Insult To Injury: Cheating Our Vets

[Gimpy]

HOW THE PENTAGON IS SHORTCHANGING WOUNDED SOLDIERS --


The U.S. military appears to have dispensed low disability ratings to wounded service members with serious injuries and thus avoided paying them full military disabled retirement benefits.



Insult to Injury

New data reveal an alarming trend: Vets' disabilities are being downgraded

By Linda Robinson


In the middle of a battle in Fallujah in April 2004, an M80 grenade landed a foot away from Fred Ball. The blast threw the 26-year-old Marine sergeant 10 feet into the air and sent a piece of hot shrapnel into his right temple. Once his wound was patched up, Ball insisted on rejoining his men. For the next three months, he continued to go on raids, then returned to Camp Pendleton, Calif.


But Ball was not all right. Military doctors concluded that Ball was suffering from a traumatic brain injury, post-traumatic stress disorder (PTSD), chronic headaches, and balance problems. Ball, who had a 3.5 grade-point average in high school, was found to have a sixth-grade-level learning capability. In January of last year, the Marine Corps found him unfit for duty but not disabled enough to receive full permanent disability retirement benefits and discharged him.


Ball's situation has taken a dire turn for the worse. The tremors that he experienced after the blast are back, he can hardly walk, and he has trouble using a pencil or a fork. Ball's case is being handled by the Department of Veterans Affairs-he receives $337 a month-but while his case is under appeal, he receives no medical care. He works 16-hour shifts at a packing-crate plant near his home in East Wenatchee, Wash., but he has gone into debt to cover his $1,600 monthly mortgage and support his wife and 2-month-old son. "Life is coming down around me," Ball says. Trained to be strong and self-sufficient, Ball now speaks in tones of audible pain.


Fred Ball's story is just one of a shocking number of cases where the U.S. military appears to have dispensed low disability ratings to wounded service members with serious injuries and thus avoided paying them full military disabled retirement benefits. While most recent attention has been paid to substandard conditions and outpatient care at Walter Reed Army Medical Center, the first stop for many wounded soldiers stateside, veterans' advocates say that a more grievous problem is an arbitrary and dysfunctional disability ratings process that is short-changing the nation's newest crop of veterans. The trouble has existed for years, but now that the country is at war, tens of thousands of Americans are being caught up in it.


Now an extensive investigation by U.S. News and a new Army inspector general's report reveal that the system is beset by ambiguity and riddled with discrepancies. Indeed, Department of Defense data examined by U.S. News and military experts show that the vast majority-nearly 93 percent-of disabled troops are receiving low ratings, and more have been graded similarly in recent years. What's more, ground troops, who suffer the most combat injuries from the ubiquitous roadside bombs, have received the lowest ratings.


One counselor who has helped wounded soldiers navigate the process for over a decade believes that as many as half of them may have received ratings that are too low. Ron Smith, deputy general counsel for the Disabled American Veterans, says: "If it is even 10 percent, it is unconscionable." The DAV is chartered by Congress to represent service members as they go through the evaluation process. Its national service officers are based at each rating location, and there is a countrywide network of counselors. Smith says he recently asked the staff to cull those cases that appeared to have been incorrectly rated. Within six hours, he says, they had forwarded him 30 cases. "So far," Smith says, "the review supports the conclusion that a significant number of soldiers are being fairly dramatically underrated by the U.S. Army."


Magic number. In an effort to learn how extensive the problem is, U.S. News spent six weeks talking to wounded service members, their counselors, and veterans advocacy groups and reviewing Pentagon data. At first glance, the disability ratings process seems straightforward. Each branch of service has its own Physical Evaluation Boards, which can comprise military officers, medical professionals, and civilians. The PEBs determine whether the wounded or ill service members are fit for duty. If they are, it's back to work. Those found unfit are assigned a disability rating for the condition that makes them unable to do their military job. The actual rating is key, and here's why: Service members who have served less than 20 years-the great majority of wounded soldiers-who receive a rating under 30 percent are sent home with a severance check. Those who receive a rating of 30 percent or higher qualify for a host of lifelong, enviable benefits from the DOD, which include full military retirement pay (based on rank and tenure), life insurance, health insurance, and access to military commissaries.


But the system is hideously complicated in practice. The military doctors who prepare the case for the PEBs pick only one condition for the service member's rating, even though many of the current injuries are much more complex. The PEBs use the Department of Veterans Affairs ratings scale, which grades disabilities in increments of 10-a leg amputation, for example, puts a soldier at between 40 and 60 percent disabled. The PEBs claim they have the leeway to rate a soldier 20 percent disabled for pain, say, rather than 30 percent disabled for a back injury. If rated at 20 percent or below and discharged, the soldier enters the VA system as a retiree where he is evaluated again to establish his healthcare benefits. Ball, for example, was found by the VA to be 50 percent disabled for PTSD.


