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THE PENTAGON'S CHRONIC NEGLECT OF IRAQ VETERANS
--
Military officials knew long ago about the
failure to take
care of America's war wounded at the
beleaguered
Walter Reed hospital.
Background with backlinks here...
http://vawatchdog.org/07/nf07/nfAPR07/nf041607-1.htm
Story here...
http://www.salon.com/news/
feature/2007/04/25/walter_reed_groups/
Story below:
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The Pentagon's chronic neglect of Iraq vets
Military officials knew long ago about the failure to take care of
America's war wounded at the beleaguered Walter Reed hospital.
By Mark Benjamin
WASHINGTON -- When the Walter Reed scandal exploded in the media in
February, bringing wide attention to inadequate care for veterans at the
Army's flagship hospital, Defense Department officials expressed shock
and claimed ignorance. Dr. William Winkenwerder Jr., the assistant
defense secretary who oversees military medicine, declared at a press
conference on Feb. 21: "This news caught me -- as it did many other
people -- completely by surprise."
But Salon has learned that the Defense Department had been conducting
monthly focus group discussions with soldiers treated at Walter Reed
since before the wars in Afghanistan and Iraq had even begun, and that
it continued to do so as wounded veterans of those conflicts arrived at
the facility. The interviews with outpatients were set up to monitor
Army healthcare and provide military officials with direct information
about it.
"They were trying to find out the good and the bad and the ugly," said a
former Defense Department official familiar with the DoD focus groups.
"That is the good-news story. The bad-news story is they did not do
anything about it."
The focus groups were conducted every month and included soldiers and
their families, according to the former Defense Department official. The
interviews sometimes took place at Walter Reed or in the department's
Force Health Protection and Readiness offices in northern Virginia. That
office helps write DoD healthcare policy and monitors health trends
among returning veterans.
A Pentagon spokeswoman, Cynthia Smith, confirmed in an e-mail to Salon
that the interviews with wounded veterans had taken place, describing
them as "focus groups to gain useful input from troops who've deployed
and accessed the military health system." Terry Jones, another Defense
Department spokesman, said in a separate e-mail that soldiers
participating in the DoD interviews were encouraged to be candid. "They
are asked how well the system has worked in identifying and treating any
health problems experienced before, during, and after deployment."
The DoD sessions were in addition to the focus groups with Walter Reed
soldiers conducted by the Department of Veterans Affairs in 2004. As
Salon reported earlier this month, the VA found more than two years ago
that soldiers at Walter Reed were "frustrated, confused, sometimes
angry" about the difficulties they faced in getting adequate care.
Until last week, the leaders of the Force Health Protection and
Readiness office, which ran the interviews, reported to Winkenwerder.
During his Feb. 21 press conference, Winkenwerder suggested that money
was not the source of the problems at Walter Reed. "Let me just say,
this is not a resource issue," he told reporters. The next day, the
White House announced that Winkenwerder would be leaving his post. (His
replacement, Dr. S. Ward Casscells, a vice president of biotechnology at
the University of Texas Health Science Center, took over last week.)
During a brief encounter on Capitol Hill last month, Winkenwerder told
Salon he had never heard of the patient focus groups conducted by the
Department of Defense. "At Walter Reed, I was not aware that there were
focus groups," Winkenwerder said. When presented with details about the
office conducting the groups, he conceded, "I know that they meet with
service members and their families periodically."
The official in charge of the Force Health Protection and Readiness
office who reported to Winkenwerder is Ellen Embrey, deputy assistant
secretary of defense for force health protection and readiness. Embrey
did not attend the focus group sessions with Walter Reed soldiers,
according to Smith, the DoD spokeswoman. Instead, the sessions were run
by Embrey's deputy, Dr. Michael Kilpatrick. But no transcripts were kept
of the interviews, according to Jones, the DoD spokesman, and Kilpatrick
is on vacation and unavailable to explain what he heard from the
soldiers who participated.
It made sense for the Force Health Protection and Readiness office to
hold focus group sessions. A Department of Defense directive from Nov.
9, 2000, orders the office to conduct outreach activities to monitor
returning veterans, "assuring and preserving their trust" in military
medicine.
