Recently, we have been blanketed with reports of the failure of the military health care system to assist our wounded warriors. In practical terms, what would you do to better the system? I know we have many former members of the military and some who have never experienced the universal health care we receive while in uniform. Additionally, we have our Brothers in Canada, England and Europe who can offer insights and proposals for discussion.
thanks
DJ
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What would you to fix Walter Reed?
210cav
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Posted: Thursday, March 08, 2007 - 05:48 PM UTC
generalzod
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Posted: Sunday, March 11, 2007 - 04:29 AM UTC
Funding for starters IMO Making sure we can get the doctors,nurses and other health care providers for them as well I'd like to say some other things..........But then that may not go over too well I'd like this thread to stay civil Right now I get mad just thinking about it
jRatz
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Posted: Sunday, March 11, 2007 - 06:42 AM UTC
There has never been a good substitute for MBWA - management by wandering around - and I strongly suspect the "leadership" got a bad case of the DC "office sits" & "be seen in important places" - need a few good field duty O-6's and CSM's to be cut loose in the system to ... well you know ... Also a couple really good troop Chaplains doing the same wandering ... And give them x-direct lines to folks who make things happen and the authority to make those things happen w/o the need for PowerPoint and multiple levels of whining and sniveling ...
Next, a reliable network of case workers with a decent worker to case ratio - say 1:10 .. and some a small officer/NCO supervisory structure to make sure things are happening ... IMNSHO, no contract operation is worth squat unless the military hires 'em as workers but does the C2 -- don't ever leave that to a contractor or most DAC either ...
But all that costs - not money, but people - and the services need to look at all the training & schooling & etc to see what can be adjusted to free up bodies for real work and that isn't easy ... These decisions, as we have seen too many times, can lead to real problems when we mortgage the future for the present ...
OTOH, one needs to separate Bldg 18 from WR. There is a lot of great stuff happening at and in WR the hospital. Bldg 18 is part of WR but not symbolic of the whole package. Some folks are painting with too broad a brush. Of course, when the senior guy (Killey(?)), goes into the "it ain't me mode" it's hard to say anything nice ...
John
blowing off steam ...
Next, a reliable network of case workers with a decent worker to case ratio - say 1:10 .. and some a small officer/NCO supervisory structure to make sure things are happening ... IMNSHO, no contract operation is worth squat unless the military hires 'em as workers but does the C2 -- don't ever leave that to a contractor or most DAC either ...
But all that costs - not money, but people - and the services need to look at all the training & schooling & etc to see what can be adjusted to free up bodies for real work and that isn't easy ... These decisions, as we have seen too many times, can lead to real problems when we mortgage the future for the present ...
OTOH, one needs to separate Bldg 18 from WR. There is a lot of great stuff happening at and in WR the hospital. Bldg 18 is part of WR but not symbolic of the whole package. Some folks are painting with too broad a brush. Of course, when the senior guy (Killey(?)), goes into the "it ain't me mode" it's hard to say anything nice ...
John
blowing off steam ...
210cav
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Posted: Sunday, March 11, 2007 - 09:26 PM UTC
I can always appreciate why we get annoyed to the point of rudeness with processes and perceived bungling. However, WRAMC is a top priority closure for BRAC. Everyone knew this. When you are on the BRAC list there are a sequence of administrative moves that automatically take place to close you down. For one, your cash flow diminishes, capital improvements stop and you begin at a given point to transition people. Why continue to place people within such a system? Well, you are assigned to a regional medical facility based on on basically two factors. One is the severity of your injury and best place for treatment and second, is placing you near your home of record. Now, here is the catch twenty two the Army too late found itself in....a boat load of needy wounded, a facility that was closing and a command structure that failed to adjust to changes. The human leadership factor should have compensated for each of these known conflicts with mission accomplishment by doing several things. First, tell your Boss that closing and keeping WRAMC open were incompatible things. Either close the place and place the wounded within other facilities or give the facility money to operate. Second, get out of your office and walk your command. It isn't as though there were not enough people over there who could and should have been pro active. Now what can and should be done, if you follow my premise here. You do not have to rant about shooting the "guilty" people. Lord only knows a lot of innocent folks will go with the guilt and vice versa. How do we fix a care of wounded system? It just did not break, it has been broken for a while. Your views?
