On Tuesday October 16th, President Bush referred to the present national system of care for injured troops as an “antiquated, bureaucratic nightmare” and announced his plans to completely overhaul the current system.

The intent of the overhaul is to streamline and simplify procedures to provide improved support for families and injured soldiers.  One proposed change is to eliminate the duplication of paperwork and physical exams for injured troops between the Pentagon and Veterans Administration.  The overhaul would also change the way injured military personnel are evaluated and compensated. 

Injured soldiers unable to return to active duty would have their disability payments replaced by a Pentagon-funded pension, while the cost of their on-going care would be shifted to the Veterans Administration.  The new plan would also place a new emphasis on the diagnosis and treatment of Post-Traumatic Stress Disorder (PTSD). According to the Veterans Administration’s own statistics, over 100,000 Iraq and Afghanistan veterans have sought treatment for PTSD.  The new approach is to simply screen all soldiers entering a veterans’ hospital for the condition without the soldier having to make the request.  The plan also includes the establishment of “recovery coordinator” positions –patient advocates assigned to oversee the management of individual veterans' care, and help them navigate the labyrinthine federal bureaucracy. 

Additional recommendations include…

• reassessment of veterans every three years
• detailed individualized recovery plans for each injured service member

• adjustment of the rating system to reflect "modern concepts of medicine and disability"

• six months of unpaid leave when a loved one is seriously wounded in combat

• up to 40 hours of weekly in-home assistance for severely injured soldiers

The administration will be able to directly implement some of the recommendations, while other elements will require Congressional approval.

The president's announcement follows the recommendations of a bipartisan commission, established in response to reports of sub-standard care at Walter Reed Army Medical Center. The commission, led by former Sen. Bob Dole (R-Kan.) and Donna Shalala, secretary of Health and Human Services during the Clinton administration, called for "fundamental change.”  When the commission issued its report, Shalala estimated that its recommendations would cost $1 billion over 10 years, but no exact price tag has been mentioned.