Since 2000, 92.7 percent of the disability ratings handed out by PEBs have been 20 percent or lower, according to Pentagon data analyzed by the Veterans' Disability Benefits Commission, which Congress formed in 2004 to look into veterans' complaints (Page 47). Moreover, fewer veterans have received ratings of 30 percent or more since America went to war in Afghanistan and Iraq, according to the Pentagon's annual actuarial reports. As of 2006, for example, 87,000 disabled retirees were on the list of those exceeding the 30 percent threshold; in 2000, there were 102,000 recipients. Last year, only 1,077 of 19,902 service members made it over the 30 percent threshold (chart, Page 49).


The total amount paid out for these benefit awards has remained roughly constant in wartime and peacetime, leading disabled veterans like retired Lt. Col. Mike Parker, who has become an unofficial spokesperson on this issue, to allege that a budgetary ceiling has been imposed to contain war costs. A DOD spokesperson, Maj. Stewart Upton, said that the Pentagon "is committed to improving the Disability Evaluation System across the board and to ... a full and fair due process with regard to disability evaluation and compensation."


Other data reveal glaring discrepancies among the military services. Even though most of those wounded in Iraq and Afghanistan have been ground troops, the Army and Marine Corps have granted far fewer members full disabled benefits than the Air Force. The Pentagon records show that 26.7 percent of disabled airmen have been rated 30 percent or more disabled, while only 4.3 percent of soldiers and 2.7 percent of marines made the grade. Services engaged in close combat, experts say, could be expected to find more members unfit for duty and meriting full retirement benefits. Instead, the Air Force decided that 2,497 airmen fall into that category while the much larger Army, with its higher tally of wounded, has accorded those benefits to only 1,763 soldiers since 2000.


How many of these veterans' cases have been decided incorrectly? Nobody knows. These statistics show trends that are clearly at odds with what logic would dictate, but there has been no effort to discover how many of those low ratings were inaccurately conferred or to ascertain why the number receiving full benefits has declined during wartime or why there is such a discrepancy between the Air Force and the other services. But there is abundant anecdotal evidence of a process cloaked in obscurity and riddled with anomalies, and of ratings that are inconsistent and often arbitrarily applied.


DAV lawyer Smith, for example, took on the case of a soldier whose radial nerve of his dominant hand had been destroyed, the same affliction former Sen. Bob Dole has. Like Dole, the soldier was unable to write with a pen or to button his shirt. "There is one and only one rating for that condition, which is 70 percent disability," says Smith. The PEB gave the soldier 30 percent, the lawyer said, "which I found to be fairly outrageous." Upon appeal to the Army Physical Disability Agency, the entity that oversees that service's disability evaluation process, the rating was raised to 60 percent. Smith recently took on another case, that of Sgt. Michael Pinero, a soldier who developed a degenerative eye condition called keratoconus that required him to wear contact lenses. Army regulations prohibit wearing contacts in combat, which should have made him ineligible for deployment and therefore unfit to perform his specific military duties. But the PEB ignored the eye condition, which Smith believes merited a 30 percent rating or more, and rated Pinero 10 percent disabled for shin splints. Smith has asked the Army to clarify whether it considers the regulation on contact lenses binding or, as one board member alleged, merely a guideline. Disputes over such distinctions are common in the Alice in Wonderland world of disability ratings.


Controversy frequently surrounds decisions on which conditions make a soldier unfit for duty. Smith took issue with a recent statement made by the Army Physical Disability Agency's legal adviser, quoted in Army Times newspaper. The official said that short-term memory loss would not necessarily render soldiers unfit for duty since they could compensate by carrying a notepad. "Memory loss is a common sign of TBI," Smith said, using the abbreviation for traumatic brain injury, which has afflicted many soldiers hit by the roadside bombs commonly used in Iraq. "The rules of engagement are a seven-step process.... If a suicide bomber is coming at you, you cannot stop and consult your notepad," he added. "I find this demonstrative of the attitude that pervades the Physical Disability Agency," which is in charge of reviewing evaluations for accuracy and consistency.


Trying to overturn a low rating can be a full-time job-and an exasperating one. Take Staff Sgt. Chris Bain, who lost the use of his arms but not his sense of humor. "They call me T-Rex because I have a big mouth and two hands and I can't do nothing with them," he jokes. He left the Army in February, but he still has plenty of fight in him. During an ambush in Taji, Iraq, in 2004, a mortar round exploded 2 feet away from him, ripping through his left arm and hand. A sniper's bullet passed through his right elbow. His buddies saved his life, throwing Bain on the hood of a humvee and rushing him to a combat hospital. Once transferred to Walter Reed, Bain refused to have his arm amputated and underwent eight surgeries to save it. That choice cost him. While an amputation would have automatically put him over the 30 percent threshold, the injury to his left arm was rated at 20 percent even though he cannot use the limb.


Bain was angry. A noncommissioned officer who had planned on 20 or 30 years in the Army, he knew his career was over, but he wasn't going to go quietly. "I wanted to be an example to all soldiers," he said. "My job was to take care of troops." He went to find Danny Soto, the DAV representative at Walter Reed he'd heard so much about. "Danny is just an awesome guy. He took great care of me, but he should not have had to," Bain says. Soto is a patron saint to many soldiers at Walter Reed. He walks the halls, finding the newly injured and urging them to collect documents for their journey through the tortuous-and, to many, capricious-system. Many soldiers are young, and after they have spent months or years recuperating, they just want to get home and are unwilling to argue for the rating they deserve. Even though he missed his wife and three children, Bain decided: "I've already been here two years, another one ain't going to hurt me. Too many people are getting lowballed."


