Originally Published: 3/21/2007
THE WALTER REED DEBACLE
By The Issue Wonk
When Dana Priest and Anne Hull of the Washington Post1 revealed that Walter Reed Army Medical Center, once seen as the “crown jewel of military medicine,” had become “something else entirely – a holding ground for physically and psychologically damaged outpatients,” the country was in shock. Priest and Hull had snuck in and out of the Walter Reed facilities for four months without the knowledge or permission of hospital officials. They said they wanted to bypass the hospital’s “very well-oiled public relations machine.” However, it has since become clear that the problems at Walter Reed have been known for quite some time.
Mark Benjamin, now a reporter at Salon.com, first wrote about the living conditions at Fort Stewart, Georgia for United Press International in 2003.2 In January 2005 he wrote another piece3 which blasted an Army policy of charging some outpatients for their meals and touched on many of the issues later uncovered in the Washington Post article.1 And in February 2005 he wrote an article about the suicide of a combat veteran discouraged by the treatment he was getting at Walter Reed.4
What were the causes of the problems at Walter Reed? Was it an incompetent command or a lack of resources? Both? Or was it something else?
Walter Reed Command. In 2002 the then-Secretary of the Army, Thomas E. White,5 appointed Lieutenant General Kevin C. Kiley commander of Walter Reed Army Medical Center. Kiley served until June 2004 when he was promoted to Surgeon General of the Army by then-Acting Secretary of Army Les Brownlee. He was replaced at Walter Reed by Major General Kenneth L. Farmer, Jr., who served until August 2006. In 2006 then-Secretary of the Army Francis J. Harvey appointed George W. Weightman to command Walter Reed. In the wake of the Washington Post article, Weightman resigned and Harvey re-appointed Kiley as temporary commander. After it was brought out that Kiley had been in charge during most of the time, he, too resigned, as did Harvey.
That Kiley knew of problems back in 2003 is not in dispute. “Steve Robinson, director of veterans affairs at Veterans for America, said he ran into Kiley in the foyer of the command headquarters at Walter Reed shortly after the Iraq war began and told him that ‘there are people in the barracks who are drinking themselves to death and people who are sharing drugs and people not getting the care they need.’”6 And Farmer said that he was aware of outpatient problems and that there were “ongoing reviews and discussions” about how to fix them when he left. He shared his concerns with Kiley, who was then his immediate commander.6 And Joyce Rumsfeld, the wife of then-Secretary of Defense Donald Rumsfeld, “was taken to Walter Reed by a friend concerned about outpatient treatment.”6
The Funding. With a war going on and tens of thousands of U.S. soldiers being injured, you’d think that funding for military health care would be climbing. Not so. Federal spending on veterans’ medical care since 2001 has “lagged behind overall national health spending.”7 Even this year President Bush’s budget assumes consecutive cutbacks to veterans’ health care in 2009 and 2010 and a freeze thereafter.8
Outsourcing. It appears that in 2000 a decision was made to outsource the “base support services, including facilities management” at Walter Reed Medical Center. The bidding process, known as an A-76 privatization review, was finalized in September 2004 and the $120 million contract was awarded to federal employees. However, the Army later reversed its decision and awarded the work to a contractor, IAP Worldwide Services.9
An internal memo from Weightman in September 2006 stated that the contract:
will impact the Hospital’s patient care mission as highly skilled and experienced personnel in the current workforce are moved in to other jobs or involuntarily separated. . . Without favorable consideration of these requests, WRAMC (Walter Reed Army Medical Center) base operations and patient care services are at risk of mission failure.10
In addition, according to Senators Henry A. Waxman and John Tierney:
[T]he decision to privatize support services at Walter Reed led to a precipitous drop in support personnel at Walter Reed. Prior to the award of the contract, there were over 300 federal employees providing facilities management and related services at Walter Reed. By February 3, 2007, the day before IAP took over facilities management, the number of support personnel had dropped to under 60. Yet, instead of hiring additional personnel, IAP apparently replaced the remaining 60 federal employees with only 50 IAP personnel.11
And who is IAP? It’s headed by Al Neffgren, a former senior Halliburton official who testified in 2004 “in defense of Halliburton’s exorbitant charges for fuel delivery and troop support in Iraq.” IAP is also “one of the companies that experienced problems delivering ice during the response to Hurricane Katrina.”11
Summary. It appears that the debacle at Walter Reed Army Medical Center was caused by all three: incompetent, ever-changing command, lack of funding, and the desire to privatize federal services.
1 Priest, Dana & Hull, Anne. “Soldiers Face Neglect, Frustration At Army’s Top Medical Facility. Washington Post, February 18, 2007.
2 Benjamin, Mark. “Sick, Wounded U.S. Troops Held in Squalor.” United Press International, October 17, 2003. (Archived at Information Clearing House)
3 Benjamin, Mark. “Insult to Injury.” Salon.com, January 27, 2005.
4 Benjamin, Mark. “Behind the Walls of Ward 54.” Salon.com, February 18, 2005.
5 According to Wikipedia, Thomas E. White was “an American business man and former U.S. Army officer” who was a senior executive at Enron.
6 Hull, Anne & Priest, Dana. “Hospital Officials Knew of Neglect.” Washington Post, March 1, 2007.
7 Krugman, Paul. “Valor and Squalor.” New York Times, March 5, 2007.
8 Taylor, Andrew. “Veterans Face Consecutive Budget Cuts.” Associated Press, February 12, 2007.
9 News from U.S. Senator Barbara A. Mikulski, September 13, 2006.
10 Memorandum from Colonel Peter M. Garibaldi, Garrison Commander, thru Major General George W. Weightman Commander, to Colonel Daryl Spencer, Assistant Chief of Staff for Resource Management, MEDCOM, September 2006.
11 Letter from Senators Henry A. Waxman and John Tierney to Major General George Weightman, March 2, 2007.
© The Issue Wonk, 2007