Salon: Walter Reed, on the cheap

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http://www.salon.com/news/feature/2007/03/06/walter_ree... /

Walter Reed, on the cheap


The Pentagon's top civilian official in charge of military healthcare wanted more money for bullets and bombs, and fewer benefits for soldiers.

By Mark Benjamin


March 6, 2007 | WASHINGTON -- It is now becoming more widely known that for years some soldiers returning from the wars in Iraq and Afghanistan have suffered neglect and poor care at Walter Reed Army Medical Center. As the military health care system has become increasingly burdened with returning veterans, some patients have also been ground down by the complex bureaucracy that is supposed to pay them disability for their wounds. Even more disturbing, some soldiers and veterans' advocates say, is mounting evidence that these problems extend far beyond the well-known military hospital in Washington, festering in varying degrees at military posts throughout the country.

The commander at Walter Reed and the secretary of the Army lost their jobs last week, after renewed media focus on the deficiencies in handling outpatients at Walter Reed set off an uproar in Washington. But the spotlight is about to shift to civilian leaders inside the Pentagon -- and while they are lower-profile characters in the Walter Reed drama thus far, their critics say they bear primary responsibility for the problems.

The Senate Armed Services Committee on Tuesday is hauling up to Capitol Hill Dr. David S.C. Chu, undersecretary of defense for personnel and readiness, and Dr. William Winkenwerder Jr., the assistant secretary of defense for health affairs. Chu and Winkenwerder, who have held those jobs since the start of the wars in Iraq and Afghanistan, are the top officials beneath the secretary of defense with the responsibility for making sure returning soldiers get prompt outpatient care and fair remuneration for their service-related ills.

Now, Congress is demanding more answers about why money was not spent to hire more doctors, case workers and psychologists to treat outpatient soldiers at Walter Reed. Questions are also swirling about why the military has apparently done nothing to fix what veterans' advocates say is a nightmarish bureaucracy for disability payments, one that leaves vets sitting around for months, sometimes even years, not knowing if they'll be taken care of for the longer term.

Critics say that Chu and Winkenwerder had the wrong priorities, focusing on cutting costs while greater numbers of returning soldiers struggled against an increasingly strained military health care system. Both men know how to manage costs: Chu is an economist and mathematician who once worked in an Army comptroller office. And Winkenwerder is a former health insurance industry executive.

But their résumés also point to the problem, according to their detractors. "The military tried to run military health care on the cheap -- like an HMO," said Paul Sullivan, who until March 2006 was a project manager at the Department of Veterans Affairs in charge of data on returning veterans. "And the consequences are the medical catastrophe and the bureaucratic nightmare that we see right now."


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