With Soto's help, Bain gathered detailed medical evidence of his injuries and went to face the board. They gave him a 70 percent rating for injuries related to the blast except for his hearing loss, which was not considered unfitting since he had a hearing aid. Oddly enough, however, the board put him on the temporary disabled retirement list instead of the permanent list. "What do they think, that after three years, my arm is going to come back to life?"


A lifetime of adjusting lies ahead for Bain. "I can't tie my shoes, open bottles of water, or cut my own food," he says. "I have to ask for help." The 35-year-old veteran has found a new sense of purpose. He's decided to run for Congress in 2008, and fixing the veterans' system is his top priority. "I do not want this s--- to happen again to anyone. No one can communicate with each other. The paper trail doesn't catch up." It's a tall order, but the soldier says that he has "100,000 fights" left in him.


A systemic fix doesn't appear to be anywhere in sight. A March 2006 report by the Government Accountability Office found that Pentagon officials were not even trying to get a handle on the problem. "While DOD has issued policies and guidance to promote consistent and timely disability decisions," the report concluded, "[it] is not monitoring compliance." But the GAO report did spur Army Secretary Francis Harvey, who was forced to resign last month in the wake of the Walter Reed scandal, to order the Army's inspector general to conduct an investigation of the disability evaluation system. After almost a year of work, the inspector general's office last month issued a 311-page report that begins to pierce the confusion and opacity surrounding the process. While it does not determine how many erroneous ratings were accorded to the nearly 40,000 soldiers rated 20 percent disabled or less since 2000, it does make three critical points: 1) the ambiguity in applying the ratings schedule should end; 2) wide variance in ratings is indisputable, even among the three Army boards, and 3) the Army's oversight body is not doing its job.


Way overdue. Army officials met with U.S. News to discuss the inspector general's report. "This is something that has been near and dear to our hearts for a long time, and it's probably way overdue as far as having someone go and take a look at it," says a senior Army official. The inspector general's team found that Army policy was not consistent with the policies of either the Pentagon or the Department of Veterans Affairs. It recommended that the Army "align [its] adjudication of disability ratings to more closely reflect those used by the Department of Veterans Affairs." For years, the Army has asserted that it has the right to depart from VA standards on grounds that it is assessing fitness for duty and compensating for loss of military career, not decreased civilian employability.


Veterans' advocates argue that federal law requires the military to use the Veterans Affairs Schedule for Rating Disabilities as the standard for assigning the ratings. But over the years, Pentagon directives on applying the schedule have opened up a whole new gray area by saying the schedule is to be used only as a guide. And the services have interpreted them in different ways, engendering further discrepancies. Soto, the DAV national service officer at Walter Reed, says that inconsistencies are especially prevalent in complex cases of traumatic brain injury and post-traumatic stress disorder. "There is a saying going around the compound here," Soto says, "that if you are not an amputee, you are going to have to fight for your rating."


The inspector general's report calls for ending the ambiguities. "What we're saying is it shouldn't be left to interpretation; it should be clearly defined," says one Army official. "If there were a way to cut down on that ambiguity, I think that variance would decrease."


Finally, the report bluntly concludes that the system's internal oversight mechanism is not functioning. "The Army Physical Disability Agency's quality assurance program does not conform to DOD and Army policy," it says-the same conclusion the GAO came to a year ago. The inspector general's report adds evidence of just how little the watchdog is doing to ensure that cases are correctly decided. The agency is supposed to send cases to either of two review boards when soldiers rebut their rating evaluations, but from 2002 through 2005, the agency sent only 45 out of 51,000 cases to one of the boards. The other review board has not been used at all.


The inspector general's team made 41 recommendations in all, finding among other things that the Army lacks a formal course for training the liaison officers who are supposed to guide soldiers through the PEB process, that the disposition of cases lags badly, that the computerized information systems are antiquated, and that the two key medical and personnel databases are not integrated and cannot communicate with each other. The report has been forwarded to the action team that Army Vice Chief of Staff Richard Cody convened-one of many official groups formed since the revelations of substandard conditions and bureaucratic delays at Walter Reed.


Veterans' advocates are skeptical that the administration or the military bureaucracy will make major changes anytime soon. In testimony to Congress last month, Veterans for America director of veterans' affairs Steve Robinson recommended taking the entire ratings process away from the Pentagon and giving it to the Department of Veterans Affairs. "It's hard to ignore the fact that in time of war they are giving out less disability," he says. "Is it policy? I don't know. But it is a fact."


Congress has not responded to this problem. Says Rep. Vic Snyder, the Arkansas Democrat who chairs the House Armed Services subcommittee on military personnel: "This whole issue of disability ratings is very complex. It is not well understood by many people, including many in Congress. That is why we set up the [ Veterans' Disability Benefits] Commission in 2004. We are hoping it will help us sort this out."


