The governmental and media response to the Walter Reed scandal scratches only the most visible layer of the larger crisis in the US military's healthcare system. The fact remains that the majority of servicemembers -- whose injuries in the course of duty do not necessitate being airlifted into Reed -- face substantial barriers to receiving any kind of care at all.
As I reported in a series of articles on Raw Story this past October, servicemembers with mental disorders are treated particularly badly. As the violence in Iraq and Afghanistan intensifies and military recruiters continue falling short of their quotas, the problem grows. More troops are exposed to ever-worsening combat conditions for increasingly longer terms of duty. And when they return, these troops face systematic barriers to proper diagnosis and treatment, starting with a post-deployment process littered with disincentives to disclose any kind of problem whatsoever.
For example, these same troops that have served two and three times longer than they originally intended are warned, while they are at the post-deployment center awaiting their release, that anyone reporting any kind of potential physical or mental disorder will be held indefinitely "for a full evaluation" while their buddies go home to their friends and families. And it's common knowledge that a mark like that on their military record could end all hopes of working for the police force, the fire department, or any other kind of security-related job.
Of the mere 5% of troops still desperate enough to vault these hurdles and acknowledge potential symptoms of post-traumatic stress (PTSD), 78% are denied further mental health evaluation after being eyeballed by... just about anyone. As Paul Reickhoff, Executive Director of Iraq and Afghanistan Veterans of America (IAVA) and an Iraq veteran explained, "The form went to me and I passed it up to my commander. Essentially, you're asking a group of people who have been in exactly the same situation, and who have no mental health training or background, to evaluate other people."
A Veteran's Administration report released this past August hints at the consequences of failing to diagnose and treat troops at the post-deployment stage: one-third of the nearly two million vets from the wars in Iraq and Afghanistan are seeking treatment from VA facilities. A full 35% received a diagnosis of a possible mental disorder. And they are waiting endlessly for treatment and compensation -- in part because they didn't report symptoms when they were supposed to, at the post-deployment center.
Of course, this isn't the way it's supposed to be. For years now the military has bristled at any suggestion that its healthcare system may be less than ideal. Even when it got busted by the General Accounting Office in 2003 for not enforcing a 1997 law that mandated pre-and post-deployment screenings for all servicemembers. Or last May, when another GAO report queried the military's low rate of referrals: it also questioned DOD's failure to require their providers to document why they had or had not granted servicemembers who showed potential symptoms of PTSD access to a professional mental health evaluation.
For all the committees and news accounts the Walter Reed scandal has spawned, there's no sign so far of substantial infrastructural or ideological change at the DOD. It can wave the head of former Army Secretary Francis Harvey around on a pole all it likes. Ditto for Maj. Gen. George W. Weightman and Lt. Gen. Kevin Kiley, the two previous commanders at Walter Reed. What does it matter when there's a limitless supply of scoundrels to run the show -- the kind of guys we've come to expect from this administration. Middle managers who hold down costs and minimize damages.
Take Dr. Michael Kilpatrick, deputy director of Force Health Protection and Readiness at DOD. He won Keith Olberman's "Worst Person in the World" award earlier this year for cooking the DOD's books to lower the statistics on the number of injured American service personnel. (By limiting the number only to those war casualties who required air transport out, he dropped the total from 47,657 to 31,493.) He's still there.
Or Michael J. Kussman, the acting undersecretary for health and the top doctor at the VA. He responded to last August's VA report by insisting that the number of troops reporting symptoms of stress probably represented a "gross overestimation" of those actually suffering from mental health disorders. He's still there, despite acknowledging in hearings that he's known about the problems at Walter Reed since 2004.
At least we're finally rid of William Winkenwerder, Jr., Assistant Secretary of Defense for Health Affairs who will be replaced in what the White House is spinning as a "previously scheduled departure from his job." He's the guy who swore, in testimony before the Senate Armed Services Committee last month, that " Walter Reed's problems did not result from lack of financing." (In 2003 he testified that all deploying and redeploying troops were receiving individual health assessments.)
Yes, the Walter Reed scandal is long overdue. But it's vital that government officials and media alike recognize that more of the administration's hacks still need to go, and that for many troops the issue is access to any kind of care at all.
Nancy Goldstein lives and writes in New York City.