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Monday, March 05, 2007

Walter Reed

I can imagine what happened.

Three things we know for sure:

The problem was focused in the outpatient programs.
The problem has been known about for some time but only recently became a public issue.
Defense Department authorities have been careful to exonerate the physicians and other caregivers at Walter Reed.

Here is my theory:

1. The ideology that governed the Defense Department in its conduct of the Iraq War did not permit preparation for the number of soldiers and marines who would require treatment and the severity of their injuries.
2. As the war became more costly and lengthier than anticipated, budgetary pressures within the Defense Department became severe. Combat operations took priority. Stateside operations, including medical, were short-changed.
3. The senior military officers in charge of the medical programs, being good soldiers, tried to make the best of it. Realizing that people would listen if the in-patient oriented senior physicians complained publicly, they supported inpatient programs at the expense of outpatient, where complaints were less likely to be heeded.

The strategy worked for two or three years and if the war had ended in a timely way it might have been successful. But it didn’t and the situation finally blew up.

What will happen now is like what happened in the Catholic sex scandals. The generals, like the bishops, who were doing what was expected of them will be sacrificed. More lucky generals will be allowed to fix the problem, the new Secretary of Defense will look like a hero, and the public’s attention will be drawn elsewhere.

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