A lot is riding on the commission. Its chairman is Lt. Gen. Terry Scott, who retired in 1997 and ran Harvard's Kennedy School of Government's National Security Program until 2001. After the Pentagon data on the disability process were presented to the commission last week, Scott said "we still don't understand the whys and wherefores" of the skewed ratings. The core problem, he believes, is that "the military was not designed to look after severely wounded people for a long time." The commission has not yet decided what changes it will recommend, but he said there is a general sense that "one physical exam at the end of service should be enough for both agencies, DOD and VA."


Cash and staff. Any solutions that call for transferring more responsibility to the Department of Veterans Affairs will have to be matched by enormous infusions of cash and staff. Already, the VA is reeling under a backlog of over 600,000 claims from retired veterans, which the agency predicts will grow by an additional 1.6 million in the next two years. Harvard Prof. Linda Bilmes, an economist who has published two studies on the costs of the Iraq war and the associated veterans' costs, projects that as much as $150 billion more will be required to deal with the wounded returning from Iraq and Afghanistan.


Meanwhile, people like Danny Soto want to know who is going to stop the military boards from giving out ratings like the 10 percent given to one soldier for a skull fracture and traumatic brain injury, when the VA later assigned a 100 percent rating. Soto is also frustrated by a recent case in which a soldier whose legs had been severely injured in a blast in Iraq was given only a 20 percent disability rating for pain and by the treatment of a man who has a bullet hole through his eye and suffers from seizures. As Soto sat with that soldier in front of the board, he asked why he had been placed on the temporary list. "At what point do you think he is going to fall below 30 percent?"


Soto is unsparing in his criticism of the bureaucracy. "This system," he says, " is so broke." Old soldiers say the root of the problem is an Army culture that preaches a "suck it up" attitude. "If you ask for what you are due, you are perceived to be whining or trying to pad your pocket," says a retired command sergeant major. "If you're not bleeding, you're not hurt. That's what we were taught."



---END---

[Packo]

Gimpy,

I've been complaining about this for years. I see it everyday from the Med-boards. Right now, just from my experience, I'm seeing more 30% ratings for Marine's and Sailors, then I am for Army personnel. It was the Army girl who got ran over by a 5 ton driven by a soldier with no license for that vehicle. She was crushed, had to have a hystorectomy, (at age 19), had PTSD, and other internal stuff. They wouldn't budge off "20%" and would not rate her for PTSD because they said it wasn't really a "disability". Sad stuff.

Pack

[reconeil]

Happy Easter to all Serving and have ever Served aside, the way I see things are WHERE DOES ONE GO to address these blatantly warranted grievances?

Our Glorious Leaders or Rulers of whatever bent are obviously more concerned about the well being of foreign nationals and gleaning many more votes from same, their bureaucracies and their very own great jobs,...and committee or debate and legally study such matters of great to death (naturally not theirs).

Pretty-much sameO-sameO with The VA Bureaucracy and The Military Bureaucracy,...WHOM BOTH are under DIRECT POLITICAL CONTROL. Plus,...everyone knows or at least should know that when you have a large gaggle of political lawyers or appointees in control of any situation,...the only ones whom TRULY benefit from any sad situations ARE same large gaggle of political lawyers or appointees and some workers and clientele.

Want to really fix Military & Veterans Care? PRIVATIZE IT, since most career political bureaucrats couldn't even balance their own check books, or know how to put on a band-aid without help from a Disaster type Emergency Service.

Besides, PRIVATIZATION was how it was in my day.
Had choice of 3 Specialists on my Service Connected Disability, in my immediate vicinity to pick from, and any local druggist to go to. Also, I just cannot believe that even the most stupid of bureaucrats would have the balls to argue that ANY Veterans missing eye, arm, leg and even nervous condition wasn't Service connected,...with A Private Physician or Private Druggist. Private Physicians & Druggists not required to put-up-with obvious political bullshit. Do what's best for patient.

Also, and before my time or after WWII and/or when most casualties ever addressed by The VA,...PRIVATIZATION also worked quite well. About 20 years later The VA really got screwed-up by The Political Breeds.

Hell,...look what happened to Social Security since politically diverted out Fund Status and put into The General Fund with Taxes and political use,...by our quite lordly politicians. Social Security has needed FIXING every year since. Before,... increasing F.I.C.A.'s 50/50 Contributions worked just fine. No longer so, once Big Brother types get into The Mix.

Neil

[Robert Ryan]

Yes that is a good article Gimpy. Reconceil you hit nail on the head with your post.

[Gimpy]

"Privatization" is NOT the answer!

That's what got Walter Reed phucked up to begin with!

[reconeil]

What you think about the matter of: "PRIVATIZATION" is quite meaningless & absurd, and especially since using a MILITARY HOSPITAL run by GENERALS as some-sort-of-vindication??? Such truly absurd.

