Walking Wounded Face Healthcare Disparity

Walking Wounded Face Healthcare Disparity 
By Diane M. Grassi

Our military has done the United States proud in its performance in the War on Terror through Operation Enduring Freedom in Afghanistan, the capturing of Saddam Hussein in Iraq and with the ongoing stabilization effort in Iraq through Operation Iraqi Freedom. Yet this 21st century-style voluntary military has been tried and tested in its numbers for the first time since the 20th century’s Vietnam War.

Disclosure of casualty rates are rarely publicized in the media and the Pentagon and White House make it clear that they want it that way. However glowing reports about improvements in medical care, which has made a significant difference in allowing so many wounded to get back to the front or to the supply line as deemed necessary for second and third tours of duty, is widely available. Precisely because of the improvements in medical care and technology, it has all but stalled the Pentagon efforts in implementing new plans to address a mounting shortage of active-duty troops, especially in light of so many hot spots circling the globe…

     Afforded by an outstanding showing of numbers of reservists of the Marines, Air Force, Navy, Army as well National Guard troops, the military clearly would be deficient of troops in the field in Iraq. Reservists now account for almost 48% of the total troops serving in both Afghanistan and Iraq with their deployments remaining up to 18 months. Unlike active-duty soldiers, reservists face an uncertain status financially upon their return making it less possible for them to reenlist. Added to that are those who return wounded, with many requiring extensive follow-up medical care.

Of those wounded in action or seriously ill during their deploy, according to reports, up to 98% survive with mortality down some 22% since the 1991 Gulf War. But along with the recovery period for those who become temporarily or permanently disabled, soldiers face required bureaucratic red-tape with which the wounded must blindly deal, and remains problematic predominantly for reservists. While the Veterans Administration guarantees two years of free healthcare for returnees from Iraq and Afghanistan, it only applies to active-duty soldiers.

The General Accounting Office released a study on February 17, 2005, revealing the pitfalls and the convoluted process required by our wounded upon returning stateside, further illuminated by reservists before the House Government Reform Committee. According to the GAO, the problem originated with the obsolete Active Duty Medical Extension program, set up in 2000. It was not staffed to accommodate the vast number of presently mobilized reservists. Not only has there been an unprecedented influx of continually returning reservists given the ongoing War on Terror, but many, many wounded who require aftercare.

However, unlike active-duty soldiers or non-reservist personnel returning to Walter Reed Army Hospital in Bethesda, MD, wounded reservists kept in medical holdover (which is the limbo status patients are kept in while awaiting determination of their medical case or if they will be cleared to resume their duty with their military unit) often lose salary as well as medical benefits. And unlike active-duty soldiers, reservists suffer from lack of job security whether they are disabled or not, as their jobs were in the private sector when called to serve up to 18 months.

During this med-hold period, reservists were automatically removed from active-duty status, leaving them without military pay and follow-up care. Although Army officials testified before Congress that they have resolved the automatic removal’ process as of July 2004, the GAO reported the program is still inefficient and in some respects has worsened problems.

For example, Sgt. 1st Class John Allen, a Special Forces reservist serving in Afghanistan in 2002 upon returning home wounded in November 2002, received a bonus consisting of a red-tape nightmare. Testifying before the House Government Reform Committee on 2/17/05, he stated that while coping with healing from extensive battle injuries he was dropped repeatedly from active-duty, losing three months of benefits and almost $12,000.00 in pay. He suffered brain trauma and injuries to his legs, torso and vision resulting from a helicopter accident and grenade blast outside Kandahar.

During those periods when Allen’s active-duty status was dropped, he was not paid, had no access to his base, had no medical coverage for his family and his medical appointments with military doctors were canceled. He had to borrow $10,000.00 from a brother to pay bills and in August 2003 when his wife went into premature labor, was denied treatment at the military hospital in Fort Bragg, NC, necessitating intervention from a senior Army commander.

One can argue that this exemplifies but one case, but sadly that would not be truthful. In fact the seniority of Sgt. Allen probably helped him some, yet he still had myriad problems in receiving assistance. Imagine this dilemma faced by a 19-year old reservist who delivered pizzas prior to serving in Iraq. And while soldiers in med-hold are primarily considered outpatients, they usually live on hospital grounds, given the extent of their injuries. But Walter Reed applies a meal charge for all outpatients, which can get expensive for a reservist without a paycheck. The Army defends this practice, claiming only outpatients are charged for meals, without consideration that processing of med-hold patients can take up to a year.

Since November 2003, the Army’s Human Resources Command processed 16,000 disabled Reserve and Guard members; more than at anytime since the Vietnam War with close to 4,000 presently being processed. For many of those reservists, their benefits were extended 30 days only requiring reapplication every 30 days. Following that 30-day process many have lost benefits, requiring them to initiate the process again. The Army claims it does not track the number of injured or ill reservists suffering from gaps in pay and benefits.  And although the Army has recently begun automatic 179-day extensions of pay and benefits for returning Reserve and Guard troops, as of the end of 2004 the Army could not account for how many soldiers were on medical extensions or how many had even returned to active-duty.

A good many reservists have been savvy enough to appeal to their local Congressional representatives for assistance. This should send a red flag to the Congress that the system is not working and one or two hearings a year where representatives of the Pentagon suggest that they are doing a good job, all things considered, in an effort to ensure their own job status is nothing less than a travesty. Responses from the Pentagon and the Department of Veteran Affairs continually repeat that the system is antiquated and not set up for an onslaught of returning wounded. Given over three years since deployments to Afghanistan and Iraq it no longer remains an acceptable answer.

For those troops already dealing with the red-tape nightmare, it comes too little too late and says little for the way the federal government has treated our members of the military. The United States government as well as the present administration basks in the glory of its military’s accomplishments yet appears to curry little favor for those who have risked their lives, and may no longer prove useful when returning to a life of disability, posing far greater challenges for them than they had prior to going off to war.

As the present quotas for reenlistments for both active-duty and reservists continue to plummet, is it any wonder that the Army as well as the Marine Corps are now recruiting high school dropouts and those who have scored poorly on military aptitude tests? Whether one agrees or not with our military participation in Iraq and Afghanistan, we owe more to our troops and their families. The status-quo from our legislators and from our governmental institutions should no longer remain as an acceptable option. And to reward our troops with bureaucratic friendly fire’ upon their return is simply tantamount to a slap in the face for those who have served our nation so proudly and so well.