You do the math

So Bush wants to take this opportunity to talk about how he has grown the VA budget under his administration -- Way wrong answer for those paying attention. He forgot to mention that the budget increase (decrease) is due to the increased co-pays and the decreased per-vet spending for the VA. The numbers of disabled Vets are growing faster than the budget is increasing, so claiming to increase the budget is BULLSHIT!!

Bush also will emphasize in the address that more than 1 million veterans have been brought into the Veterans Administration health care system since 2001 and that his fiscal 2008 budget proposal includes a request for more than $86 billion for veterans' services, representing a 77 percent increase since he took office.

---Bush Orders Review of Service Members' Care
By William Branigin

Washington Post Staff Writer
Friday, March 2, 2007; 5:18 PM

WRAMC ain't the first

In September, 2004 I left the 101st Airborne Division and became a MEDDAC soldier in the Medical Hold Company. I was awaiting separation from the Army because of injuries I received while deployed. My wife was also having serious medical problems (BUT THAT'S AN ENTIRELY DIFFERENT STORY).
When I came over to the Ft. Campbell Hospital, Blanchfield Army Community Hospital (BACH) I was offered a company command. The Troop Commander, a Major, was an energetic and compassionate leader - I had a great deal of respect for her and wanted to accept the job. Especially after she discussed what my duties and responsibilities would entail:
The Medical Hold barracks were horrible. Much like the ones at WRAMC now featured all over the news they were full of mold, mildew, asbestos, and deteriorating construction - holes in walls, broken window frames - these were not suitable for soldiers. There was no handicap access and no elevators - and, like at WRAMC, these soldiers were severely disabled I walked through these barracks and wanted to help get them fixed.

The Troop Commander had been working on getting these fixed since they had taken command but to no avail.
I did not accept the company command - my wife's health had deteriorated too much. If I took command I would either abandon her, or be in a position where I could let soldiers down - I was not willing to accept either of these outcomes. I helped with the company in a limited capacity and took care of my wife.
The soldier's barracks situation improved before my wife was granted access to the care she needed in order to heal.

When we requested work orders on these dilapidated buildings the housing office would explain that because the barracks were so old, and marked for destruction, funding could not be approved to renovate or otherwise fix the problems. New construction on-post had priority over old construction - understandable - but it didn't address the current housing problems.

Eventually, after many false starts, the Troop Commander found ways to correct the problem as much as possible. She found ways to get repair work done. Some soldiers moved to a hotel off-post. The soldiers got moved to a better building almost a year later. But better than what? What is considered acceptable? They just moved to a somewhat better building. It's still old and falling apart and won't get renovated, either.

AND I KNOW SHE BROUGHT THESES PROBLEMS HIGH UP THE CHAIN OF COMMAND.
She did her job but found little support from above.

But Ft. Campbell is getting a new command center - it looks nice, IT's HUGE!! Lot's of money going into that development.

The Army is about people, soldiers, not about machinery or equipment. What good will that equipment be if there are no more soldiers left to use it?

accountability

Walter Reed's Commander just got canned, NOW WHAT?
In the reports yesterday soldiers at WRAMC were being punished for their leaders' failures. The First Sergeant was fired, and now the 2-star General got fired, too.
I wonder about the people in-between . . .
There is quite a large gap in rank-structure and accountability between the Company 1SG and Hospital Commander.
BUT - the burden of Command is great and a new commander may be the right start. I trust that the investigators will discover many systematic failures as well as human failures in this whole mess - after all, someone has to design, implement, and oversee this broken system.
The President was at WRAMC a few months ago. Having prepared for VIP guests at various-level functions I can assume that the preparations made prior to the President's visit included making sure all the "bad things" were covered over.
So, while I believe our President is failing in many ways, in this instance I would not be surprised if the military shielded themselves from looking bad.
And that just goes back to integrity and the lack there-of at high levels of the military chain of command. The really good leaders, the ones who put their troops before themselves, usually get passed-over and forgotten. But that's another rant for another day.
Instead I am left to ponder what will become of military medicine - this shit storm may be the catalyst of change so desperately needed.
The Army Times is doing a great job tracking the problems with disability ratings and other issues surrounding the Medical Evaluation Board (MEB) process.
Hopefully the new governmental leadership will start doing what they were selected to do - fix the broken shit the current administration won't admit is broken.