But that trust has been shattered, according to a bipartisan report on
the Walter Reed scandal delivered last week to recently installed
Secretary of Defense Robert Gates. "Rebuilding the Trust," written by
the Independent Review Group impaneled by Gates, notes that "first class
trauma care is provided from the time of injury ... and during inpatient
hospitalization." But the panel delivered a scathing indictment of the
penny-pinching policies and leadership failures that beset Army
outpatient care. "The breakdown in health services and care management
occurs once the servicemember transitions from inpatient to outpatient
status."
Jim Bacchus, a former Democratic congressman from Florida and a member
of the Independent Review Group, said the outpatient scandal mirrors the
larger failure by the Bush administration to plan for the ramifications
of war. "To me, all of this is merely one more sign that the Bush
administration simply did not foresee the consequences of going into
Iraq," Bacchus said in a phone interview. "It is now a very visible sign
of the failure of foresight."
The report describes the Army's outpatient program as overwhelmed by
casualties and starved for resources. Soldiers caught in its trap must
fight a nightmarish bureaucracy for months or even years as they
struggle to get disability payments. They often do so without the help
of caseworkers, who are in short supply.
The report also points out that as the wars go on, the number of mental
healthcare providers working for the military is decreasing. The report
is particularly critical of the failure to take care of soldiers at
Walter Reed with invisible wounds such as post-traumatic stress disorder
and traumatic brain injury. "Numerous servicemembers, and their
families, expressed considerable angst regarding the lack of diagnosis
and/or treatment" for those conditions, according to the report.
But supposedly, PTSD treatment at Walter Reed had been under scrutiny by
military officials, according to Smith, the DoD spokeswoman. "In 2005, a
second track [of focus groups] was added to become more behaviorally
health oriented and specifically address post-traumatic stress
disorder," she said.
There are other indications that Pentagon leaders should have known
about the problems at Walter Reed long ago. The Independent Review Group
report notes that some of the failures in Army healthcare have been
documented in a raft of government reports going back for years.
"Numerous reports by agencies within both the executive and legislative
branches of government have previously identified problem areas," the
report says. "Regrettably, many of these problems still exist." An
appendix in that report lists 16 previous government reports and
congressional testimony documenting breakdowns in Army healthcare,
including studies by the Government Accountability Office, Congress'
investigative arm.
Bacchus said the systemic problems in Army healthcare were relatively
well known within the military. (Salon began reporting on problems at
Walter Reed in 2005.) When articles in the Washington Post in February
pushed the story into the mainstream, few were surprised. "We found that
a lot of people in the military were waiting and hoping that someone
would ask the right questions," Bacchus said.
Army Secretary Francis Harvey, Army Surgeon General Lt. Gen. Kevin
Kiley, and Walter Reed's commander, Maj. Gen. George Weightman, all lost
their jobs in the wake of the Walter Reed scandal. But the Independent
Review Group report suggests they are not the only ones responsible for
the failures. "Authority to correct the most difficult issues was beyond
the local commander and the service secretaries," the report says. "Yet
to be addressed is the role of policy and oversight that control the
budget and direct resources for military medicine."
The policy and purse strings are controlled by the top civilian leaders
at the Pentagon. Perhaps the most influential among them is Dr. David
S.C. Chu, undersecretary of defense for personnel and readiness, who has
responsibility for military healthcare, including disability benefits,
and who reports directly to the secretary of defense. Chu, an economist,
mathematician and former Army comptroller, has been in that role since
the summer of 2001. He told the Senate Armed Services Committee last
month he was "deeply chagrined" by the Walter Reed fiasco.
But veterans advocates roundly criticized Chu after he famously told the
Wall Street Journal in early 2005 that the Pentagon was spending too
much on veterans' benefits, and they remain deeply skeptical of him.
"What is happening at Walter Reed and other military facilities is a
natural consequence of trying to fight the war on the cheap," said Rick
Weidman, who works with Vietnam Veterans of America. When it comes to
Army healthcare, he said, "it was David Chu who was running that train."
Unlike the leaders beneath him who have been implicated in the Walter
Reed scandal, Chu remains in his post at the Pentagon.
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Larry Scott --
