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POLICY: A National Disgrace By John Irvine

When the story first came out, it didn’t look like much.
Just a few problems that needed correction: a little mold here, a few repairs
there, the inevitable complaints from disgruntled patients. But two and a half
weeks after the Washington Post ran a little story by reporters Dana Priest and
Anne Hull titled “Soldiers Face Neglect, Frustration At Army’s Top Medical
Facility
“ the Walter Reed scandal has become without question the top story in the country. 

Today, Priest and Hull return with another lengthy piece examining
conditions in the military healthcare system in other parts of the country titled
Walter Reed Not an isolated case.” The two reporters say that after their initial story ran they were contacted by "literally hundreds of soldiers" from around the
country with similar stories to share. The pair writes:

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.

That appears to answer a question that many people had been wondering about. As New York Democrat Charles Schumer put it over the weekend “if it’s
this bad at the outpatient facilities at Walter Reed, how is it in the rest of the country?” On Sunday,
Schumer called for a bipartisan commission – possibly to be headed by former
secretary of state Colin Powell – to examine conditions facing returning
service men and women.

Predictably, conservative critics around the blogosphere are
pointing at the debacle as evidence that any government run healthcare system
would be a disaster. Kevin MD writes: “What’s happening at Walter Reed is small
sample of how government-run health care would turn out. Does the public understand
the implications of a nationally-run health care system?”

"Will the Bush-bashers join with free-market critics to effect real change and
help the troops who need and deserve better care? We’ll see," writes Michelle Malkin.

On THCB Eric Novack follows along in the same vein, writing: “legislators and bureaucrats have been made
aware of some of these problems for years and years. And yet, nothing
significant has changed. The missing interpretation: the absolute fundamental
inability for government-run organizations to escape convoluted, bureaucratic,
non-meritorious based hierarchies. Anyone still for VA care for all of the USA
now?”

But not everybody agrees. On the other side of the
aisle, many Democrats are arguing that privatization is to blame for the problems found at the base. Many are
pointing at an internal memo from Walter Reed garrison Commander Peter
Garibaldi to Weightman that allegedly detailed specific problems at the facility, weeks before
the Post report. (You can read the actual memo here.)

The
memorandum “describes how the Army’s decision to privatize support services at Walter Reed Army Medical Center was causing an exodus of ‘highly skilled
and experienced personnel,’” the committee’s letter states. “According to
multiple sources, the decision to privatize support services at Walter Reed led
to a precipitous drop in support personnel at Walter Reed.” The letter said Walter Reed also awarded a
five-year, $120-million contract to IAP Worldwide Services, which is run by Al
Neffgen, a former senior Halliburton official.

The Walter Reed scandal has already provoked a massive outpouring of
commentary on editorial pages, blogs and news sites. A few more highlights:

Reporters at Salon.com are angry.They’re saying they ran
the Walter Reed story first
, way back in 2003. They’re not accusing the Post
of plagiarism. Or are they? It’s hard to
tell.

Washington Post ombudsman (shouldn’t it be ombudsperson?)
Deborah Powell has some of the back story on the reporting that broke the
Building 18 story.

But aren’t the
problems at Walter Reed the sort of thing that can happen at any large
organization if the people at the top lose touch?  I can’t help but think that
Philip Carter’s commentary “Walter Reed and the Reverse BS Filtration System,” which
ran in Slate last week, should be required reading for every business student
in the country. 

“Walter Reed’s
problems also illustrate just how bad the Army has gotten at passing
information—particularly negative information—up and down its chain of command.
Typically, subordinate units submit reports on a daily, weekly, and monthly
basis to their headquarters. At each level of command, these reports get
filtered, collated, combined, and resynthesized. Like the children’s game of
telephone, the message frequently changes in transmission. The result can be a
terribly distorted picture of reality at the higher echelons of command.”

Major problems get
renamed "obstacles," or "challenges," or some other noun
that connotes a temporary delay in forward progress, reflecting the pervasive
"can do" optimism of the military officer corps. Staff officers at
each level of command refine and insert caveats into reports to ensure they
don’t rock the boat too much. By the time information reaches a senior
commander or civilian official, it no longer reflects reality.

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...::alana::....Stella BaskombkarenRickRight Recent comment authors
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...::alana::....
Guest
...::alana::....

health care that the goverment give for “free” is rubbish i dont believe that i am a polical person and i dont pretend to be because our goverment is ovepowered with politics.(whatever that may be) health care is something that this country should value as many ther countrys dont have it. although there have been many problems with the system that we use it doesnt change the fact that it does work but in many cases were people have sued the nhs it has been the goverments fault and not the doctors and nurses that treat us.
….::alana::….

