Investigations of Military Health Care Move Forward

President Bush on Wednesday said that a bipartisan panel he appointed to investigate medical care provided to troops when they return from service will work to restore confidence in the system, the AP/South Florida Sun-Sentinel reports (Riechmann, AP/South Florida Sun-Sentinel, 3/8).

President Bush on Tuesday named former Sen. Bob Dole (R-Kan.) and former HHS Secretary Donna Shalala as co-chairs of the commission. Dole, a senator for 28 years, is a disabled veteran from World War II. Shalala was appointed as HHS secretary by President Clinton in 1993 and served as agency head for eight years, the longest period in history.

Dole and Shalala met with the president at the White House on Wednesday.

Bush formed the commission after the Washington Post published a two-part series that examined conditions at Walter Reed Army Medical Center. One article profiled the state of Building 18, which has mold, cockroaches and stained carpets, among other issues. The series also examined the process by which injured soldiers seek disability compensation (California Healthline, 3/7).

Bush after his meeting with Dole and Shalala on Wednesday said, "Any report of medical neglect will be taken seriously by this administration, (and) I'm confident, by the Congress, and we will address problems quickly" (Schreck, Los Angeles Times, 3/8). Bush added, "I'm confident that this commission will bring forth the truth" (AP/South Florida Sun-Sentinel, 3/8).

Shalala said the problems discovered in military hospitals are "an embarrassment for the country." She said her new role as co-chair of the President's commission will be "to look at what improvements should be made for soldiers from the moment they're hurt on the battlefield to the day they return into civilian life." She added that Bush "made it very clear that if one soldier doesn't get high-quality treatment and isn't transitioned back into civilian life, or back into the military, that's unacceptable. You could sense his anger and his anxiousness that we move as quickly as possible" (Clark/Driscoll, Miami Herald, 3/8).

Dole said, "Obviously, it's a tragedy." He added, "Obviously, somebody dropped the ball." Dole said the seven remaining members of the panel would be named later this week or early next week (AP/South Florida Sun-Sentinel, 3/8).

House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.) in a letter sent to Bush on Wednesday suggested that the president include service members and their family members on the commission. They also suggested that Bush consult with both Democratic and Republican members of Congress before selecting the panel (Vogel/Tyson, Washington Post, 3/8).

At a news conference on Tuesday, Defense Secretary Robert Gates said he has ordered a high-level review of all Defense Department medical programs and facilities "to ensure that we are providing all of our troops the standard of care that they deserve."

Gates said that it is crucial that "from the standpoint of the soldier and not from the bureaucratic standpoint" that the "quality of attention and care ... is what it should be." He added, "I'm concerned that it is not." Gates said he is particularly concerned about the transition of wounded troops between DOD-operated facilities and those run by the Department of Veterans Affairs, noting that that transition can result in the most serious bureaucratic snags (Landay, McClatchy/Contra Costa Times, 3/7).

Officials from a separate commission created to investigate problems at Walter Reed on Wednesday said the facility likely lacks sufficient funding and staff for rehabilitative services (Vogel/Tyson, Washington Post, 3/8).

Gates last week announced the creation of an independent panel to examine outpatient conditions at Walter Reed and other military hospitals. The eight-member panel will examine all rehabilitative care and administrative procedures at Walter Reed and the National Naval Medical Center in Bethesda, Md.

The panel is co-chaired by Togo West, former VA secretary and secretary of the Army during the Clinton administration, and by John Marsh, former secretary of the Army under President Reagan and a former Virginia congressman. The panel also will include two former members of Congress, three retired senior military officers and a retired command sergeant major.

The panel's report is due within 45 days, Gates said (California Healthline, 2/26).

Marsh said, "That's my first impression, that there are personnel shortages and funding shortages."

West said that the commission has not reached any final conclusions about the root of problems at Walter Reed. He said, "We want to be careful about judging too soon."

