Senate Democrats

Pattern of Neglect: The Bush Administration is Failing Our Troops and Veterans

Mismanagement and poor leadership in the military and veterans’ medical system is not meeting the needs of troops returning from the battlefield

Many soldiers returning from Iraq and Afghanistan are not being provided the care they have earned and deserve.  As recent congressional oversight and news media investigations have uncovered, wounded soldiers at Walter Reed Army Medical Center have endured substandard and, at times, deplorable living conditions, and also have faced significant bureaucratic hurdles while being treated at its outpatient unit.  Congressional hearings and press reports have detailed neglect at the Center’s facilities and document first-hand accounts of soldiers being denied proper care and facing delays and obstacles to receiving medical evaluation and treatment.  These problems have raised concerns about the capacity of the military and Veterans Administration medical system to provide outpatient care for returning soldiers and, in particular, to deal with the long-term health care challenges many of our soldiers face as a result of brain injuries, post-traumatic stress, and other debilitating physical and psychological wounds.

  • Living facilities are substandard.  Investigative reports have uncovered unacceptable living conditions in many of Walter Reed’s outpatient facilities, ranging from moldy walls, leaks, and other problems.  According to these reports, Walter Reed is struggling to accommodate its nearly 700 outpatients.  With all of its available beds taken, the Center has placed many wounded soldiers in overflow facilities at nearby hotels and apartments. (Washington Post, 2/18/07)
  • Care coordination is inadequate.  Reports also cite a shortage of trained case managers and patient advocates to ensure that wounded soldiers are able to gain access to proper medical care and assistance with the complex processes of disability and medical evaluation.  As a result, the Washington Post reports that soldiers often “feel alone and frustrated,” and many have been unable to gain adequate treatment for depression, and other serious mental conditions.  The paper cites a poll conducted at Walter Reed last march in which 75 percent of troops said that their experience was “stressful.”   (Washington Post, 2/18/07)
  • Red tape hinders soldiers’ ability to gain access to needed care.  According to the Washington Post, “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 process for evaluating and determining the status of outpatients reportedly takes an average of 200 days at Walter Reed.  As a result of the overly complex bureaucratic system, outpatients often suffer inadequate care and face delays in treatment. (Washington Post, 2/18/07; New York Times, 3/2/07) 

Lack of leadership and accountability at Walter Reed allowed problems to go unaddressed for years.  The Washington Post reports that many of the top officials at Walter Reed were aware of these problems as early as 2003.  According to interviews, family members, veterans groups, and members of Congress informed Walter Reed officials – including then-commander of the facility, Lt. General Kevin Kiley – of the poor living conditions, bureaucratic obstacles, and inadequate treatment that outpatients were enduring at the Center more than three years ago.  And, as highlighted in recent congressional testimony, officials should have been aware of these egregious conditions after they were presented in a March 2006 GAO report that was critical of the military disability system.  The report called for improved oversight “to ensure consistent and timely outcomes for reserve and active-duty service members.” (Washington Post, 3/1/07; GAO; 3/06)

Signs of systemic neglect: similar problems exist at military and veterans hospitals across the country.  Media stories have documented complaints similar to those uncovered at Walter Reed about conditions at Fort Lewis, Fort Dicks, Fort Knox, Fort Bragg, and Fort Irwin.  In recent congressional oversight hearings, several of the Army’s top leadership also acknowledged that many of the problems at Walter Reed are plaguing military and VA facilities nationwide.  Army Surgeon General Lt. General Kevin Kiley told the Armed Services Committee that “what’s going on at Walter Reed in terms of the frustration of the staffs and the patients is probably mirrored to some extent in most of our other facilities, as I hear commanders talk to us about these issues.”  Similarly, Army Chief of Staff General Peter Schoomaker testified, “I think Building 18 became a metaphor for a bigger problem, and that is the frustration that we’ve been discussing and the bureaucracy and the inexplicable rules and the bureaucracy that surrounds that.” (Washington Post, 3/5/07; Armed Services Committee Hearing, 3/6/07)  

The story of neglect at Walter Reed is but the latest example of the Bush Administration’s failure to properly care for our nation’s veterans and service members

The President’s proposed Fiscal Year 2008 funding level for VA medical care is not sufficient to meet the needs of veterans.  While the requested medical care budget is $2 billion above Fiscal Year 2007 levels, after factoring in health care inflation and increased patient utilization rates, it amounts to a mere .14 percent increase over last year’s allocation.  The proposed minimal and inadequate increase has raised real concerns about whether the VA will be able to meet the demands of new enrollees or allow for vital new initiatives, including enhancements to mental health services for OIF/OEF veterans. (Fiscal Year 2008 Budget Proposal)