Stella Baskomb
Guest
Stella Baskomb

“So the scandal of WRAMC stands as a shining example of what’s wrong with privatizing health care.”
That poses an interesting dilemma for the design of universal health care.
Continue to permit private administration of health care facilities
Or – convert all workers at health care facilities into government employees.
Appears that we’ll either end up with a nation-full of Walter Reeds privately managed, or a nation-full of Walter Reeds publicly-managed.
Sure gives me a warm feeling.

Rick
Guest
Rick

Karen,
You just demonstrated the real danger of this problem. Walter Reed is not a VA facility. It is an Army facility. The VA merely provides the coverage for some of the soldiers in question. The VA has very good facilities, some of the best in the country, and it is unfortunately being smeared because the status or condition of some of the soldiers required that they be treated at Walter Reed. Don’t let the problems of Walter Reed scare you away from the VA system.

karen
Guest
karen

My father, now 82, served with honor under General Patton in WWII.
After reading this, he will never go to any VA facility as long as I draw breath and a paycheck. This is not the way to reward our servicemen and women.

Rick
Guest
Rick

Per Paul Krugman in yesterday’s NYT, WRAMC was privatized. And under very hinky circumstances. IAP Worldwide Services, a company run by two former Halliburton executives, received the contract after the Army reversed the results of an audit concluding that government employees could do the job more cheaply.
So the scandal of WRAMC stands as a shining example of what’s wrong with privatizing health care.

Right
Guest

Well, this shows the fallacy of a socialized medicine system. We have the greatest health care system money can buy. If we opened veteran heath care to the free market, these guys would be able to get great health care. It’s time to let the market solve this. I say close Walter Reed altogether.

David Palmer
Guest

Well, yesterday as I wrote the solicited comment below to the Reserve Officers Association of the United States, I thought that I should mention that when it is all said and done we will find out that the problems at Walter Reed Army Medical Center are related to contractors, just as is the issues with TRICARE, TRS, TDP and the rest of military medical care. I didn’t, but I am now. Last evening before going to bed I saw an article on the internet speaking of the issues at Walter Reed Army Medical Center. As I read it, I kept… Read more »

Right
Guest

Well, this shows the fallacy of a socialized medicine system. We have the greatest health care system money can buy. If we opened veteran heath care to the free market, these guys would be able to get great health care. It’s time to let the market solve this. I say close Walter Reed altogether.

John Irvine
Guest

Maggie, I think you make a good point about the anecdotal nature of the Post’s report yesterday. I’d wondered about that. This seems like an example of the way the digital age has compressed the news cycle. In the old days, our would-be Woodwards and Bernsteins would have had to have spent a long time doing the legwork to follow up on their initial report. They would have had to physically pick up the phone and contact people. They would have had to have gone to god-forsaken parking garages in the middle of the night and hidden in the shadows… Read more »

Mark
Guest

The Regimental Surgeon of the U.S. Marines Manuel Tanguma has inquired about the use of a medical device proven to aide in the prevention of concussion in NFL players. The NFL’s concussion expert was forced to resign last week because of his concussion policy and omission of these statistics. NFL statistics confirmed in an AAOP study that warranted further study, that was never done. Dr. Tanguma has communicated with a Harvard MGH researcher about a proposed study at Walter Reed. Now we understand, why it hasn’t happened, the Red Tape of the military bureaucracy. This is a medical procedure many… Read more »

John T. Gregg, MD
Guest
John T. Gregg, MD

The problem with all of the hoopla over WRAMC and OP medical care, is to put this into the context of all the similar hoopla in 2003 as to the BRAC recommendations as to closing Walter Reed, and combining the services medical facilities in DC. IIRC, there have been several attempts at same over the last 30+ years, all thwarted by congressional interests in the region, trying to keep status quo, and from within the military medical administrative establishment – wouldn’t want to lose any high rank prestige slots near the center of power. WRAMC should have been closed and… Read more »

Maggie Mahar
Guest
Maggie Mahar

The linked story suggesting that Walter Reed is typical of the VA system (“It’s Not Just At Walter Reed”) depends so heavily on anecdotes that it’s hard to know what to make of it. (Also, it’s worth noting that Walter Reed is not part of the VA system. The story slides from Walter Reed to the VA without making that point clear.) I, too, can share an anecdote. My brother-in-law, who is a Vet, recently went to the VA hospital here in New York City to get some medication and a doctor noticed his hearing aid. He inquired about my… Read more »