thanks
DJ
thanks
DJ
generalzod
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Posted: Sunday, March 11, 2007 - 10:39 PM UTC
DJ
I had forgotten that place was part of the list of bases/facilities to be closed
John
Great points
I had forgotten that place was part of the list of bases/facilities to be closed
John
Great points
210cav
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Posted: Sunday, March 11, 2007 - 11:02 PM UTC
Quoted Text
DJ
I had forgotten that place was part of the list of bases/facilities to be closed
John
Great points
John-- the Army response now is just a waste of time and money, if they continue with closing. I believe they will continue with closing and walk away from the millions being spent to stop the bad press. Of course, the city of Washington is pushing them to retain the facility and above all put improvements into the buildings. If the place closes, the city will assume control. If the place stays open, the city will claim political victory. Once a place is on BRAC, it is going to close. How soon it does is another question. Brings us back to caring for those wounded in service. Someone can correct me, but as I recall the current process goes like this-- You have to appear before a medical review board if your injuries are of such a nature that the Army (or any other branch of the Service) considers you no longer able to function within the military. So, when you go there, the board looks at your medical records and talks to you. If a guy/gal wants to stay and they can get a head nod from the medics, usually a board goes along with their desires. All's well, they get released from the hospital and return to an assignment. On the other hand, if , and this is what we are discussing here, the person either desires or is simply unable to continue to serve, they send the records to Fort Sam Houston, Texas for review by the Army Disability Board. This is where it bogs down. You sit under the hospital's care until the Disability Board determines your compensation/disability rating. There is nothing much for you to do except punch a hole in the sky waiting. The WRAMC problem (IMHO) comes from the poor manner in whch they are dealing with this idle pool of people living in limbo. The hospital cannot do anything to speed the process and certainly the individual has no latitude. Before the Washington Post wrote the series of articles, the WRAMC and the Army were content to let you sit in squalor or go home. Now, they have been embarassed and are putting (IMHO) a bandaid on a sucking chest wound. The Army need to re visit the entire process and see how best to be fair to all and expeditiously review the back log of cases. Your thoughts?
DJ
PS-- take it from me, it is even more "broken" when you appply for VA compensation....
PPS--- I just read that the current Army Surgeon General is retiring, bet he will not go out the door as an 0-8
jRatz
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Posted: Monday, March 12, 2007 - 07:15 AM UTC
The points about BRAC & resources are valid.
But ...
Killey(?) said "At my pay grade I don't inspect barracks..." or something like that - he did use word "barracks". Evidently no one else did either. That is not the way a good number of us learned how to soldier.
My point about case workers applies to boards - man 'em, train 'em, run 'em and get the backlog down. What can the big wheels be thinking? Months in limbo, waiting on paperwork ?
John
But ...
Killey(?) said "At my pay grade I don't inspect barracks..." or something like that - he did use word "barracks". Evidently no one else did either. That is not the way a good number of us learned how to soldier.
My point about case workers applies to boards - man 'em, train 'em, run 'em and get the backlog down. What can the big wheels be thinking? Months in limbo, waiting on paperwork ?
John
generalzod
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Posted: Monday, March 12, 2007 - 07:42 AM UTC
Why is Walter Reed being closed down during a war? That makes no sense to me
Halfyank
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Posted: Monday, March 12, 2007 - 11:18 AM UTC
Quoted Text
Why is Walter Reed being closed down during a war? That makes no sense to me
Why is Walter Reed being closed at all is what makes no sense to me. Now I don't claim to know anything about anything that happens at WR but it seems to me that from a purely PR point of view WR should be the very last medical facility to ever close. Ask the typical man on the street to name a military hospital and chances are pretty good they'll name WR. It's got the history behind it, the name recognition, the works. It's almost like they were considering closing West Point or Annapolis in favor of some newer school somewhere.