  • The Bush budget underestimates the needs of service members returning from the wars in Iraq and Afghanistan.  The President’s Fiscal Year 2008 budget anticipates that just 54,000 additional OEF and OIF veterans will seek VA services – a projection that veterans service organizations and utilization trends suggest will fall significantly short of actual demand.  The Senate Veterans’ Committee majority staff estimates that VA projections could be 50,000 patients short of demand. (Veterans’ Affairs Committee, Majority Staff, 2/07)
  • Mental health needs of returning OIF/OEF veterans is on the rise; more than one-third of Iraq and Afghanistan war veterans seeking VA health care services report mental health disorders.  According to the VA’s data, nearly one-third of Iraq and Afghanistan war veterans – more than 205,000 returning service members – have sought health care through the VA, with more than 35 percent of those veterans reporting mental health disorders.  These numbers have risen dramatically in the past two years as more troops have completed multiple tours in Iraq and Afghanistan, triggering concerns among many veterans groups that the VA will not be able to meet growing demand. (Veterans Health Administration, November 2006; Associated Press, 9/23/06)

Veterans are forced to endure long delays in the processing of claims.  There currently is a backlog of more than 632,000 compensation and pension claims at the VA, with 26.9 percent of these claims pending for more than 180 days.  As the Center for American Progress reports, “More than a quarter of military veterans with disability cases before the Department of Veterans Affairs wait six months or longer for the agency’s decision, creating financial hardships for them and their families. … As of March 3, the VA had almost 401,000 pending cases for disability compensation with almost 115,000 languishing for six months or more.” (Veterans Benefits Administration, Monday Morning Report, 3/3/07; Progress Report, Center for American Progress, 3/11/07) 

An estimated 500-1,000 veterans of the wars in Iraq and Afghanistan are now struggling with homelessness.  Veterans service organizations warn that this number is likely to increase dramatically in coming years, as more returning soldiers separate from active-duty service – many with serious mental health problems and debilitating injuries that can lead to unemployment and, eventually, homelessness.  Advocates point to the lack of resources available for struggling veterans: there are only about 15,000 beds at VA hospitals and shelters across the country, nearly all of which are presently filled. (Newsweek, 2/24/07)

Bush policies have pushed our military forces to a breaking point.  A report prepared for the Pentagon one year ago concluded that the Army cannot maintain its current level of operations without risking permanent damage to the quality of its force.  In testimony before Congress in July, Army Chief of Staff General Schoomaker reported funding shortfalls and voiced significant concerns about the Army’s readiness.  He stated that the Army will need $17 billion in 2007 and as much as $13 billion annually until two years after the end of the Iraq war to reset equipment and ensure readiness. (Andrew Krepinevich, Thin Green Line, 1/06, USA Today, 7/27/06)

  • Bush Administration mismanagement of our military forces has left our country without a strategic reserve.  Currently there are no active or reserve Army combat units outside of Iraq and Afghanistan that are rated as “combat ready.”  According to an August letter from the National Security Advisory Group, “Two thirds of the Army’s operating force, active and reserve, is now reporting in as unready” and “There is not a single non-deployed Army Brigade Combat Team in the United States that is ready to deploy,” statements confirmed by senior military officials and other experts. (National Security Advisory Group, 8/1/06)
  • American troops are being sent into combat without the right equipment.  According to a recent Department of Defense Inspector General Report, troops lack up-armored vehicles, communications equipment, electronic jammers for roadside bombs, and heavy machine guns. (DOD/IG, Equipment Status of Deployed Forces, 1/25/07)
  • Non-deployed troops are not ready.  Top military leaders – including Army Chief of Staff General Peter Schoomaker, National Guard Bureau Chief Lt. Gen. Steven Blum, and Joint Chiefs Chairman Peter Pace – have recently testified before Congress that non-deployed U.S. forces are not sufficiently equipped and that equipment shortfalls affect their ability to train and respond to any new threats. (Congress Daily, 2/8/07)

 

The President’s Fiscal Year 2008 budget would cut funding for the sustainment of defense health facilities.  As the recent reporting from Walter Reed – as well as other military and veterans hospitals across the country – spotlights, there is an urgent need to improve conditions at defense health facilities.  Despite this, the President’s budget actually would cut funding levels for these by 13 percent, raising concerns that the Department will not have the resources to address the current problems or make necessary improvements in military health facilities. (Armed Services Committee Hearing, 3/6/07)

The U.S. military does not have enough mental health professionals to meet the needs of the growing number of emotionally damaged war veterans.  A survey conducted by Navy psychologist Commander Mark Russell of 133 military mental health providers between 2003 and 2005 found that 90 percent of the psychiatrists, psychologists, and social workers reported no formal training or supervision in four Post-Traumatic Stress Disorder (PTSD) therapies recommended by the Pentagon and Department of Veterans Affairs. (USA Today, 1/17/07)

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