Veterans need the best care possible, and shoddy treatment by the Pentagon is inexcusable

Sunday, November 11, 2007

By Kit Bond

Veterans Day gives us the opportunity to remember that we would not enjoy the freedoms we have today were it not for the willingness of our troops and our veterans in every generation to fight on our behalf against America's enemies.

We must also remember our obligations to them while they are deployed and when they return home.

Our soldiers, sailors, airmen and Marines fighting in Iraq and Afghanistan volunteered to serve their country in the War on Terror and are doing so courageously and without complaint.

They are fulfilling the obligations they agreed to when they enlisted. At home, though, we are too often falling short in meeting our duty to them.

For several years we had the wrong strategy in place in Iraq, at great cost to our troops. Thankfully, that has been remedied by Gen. David Petraeus and his plan, which is achieving great gains and a reduction in violence in Iraq.

We need to do a better job of ensuring that our ground forces are getting the equipment they need, such as mine-resistant ambush-protected vehicles, to perform their missions and reduce the risk of injury or death.

We are also realizing that we have much more to do for our troops who return with injuries that are invisible to the eye, but very real to the spirit, such as post-traumatic stress disorder and traumatic brain injury.

Army studies have found that up to 30 percent of soldiers coming home from Iraq suffer from depression, anxiety, combat exhaustion or PTSD, with those serving multiple tours 50 percent more likely to suffer from acute combat stress.

At the same time, the military mental-health system is understaffed and difficult to navigate at a time when soldiers and their families need help the most.

Earlier this year, the Centers for Medicare & Medicaid Services complicated matters by reducing its reimbursement rate for psychologists and social workers by 9 percent.

Because the Department of Defense bases its reimbursement rates for Tricare military health system providers on the rates designated by the Centers for Medicare & Medicaid Services, this led to an equivalent decrease in payments to mental-health providers who treat service members and their families.

Many psychologists and social workers have indicated they may have to reduce their caseloads or leave the Tricare program altogether.

To address this, several senators and I successfully included an amendment to the National Defense Authorization Act for fiscal year 2008 giving the secretary of defense the flexibility to increase mental health reimbursement rates for Tricare if access to services is threatened.

Even more alarming than the decrease in reimbursement rates, it appears the Pentagon is ducking its responsibility to pay for the care of some afflicted with PTSD or TBI by inappropriately using a personality-order discharge to separate them from active duty.

These service members are being discharged not because of their injuries, but because of their supposed pre-existing personality disorder.

More than 22,500 pre-existing personality disorder discharges have been processed in the last six years, an average of 10 service members a day.

When a service member is discharged this way, he or she often loses health-care benefits and must repay any enlistment bonuses. Either circumstance can send injured service members and their families into debilitating debt and further exacerbate the invisible injuries they have received.

This shoddy treatment of our combat veterans is inexcusable, and the Pentagon should know better. The federal government has a lifelong responsibility to care for those who may never be whole again as a result of service-connected injuries.

Sen. Barack Obama or Illinois and I led a bipartisan group of senators in an amendment to the 2008 Defense Authorization bill to limit the Pentagon's use of personality disorder discharges. Sen. Claire McCaskill of Missouri is leading the effort to protect this amendment, which is opposed by the Pentagon, in the conference deliberations on the bill.

We ask a lot of our troops and their families. In return, we need to ensure our leaders have the best strategy in place for victory and that our troops have the right equipment to perform their missions and the best care available when they return home.

Kit Bond represents Missouri in the U.S. Senate.

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