This is how they support the troops?
The official reaction to the revelations at Walter Reed has been swift, and it has exposed the potential political costs of ignoring Oliva's 24.3 million comrades -- America's veterans -- many of whom are among the last standing supporters of the Iraq war. In just two weeks, the Army secretary has been fired, a two-star general relieved of command and two special commissions appointed; congressional subcommittees are lining up for hearings, the first today at Walter Reed; and the president, in his weekly radio address, redoubled promises to do right by the all-volunteer force, 1.5 million of whom have fought in Iraq and Afghanistan.
But much deeper has been the reaction outside Washington, including from many of the 600,000 new veterans who left the service after Iraq and Afghanistan. Wrenching questions have dominated blogs, talk shows, editorial cartoons, VFW spaghetti suppers and the solitary late nights of soldiers and former soldiers who fire off e-mails to reporters, members of Congress and the White House -- looking, finally, for attention and solutions.Several forces converged to create this intense reaction. A new Democratic majority in Congress is willing to criticize the administration. Senior retired officers pounded the Pentagon with sharp questions about what was going on. Up to 40 percent of the troops fighting in Iraq are National Guard members and reservists -- "our neighbors," said Ron Glasser, a physician and author of a book about the wounded. "It all adds up and reaches a kind of tipping point," he said. On top of all that, America had believed the government's assurances that the wounded were being taken care of. "The country is embarrassed" to know otherwise, Glasser said.
The scandal has reverberated through generations of veterans. "It's been a potent reminder of past indignities and past traumas," said Thomas A. Mellman, a professor of psychiatry at Howard University who specializes in post-traumatic stress and has worked in Veterans Affairs hospitals. "The fact that it's been responded to so quickly has created mixed feelings -- gratification, but obvious regret and anger that such attention wasn't given before, especially for Vietnam veterans."
Across the country, some military quarters for wounded outpatients are in bad shape, according to interviews, Government Accountability Office reports and transcripts of congressional testimony. The mold, mice and rot of Walter Reed's Building 18 compose a familiar scenario for many soldiers back from Iraq or Afghanistan who were shipped to their home posts for treatment. Nearly 4,000 outpatients are currently in the military's Medical Holding or Medical Holdover companies, which oversee the wounded. Soldiers and veterans report bureaucratic disarray similar to Walter Reed's: indifferent, untrained staff; lost paperwork; medical appointments that drop from the computers; and long waits for consultations.
Sandy Karen was horrified when her 21-year-old son was discharged from the Naval Medical Center in San Diego a few months ago and told to report to the outpatient barracks, only to find the room swarming with fruit flies, trash overflowing and a syringe on the table. "The staff sergeant says, 'Here are your linens' to my son, who can't even stand up," said Karen, of Brookeville, Md. "This kid has an open wound, and I'm going to put him in a room with fruit flies?" She took her son to a hotel instead.
"My concern is for the others, who don't have a parent or someone to fight for them," Karen said. "These are just kids. Who would have ever looked in on my son?"
Krugman provides the necessary context:
For all its cries of “support the troops,” the Bush administration has treated veterans’ medical care the same way it treats everything else: nickel-and-diming the needy, protecting the incompetent and privatizing everything it can. What makes this a particular shame is that in the Clinton years, veterans’ health care — like the Federal Emergency Management Agency — became a shining example of how good leadership can revitalize a troubled government program. By the early years of this decade the Veterans Health Administration was, by many measures, providing the highest-quality health care in America. (It probably still is: Walter Reed is a military facility, not run by the V.H.A.)But as with FEMA, the Bush administration has done all it can to undermine that achievement. And the Walter Reed scandal is another Hurricane Katrina: the moment when the administration’s misgovernment became obvious to everyone.
The problem starts with money. The administration uses carefully cooked numbers to pretend that it has been generous to veterans, but the historical data contained in its own budget for fiscal 2008 tell the true story. The quagmire in Iraq has vastly increased the demands on the Veterans Administration, yet since 2001 federal outlays for veterans’ medical care have actually lagged behind overall national health spending.
To save money, the administration has been charging veterans for many formerly free services. For example, in 2005 Salon reported that some Walter Reed patients were forced to pay hundreds of dollars each month for their meals.
More important, the administration has broken longstanding promises of lifetime health care to those who defend our nation. Two months before the invasion of Iraq the V.H.A., which previously offered care to all veterans, introduced severe new restrictions on who is entitled to enroll in its health care system. As the agency’s Web site helpfully explains, veterans whose income exceeds as little as $27,790 a year, and who lack “special eligibilities such as a compensable service connected condition or recent combat service,” will be turned away.
So when you hear stories of veterans who spend months or years fighting to get the care they deserve, trying to prove that their injuries are service-related, remember this: all this red tape was created not by the inherent inefficiency of government bureaucracy, but by the Bush administration’s penny-pinching.
But money is only part of the problem.
We know from Hurricane Katrina postmortems that one of the factors degrading FEMA’s effectiveness was the Bush administration’s relentless push to outsource and privatize disaster management, which demoralized government employees and drove away many of the agency’s most experienced professionals. It appears that the same thing has been happening to veterans’ care.
The redoubtable Henry Waxman, chairman of the House Committee on Oversight and Government Reform, points out that IAP Worldwide Services, a company run by two former Halliburton executives, received a large contract to run Walter Reed under suspicious circumstances: the Army reversed the results of an audit concluding that government employees could do the job more cheaply.
And Mr. Waxman, who will be holding a hearing on the issue today, appears to have solid evidence, including an internal Walter Reed memo from last year, that the prospect of privatization led to a FEMA-type exodus of skilled personnel.
When privatization is a means to another end it can at times make sense; when it becomes and end in itself, however, the unintended negative consequences can be dramatic. Over the past decade or so, privatization moved from the realm of policy solution to ideology for many Republicans, transforming it from a means to an end in itself. The result, predictably, has been disastrous.
Privatization isn't a magic bullet. It doesn't always save money. It doesn't always provide improved quality of service. It doesn't always provide greater accountability. Theory and practice aren't even remotely the same thing. Why people cannot see that is completely beyond me.
Want more? Hilzoy has what you need.
UPDATE: Washington Monthly really has what you need. Really.
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