It’s great to see the Post doing investigative reporting that actually changes the national conversation and improves people’s lives. But its series on the squalid conditions facing some veterans at Walter Reed Army Medical Center also has the potential to do harm unless the context of the story gets more play.
For example. True or false. Walter Reed is a VA hospital. The answer is false. The VA has nothing to do with Walter Reed, which is an Army hospital. That’s why the Secretary of the Army took the fall.
Yet as the author of a Washington Monthly cover story on the VA entitled “Best Care Anywhere” (and as the author of a forthcoming book by the same title) I know all too well that many people don’t get the distinction. My email box is overflowing with people wondering what I think of the VA now that it has been enveloped in scandal.
From this I conclude many Americans are taking the wrong lesson from the series. If you are left with the impression that Walter Reed is a VA hospital, then it’s just a short leap to concluding that the problems exposed there are indicative of the veterans health care system as a whole. And from that point, conservatives conclude that the whole story just goes to show what happens when the government gets into the health care business, while liberals use the same VA “scandal” to bash Bush.
Look, the VA has its problems. Because the White House and Congress won’t give it the funding to honor past promises to veterans, it now has to limit new enrollments to vets who have service-related illness or who can meet a strict means test. It’s also having trouble ramping up to meet the needs of the unexpectedly large number of young vets diagnosed with mental illness. But despite these challenges, the fact remains that the VA enjoys the highest rate of consumer satisfaction of any American health care system, public or private.
And outside experts agree that the VA deserves this high rating from its patients. A RAND Corporation study published in the The Annals of Internal Medicine concludes that the VA outperforms all other sectors of American health care in 294 measures of quality. In awarding the VA a top prize in 2006 for innovation in government, Harvard’s John F. Kennedy School of Government gushed that “While the costs of healthcare continue to soar for most Americans, the VA is reducing costs, reducing errors, and becoming the model for what modern health care management and delivery should look like.”
Let’s hope the press doesn’t miss that “story behind the story.”
I wasn’t aware of the confusion — it’s the Pentagon not the VA that is the problem. A televised report on this story makes this clear.
The VA appears to be more concerned with the welfare of the veterans, which is only fitting. As is often the case, institutions are guided by organizational dynamics related to their goals and how they were formed. There may be an emphasis on cost cutting at the VA, but their general mission — to serve veterans — doesn’t appear to have been compromised by mixed allegiances. However, the same can not be said for the military.
The Pentagon, or the Army as the case may be, has had an economic interest in reducing the disability payments to veterans and has been attempting to entrap (in one report) veterans into signing forms that would allow the Pentagon to declare their disability as unrelated to combat. A questionnaire sent out by the military asks the question: “do you drink?” An affirmative answer to this question is being used to disqualify Post-Traumatic-Stress cases as stemming from alcohol abuse.
However, the emergency care at Walter Reed is reported to be excellent, but the outpatient care, which apparently occurs after the Army makes it’s disability determination, seems to be atrocious.
Much as with insurance companies, having the agency in charge of determining the award creates a conflict of interest. Pressures to reduce costs or free up funding for other purposes can — and apparently has — result in a distortion of the process of determining disability.
I haven’t researched this story yet, so I encourage others to check into it rather than relying solely on this report.
right. because no one ever drank to self-medicate their post-traumatic stress.
After seeing a potential huge liability — PTS — the military appears to be looking for ways to minimize future costs. Given the intangible nature of the ailment, as well as it’s possible application to a wide cross section of combat veterans, it combines all the traits that make it hard to prove and easy (for the bureaucracy) to dismiss.
Since diagnosis would appear to be somewhat subjective and dependent on self-reporting, and reducing it’s diagnosis would save the military a ‘boatload’ of cash, it seems to be headed the way of another ‘mythical’ ailment — exposure to Agent Orange. A former roommate, a Vietnam vet, found out the hard way about the Catch-22 related to Agent Orange, when his insurance was canceled while the government still continued to insist there was no such medical problem.
Yet another possible motive for the “there is no PTS” argument might be it’s logical implication for the “war is fun” meme. We wouldn’t want anyone to realize that exposure to combat causes trauma? That would take all the fun out of it, and dampen our enthusiasm for the “adventure.”
plongman, I know you are a vet, but do you now or have you ever worked at a VA hospital? Have you now or ever worked at a military hospital? What is your qualifications as such to make statements that you are making. I am not saying you are wrong. I just want to know who you are and what qualifiers you have. You are so right at to differ between the active military hospitals and the VA hospitals and or out patient clinics or such. Thanks a good diary. hugs
Just a qualification on my earlier post — I’m not vouching for the care given vets through the VA, merely stating that reports on the situation are focusing on the Pentagon, or the Army, rather than the VA.
There is still room to fault the VA, and I’ve heard complaints related to their services (or lack of).
I think understanding how these institutions operate is important to solving the problem. When faced with uncomfortable truths, bureaucracies have an annoying tendency to disappear problems that don’t fit with their budgetary priorities. Government run like a business becomes corrupt just like business. Unfortunately, for the affected vets, there is no invisible hand ready to supply what had already been promised by government.
very true! on all accounts. thanks….
I’m not a vet, nor do I have any connection to the VA. I’m a senior fellow at the New America Foundation (http://www.newamerica.net) who has been doing a lot of research and writing about the VA over the last three years. For those who would like to learn more about the VA and why it provides the best argument for government run health care, check out my cover story for the Washington Monthly at. A book based on the article, Best Care Anywhere: Why VA Health Care is Better than Yours, will be published by PoliPoint in April.
so let us see. We have a system that is connected to and controlled by the pentagon. We have a organization that is now attempting to shift to non-governmental contract players. We have a group of “Generals” that just keep trying to cover their asses and who are willing to shift the blame for this insanity to anyone, including the patients that they are responsible for. Oh, and by the way, they are also willing to lie to the public as well as the congress.
What the hell- it really won’t matter one god damned bit cause the system is completely broken.
And now we have this “plongman” posting this effing excuse! Hey Boo- a little mor concern regarding just who gets to post.Waddya say.When we all know that the major media outlets are controlled by the corpoprates, let us try and keep blogs such as this one clean and unpolluted by such crass ass kissing. So, let us not forget the story behind the story- The story of the administrations lying, the pentagon lying, the heads of the va and the surgeon gen of the army lying.
That is the real story behind the story ole plonger!
let’s be fair here, ok? plongman does sound a little too much like a VA PR person, but he’s not lying.
It’s been clearly explained that the current mess at Walter Reed is the DOD’s fault.
The VA is not controlled by the DOD, it’s the Dept. of Veterans Affairs. IMO the VA would be better off if it was still part of DOD; now it’s the Pentagon’s poor stepchild. I think it’s fair of the diarist to remind us that the VA is doing a pretty good job given the limited funding it gets.
Anecdote, fwiw: a neighbor of mine, WW2 vet, recently spent some time in the local VA hospital. I think he was there a couple of weeks for pneumonia. He was quite happy with the care he’d received – and then cursed Reagan for cutting dental care from veteran’s benefits.
We should remember that if the system is broken, republicans broke it by not funding it. The VA does contain, at least in some places, good doctors and nurses and staff members.