In related news, congressional hearings took place on Wednesday as lawmakers continue to investigate the issues (Washington Post, 3/8).

Several Army officials -- including Walter Reed commander Maj. Gen. George Weightman and Army Secretary Francis Harvey -- were fired last week after the Post series was published.

Maj. Gen. Eric Schoomaker, who previously was commander of the Army's Medical Research and Material Command at Fort Detrick, Md., now serves as acting chief of the facility (California Healthline, 3/7).

Before the Senate Appropriations Committee on Wednesday, Lt. Gen. Kevin Kiley -- the surgeon general for the Army and commander of the U.S. Army Medical Command -- said that Pentagon budget officials in recent years have required military medical providers to cut millions of dollars for medical services. Kiley said, "This year, it's $80 million in my core budget. Next year, it's on the order of $142 million." He added, "I can't find $142 million in efficiencies."

Sen. Ted Stevens (R-Alaska) during the hearing said that the Pentagon cut nearly $500 million from the military medical budget this year and plans to cut $800 million next year. He said, "It is shocking to see, at a time when the military medical facilities need more money, that we have budget people directing reductions. I'm really, really alarmed at that."

At the hearing, officials reported a "serious shortage" of military nurses in the military care system.

According to testimony by Nurse Corps leaders, the Army, Navy and Air Force each has a 10% shortage of nurses, with shortages of as much as 40% in some specialties.

Maj. Gen. Gale Pollack, chief of the Army Nurse Corps, said that army nurses are leaving service at double the average attrition rate for Army officers. She said, "The future of the Army Nurse Corps is in jeopardy."

Kiley and Army Chief of Staff Peter Schoomaker also testified at a House Appropriations defense subcommittee hearing on Wednesday (Washington Post, 3/8).

In related news, House Democrats on Wednesday said they were close to an agreement on a supplemental funding bill that would provide billions more dollars than requested by President Bush for military and domestic funding, CongressDaily reports. Under the bill, an additional $1.7 billion would go toward military health programs, including $20 million to address issues at Walter Reed and funds for the treatment of post-traumatic stress disorder and brain injuries.

House Appropriations Committee Chair David Obey (D-Wis.) said he expects the bill to achieve bipartisan support. He added that the bill would be ready for a vote within his panel next week (Cohn et. all, CongressDaily, 3/8).

Three broadcast programs reported on the Senate hearings and other issues related to VA medical centers. Summaries appear below.

• CBS' "Evening News": The segment includes comments from Rep. Bill Young (R-Fla.); Kiley; and Shalala (Orr, "Evening News," CBS, 3/7). Video of the segment is available online. In addition, "Evening News" on Wednesday reported on the suicide of a Marine who had received treatment at a VA medical center after returning from Iraq (Alfonsi, "Evening News," CBS, 3/7). Video of the segment is available online.
  
• C-SPAN's "Washington Journal": Guests on Wednesday's program included Reps. March Kaptur (D-Ohio) and Rodney Frelinghuysen (R-N.J.) ("Washington Journal," C-SPAN, 3/7). Video of the segment is available online.
  
• KPCC's "Air Talk": The program on Wednesday included a discussion Michael Zacchea -- a veteran of the wars in Iraq and Afghanistan and a spokesperson for Iraq and Afghanistan Veterans of America -- about VA medical centers and medical treatment for veterans. The program also included phone calls from veterans, enlisted soldiers and their families (Mantle, "Air Talk," KPCC, 3/7). Audio of the segment is available online.
  
• PBS' "NewsHour with Jim Lehrer": The segment includes comments from Sens. Daniel Inouye (D-Hawaii), Patty Murray (D-Wash.) and Barbara Mikulski (D-Md.); and Vice Adm. Donald Arthur, the surgeon general for the Navy. The program on Wednesday also included discussions with Murray and Sen. Lindsey Graham (R-S.C.) (Woodruff, "NewsHour with Jim Lehrer," PBS, 3/7). Audio and a transcript of the segment are available online.