Military Med system FUBAR -- part 3 (5? 67?)

But it also should not have taken newspaper articles to bring change to outpatient conditions at Walter Reed. And while filthy conditions at Building 18 are a temporary problem for these veterans, lowball settlements may leave soldiers and their families impoverished for life.

-- Washington Post Editorial, "Rotten Homecoming" -- 21 FEB 07

I find it nearly impossible to explain how this stuff can happen, when family or friends ask. If I'm bitching about how frustrated I am with being denied treatment or only getting it after a 3-year fight, it's understandably bizarre. I got tired of trying, because it always ends up in, "Well why don't you just...(..)?"

Which would work in any OTHER HMO.
And which wouldn't be necessary if more of the leadership were more interested in patient care and troops' well-being, than number-crunching and avoiding conflict with unethical practitioners.

Here's the systematic issue:

The biggest problem is: most of us wounded, maimed or disabled get
stuck at our shitty little "Army Community Hospitals" (ABHs) on our
own posts--away from the specialty clinics, support programs &
publicity of Walter Reed. Honestly, I'm horrified things got so bad
at Walter Reed, thank god for WaPo--but those articles exposed maybe
5% of the systematic failure to do right by injured troops.

It kills me how the Pentagon makes it sound like all "severely
injured" troops are getting care at Walter Reed. Or its sister-Army
Medical Centers (AMCs).
Bullshit--it's where a severely injured troop goes ONLY if he/she's
wicked lucky, Knows Someone or has a dramatic external injury. The
rest of us "severely injured" hospital-bunnies would all but pull out
a buddy's IV to get to Walter Reed. It's like Xanadu, heaven, a place
of wonder.
The difference? At Medical Centers like WallyWorld you get, you
know, medical treatment along with your
moldy/infested/condemned barracks... Rumor has it: the troops are
sometimes even treated like patients instead of weaklings or shitbags.
WOW!

The majority of us-- shrapneled digestive systems, organ failures,
traumatic brain injuries, spinal cord issues, single-arm amputations,
or whatever (even cancer) get scattered around the country, out of the
public eye (i.e., in little army towns with no investigative
reporters). At these ACHs, hospital administrators can deny
treatment, falsify records, or otherwise screw us with no
repercussions that I've seen, ever.

To be fair: most of the people at these Army Community Hospitals on
tactical/"grunt" posts are AWESOME. Many are army wives or formerly
troops themselves. 90%+ are professional, sweet, and busting their
ass to keep things going. They're so exhausted from dealing with
overcrowded clinics and increasingly pissed off patients, I truly
don't know how they stay sane. I submit "Good Job!" reports on them
whenever possible.

The problem, as usual in a bureaucracy, lies with:
A. Pentagon bean-counters (generals or senior civilians)
shortchanging the outlying hospitals to fund whatever rusty-ass
Artillery system got porked in again this year
B. Hospital admin types (senior officers) who pretend everything's
SUPER instead of grabbing their sack and addressing , or
C. A few unithical & power-trippy doctor or nurse (usually one in
charge of a clinic) too senile, incompetent, ambitious or psychotic
for the whole "medical care" thing

Of course, they're the "authority" or "professionals" so they're the
ones who get to give all the official input. We start thinking we're
just crazy, til we figure out the odds of simultaneous, identical mass
hallucinations are slim. Even on wacky pain meds.

I just don't know how to get help for all of us at outlying hospitals.
I've tried. Others here have worn themselves out trying. How do you
raise hell in Pudunk, Kentucky/Tennessee border for Peter's sake. ANY
suggestions would be genuinely appreciated. Congressionals get shot
down as fast as...quail-hunting partners. We're not allowed to sue
for malpractice (not that most of us would...but the threat might help
quality control)

Recovery Ops

I'm glad the lid finally got blown off the military covering-up the failures of the administration. These problems so recently brought to light about WRAMC (Walter Reed Army Medical Center) are only superficial. Taco Bell has rats and roaches. The real problem is the leadership's failure to take corrective action. These problems have been known for a long time.
Good leaders are not just the lucky people who have no problems during their periods of responsibility. (Though many generals and high-power politicians have either been so lucky, or have done a hell-of-a-job covering things up) The best leaders are the ones who can take horrific problems and conditions and make the situation better. It will take leadership beyond the capability of those currently in charge to fix this problem.
This should be investigated - letting conditions get this bad is dereliction of duty. But to say that leadership knew nothing of the problems adds insult to injury - quite literally in this case.
Either the high-up leaders didn't care enough to inspect all facilities, facility managers lied to higher-up leaders, or the higher-up leaders knew, and did nothing to fix matters. Each of these possibilities demonstrate the dire circumstances within the DoD's management of military medical practices.

