February 25, 2005

Budget Said to Shortchange Veterans / Mental Health Services May Fall Short

By Michael Standaert

According to a recent Pentagon estimate, 30 percent, or about 100,000 troops, have or will develop mental health issues such as post-traumatic stress disorder, or PTSD, after coming home.

And with the federal Veterans Affairs budget falling short of what both its staff and critics have called for, veterans’ advocates fear the government is unprepared for what might be a growing problem.

Since the invasion of Iraq, the Veterans Affairs Department has been offering two years of free health care, including mental health, to combat veterans.

And the Defense Department recently began giving a questionnaire on “post traumatic stress disorder [and] psychological and social readjustment” to veterans three to six months after returning, according to Dr. William Winkenwerder Jr., the assistant defense secretary for health affairs.

Michael O’Rourke, a health care expert with the Veterans for Foreign Wars in Washington, D.C., said six months is not long enough, because PTSD is “insidiously slow in coming on … It’s known as post-traumatic because [it] doesn’t present itself the day they get back.”

This adds up to a “looming problem,” according to Paul Rieckhoff, a former infantry platoon leader and founder of the veterans advocacy group Operation Truth.

“There is little transitional support available for returning veterans,” he said. “There is not enough therapy and prevention education support yet for our troops.”

Telephone and email inquiries to the Veterans Affairs and Defense Department press offices in Washington were not returned. Regional VA staff acknowledged budget problems, but said mental health services had improved.

Gene P. Gibson, the public affairs officer at San Francisco’s VA medical center, said her facility is “well-positioned to provide service to veterans in our area.”

She said that in the past outreach has been held up by problems in tracking veterans after they return, by a lack of communication between the Defense and Veterans Affairs departments, and by a prohibition on spending taxpayer money on advertising.

“In all the years past, the veterans have had to find us,” something they have not always been willing to do, she said. “[W]hen you go back to civilian life, the last thing you want is someone telling you, especially when you’re healthy, [that] you have to go to the VA.”

For Operation Iraqi Freedom, Gibson said that the Defense Department has begun forwarding discharged soldiers’ contact information to Veterans Affairs, which then sends a letter informing them of their benefits.

She also noted that every VA hospital now has a combat case-manager who contacts local veterans to help connect them with a range of health services.

Gibson describes veterans as “not merely patients, but heroes,” and said staff at the San Francisco medical center tries to work around budget restrictions by visiting “veterans’ service organizations, civic organizations, charitable organizations, we go to health fairs, anything we can do at little or no cost. We aren’t supposed to be spending tax dollars on [advertising] … the money has to be spent on health care.”

In Ohio, a VA nurse who spoke on condition of anonymity praised the dedication of her colleagues, and said the quality of care offered in her region is “excellent.”

She said the local VA hospitals are ready for the influx of Iraq veterans, but noted that the three local psychiatric wards each have “only 29 beds … and that’s not a lot.”

Handling new admissions along with aging veterans from World War II, Korea and Vietnam, who suffer from maladies such as Alzheimer’s disease or dementia, could overload the system, she said.

Many of the complaints come down to funding, and at times the rhetoric has been bitter.

Former Veterans Affairs Secretary Anthony Principi sought to boost his 2005 budget by $1.2 billion, but ultimately came away with only a $500 million increase in medical care.

The projected 2006 Veterans Affairs health care budget submitted to Congress by the Bush administration has an even bigger gap — $3.1 billion short of what the veterans’ advocacy project Independent Budget has requested.

The federal veterans’ budget infuriated former Veterans of Foreign Wars Commander-in-Chief Edward S. Banas Sr., who said the Bush administration’s 2005 veterans’ allocations are a “disgrace and a sham.”

Banas’ successor, John Furgess, said on Feb. 7 that the 2006 budget was “shameful” because it “doesn’t acknowledge that the costs of war continue long after the last shots are fired.”

The VA nurse in Ohio listed a number of improvements she would make to her hospital’s facilities, but said even boosting the department’s budget would only be a partial solution due to “random waste” and bureaucratic “twists and turns.”

“Money is spent foolishly,” she said, “without any accountability. People pay triple for what they could get cheaper. Because it’s the government, [vendors] charge more … Because they’re using other people’s tax dollars, nobody seems to care. The money could be spent in better ways for veterans, for all that is lost for ridiculous things.”

Newsdesk.org staff contributed writing and editing to this article.

2 thoughts on “Budget Said to Shortchange Veterans / Mental Health Services May Fall Short

  1. Not enough $ for the ones who shouldered the burden. But there’s enough to continue big-ticket projects.
    I KNOW what I’m saying.

    Today’s habit of treating each crisis as “the elephant everyone can ignore”
    obviously allows uncontrolled growth of the antidote required in the future.
    The needs of veterans returning from Iraq, currently visible, will soon become
    impossible to put off any longer. A clue with relevance to a solution, can be
    drawn from two references:
    [1] “Forgotten Heroes” NEWSWEEK March 5, 2007, pp.29-37.
    [2] The latest assessment of performance for the defense industry’s largest
    budget items, (GAO-08-467SP March 31, 2008)

    The contrast could hardly be more marked; soldiers risking everything vs an
    industry – created to support them – aimlessly squandering allocated resources.
    Keep in mind that, since the GAO report refers to the largest items in the
    defense budget, the waste is maximized while also choking off smaller projects
    needed for future developments. Immediately two self-evident steps
    * priority reassessment for possible reallocation of resources and
    * far less reliance on contractors to manage/oversee acquisitions
    will encounter a wall of opposition. Unfortunately the opposers are among
    those whose cooperation is needed for any solution to take effect. Let me
    try anyway.