You should instead look at things much more realistically and pragmatically and much less politically blaming of your nemesis and/or anything Republican/Conservative, INSTEAD. More historically also couldn't hurt, either.

Circa 1945 and/or when America unarguably had the LARGEST MILITARY CASUALTIES EVER,...The Great Majority or Multitude of Wounded Americans not being cared for in U.S. Military Hospitals received all their needed treatments and medications PRIVATELY & LOCALLY.

About 15 years or so later and politicians changed a perfectly GOOD working system while bloating The VA Bureaucracy as ALL OTHER American Bureaucracies,...that's when all: "The Horror Stories" first came to be, and have ever increased.

In fairness, way-back-when ONLY Service Connected Disabilities had to be addressed by The VA, and such was manageable. Nowadays, The VA has to pretty-much cover every malady afflicting Veterans,...whether Service Connected OR NOT.

Know for a fact that as A Veteran I can get many similar medical screenings from The VA, which most Americans get through premium paid for Medicare. Also, CANNOT get Free Eyeglasses through Medicare. WHEREAS, can certainly get Free Eyeglasses from VA and/or The American Taxpayer,...if I so choose.

Neil

[Gimpy]

Once again your arrogance is only exceeded by your ignorance!

How in the hell you can sit there and spout your bullshit without an ounce of comprehension and/or factual knowledge to support your ridiculous rants just is nothing short of outrageous.

Where the hell do you come up with your horseshit, the Rush Limbaugh school for radical fachists right-wing fanatics.

You do NOT have a freakin CLUE of what you speak!

The United States has the most comprehensive system of assistance for veterans of any nation in the world.

Congress established a new system of veterans benefits when the United States entered World War I in 1917.


Included were programs for disability compensation, insurance for servicepersons and veterans, and vocational rehabilitation for the disabled. By the 1920 s, the various benefits were administered by three different Federal agencies: the Veterans Bureau, the Bureau of Pensions of the Interior Department, and the National Home for Disabled Volunteer Soldiers.


The establishment of the Veterans Administration came in 1930 when Congress authorized the President to "consolidate and coordinate Government activities affecting war veterans." The three component agencies became bureaus within the Veterans Administration. Brigadier General Frank T. Hines, who directed the Veterans Bureau for seven years, was named as the first Administrator of Veterans Affairs, a job he held until 1945.


The VA health care system has grown from 54 hospitals in 1930, to include 171 medical centers; more than 350 outpatient, community, and outreach clinics; 126 nursing home care units; and 35 domiciliaries. VA health care facilities provide a broad spectrum of medical, surgical, and rehabilitative care. The responsibilities and benefits programs of the Veterans Administration grew enormously during the following six decades. World War II resulted in not only a vast increase in the veteran population, but also in large number of new benefits enacted by the Congress for veterans of the war. The World War II GI Bill, signed into law on June 22, 1944, is said to have had more impact on the American way of life than any law since the Homestead Act more than a century ago. Further educational assistance acts were passed for the benefit of veterans of the Korean Conflict, the Vietnam Era, Persian Gulf War, and the All-Volunteer Force.


And The DAV says this:-----------


David Goramn----Disabled American Veterans Legislative Officer:


"We believe the best course for most enrolled veterans in VA health care is VA?sproviding continuity of care in facilities under the direct jurisdiction of the Secretary of Veterans
Affairs.

For the past twenty-five years or more all major veterans service organizations haveconsistently opposed a series of proposals seeking to contract out or to ?privatize? VA healthcare to non-VA providers on a broad or general basis. Specific incidences of such proposalshave occurred in the states of Maryland, Minnesota, Oregon and Florida. Ultimately, these ideaswere rejected by Congress or the Federal courts. We believe such proposals?ostensibly seeking to expand VA health care services into broader areas serving additional veteran populations at less cost, or providing health care vouchers enabling veterans to choose private providers in lieuof VA programs, in the end only dilute the quality and quantity of VA services for all veteran patients. Given the dire financial straits VA has experienced over several recent fiscal years, this is an important policy to sick and disabled veterans, and to those who represent their interests."


Now, go to the corner and put on your 'dunce cap' before you speak so loudly about what you know so very little about !


PS--------Your also FULL OF SHIT about getting 'free eye glasses' from the VA!--The ONLY DAMN way any veteran can get 'free eye glasses' would be because of a 'service connected' eye condition OR if you are rated at 100% permanent & total for all service connected conditions! All you have to do is READ the damn VA benefits booklet to see where you're onnce again lieing through your teeth!

[reconeil]

Bullshit all the tons of rhetoric you want, since you usually do anyway. But, people certainly more knowlegable about American History and The VA than you CLAIM TO BE,...know better. Or, the reality that after WWII The VA was largely PRIVATIZED except for Veteran Hospitals, Veteran Homes and the bureaucracy to pay for such, plus MANY local Private Sector Physicians/Specialists and Pharmacies.

Bluster, fluster and name call all you want like a TRUE Democrat Excuser of even The Absurd. But until VA was totally de-privatized by your supremacist type politicians, The: "VA Horror Stories" used to be few and far between. Now they are legion.

