Wednesday, March 07, 2007

Betrayal at Walter Reed - Part 2

The ongoing scandal over the treatment of wounded veterans at Walter Reed hospital continues to be news in most of the country. The story is still in the news for several reasons: members of Congress see it as a chance to grandstand in front of the cameras; Republicans and Democrats alike see it as a chance to beat each other up; and - most important - it strikes a chord in the hearts of average Americans. This country has a tradition of standing up for the underdog, and the sight of horribly wounded veterans shabbily treated tends to rouse the best of our instincts.

But citizens being concerned doesn't fix the problem, and neither does the standard Congressional response of holding hearings at which hapless witnesses can be berated in front of rolling cameras. Two things will fix the problem: leadership and money.

The vast and unexpected cost of the war in Iraq has led the Army - and the Defense Department in general - to strip funds from day to day operating accounts to pay the war tab. The routine "operations and maintenance" accounts which provide the funds to maintain infrastructure are being pillaged to buy new and repair damaged equipment and to pay the costs of maintaining a huge force in a high-intensity fight. An article by Paul Eaton in yesterday's New York Times notes that the Army last year had a $350 million shortfall in its budget for upkeep at installations around the world. This is the money that removes the mold and traps the rodents and exterminates the insects that have been the focus of the Walter Reed scandal. He also notes that Walter Reed has been selected to close by the Base Realignment and Closure Commission (BRAC), the kiss of fiscal death which means that the Army will be unwilling to invest money in a facility with no future. Finally, and most shocking, Mr Eaton documents that Congress, in the 2007 appropriations bill for the Pentagon, cut by 50% the financing for the Army's research and treatment program on traumatic brain injuries...which are, as has often been reported, some of the most prevalent injuries suffered by soldiers in Iraq, and which program was conducted at - Walter Reed!

No one has covered themselves with glory in this appalling scandal: the Army leadership, the Administration, the Veterans Administration. There's plenty of blame to go around. So what's to be done to fix the problem?

First, spend the money. That's easy to say at a time when the Services are scrambling to pay the huge cost of the war and also trying to field expensive new weapons (such as the Air Force's F-22 and F-35 and new ships for the Navy). In his article cited above, Mr Eaton says that "The money to care for our soon-to-be-veteran soldiers should not come from the Defense Department budget." Perhaps not. But where, then, should it come from? The Department of Health and Human Services, which is itself chronically underfunded? The State Department? The Interior Department? Where? For one thing, the President could take a double shot of reality and start raising taxes to pay for the war, instead of cutting taxes to advance a feel-good political-economic philosophy aimed at buying votes.

This leads to the second fix: show leadership, starting with the President who has thus far refused to treat the cost of the war as a visible part of the Federal budget. The Army's senior leaders, backed up by the Secretary of Defense, need to stand up for their soldiers and insist on the funding for the treatment they deserve. Generals don't just get to wear nice uniforms and sit in huge offices - they have a solemn responsibility to care for those who sacrifice limbs and lives. They need to speak truth to power.

This is a time for strong leadership and hard choices. Strong leadership doesn't just mean standing in front of cameras and sternly intoning platitudes...it means making the tough decisions on where to find money and how to spend it. It means making politically difficult choices that are morally right. It means keeping promises made to the young men and women who go in harm's way, no matter how hard it is.

It means having leaders with integrity and courage. These, sadly, are in short supply.

The Walter Reed scandal is a very hard one to resolve. But that's why we elect political leaders and promote generals - to work together to solve those impossible problems.

But I'm not holding my breath.

Have a good day. More thoughts tomorrow.

Bilbo

1 comment:

Don Carr said...

Walter Reed IS on the BRAC list, but NOT to close. It is on the list to be realigned, and I don’t believe that’s any “parsing” or play on semantics. As it’s written, the services and treatment available to patients are NOT closing!

What BRAC will do is realign primary and secondary care at the current Walter Reed to a new hospital at Fort Belvoir, and most everything else in the old facilities, including tertiary care, to an upgraded Bethesda facility. Only once the Bethesda and Fort Belvoir facilities are up and running with the services realigned from the old WRAMC will the old campus on Georgia Avenue close. Even the name Walter Reed – as in, “Walter Reed National Military Medical Center” – will still be very much up and running.

Key point is that none of the care services talked about in the hearings the last few days will be “closed.” But, I’m afraid a lot in the general public are certainly left with the impression that the hospital’s services are on the chopping block. That is NOT how the current BRAC legislation reads – the term “close” isn’t used in the same way it is for such installations as Fort Monroe, for example, which IS to be closed.

“Closure” of Walter Reed is being referred to a great deal more in an alarmist fashion than in any fashion that truly helps get to the bottom of the issue today’s hearing was about. My experience tells me that assertions that “being on the BRAC list” make it hard to attract and keep good staff are similarly alarmist. I believe that is due more to the privatization and A-76 challenges WRAMC has faced, and has its roots back much further than 2005 when the current BRAC changes were announced.

The intent of the entire BRAC process is that it be immune from political manipulation. It will take congressional debate on the floor – opening up the entire law, not just that pertaining to Walter Reed – and, thus, I believe create a great many more problems than it would solve to try and delete reference to Walter Reed, particularly when one considers that the problems people think they would solve aren’t really in the BRAC mandate in the first place.

Walter Reed being on the list is only a problem related to the current situation if we’re talking about its services going away, but, we’re not. I believe that, if we’re not careful, we’re going to waste a lot of time dealing with “Walter Reed on the BRAC list” in the name of finding and solving problems that have little with the BRAC list at all.