Saturday, March 03, 2007

Military Medicine Morass



You medical people will have more lives to answer for in the other world than even we generals.

-Napoléon


The Walter Reed story continues to play out across the media, and the ramifications expanded over the last 48 hours. For those out of the loop, an explosive Washington post exposé revealed squalid conditions and a morass of bureaucratic problems at the Walter Reed Medical Center on February 18th.

The General in Charge of Walter Reed was relieved, and then the Secretary of the Army was fired, largely because of his tepid response to fixing the problems at the Hospital (ie don't put the general who just left six months ago in charge of the hospital, he's probably part of the problem!).

The President himself addressed the issue, and plans to start a bipartisan investigation to "i
nvestigate how this situation was allowed to happen, how it can be fixed, and how we can prevent it from happening again".

It is shameful that wounded American Soldiers were housed in such atrocious conditions, and that after five years of war that procedures could not have been streamlined to free at least one group of people, the wounded, from the life-sucking procedural bureacracy that comprises the military's inner workings.

There are some silver clouds here though, meager though they may be. First of all, the military healthcare system is going to come under intense scrutiny, especially as it applies to the care of wounded Soldiers. The nerve-wracking process that casualties must go through to receive disability will likely be a casualty itself of this scandal as well; perhaps actuaries will play a lesser role in the process of determining disability payments, and future wounded Soldiers will move more quickly to their medical boards as well.

Secretary Gates set a good, stern example for his enormous defense bureaucracy, too. The SecDef held senior leaders accountable, and you can bet that his cannon shot into the chests of the former Army Secretary and hospital commander will be heard loud and clear across the ranks; no doubt there are closets being cleaned as these words go to print.

8 comments:

allen said...

bob w,

Thanks for a job well done!

Doug said...

"Secretary Gates set a good, stern example for his enormormous defense bureaucracy, too"
---
Agreed.
Exactly what GWB should have done 6 years ago.
Instead, he did the opposite with his "New Tone," and the country has paid dearly for it.

Tiger said...

Agree, Sec. Gates actually seems to know what he's doing, unlike Rummy.

Let's just hope El Bush will allow him to do a proper job in the ME!

2164th said...
This comment has been removed by the author.
2164th said...

It is not enough for the military to worry about the public opinion disaster of pealing paint and moldy wallpaper at walter Reed. A far greater issue is the immediate short term and long term rehabilitation of the victims of traumatic head injuries.

This is something that should not be attempted by the military. There are superb facilities all across the United States that have many years of experience in the care of traumatic head injury. The long term affects of THI are profound for the individuals and families. It is a life long commitment by family and community. It is very expensive.

The individual case would best be paid for by the US treasury, preferably with a consumption tax on imported oil.

THI requires a strategy of re-integrating the individual to his family and community. The care should come from the local community. It is not a mission that belongs to the military except in a supervicory and funding role.

Harrison said...

bob, thanks for the post!

deuce is right in highlighting THI and its significance - there is probably a considerable discrepancy between the severity and wide range of repercussions of THI, and the amount of attention that is being paid to treating it. Most medical researchers across the world eschew working on THI because it seems utterly mundane compared to contagions, cancers and pathologies.

As bob himself addressed in a previous post a few months back, trauma is a serious factor that weighs in when considering the length of tour of duty for our troops in the war theatre. Attacking the problem at its psychological roots might trigger more long-term benefits for our deployment strategy as well as ensuring the preservation of the morale and safety of our troops. I cannot say how much more comfortable I would feel if I knew that in case of injuries, there would be speedy and adequate medical help - this would clearly give our troops the psychological reassurance on the battlefield.

2164th said...
This comment has been removed by the author.
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