Thursday, March 1, 2007

How the U.S. is failing its Veterans



The Brain has posted over the past couple of years about the way our soldiers and veterans are treated by the government. Newsweek's cover story this week is about how their medical care, particularly after discharge for grievous wounds, is being bungled and mismanaged.

One reason to worry about a crush of new vets at the VA has to do with the proportion of wounded to dead Americans in Iraq. Though we tend to mark the grim timeline of the war by counting fatalities, what really distinguishes this conflict is how many soldiers don't die, but suffer appalling injuries. In Vietnam and Korea, about three Americans were wounded for every one who died. The ratio in WWII was nearly 2-1. In Iraq, 16 soldiers are wounded or get sick for every one who dies. The yawning ratio marks progress: better body armor and helmets are shielding more soldiers from fatal wounds. And advanced emergency care is keeping more of the wounded alive. The VA's Kussman says that soldiers who survive the first few minutes after an explosion have a 98 percent chance of surviving altogether. But that means an increased burden on the VA's health-care system.

The "increased burden" has led to delays in treatment that have caused Vets to commit suicide. Unconscionable and unacceptable.

There are quite a few of the Vets' personal stories in the article, some heartbreaking, some that totally piss you off, and some that are heroic.

Kenneth is a Marine master sergeant who'd been in the Corps for nearly 18 years. He was on his second tour in Iraq when a sniper bullet ricocheted off the metal hatch on his vehicle and hit him directly below the right eye, grazing the front of his brain and exiting near his left ear. Among other things, he was diagnosed with traumatic brain injury, which has become the signature wound of the Iraq war. Tonia had to fight the Marine Corps to keep him from being discharged, figuring he'd get better medical care if he remained in active service. But some of his treatment has been outsourced to the VA.

One of the tricks she learned early on was to demand photocopies of her husband's records—every exam, every X-ray, every diagnosis—and personally carry the file from appointment to appointment. "I don't know if there is a more formal protocol for transferring documents, but I know that what I brought ... was definitely put to use." When Sargent was transferred to the VA's lauded Polytrauma Center in Palo Alto, Calif., doctors there encouraged her to go home to Camp Pendleton near San Diego and treat his stay at the hospital as if it was a deployment. "After two weeks, they asked me how long I was planning to stay with my husband," she says. "They said it was his rehab, not mine. But I needed to learn how to care for him, and he suffered from extreme anxiety without me." She pushed back, staying in Palo Alto until he completed his care.

That Marine is damn lucky to have a wife like that.

And just why do you suppose the system is failing these troops so badly?

But veterans' support groups and even some former and current VA insiders believe there's a reluctance in the Bush administration to deal openly with the long-term costs of the war. (All told, Bilmes projects it could cost as much as $600 billion to care for GWOT veterans over the course of their lifetimes.) That reluctance, they say, trickles down to the VA, where top managers are politically appointed. Secretary Jim Nicholson, a decorated Vietnam War veteran who was chosen by Bush in 2005, tends to be the focus of this criticism.

The senior VA manager who did not want to be named criticizing superiors told NEWSWEEK: "He's a political appointee and he needs to respond to the White House's direction." Steve Robinson of Veterans for America levels the accusation more directly. "Why doesn't the VA have a projection of casualties for the wars? Because it would be a political bombshell for Nicholson to estimate so many casualties." The VA denies political considerations are involved in its budgeting or planning. Nicholson declined to be interviewed but Matt Burns, a spokesman for the VA, called Robinson's comments "nonsensical and inflammatory," adding: "The VA, in its budgeting process, carefully prepares for future costs so that we can continue to deliver the quality health care and myriad benefits veterans have earned."

Sounds like more of the politics, obfuscation, spin, and lies we've come to expect from this administration, all the while runnin' lip service on "the best care we can offer our veterans".

Shorter: Just more Bush criminal incompetence.

The article is quite long and well done, I think. Since I've saved you a trip to the newsstand and $4.95, please go read it.

It's the bare tip of the iceberg. The problem is going to be with us for the foreseeable future and beyond until enough people are made aware of it often enough that the collective conscience of the nation is disturbed enough to demand what's right for our Veterans. The sooner the better.

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