Stars and Stripes, August 9, 2007

On July 25, a bipartisan presidential panel on military and veterans’ care released a report suggesting improvements to medical care provided by the Department of Defense and Veterans Health Administration. Formed in response to the recent debacle at Walter Reed Army Medical Center, the commission confirms the need for drastic reform.

Led by former Sen. Bob Dole and former U.S. Health and Human Services Secretary Donna Shalala, the commission issued 35 recommendations, all endorsed by President Bush. It should come as no surprise that most recommendations are directly related to the injuries being sustained in Afghanistan and Iraq.

Every modern war seems to be typified by a distinct illness. World War II veterans suffered exposure to radiation from testing atomic bombs; Vietnam War veterans tended to suffer from post-traumatic stress disorder (PTSD), as well as other physical effects due to Agent Orange exposure, while today’s soldiers are experiencing high rates of both traumatic brain injury (TBI) and PTSD. The use of improvised explosive devices (IEDs) by terrorists and insurgent forces has made TBI and PTSD some of the most prevalent injuries of this war.

According to the presidential panel’s findings, more than half of all troops questioned had experienced a blast-related head injury. These blasts can cause serious physical damage, as well as severe head trauma, making it imperative the troops seek proper care. Unfortunately, both DOD and VHA have been unable to ensure this treatment because of a lack of qualified professionals within the two departments, and this is not entirely the fault of the bureaucracy.

America is short of many of the professionals needed to treat wounded heroes: physicians, occupational and physical therapists, psychologists, vocational specialists, and speech language pathologists. But homeward- bound heroes can’t wait for the bureaucracy to overcome its inertia and reinvent its resources, as Dole and Shalala recommend. There is a faster, more flexible and compassionate way to increase the supply of health professionals serving our wounded warriors.

By creating vouchers for veterans with PSTD- and TBI-related injuries, DOD and VHA could alleviate this shortage while giving our heroes control over the care they receive.

The military is already familiar with another type of voucher, for education. The Montgomery G.I. Bill and the Army Medical Department program (AMEDD) allow students to enroll in the college of their choice and have their tuition covered by the military with the understanding that reimbursement will be paid through corresponding years of service. This program has provided first-rate education to our nation’s servicemembers and recruited some of the brightest minds for service.

Medical vouchers would also increase access to care, because veterans often must travel long distances to a government-controlled facility for treatment. Currently only nine core specialized Defense and Veterans Brain Injury Centers (DVBIC) exist within the United States. Conversely, private-sector care tends to be more dispersed and is prevalent wherever demand exists.

Surely it makes sense to allow our veterans to go home and recover with their families, if they choose, rather than make their families come to wherever the government chooses to provide care.

Advocates of government monopoly health care have touted the VHA as a positive example for a “single-payer” system in the U.S. This is a bad idea, for reasons outlined in the commission’s report.

The Department of Veterans Affairs may look relatively good in peacetime, but it buckles under the stress of war.

The panel made some worthy suggestions and went to great lengths to avoid just “patching the system, as has been done in the past.” But massive bureaucratic inertia continues to cause veterans harm. In order for real reform to take place, legislators must first concede that the power of individual choice is necessary in order to provide our nation’s finest with the care they deserve. Adam Frey is a summer policy fellow at the Pacific Research Institute in San Francisco. PRI’s stated mission “is to champion freedom, opportunity, and personal responsibility for all individuals by advancing free-market policy solutions.”