Collateral Damage

In the two weeks since the scandalous conditions at Walter Reed Hospital’s Building 18 were exposed in a front page Washington Post article, the media has been filled with accounts of the military's neglect of America’s wounded veterans. The Army Times this weekend has a depressing story about the Pentagon’s efforts to suppress further complaints from wounded Iraq returnees at the facility.

The response by the Bush administration and the army, at first denying responsibility and then firing the generals in charge, has been nothing short of pathetic. In his Saturday radio address, the president, without admitting responsibility, vowed to make amends.

Let’s briefly review the extraordinary record of this two-term president. He’s gone from ignoring warnings that “Osama Bin Laden Is Determined to Strike in the U.S”; to lying about the casus belli for war in Iraq; to failing to plan for the war’s aftermath; to bungling the response to Hurricane Katrina. Now, his administation must bear responsibility for mistreating the very people whose lives have been devastated by his war policies.

The next victim of this administration’s incompetence could well be the Veterans Administration, which in recent years has earned a well-deserved reputation for excellence. This morning's Washington Post follows up on a torrent of emails from veterans around the country complaining about conditions at the nation's VA hospitals. The story includes some horrifying stories about mistreatment of recently wounded Iraq veterans. "It is just not Walter Reed," the headline said.

Advances in battlefield medicine have changed the calculus of war-time casualties. During Vietnam, there were three wounded for every death in battle. In Iraq, that ratio has skyrocketed to 15 to 1, with many more seeking treatment for the post traumatic stress that hadn’t been recognized in the immediate wake of prior wars.

As Linda Bilmes, a Harvard Kennedy School of Government researcher, wrote recently in the Los Angeles Times:

So far, more than 200,000 veterans from Iraq and Afghanistan have been treated at VA medical facilities — three times what the VA projected, according to a Government Accountability Office analysis. More than one-third of them have been diagnosed with mental health conditions, including post-traumatic stress disorder, acute depression and substance abuse. Thousands more have crippling disabilities such as brain or spinal injuries. In each of the last two years, the VA has underestimated the number of veterans who would seek help and the cost of treating them — forcing it to go cap in hand to Congress for billions of dollars in emergency funding.

The VA system has a reputation for high-quality care, but waiting lists to see a doctor at some facilities now run as long as several months. Shortages are particularly acute in mental health care. Dr. Frances Murphy, the VA's deputy undersecretary for health, recently wrote that some VA clinics do not provide mental health or substance abuse care, or if they do, "waiting lists render that care virtually inaccessible."

Two years ago, New America Foundation senior fellow Phillip Longman offered an eye-opening account in the Washington Monthly of the VA's transformation from an object of scorn into one of the best health care delivery systems in the country. His book on that turnaround is due out in a few weeks.

Bad timing. What should have been a poster child for what a single-payer health system could do for America has been undermined by the incompetence of this administration. Now, a large part of the public will see it -- unjustifiably -- as just another institution failing the American people.

Posted by gooznews at March 4, 2007 04:28 PM