Guess that's what Democrats call: "Progress"?
Hey,...maybe after Pelosi fixes everything or pacifies Islam,...she can also squeeze in some time to fix whatever wrong with The VA and pacify We Veterans?

Neil

[Gimpy]

Originally posted by reconeil The: "VA Horror Stories" used to be few and far between. Now they are legion.



Neil

'Legion' my ass !---------------Are you nuts?


Well Neil, I see that you didn't wear that 'DUNCE HAT' long enough for it to have any substantial effect on your ignorance of historical FACTS, huh?

You spend entirely too much time running your MOUTH rather than using your eyes and gray matter to comprehend the TRUTH!

Here's some MORE 'FACTS' for you to try and absorb through that thick skull of yours.


---START--



Best practices

Unlike the Army's Walter Reed hospital, the VA hospital system is ranked, by many measures, as the best in the country


By Drake Bennett------ March 2007

THE REPORTS OF squalor and neglect uncovered at Walter Reed Army Medical Center have been vivid -- wounded soldiers, often crippled, heavily medicated, or brain-damaged, left to fend for themselves throughout the sprawling, overcrowded facility, in rooms with mouse droppings, cockroaches, and moldy, crumbling walls.


But what has given an extra edge to the outrage has been the suspicion that Walter Reed is not the exception but the rule, the most galling symbol of a badly broken system. The Walter Reed scandal is "the tip of the iceberg of what is going on all around the country," said Henry Waxman, the California Democrat who heads the House Oversight and Government Reform Committee, at a hearing Monday. Veterans and active-duty military personnel have detailed similar problems and frustrations in other hospitals.


As the indignation has mounted, not only the military hospital system -- Walter Reed is an Army hospital -- but the Veterans Health Administration has come under attack. The VA healthcare system -- an entirely separate and far larger network of hospitals and clinics run by a civilian agency, the US Department of Veterans Affairs -- has for years been a target of conservatives . A government-operated, single-payer system with 5 million patients, it is the closest thing this country has to socialized medicine.


Some commentators have taken advantage of the recent scandal to resurrect their free-market critiques of the VA. George Mason law professor David Bernstein, writing last Monday on the widely read blog the Volokh Conspiracy, suggested that the recent scandal was a measure of vindication for small-government conservatives, "who have been criticizing the VA for years."


After all, mold, mouse droppings, and neglect fit well with the image many have of the VA system. The portrayal in movies like "Coming Home" and "Born on the Fourth of July" of VA hospitals as shabby places where veterans were ignored by incompetent staff was for decades fairly accurate. In 1992, two corpses found on the grounds of a Virginia VA hospital turned out to be patients who had gone missing months before.



Today, however, that image is dramatically outdated. By many measures, VA hospitals and clinics are in fact the best in the country, and they achieve these results while spending 25 percent less per patient than Medicare. Recent studies from the Rand Corporation, the New England Journal of Medicine, and the National Committee for Quality Assurance, a healthcare watchdog organization, ranked the VA system, by a variety of criteria, as better not only than the sort of care offered by Medicare but even the best civilian healthcare plans .



Phillip Longman, a fellow at the New America Foundation and author of the forthcoming book "Best Care Anywhere: Why VA Health Care Is Better Than Yours, " says that among the veterans who rely on the system, "The overall picture is one of overwhelming satisfaction with the care."


Indeed, the great complaint among veterans today is not about the care they receive in VA hospitals, but about the difficulty of getting into the system in the first place .


. . .


The man widely credited for the turnaround is Kenneth Kizer , a doctor trained in emergency medicine who was appointed By president Bill Clinton and ran the VA's healthcare system from 1994 to 1999 .


"You have to tailor what you're doing to the needs of the patient," says Kizer, now the CEO of the healthcare information technology firm Medsphere. "The adage I've always used is that the patient is the center of the universe."


But the changes Kizer instituted at the VA had as much to do with standardization as tailoring. To cut down on the sort of doctor errors that kill tens, if not hundreds, of thousands of patients in the US every year, the VA system spelled out clear, evidence-based treatment guidelines for its physicians. Doctors and hospital directors were evaluated and publicly rated, for example, on how often their diabetic patients had their vision and kidney function checked, or how often heart attack victims were given cholesterol-lowering drugs and beta-blockers.


Research has incontrovertibly shown that such simple measures can save lives and improve the health of patients, yet they're often neglected by private doctors. According to Donald Berwick, a professor of pediatrics and healthcare policy at Harvard Medical School and a pioneer in the field of "evidence-based" medicine , in the American healthcare system as a whole, patients get these sorts of treatments only 70 to 80 percent of the time. In the VA system, that number is 98 to 99 percent.

To aid its medical staff, and to help keep an eye on them, the VA developed an electronic medical-records system called VistA. In contrast to the civilian system, in which at most a quarter of hospitals have computerized records (few of which can effectively share information with other hospitals) , all VA patient records are now computerized, and a doctor at any VA hospital or clinic can immediately pull up the complete records of any patient nationwide. Safeguards built into the software have all but eliminated drug prescription errors: In civilian hospitals and pharmacies, the error rate is as high as 8 percent, in the VA system it's 0.003 percent.