210cav
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Posted: Monday, March 12, 2007 - 04:59 PM UTC
Quoted Text
Why is Walter Reed being closed down during a war? That makes no sense to me
Well, the Base Realignment and Closure Commission (BRAC) is composed of people selected for their objectivity. They do a very good job IMHO. There is a balance of Republican and democrat members appointed by the President and approved by the congress. The board does the congressional job of closing unnecessary facilities. They begin by receiving a list of bases and facilities recommended for closure from the Department of Defense. Working with that list they tour the bases and interview people. The list they produce for the congress is subject to an "up or down" vote by the congress. In other words, they either aprove the whole list or none of it. As for WRAMC. It was on the list. The hospital while a sentimental and historical favorite of the Army has no room for growth, is in a relatively inaccessible area (try parking there) and there are better facilities available. I speak here for example of the Eisenhower Medical Center in Georgia and Brooke Army Medical Center in Texas. The BRAC list was subsequently approved and the place is scheduled for closure. Now, here is the catch twenty-two. Although approved for closure, the congress must appropriate the funds to do so, All they have to say is "we have no money at this time" and the place stays open but with a diminished staff and funding only to retain basic services. This is what happened at WRAMC. Kinda like being half-pregnant. While we witness a rush of stop gap actions underway, the long-term challenge is to fix the disability system. No one has complained of the medical treatment afforded them by the hospital, they justifiably state that the living conditions are appalling. I agree, but that is being fixed for what I perceive to be a PR move to get the Army out of hot water with the general public. No one is addressing the long range problem of how to treat disabled Soldiers with dignity and compensate them for their sacrifices. My two cents.
DJ
jRatz
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Posted: Tuesday, March 13, 2007 - 06:30 AM UTC
DJ,
Your " ....I agree, but that is being fixed for what I perceive to be a PR move to get the Army out of hot water with the general public. No one is addressing the long range problem of how to treat disabled Soldiers with dignity and compensate them for their sacrifices. ...."
Yes, but we cannot allow the present situation to continue while the systemic issues are corrected ... Hopefully the rolling heads are indicative of seriousness. Usually if it's just a coverup, only smaller heads roll.
John
Your " ....I agree, but that is being fixed for what I perceive to be a PR move to get the Army out of hot water with the general public. No one is addressing the long range problem of how to treat disabled Soldiers with dignity and compensate them for their sacrifices. ...."
Yes, but we cannot allow the present situation to continue while the systemic issues are corrected ... Hopefully the rolling heads are indicative of seriousness. Usually if it's just a coverup, only smaller heads roll.
John
210cav
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Posted: Tuesday, March 13, 2007 - 04:48 PM UTC
John-- I trust the Army and the Department of Defense will pursue a long range program than combines incremental increases with breakthrough goals to solve this man made crisis. It did not start with this reported incident. It has lingered for too long, arguably since the Revolutionary War, without a solution. As a wise man once said "hope is not a methodology." We need knowledgeable people to get and stay involved to resolve this one. Continue to monitor this one and do what we can to assist those in pain.
DJ
DJ
hellbent11
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Posted: Wednesday, March 14, 2007 - 11:50 AM UTC
I would send some guys from the brig to do the basic painting/repair work/mold cleanup. Better funding spent in the right areas would also help. 
no-neck
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Posted: Saturday, May 12, 2007 - 03:54 PM UTC
I think government is invested in providing the minimum while taxing us the maximum and pocketing the difference. I'm not sure the gov has any interest in the taxpayers other than a source of income. The gov got us into Nam with a lie and into Iraq with a lie and a few people made a lot of money. Maybe we should only fight wars that threaten us.210cav
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Posted: Sunday, May 13, 2007 - 11:11 PM UTC
Quoted Text
There is an interesting point..."the lie" introduction. The German historian (Rankin or von Rankin depending on who you consult) said in essence you cannot understand history unless you put yourself in the mindset of the person at the time the decision was reached. I am freely interpreting his 19th Century statement and approach here, but my point is that people lie (defined as knowing telling you a falsehood) as compared to making the best decision based on available information (error on the side of caution). There are those who say, for example, dropping an atomic bomb on Japan was incorrect given the Japanese were ready to capitulate. Well, sure you know that today (or think you do) but the guy on the spot (Truman) only knew that the Japanese were not making it obvious that they were surrendering. He made a decision based on his best estimate of the situation. Whether we now transfer this same thought process to Vietnam or Iraq, my point remains, the individual either told us a falsehood or made the best call.....what do you think?
