Clinton's VA a D and Bush's VA a D-? Or should I grade with a curve because there are more troops to process now than under Clinton? They both get a D?
To me, both grades are unacceptable. And how many Congressmen, Republican or Democratic, are still in office today? Where is their accountability.
The sad thing is that I could pull out a Congressional file from, say, 1994 and today, and I bet the VA leadership would be crowing that current efforts would get the annual backlog down to 200,000.
Never got there, did it?
Now, here someone can say something about politics. If you think BRAC is political, go to a hearing over the closure of an outmoded, unsafe VA hospital. The people who oftentimes will the ones most likely to benefit from scrapping the old hospital are the ones fighting it.
You also talk about changes in billing. I wonder if, like many vets, you even got an accurate invoice for your co-pay. Why do I say this? Because GAO continues to say, over and over again, that one of the real problems with VA has been the VBA tracking systems for bills and payments.
I voted for Clinton. I voted for Nader the second time around because Bill didn't need my help. But if I worked for VA's Veterans Service Network, what would I have thought about the Clinton administration's competence? Four years to build the network, and the cost overrun was $92 million.
It was supposed to take two years to build and cost $8 million.
Where was Congressional oversight there, snapping at Clinton's hindquarters to get it done, on time, on budget and actually provide some freakin' accurate care for vets?
And although no one likes to talk about it, another hidden problem is the lack of burial space for our dead. Not the 3,000 who have perished in Iraq during OIF, but the bubble of vets and their family members who have earned the right to burial in a federal cemetery. What is Congress doing today to account for that reality decades from now?
I believe the one person we could elect who can bring true VA AND nationwide healthcare reform is Hillary Clinton.
If I'm telegraphing a vote, sorry.
The only Republican I ever considered voting for was Dole, and that was only because of his lifelong commitment to the American soldier, in peace and war.
I believe Hillary also shares those values and that, for her, it's not just politics. Like her husband, she will hire the right people to make reforms. Unlike her husband, she will earn the respect of all Americans for bringing meaningful healthcare to vets, military dependents AND every civilian out there.
My retirement could coincide with her oath of office. Maybe Publius and I can sit together in the VA waiting room.
Pass the Scholastic.
Give me a break.
Total manhours. Total cost. Total casualties. Net benefits.
Somalia and Iraq are not even remotely in the same universe, and you can crank up the violins and cry all the crocodile tears you want MSR, you're nothing but damned dissembler up to your neck in stale BS.
Oh, noooooo!!!. Maybe on a golf course or in a bar (that VFW redneck joint you liked?), but not there.
Keep it up, MSR. And take care of the troops. And always, always keep your sense of humor. Helps in the bad times. Especially the black humor. As we used to say in Vietnam, "they can kill you, but they can't eat you." You figure it out.
WRT Hillary, well, who knows? You do recall how she butchered the best chance the nation ever had for universal health care, right? But maybe she's learned a few things. I do know one thing: it'd be a real stretch for me to even think of going with BushCo this time around. If the best they've got is McCain, then I say, no thanks. Actually, I'm kind of intrigued by Obama right now. Lack of experience in politics? Well, how much did Washington and Lincoln have?