Phillip Longman argues that it's not in spite of the fact that the VA is a large, monolithic federal agency that it's had such success, but because of it. Sweeping changes mandated at the top of the organization can be instituted throughout the system, and the fact that the VA gets its funding in a lump sum rather than in small payments from insurers (the way civilian hospitals do) makes it far easier to invest in large infrastructure improvements. Unlike Medicare, the VA can use its size to bargain over prices with pharmaceutical companies, and has done so aggressively.

Furthermore, the fact that VA patients, unlike those in civilian health plans, tend to stay with the system for life means there's also an incentive to focus on long-term preventive care, a proven method of keeping medical costs down.

As in any large heathcare system, complaints do remain, and the quality of care varies from facility to facility. But the concerns of veterans groups today tend to center not on the care itself but on access to it. According to Peter Gaytan, who as the American Legion's director for veterans affairs and rehabilitation has visited every VA hospital in the country, "There's no question the care has improved substantially in the past 20 years, and we're hearing that directly from patients, from veterans. The issue for us today is accessibility."


Like the military hospital system, the VA faces a surge of new patients returning from Iraq and Afghanistan with physical and psychological wounds. And the system, to an extent, has been the victim of its own success. While wait times for care were cut in the 1990s, they've begun to grow again, as veterans who could afford to be treated at civilian facilities, hearing of the system's improvement, flocked to the VA.


In an effort to address the problem, the VA tightened its eligibility requirements -- Congress has limited eligibility in the past, but a 1996 law had ensured all veterans of VA care. Since 2003, however, only those who make less than $27,790 a year (the cut-off is higher if they have dependents) or who have "service-related" conditions or recent combat experience can get in.


The change has not been popular. "Only in America," says Kizer, "would you close the doors on a system that's providing higher quality care and customer satisfaction at unprecedented levels and at half to two-thirds the cost and put those patients in another system." The way he sees it, the more veterans we can get into the VA system -- or the more the rest of the American healthcare system can learn from it -- the better.


---END---



Now my dear Neil, it's time for your "history lesson"!

There is a basic right owed to the men and women who serve to protect the integrity of this nation?s democratic promise. As said by the only great Republican:

?? to bind up the nation's wounds, to care for him who shall have borne the battle and for his widow and his orphan, to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations.? Abraham Lincoln, second inaugural address, March 4, 1865

Twenty-five years ago, March 14, 1981 Jim Hopkins, Marine veteran of Vietnam, born on the Marine Corps birthday of November 10, drove his army Jeep through the glass doors and into the lobby of the multi-million dollar, showcase edifice of Wadsworth VA hospital, at Los Angeles, California. He did so to protest the gross, willfully negligent treatment given US veterans within the VA system. In specific, those veterans of the US war in South East Asia, aka, the Vietnam War.

He fired rounds from his AR 14 into the official pictures of then Republican President Ronald Reagan and Ex-President Jimmy Carter. For emphasis he then fired his .45 caliber handgun and a shotgun screaming that he was not receiving the medical attention needed. Hauled from the hospital by law enforcement, he screamed into the cameras that his brain was ?being destroyed by Agent Orange.? That sent both a shock wave and a wake up call through the US and became a clarion call to thousands of veterans who felt the very same as did Hopkins.

Ron Bitzer, director and founder of the LA based Center for Veteran?s Rights took up his case. His specialty was vets suffering from Post Traumatic Stress Disorder, (PTSD) who had come into conflict with law enforcement due to their illness.

Hopkins? case gave national voice to three major issues for vets:

1- The failure of Reagan?s administration to investigate the damage caused by Dow Chemical?s dioxin based defoliants spread all over Southeast Asia known as Agent Orange, Blue and other quaint names. And its refusal to treat vets and their families for its damaging effect on both, (especially the obvious appearance of birth defects of children born to the vets.)

2- The refusal to acknowledge the illness of PTSD and to investigate its damage on vets and to provide appropriate treatment.

3- The callous and insulting disrespect shown the vets by Reagan and his efforts to cut both the benefits of the vets and to close their outpatient treatment centers.

After being released from in-hospital treatment from the VA hospital he was transferred from the LA County Jail Hopkins and went on a speaking tour to vets. Despite the best efforts to help him, Hopkins died of mysterious causes on May 17. The news of his death, now a hero to Vietnam veterans, spread across the country sparking a sit-in the same lobby by veterans. As Reagan alternately ignored and then ridiculed the veterans, as the VA proclaimed its innocence of neglect, the protest grew until it became a hunger strike led by highly decorated Vietnam combat veterans.

The hunger strike drew mass coverage by the US and world news. In the face of the aroused public, Reagan ignored calls for investigation, but held off forced eviction. When we rejected the government?s poor faith negotiations, Reagan called in the Federal forces. But we were prepared and within days were camped out in front of the White House and had forced meetings with various congressional Veteran?s committees. Fearing that any moment one of the vets would die and would trigger an armed response by the many outraged veterans across the country, the Democratic Congress finally forced the Reagan Administration to negotiate a compromise:

The veteran?s strike would end after fifty-three days and the Democratic Congress would over-ride Reagan so that the Vet Centers would remain funded and open; there would be scientific and medical investigations into both the effects of the dioxin defoliants and into the illness of PTSD.

