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Senator shocked by lack of plans for vet care

The military’s surgeons general withstood a blistering attack Wednesday from an angry Senate appropriator who thinks the federal government is ill prepared to meet the short- and long-term needs of wounded combat veterans.

Sen. Barbara Mikulski, D-Md., had the Army’s surgeon general, Lt. Gen. Kevin Kiley, in her sights, but the Navy and Air Force medical chiefs were hit by collateral damage as Mikulski demanded to know about the government’s “50-year plan” for caring for today’s wounded service members. She never received an answer.

She was one of several members of the Senate defense appropriations subcommittee who questioned the service’s health officials about whether the problems now surfacing at many Army hospitals — administrative delays in the medical treatment and disability review process for wounded veterans — are a sign of larger problems.

Fired up when she didn’t like the answers she got, Mikulski began rattling off questions faster than Kiley could answer.

“Do you have a plan for Tricare for them? Do you have a plan for assisted living? Do you have a plan for long-term care? Do you have a plan for family assistance?” Mikulski asked. “Do you have a plan to pay for the divorce lawyers? Do you have any plan at all for any of this?

“No, ma’am. I do not,” Kiley said.

“I find this shocking. This is a war that we have been fighting for five years,” Mikulski said. “Five years, longer than World War II, where these men fought and bear the permanent wounds of war. That’s why they’re so passionate about this.”

Mikulski pressed Kiley and his counterparts, Navy Surgeon General Vice Adm. Donald Arthur and Air Force Surgeon General Lt. Gen. James Roudebush, to take a long-range view of issues such as converting military medical care jobs to civilian positions and outsourcing civil service jobs to private companies and closing hospitals, such as Walter Reed.

She was not the only one demanding answers. Sen. Ted Stevens of Alaska, the former chairman and now ranking Republican on the defense appropriations subcommittee, questioned how the three services could be ordered — again — to make cuts in their medical budgets that the Defense Department is calling “efficiency wedges” when the nation is at war. For 2008, the Bush administration’s budget plan would cut $222 million from the Army budget, $234 million from the Navy and $323.7 million from the Air Force.

Stevens called the cuts “totally unrealistic.”

Mikulski said the immediate problems, including the efficiency wedge cuts, can be easily solved by providing more money. Her concern is about the future — what she calls a 50-year care program.

“We had men and women who were injured and they’re 19 to 20 years old. They’re going to be alive for 50 years if it all works the way it should,” Mikulski said.

The Bush administration, the Defense Department and Congress need to think about what that means for the military health care system and for the Department of Veterans Affairs, which will both be responsible for medical care, benefits and some social assistance, she said.

“Yes, we can look at Walter Reed. Then, where do they go to rehab? And then, when they leave rehab, where do they go from there? Are they going to go into nursing homes? Are they going to go into assisted living? Or if they get home health care, who’s going to help the families, these 19-year-old brides, with assistance with living for a guy who might have 40 percent of his brain shot off or no arms or no legs and the stress on the family?” she said.

“I think we have to start calling it the 50-year commitment.” Mikulski said.