Paul D. Eaton is a retired Army major general.Casualties of the Budget WarsSat Mar 10, 2007 02:23March 6, 2007
Casualties of the Budget Wars
By PAUL D. EATON
Fox Island, Wash.
IN his 1997 book “Dereliction of Duty,” Col. H. R. McMaster wrote that “the ‘five silent men’ on the Joint Chiefs made possible the way the United States went to war in Vietnam.” So it is today with the war in Iraq. Regrettably, the silence of our top officers has had a huge impact not just on the battlefield but also on how we have brought our injured warriors home from it. These planning failures led to the situation at Walter Reed Army Medical Center recently reported by The Washington Post, which resulted in the firings of the hospital’s commander and the secretary of the Army.
The sad truth is that The Post’s reports weren’t entirely new: Mark Benjamin, of United Press International and the Web magazine Salon, and Steve Robinson, the director of veterans affairs at Veterans for America, have been reporting on the disgraceful treatment of our war wounded since 2003. More important, the Walter Reed scandal is simply the tip of the iceberg: President Bush, former Defense Secretary Donald Rumsfeld and Congress all pointedly failed to provide the money and resources for our returned troops wherever they are, both the obviously wounded and those who may seem healthy but are suffering mentally and physically from their service.
Soldiers have long joked: “If you are really sick or injured, Army medical care is O.K. But if you are hurting only a little, especially if it isn’t visible, you’re in big trouble.” The American soldier still receives the best trauma care in the world, especially at Walter Reed. The problem there has been with deplorable outpatient care management. The military health system is seriously undermanned and underfinanced for the number of casualties coming home. Also, there has been little preparation for identifying and treating post-traumatic stress injuries.
Last year, because of spending in Iraq, the Army had a $530 million shortfall in its budget for posts at home and abroad. This forced the Army’s vice chief of staff, Richard Cody, to tighten belts that were already at the last notch.
Hospitals have taken a big part of the financial hit. General Cody has warned Congress that failure to shore up the tottering military health care system could become a “retention issue.” David Chu, the Pentagon’s under secretary for personnel and readiness, told The Wall Street Journal that veterans’ costs “are taking away from the nation’s ability to defend itself.”
The result is that Walter Reed and every other domestic Army post have struggled to house soldiers properly after their release from the hospital. For the lucky ones, family members pick up the slack, making sure that follow-up care is provided, that prescription drug regimens are followed, that therapists show up for rehabilitation sessions. Those without family help tend to slip between the cracks.
Walter Reed, in particular, has another problem. The Base Realignment and Closure Commission decided in 2005 to shutter this critical hospital. I won’t debate that decision now — what’s done is done — but when the commission decides you will close within a few years, money dries up real fast. It is no wonder that buildings fell into disrepair and recovering soldiers slipped off the radar screen.
This was the fiscal environment that Maj. Gen. George Weightman stepped into last August when he took command of Walter Reed. I have known George since he was a plebe at West Point. He is bright, honorable and energetic — and always capable. But as another of his admirers told me, “He was the captain of that ship.” And now he has gone down with his ship — the victim of Mr. Rumsfeld’s wrongheaded cost-cutting and the joint chiefs’ failure to stand up to the civilian leadership.
So, what can we do to ensure that good men like General Weightman aren’t put in impossible situations and, more important, that our fighting men and women get the care they need? A good first step has been taken: Secretary of Defense Robert Gates fired the secretary of the Army, Francis Harvey, who was a true Rumsfeld man and viewed by many as more loyal to his boss than to the Army. But some other prescriptions seem obvious:
•I would encourage every member of Congress, ever senior Pentagon official and every White House staff member to read the articles Mark Benjamin has written on soldier care, beginning with the 2003 report he did on Fort Stewart in Georgia. The train in this wreck left the station a long time ago.
•The Pentagon must do something it has, amazingly, never tried: develop an official doctrine on how to “redeploy” a soldier from the combat zone to the peaceful zone. This means hiring mental health experts to thoroughly analyze the psychology of the returning soldier, and making a commitment to building a health care network that can meet the needs of a growing population of injured soldiers.
•Congress must increase financing for research into traumatic brain injuries, the signature malady of this war. Unbelievably, in its Pentagon appropriations bill for 2007, Congress cut in half the financing for the Army’s main research and treatment program on brain injury (which, no surprise, is at Walter Reed).
•The government should also expand grants to the Fisher House program, a public-private partnership that has “comfort homes” at every major military medical center. These provide families of wounded troops with housing, kitchens, laundry rooms and other support services. The program serves more than 8,500 families a year, but will struggle to keep pace with the growing number of returning wounded.
•Like so many government departments, the military has a medical computer system that is made up of a hodgepodge of antiquated machines with outdated software that often can’t communicate with one another. This needs to be replaced with a user-friendly system that can efficiently track the wounded as they make their way through the system.
•The Pentagon must revamp the Medical Evaluation Board process, the system under which a soldier suffering from injury is screened to see if he should be given a discharge and a disability pension. Cases now are handled in a haphazard way and can drag out indefinitely; each should be held to a disciplined timeline.
•The general effort by Mr. Rumsfeld and Mr. Harvey to privatize services at Army bases needs to be reined in. Some of the problems at Walter Reed seem to have been caused by the contracting out of maintenance services and other support jobs.
•While we address the needs of uniformed men and women, we need to assess our civilian employees as well; most are excellent, but some are entrenched and in need of firing.
•The money to care for our soon-to-be-veteran soldiers should not come from the Defense Department budget. The immense costs of medical care are simply too attractive to Pentagon budget-cutters, creating a conflict of interest between the war effort and the health of our troops.
•And, of course, we must move the outpatient soldiers out of Walter Reed immediately. It is a small, old installation with few recreational outlets in a neighborhood of Washington that is unwelcoming to patients’ families. Fort Lewis in Washington State, for example, is a large, well-equipped installation in a beautiful area with a good program for recovering soldiers. And the big goal should be to get our wounded troops off bases entirely and back their own homes, with adequate medical care and insurance.
The other day I had a phone conversation with Mr. Robinson, a former Army Ranger whose group aids Persian Gulf war veterans suffering with health disorders. “The problem with Walter Reed and the nation’s defense health program is much more than money, mold and mice,” he said. “It is about leadership.” He’s right. And with Secretary Gates, I expect the Joint Chiefs of Staff to be able to resume their rightful role in our nation’s defense
Paul D. Eaton is a retired Army major general.
3/9/07 HBO: "Real Time with Bill Maher"
Army General.... BLAME...BLAME...BLAME
Paul D. Eaton is a retired Army major general.
Roseann Barr Arnold.... "GREAT"!
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