Today it is undeniable that those who so profoundly claim they "support the troops" have the very same callous disregard for the health and welfare of our troops sent to fight their wars, PAST & PRESENT. In a nation where profit rules over healthcare how can one avoid the reality that these "compassionate CONservatives" care not for its' people but only the power of profit?

For over 5 years news stories have addressed the Bush-Republican cuts in the VA budget. Simultaneously, the dollar amount spent by Bush-Republicans spending on Iraq has risen to an extinct beyond any war ever fought, including WWII. At the same time the profits of the military-industrial-media and drug industry complex have grown exponentially with the war budget increases. Simultaneously the number of injured veterans has outgrown the VA?s and Bush administrations negligently conceived plan of treatment and as a result we have the scandal that is developing. This is in keeping with the malevolent attitude of Bush-Cheney?the two are married in purpose.
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Why would a Republican Congress, which functions as the chief lobbyists of a ?for profit healthcare system,? appropriately see to the delivery of the best example of socialized medicine? The VA?

Why is it that every time the harbingers of economic doom speak of reform they talk of cutting the social welfare programs of Medicare and Social Security and the VA heath care system? Because the system is geared to fail; its failures hidden under the flag of patriot zeal to 'reduce government spending' -----until there is disclosure of its gross and inadequate funding which in fact causes failure if allowed to continue!

The truth is that Reagan Republican administration, the chief proponents of ?for profit? Trickle Down Economics did not move until faced with the threat of a popular uprising led by Vietnam vets. And was also over-ridden by a DEMOCRATIC CONGRESS!

The conditions at Walter Reed are but symbolic of an entire system of malfeasance and mistreatment as rotten and antihuman as when we Vietnam Veterans took on and defeated Reagan 25 years ago; as fetid and of ill purpose as the last Republican congress and Whitehouse which has allowed this current condition to happen.

In virtually every appearance by any and every elected politician that speaks of the current war publicly calls out to ?support for our troops? yet refuses to address that which is continuing their suffering as we speak? Mandatory funding of VA health care! And roused by these hucksters the pathetically deluded, self-injuring American public (well about 30 % of them anyway!) adorns their cars with ?Support Our Troops? stickers while refusing to understand that they are in fact supporting our troops with lip service only, as their own government is killing these very same troops slowly by allowing things such as the Walter Reed scandal and under-funding the VA to go unchecked?

With more of this bullshit in the planning before the last election, and even afterward as suggested by the Bush Budget for VA health care for 2008 and beyond. Let me suggest that the ruling power, especially the reactionary power of Bush-Cheney republicans, will never relent unless it faces overthrow by a progressive democratic uprising that will throw their asses out of office! That time has come again. Or again, nothing will change except this time matters will worsen. The historical FACTS prove this, and the FACTS are undeniable !

[reconeil]

WOW!!!, Gimpy,...SO MANY words saying so little,...as usual.

Talk about Fanatical Democrat Cheerleaders and/or career-political supremacists FEEBLY (always so-damn-transparent & obvious) trying to make Democrat Leaders & Appointees always look Good, while always trying to make Republicans look Bad. Doing so no matter when, where, why or what for,...IS TRULY dense or: "DUNCE".

Besides Oh One of Many Political Phonies, you just like anyone else cannot have it both ways or expect people to believe what comes out of both sides of your mouth (The typical Dem norm), and/or as already witnessed daily by Leftist Under-miners on nationwide TV.

Personally, how in one breath (actually MANY, MANY, MANY breaths) can you state that Veterans receive the very best Medical Care on earth, whereas America's Civilian Population DO NOT? Or, and for that matter, how can you claim such while simultaneously bellyaching about so many things wrong with The VA?

Also, do you honestly believe that any Civilian Specialists as once greatly used by VA, would not have recognized, diagnosed and treated Veterans' ailments due: "Agent Orange",...FOR 10-15 YEARS??? I don't believe so.

Then too, do you honestly believe that Civilian Specialists would require Veterans to be legally represented prior to being diagnosed & treated for PTSD??? Again, I don't believe so.

Whether for Civilian Doctors or: "Shrinks", I'm sure that Military Combat Records, Wounds (if any) and Combat Decorations would suffice for warranting treatment of Veterans, for both: "Agent Orange" & "PTSD" ailments, just to mention only 2 points of continuing contention by current VA. Apparently, such was/is not necessarily so for The VA Bureaucrats.

Whatever, and maybe if VA were much less politicized and Greatly Reduced its Legal Department or Legal Staff, and also had many more physicians in charge INSTEAD,...such would be a good step in the right direction? Privatizing Out-Patient Care & Medications as once used to be after WWII and/or when MOST such was needed in American History,...couldn't hurt either.

Neil