DJ
no-neck
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Posted: Tuesday, May 15, 2007 - 09:14 AM UTC
DJ You are correct sir! Hindsight is 20/20. Replace "lie" with "misinformation". I think, however, that lie is correct in talking about Tonkin gulf. North Viet Nam's navy never posed any credible threat.210cav
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Posted: Thursday, May 17, 2007 - 11:50 PM UTC
Quoted Text
Earl-- that is what always causes me to take a deep breath before speculating that a particular presidency "lied" when they decide to execute a program. Did Kennedy tell us the truth about missiles in Cuba or did he relate what he knew when he knew it? Superimpose any other situation on this framework and I personally can come to several conclusions. For example, as HR McMaster's points out in his great book Dereliction of Duty, President Johnson told one thing to the military leadership, one thing to the State Department and an all together different thing to the Congress. His secretary of defense (McNamara) closely followed his lead. They were purposely deceivving all listeners. In my humble opinion, using the same criteria I suggested in the initial e mail, I conclude the Johnson Administration lied to the American people about Vietnam (cost, cause and negotiations) that resulted in an even greater tragedy. Bush and crew must wait for time and history to judge their actions. Any wartime administration receives criticism, if we win it is of the soft type. When we lose, it can be caustic and revealing. Time will tell.
thanks
DJ
no-neck
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Posted: Sunday, June 10, 2007 - 10:53 PM UTC
DJ, we agree that the gov't took us to Nam with a lie . We're waiting to see if the gov't took us to Iraq with a lie. I see your point in derfering judgement but look at your own example. Truman thought the BOMB was a big bomb and used it. Truman and his constituants endorsed all kinds of bigger better weapons to end the war started by Japan. Why does he get slammed for using it?
210cav
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Posted: Sunday, June 10, 2007 - 11:46 PM UTC
Quoted Text
DJ, we agree that the gov't took us to Nam with a lie . We're waiting to see if the gov't took us to Iraq with a lie. I see your point in derfering judgement but look at your own example. Truman thought the BOMB was a big bomb and used it. Truman and his constituants endorsed all kinds of bigger better weapons to end the war started by Japan. Why does he get slammed for using it?
Earl-- Truman and our Nation get "slammed" for employing the atom bombs on the Japanese, in my opinion, because revisionist historians and others of less intellectual curiosity, believe Truman had perfect knowledge that Japan was a defeated country just waiting to surrender. I would arge that the USA felt the bomb would be used in coordination with several other actions:
1. the continued sea blockade of Japan
2. the continued air camapign against Japan
3. an invasion of the home islands
4. Russian intervention
I would also point out that the Japanese did not capitulate until after the Russians entered the war and pushed their forces out of Manchuria. The bombs were employed as one of several means to an end. They were not thought to be ends in themselves. I would commend Choice Under Fire by Michael Bess to anyone looking to see the moral implications and reasoning that went into the dropping of the weapons. Nothing is perfect especially information gathering that we can turn into actionable intelligence. However, to appreciate the presidential decision making process, one must do everything to put themselves into the mind set of the decision maker at that time. What we "know" now is not necessarily what we "knew" then. I would use the same thought process in evaluating our recent decision to invade Iraq.
DJ
CaptainA
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Posted: Thursday, June 14, 2007 - 01:39 AM UTC
Quoted Text
Recently, we have been blanketed with reports of the failure of the military health care system to assist our wounded warriors. In practical terms, what would you do to better the system?
I would stop sending them customers.
CaptainA
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Posted: Thursday, June 14, 2007 - 01:48 AM UTC
Quoted Text
PS-- take it from me, it is even more "broken" when you appply for VA compensation....
[
I was an adjudicator for the VA. You should see how screwed up it is from the inside. I actually had a Service Center Manager send out an e-mail to not complete any more claims, because we had reached the monthly quota.
PS-- take it from me, it is even more "broken" when you appply for VA compensation....
210cav
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Posted: Thursday, June 14, 2007 - 01:51 AM UTC
Carl-- I am sure we can share horror stories on the trials and tribulations of military related compensation.... 
Somehow, someway, it usually works. It can confuse and confound the applicant.
DJ
Somehow, someway, it usually works. It can confuse and confound the applicant.DJ
redshirt
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Posted: Thursday, June 14, 2007 - 10:12 AM UTC
“The Army needs to re visit the entire process and see how best to be fair to all and expeditiously review the back log of cases. Your thoughts?” 210CAV
How about the military treats -all- wounds/ illnesses received while in uniform. Sounds kind of expensive? Good! Maybe congress and the president should budget the money up front too.
Service in uniform deserves nothing less.
They will be forced to think twice, check and reference their sources and use far more restraint. The government needs to stop being a cash cow that can be milked by outsourcing contractors and privatization. Especially when these same entities gather the data for decisions that can be made on their behalf, lobby the decision makers and fan the flames for their cause ($). Take a Terrible tragedy and create a knee jerk do-something/ anything band wagon you politically can’t miss even if it means waste, less freedom and death. Really, how can 20 guys with box cutters bring us down or take away our freedom?-Only if we let them.