What is more - Walter Reed is hallowed ground for injured troops - it's a MEDCEN (Medical Center), in the middle of Washington D.C.!!! The outlying community hospitals in the Army don't have nearly what WRAMC can provide. Soldiers in outlying hospitals live in worse conditions (yeah, I've seen them and smelled the puke left in the asbestos filled hallways by cancer patients returning from chemo and radiation treatment, and I've seen the moldy showers where burn-victims and amputees have to bathe) and there is no spotlight to fix them!!

These troops have returned home from war with life-changing wounds and injuries and the administration continues their "fight the war on the cheap" mentality by cutting corners on health care.

And why can't soldiers make a cause for this themselves? Why is it that these men and women fought a faceless, far-off enemy and can't stick-up for themselves? Easy - they have no weapon, and no support. The majority of seriously injured troops returning to these piss-poor conditions are low-ranking and have little-to-no family or financial support. Battling the physical injuries and psychological trauma of their injuries and the PTSD most likely linked to that injury leaves our combat-trained service members in an unsupported position. They have no recourse against shitty medical care and have no one to guide them through the red-tape involved in transitioning from active duty to the civilian world. Sure there are benefits and programs linked to service - but what good are these services when they are not made accessible to vets and families who would most benefit from them. Besides, most of these vets-to-be just want to get on with their lives - they aren't the type to wallow in misery.

Hopefully this WRAMC shitstorm won't stop in DC - so many more military hospitals need the spotlight turned on. Hospital leaders need to be held accountable for their neglect of troop health.


So if it takes the press corps to motivate the leadership of "this great Nation" so be it - our troops deserve better treatment and their leadership lacks the character, the moral courage and the intestinal fortitude to find a way to provide it.

Washington Post Article

http://www.washingtonpost.com/wp-dyn/content/article/2007/02/17/AR2007021701172.html

Here is the beginning:

Soldiers Face Neglect, Frustration At Army's Top Medical Facility

By Dana Priest and Anne Hull

Washington Post Staff Writers
Sunday, February 18, 2007; Page A01

Behind the door of Army Spec. Jeremy Duncan's room, part of the wall is torn and hangs in the air, weighted down with black mold. When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. The entire building, constructed between the world wars, often smells like greasy carry-out. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses.

This is the world of Building 18, not the kind of place where Duncan expected to recover when he was evacuated to Walter Reed Army Medical Center from Iraq last February with a broken neck and a shredded left ear, nearly dead from blood loss. But the old lodge, just outside the gates of the hospital and five miles up the road from the White House, has housed hundreds of maimed soldiers recuperating from injuries suffered in the wars in Iraq and Afghanistan.

There's something you don't see every day

On character:
I once heard character defined as having the discipline to perform a task at 0200 when no one else was around to watch. I've also hear it described as doing what's right for no other reason than the fact that it's the right thing to do.
I must say I was quite disappointed to hear a captain announce to his subordinates that he didn't feel compelled to attend a meeting with his subordinates because the colonel wasn't going to attend. So the captain needed the colonel to hold his hand through the meeting with the troops? I guess so. So who was there with the troops? Not the captain, not the colonel, no, just the sergeant major who has no choice but either pass the buck to the colonel or just say "I have no idea what you're talking about." And he probably had no idea. No senior administrator or commander wants to believe anything that comes out of meetings about unethical medical practices. The military puts its doctors in a pretty safe bubble - Feres.
Where does character fit into all this? Well, that's the problem -- it doesn't. I haven't seen many leaders of character since I left the line. If a company commander needs a colonel's direct line of sight to do the right thing then our military is just falling to pieces. Captains shouldn't need that kind of supervision, and soldiers should never have reason to worry that their captain is only getting pulled along by the colonel on a tight leash, taking every opportunity to dodge some irksome duty.

-- Ragin' Ranger OUT