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February 20, 2007
John Hawkins A Reality Check About Hospitals Run By The Government

This week-end, the WAPO did a story on how wounded soldiers flown back to the states and treated at Walter Reed Army Medical Center are finding that the hospital is unorganized, indifferent, and drowning in red tape. Here's some of what the troops are going through (Hopefully the attention this story is getting will jolt some bureaucrats into action):

"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.

...While the hospital is a place of scrubbed-down order and daily miracles, with medical advances saving more soldiers than ever, the outpatients in the Other Walter Reed encounter a messy bureaucratic battlefield nearly as chaotic as the real battlefields they faced overseas.

On the worst days, soldiers say they feel like they are living a chapter of "Catch-22." The wounded manage other wounded. Soldiers dealing with psychological disorders of their own have been put in charge of others at risk of suicide.

...Vera Heron spent 15 frustrating months living on post to help care for her son. "It just absolutely took forever to get anything done," Heron said. "They do the paperwork, they lose the paperwork. Then they have to redo the paperwork. You are talking about guys and girls whose lives are disrupted for the rest of their lives, and they don't put any priority on it."

...Life beyond the hospital bed is a frustrating mountain of paperwork. The typical soldier is required to file 22 documents with eight different commands -- most of them off-post -- to enter and exit the medical processing world, according to government investigators. Sixteen different information systems are used to process the forms, but few of them can communicate with one another. The Army's three personnel databases cannot read each other's files and can't interact with the separate pay system or the medical recordkeeping databases.

...The frustrations of an outpatient's day begin before dawn. On a dark, rain-soaked morning this winter, Sgt. Archie Benware, 53, hobbled over to his National Guard platoon office at Walter Reed. Benware had done two tours in Iraq. His head had been crushed between two 2,100-pound concrete barriers in Ramadi, and now it was dented like a tin can. His legs were stiff from knee surgery. But here he was, trying to take care of business.

At the platoon office, he scanned the white board on the wall. Six soldiers were listed as AWOL. The platoon sergeant was nowhere to be found, leaving several soldiers stranded with their requests.

Benware walked around the corner to arrange a dental appointment -- his teeth were knocked out in the accident. He was told by a case manager that another case worker, not his doctor, would have to approve the procedure.

"Godd*mn it, that's unbelievable!" snapped his wife, Barb, who accompanied him because he can no longer remember all of his appointments.

Not as unbelievable as the time he received a manila envelope containing the gynecological report of a young female soldier."

The sad reality is that Walter Reed is run from top to bottom by the government through Veteran's Affairs and when you put people with the same sort of mentality that you see at the IRS, DMV, and Post Office in charge of medical care, it's not a surprise that it turns into a poorly run bureaucratic nightmare. That's what the entire federal government is like, so why would people think it would be different when it comes to medical care?

Moreover, this is nothing new. VA care stunk under Clinton, it stinks under Bush, and 10 years from now, whether a Republican or Democrat is in charge, no matter what they promise or how much people complain, it will still stink. That is the nature of the beast with anything run by the federal government.

You want to make a real difference for the troops? Long term, get people in there who have to hustle, who aren't government drones. In other words, privatize things as much as possible. Get different companies competing to serve the troops instead of leaving them in the hands of government workers. That's the only way you're ever going to get things really working, instead of just making them "less bad" for a little while because the WAPO is putting the heat on.

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