How can any government responsibility be done better and more efficiently by a company who will want at least some profit, and once in the door protect its market share and constantly look for more?-It can't
How about the military treats -all- wounds/ illnesses received while in uniform. Sounds kind of expensive? Good! Maybe congress and the president should budget the money up front too.
Service in uniform deserves nothing less.
They will be forced to think twice, check and reference their sources and use far more restraint. The government needs to stop being a cash cow that can be milked by outsourcing contractors and privatization. Especially when these same entities gather the data for decisions that can be made on their behalf, lobby the decision makers and fan the flames for their cause ($). Take a Terrible tragedy and create a knee jerk do-something/ anything band wagon you politically can’t miss even if it means waste, less freedom and death. Really, how can 20 guys with box cutters bring us down or take away our freedom?-Only if we let them.
How can any government responsibility be done better and more efficiently by a company who will want at least some profit, and once in the door protect its market share and constantly look for more?-It can't
210cav
Member Since: February 05, 2002
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Posted: Thursday, June 14, 2007 - 11:45 PM UTC
Quoted Text
“The Army needs to re visit the entire process and see how best to be fair to all and expeditiously review the back log of cases. Your thoughts?” 210CAV
How about the military treats -all- wounds/ illnesses received while in uniform. Sounds kind of expensive? Good! Maybe congress and the president should budget the money up front too.
Service in uniform deserves nothing less.
They will be forced to think twice, check and reference their sources and use far more restraint. The government needs to stop being a cash cow that can be milked by outsourcing contractors and privatization. Especially when these same entities gather the data for decisions that can be made on their behalf, lobby the decision makers and fan the flames for their cause ($). Take a Terrible tragedy and create a knee jerk do-something/ anything band wagon you politically can’t miss even if it means waste, less freedom and death. Really, how can 20 guys with box cutters bring us down or take away our freedom?-Only if we let them.
How can any government responsibility be done better and more efficiently by a company who will want at least some profit, and once in the door protect its market share and constantly look for more?-It can't
Wow! You covered a lot of ground in this reply. Let me see if I can organize my thoughts to address your points.
1. the government should care for those it sends into battle. No argument. I am a firm believer that if we applied a containment strategy with regard to Iraq, we would not be in the bottomless pit we find ourselves today. This strategy would have used Kuwait and Afghanistan as firm bases and allowed us to conduct large scale raids into Iraq to discover and destroy any and all WMD facilities. If we found none, who would care? We would be in and out of the country before anyone would notice. It would have also kept Saddam guessing along with Asad in Syria---"where are they going next?" We did not use this as leverage. So, now we are in a tar pit. We cannot let loose and we cannot afford to hang on. It is a mess and those brave people who are over there need our full and unconditional support. In the end, the government has an absolute responsibility to provide for those who answered the call. Regardless of the merits or lack thereof of the conflict.
2. as to contractor support. Well, I have a personal stake and interest. I am a defense contractor. It has been my observation that the vast bulk of corporations who support the military take a personal interest in their work and by in large do a remarkably good job at supporting the Warfighters. Some do not.
Hope this spurs further discussions and comments.
DJ
redshirt
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Posted: Saturday, June 16, 2007 - 12:18 PM UTC
“as to contractor support. Well, I have a personal stake and interest. I am a defense contractor. It has been my observation that the vast bulk of corporations who support the military take a personal interest in their work and by in large do a remarkably good job at supporting the Warfighters.” 210cav
Contractors do a necessary job, without a doubt. I certainly don’t want to break any ones rice bowl.
However, I think that they should work for the government and be organized and supervised by military personnel who have a vested interest in seeing that their careers are not damaged and have the UCMJ to consider when seeing things are done and done right. The only incentive a corporate contractor has is maintenance of their contract. Corporations and contracts define and limit liability, the burden of unrestricted responsibility needs to be in place.
Contractors do a necessary job, without a doubt. I certainly don’t want to break any ones rice bowl.
However, I think that they should work for the government and be organized and supervised by military personnel who have a vested interest in seeing that their careers are not damaged and have the UCMJ to consider when seeing things are done and done right. The only incentive a corporate contractor has is maintenance of their contract. Corporations and contracts define and limit liability, the burden of unrestricted responsibility needs to be in place.
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