    I could elaborate on and on, but I’ve already done that – in person and in print,
    getting virtually nowhere. This is way WAY too big for one guy swimming upstream.
    What’s needed is concerted effort by a group of non-opportunistic informed people
    and NO aspiring billionaires. All I can do now is draw attention to this growing
    crisis – and even that limited objective runs into a brick wall. Every group
    sees this as some other organization’s problem. Meanwhile our veterans continue
    to suffer tragedy after tragedy. Let’s finally
    * stand up and say how wrong this is
    * pool our information, collecting steps toward a solution.
    I can help. I know how to fix part of it – here’s my contribution:

    I’ve written and spoken on this subject for years, everywhere possible,
    sending my writings to dozens of people at highest, lowest, and intermediate
    levels in government, industry, academia, and, military plus veterans’
    organizations (all with different sets of priorities; one recipient found it
    provocative; another wondered whether this writer was “crazy”). Still, many
    informed (in some cases highly influential) individuals agree with me but no
    organization has focused the realization into a plan. The challenge is to
    bring the collective wisdom of these groups and individuals together. Why
    can’t that happen, especially now when so many heroic individuals sacrifice
    life and limb halfway across the planet? The consensus is: it’s too big
    and too many jobs depend on the status quo – it can’t be changed. I don’t
    accept that; I want to challenge corporate managers to change the climate.
    Here are some meaningful ideas.

    For criticism of the defense industry, familiar cries about fraud often won’t
    hit the nail on the head. No one goes to the slammer for poor practice.
    Usage of sub-par methods isn’t justified, of course, but it isn’t illegal.
    It isn’t even unethical if done out of ignorance, but that isn’t the subject
    to be explored here. Our big corporations, with top priority attached to
    short-term profit, often find it useful to avoid approaches known to be
    superior.

    In avionics (from AVIation electrONICS – a major cost factor for warplanes
    and other aircraft), a number of reasons can explain why this problem is so
    insidious, and why it produces poor performance and/or a cost explosion.
    Understanding this doesn’t require technical expertise:
    * Expensive items in the defense budget include many separate subsystems.
    * Subsystems come from independent suppliers uncommitted to each other.
    * Subsystem suppliers often try to expand into providers of complete systems.
    * Subsystems can be designed to work well with “our but not other” equipment.
    * More control over a system means more control over modification costs.
    * Modifications bring major profits, reducing motivation for early success.
    * Slogans constantly express commitment to excellence – but only verbally.
    * Excellence in separate parts does not at all guarantee excellence overall.
    * Companies carry ideas of “proprietary” products and concepts to extremes.
    * System integrators lack enough time, access to proprietary info, and clout.
    * Overseers, if wise enough to master the issues, lack time to investigate.
    * Superior methods are often misrepresented as needlessly complex overkill.

    To those aiming at solutions, “vendor lockdown” is a familiar phrase.
    You can see the rationale; something like (“You have our ___ and it works
    best with the way we do __ – anything else will cost more”). Common-sense
    standardization, proposed for compatibility among separate parts, could have
    and should have been accepted over a decade ago.

    One trend that is slowly gathering momentum is effort to restore the former
    expertise in agencies of the armed services (relying less on conglomerates).
    That step could relieve some problems just listed (e.g., by eliminating
    from competition proposed approaches with proprietary claims). Until that
    becomes a reality, there are steps that could be taken now. The defense
    industry’s obligation to place troop support at the top of the priority list
    could hardly be more obvious; it shouldn’t even have to be mentioned.
    Unfortunately the reality is: it not only needs to be mentioned; it
    needs to be shouted. At the same time, nothing will be accomplished by
    bashing corporations whose cooperation is needed to fix this problem. So –
    to those with clout in the defense industry: forget your career for a moment.
    This is about your conscience. Wouldn’t you welcome a climate where rational
    planning could enable goals aiming toward long-term (instead of short-term)
    profit? Doing the right thing benefits the business eventually. Relearn
    how to wait.

    Time after time I’ve heard luncheon speeches warning about how the U.S.
    can’t afford careless spending of the defense budget. Everyone agrees
    that it was a wonderful speech – and immediately proceeds with business
    as usual. Where’s the reality?

    No illusions here about reform of procurement for avionics – plus vetronics
    (from VEhicle elecTRONICS) and shipboard electronics – solving the whole
    problem. There are other items in the Defense Department inventory and,
    furthermore, documented abuses by the war service industry are worse than
    issues just discussed here. Still, a legitimate way to fix something big
    is to fix each part. The captains of industry need to prove that there
    are some things more important than profit-now. Help me refuse to quit –
    NOT for my sake but for those who shoulder the burden. Those are the real
    heroes; we all know that. A country that fails its best heroes can’t
    possibly stay strong.

    From government, industry, academia, and, the military there are hundreds of
    former administrators with organizational skills I lack. Many of them, for
    retirement or other reasons, are not putting those abilities to use, Here
    is a worthwhile – even urgent – objective that could be served by awakening
    organizational skills now lying dormant. Here’s a “template” – In the musical
    play 1776 – and in the YEAR 1776 – the characters had differences of opinion
    and limitations like everyone else. That didn’t prevent them from hammering
    out a very important agreement. Something like that needs to happen, to
    reform all industries organized for the purpose of protecting troops put
    in harm’s way. Eisenhower warned us about this decades ago.

    ______________________________________________________________________________
    Jim Farrell, author of “Integrated Aircraft Navigation” (1976) plus “GNSS
    Aided Navigation and Tracking” (2007) is in a position to know something
    about what’s OK – and what isn’t – in avionics, both defense and commercial.

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