Selasa, 06 Maret 2007

Just a Little Bit Cynical...

I’m projecting here, but Bec asked in the comments if I thought Bob Dole and Donna Shalala were good choices to head up the presidential commission that will tar and feather the usual suspects investigate the military health care scandal. The short answer: yes. The long, and cynical, answer follows. Oh, and the “projecting” bit? I’m projecting that Bec, and possibly others, are wondering why I haven’t commented on the Walter Reed thingie. That’s part and parcel of the long answer…

First: the caveats.

  • In my 22-year Air Force career I never was shot at, let alone wounded. So it goes without saying I never spent any lengthy amount of time within the tender embrace of the military health system, let alone undergo numerous operations and months, if not years, of physical therapy.
  • I was always subject to the Air Force’s health care system, save for the one-year period of time I spent in an AF tenant unit on an Army post. Say what you will, but I believe the stereotype of the USAF providing better people-care than our sister services. Just sayin’.
  • I have never entered a Veterans Administration (VA) medical facility except as a visitor. So, by definition, I’m not qualified to render any sort of first-hand judgment on the quality, or lack thereof, of VA care. Their reputation isn’t sterling, however. Once again, just sayin’.
  • The current scandal is less about the VA and more about the military. But the scandal will grow to include the VA, much sooner than later.

The military and the VA…especially the VA…have long-standing reputations (deserved or not) for providing mediocre health care to their clients. And “mediocre” may be too kind. There are, and have been, periodic scandals about abuse, neglect, incompetence, malpractice, and various other evils surrounding the military medical establishment as long as those organizations have been in existence. If you missed them, you haven’t been paying attention, or you’re very young. I myself am way too young to remember the earliest scandals, which began shortly after the Civil War. But the scandals come close on the heels of the nation’s latest war. The Biggie for my generation was the Agent Orange scandal and the associated lawsuits filed by veterans (and others) long and tortuous path through the courts.

Enter the cynicism. The military’s health care system will always be plagued by scandal, simply because it’s part of a large bureaucracy. And bureaucracies are the bane of modern existence, as we all know. As an example, does anyone really believe the average DMV will ever get fixed in our lifetime, or the lifetimes of our great-great-grandchildren? If so, then you also harbor hopes about the military medical system. I’m not equating the functions of the medical system and those of the DMV, they are apples and oranges, except for the fact they are both large bureaucracies and as such are subject to the immutable laws of nature, specifically the Law of Inertia. But can one expect meaningful change from another Commission? I think not. But we’ll do it. We’ll Commission. Yet again.

There will be much gnashing and thrashing. There will be lots…too much…blame-mongering and finger pointing for political gain. It’s already begun.

In hearings of the Oversight and Government Reform Committee at Walter Reed Hospital, Chairman Henry Waxman (D-Los Angeles) said that veterans and their families are "flooding us with complaints" and that "this may be the tip of the iceberg of what is going on all around the country."

And, citing a litany of news stories and congressional reports, Waxman threw doubt on claims by the Army's higher-ups that they were surprised by the Post's disclosures two weeks ago.

"They said, 'We never knew things were out of hand.' " Waxman said. "I have a stack of reports and articles that sounded the alarm bells."

I watched part of those hearings on C-SPAN yesterday. While not all of the proceedings were marked by blatant political posturing, there was enough if it to turn one’s stomach. Surprised?

So. What to do? I’m not advocating a “business as usual” approach. By all means, bring on the commission(s). Air it out. Make your recommendations. Do your absolute BEST to implement the recommendations and thereby ensure we’ll never see a scandal like this again. Until this war is over, that is, and the military recedes into obscurity until the next war. By "obscurity" I mean the military will become a wasteful use of funds that could be better used to stamp out drug abuse or protect Spotted Owls. That's just the way things work in America.

I could say more on this subject, but I think you get my drift. I’ll end on a positive note: My past and present experiences with the Air Force Medical Corps have been nothing short of superlative. The fact that I’m getting old and have (not to mention will need) direct access to the medical folks at Cannon AFB is one of, if not the, principal reasons I stay docked in Portales. I only wish every other military person and veteran had it as good as I do.

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