thedrifter
03-10-07, 07:55 AM
Free Walter Reed
The wounded deserve more than political recrimination.
Saturday, March 10, 2007 12:01 a.m. EST
The reports of poor conditions at Walter Reed Army Medical Center have set off a political firestorm. It remains to be seen whether the system that created the problem is capable of fixing it.
The Walter Reed facility is located inside the District of Columbia. While the press reports have been dramatic, it strains credulity to think these problems are suddenly news to Congress and all its staff, the executive branch, the Pentagon (across the Potomac), the rest of the Washington press divisions or servicemen and their families.
So now Congress is holding hearings, the White House is setting up an independent commission and Vice President Dick Cheney has pledged "there will be no excuses, only action." Arguably "only action" is a federal-government oxymoron. The action so far has consisted of firings and recrimination. If this continues, the incentive for anyone in government to think innovatively about Walter Reed will fail.
Not surprisingly, the story beneath the Walter Reed mess is a morass. It is government, in its inevitable sprawl, working at cross purposes with itself. For starters, Walter Reed is scheduled to shut down in 2011 as part of the base-closure commission process. No surprise that resources going into Walter Reed would not rise under this circumstance.
Meanwhile, President Bush has proposed spending $38.7 billion on military health care in the coming year--double what the military spent in 2001. Over the past six years the military has expanded health coverage for reservists and for military families and has added a more generous prescription drug benefit.
What has happened is that for more than a decade military health care has shifted away from long hospital stays in favor of increased outpatient care, mirroring the private-sector trend. The military and the entirely separate Department of Veterans Affairs--which itself spends tens of billions of dollars on health care--have shuttered large in-patient facilities and opened hundreds of outpatient clinics.
By and large this has been for the good. The military in fact is a pace-setter in medical procedures to treat the severely injured; it drives advances in prosthetic limbs, trauma care and reconstructive surgery. Approximately 98% of those wounded on the battlefield who reach a hospital survive. Consider the following comparison: The ratio of those wounded to killed today is seven to one; in Vietnam that ratio was closer to three to one. And the VA is excelling at outpatient care. The Rand Corporation recently found that on nearly every measure of quality of care--preventive services, follow-ups, chronic care--VA patients receive better care than most civilians.
But the problems are real and significant. The military provides health care to more than nine million people. The VA runs the largest unified health-care program in the country to cover an additional five million people. It's predictable that patients will get lost inside a government system this vast. In recent weeks veterans from the Korean and Vietnam wars have stepped forward to tell their own stories of fighting the health-care bureaucracy.
More than three million people eligible for cheap prescription drugs through the VA are opting instead to pay a little extra for Medicare drug coverage. Why? Because, as a Manhattan Institute study recently found, only 22% of the most important drugs released in recent years are covered by the VA.
These manifest problems will now tread water while we await the president's commission, Congress's hearings and on into the darkness. We have some shorter-term ideas to get help where it's needed.
For starters, free the patients captive inside this system. Congress should give these wounded soldiers vouchers to pay for out-patient care anywhere in America they wish--near home and family, at innumerable state-of-the-art rehab facilities, at specialized care institutions. Army word-of-mouth would quickly transmit data on best care, location, cost and family support. The professionals and staff in these places would move heaven and earth to help the service men and women.
To make this work, give a primary role to nonprofit foundations. The Fisher House program of comfort homes for families is perhaps the most famous. There are others more than willing to help.
Certainly the government needs to right its own battered programs. But in the meantime, let the American people--the world's greatest reservoir of medical, financial and volunteer skills--at last get involved helping those who've been fighting on our behalf in Iraq and in the war on terror.
Ellie
The wounded deserve more than political recrimination.
Saturday, March 10, 2007 12:01 a.m. EST
The reports of poor conditions at Walter Reed Army Medical Center have set off a political firestorm. It remains to be seen whether the system that created the problem is capable of fixing it.
The Walter Reed facility is located inside the District of Columbia. While the press reports have been dramatic, it strains credulity to think these problems are suddenly news to Congress and all its staff, the executive branch, the Pentagon (across the Potomac), the rest of the Washington press divisions or servicemen and their families.
So now Congress is holding hearings, the White House is setting up an independent commission and Vice President Dick Cheney has pledged "there will be no excuses, only action." Arguably "only action" is a federal-government oxymoron. The action so far has consisted of firings and recrimination. If this continues, the incentive for anyone in government to think innovatively about Walter Reed will fail.
Not surprisingly, the story beneath the Walter Reed mess is a morass. It is government, in its inevitable sprawl, working at cross purposes with itself. For starters, Walter Reed is scheduled to shut down in 2011 as part of the base-closure commission process. No surprise that resources going into Walter Reed would not rise under this circumstance.
Meanwhile, President Bush has proposed spending $38.7 billion on military health care in the coming year--double what the military spent in 2001. Over the past six years the military has expanded health coverage for reservists and for military families and has added a more generous prescription drug benefit.
What has happened is that for more than a decade military health care has shifted away from long hospital stays in favor of increased outpatient care, mirroring the private-sector trend. The military and the entirely separate Department of Veterans Affairs--which itself spends tens of billions of dollars on health care--have shuttered large in-patient facilities and opened hundreds of outpatient clinics.
By and large this has been for the good. The military in fact is a pace-setter in medical procedures to treat the severely injured; it drives advances in prosthetic limbs, trauma care and reconstructive surgery. Approximately 98% of those wounded on the battlefield who reach a hospital survive. Consider the following comparison: The ratio of those wounded to killed today is seven to one; in Vietnam that ratio was closer to three to one. And the VA is excelling at outpatient care. The Rand Corporation recently found that on nearly every measure of quality of care--preventive services, follow-ups, chronic care--VA patients receive better care than most civilians.
But the problems are real and significant. The military provides health care to more than nine million people. The VA runs the largest unified health-care program in the country to cover an additional five million people. It's predictable that patients will get lost inside a government system this vast. In recent weeks veterans from the Korean and Vietnam wars have stepped forward to tell their own stories of fighting the health-care bureaucracy.
More than three million people eligible for cheap prescription drugs through the VA are opting instead to pay a little extra for Medicare drug coverage. Why? Because, as a Manhattan Institute study recently found, only 22% of the most important drugs released in recent years are covered by the VA.
These manifest problems will now tread water while we await the president's commission, Congress's hearings and on into the darkness. We have some shorter-term ideas to get help where it's needed.
For starters, free the patients captive inside this system. Congress should give these wounded soldiers vouchers to pay for out-patient care anywhere in America they wish--near home and family, at innumerable state-of-the-art rehab facilities, at specialized care institutions. Army word-of-mouth would quickly transmit data on best care, location, cost and family support. The professionals and staff in these places would move heaven and earth to help the service men and women.
To make this work, give a primary role to nonprofit foundations. The Fisher House program of comfort homes for families is perhaps the most famous. There are others more than willing to help.
Certainly the government needs to right its own battered programs. But in the meantime, let the American people--the world's greatest reservoir of medical, financial and volunteer skills--at last get involved helping those who've been fighting on our behalf in Iraq and in the war on terror.
Ellie