The United States has likely reached a grim but historic milestone in the war on terror: 1 million veterans injured from the fighting in Iraq and Afghanistan. But you haven't heard this reported anywhere else. Why? Because the government is no longer sharing this information with the public.
All that can be said with any certainty is that as of last December more than 900,000 service men and women had been treated at Department of Veterans Affairs hospitals and clinics since returning from war zones in Iraq and Afghanistan, and that the monthly rate of new patients to these facilities as of the end of 2012 was around 10,000. Beyond that, the picture gets murky. In March, VA abruptly stopped releasing statistics on non-fatal war casualties to the public. However, experts say that there is no reason to suspect the monthly rate of new patients has changed.
VA ceased to disclose this data despite President Obama’s second-term campaign pledge that his administration would be open and transparent. Absent information about the number of soldiers that have sought government medical help and about the types of injuries they had, policymakers, Capitol Hill and health care professionals may be hamstrung in making decisions about funding for crucial veterans' health programs and the treatments and diagnostic tools that should be researched and targeted. The reliability of future military strategies could be in jeopardy as well.
VA's actions are "a gross injustice to veterans and the taxpaying public," says Anthony Hardie, a Gulf War veteran and veterans' advocate who has testified before the House Veterans' Affairs Subcommittee on Oversight and Investigations. Hardie suggests that Congress should tackle the problem, perhaps even legislatively, noting that withholding the data "reflects a VA pattern of abuse and lack of transparency."
Rep. Jeff Miller, R-Fla., the chairman of the House Committee on Veterans' Affairs, stopped short of making such a harsh assessment, but just barely. VA's records on veterans from Afghanistan and Iraq, he says, “were a valuable resource for the committee, and it's unfortunate that VA has decided to discontinue them for now. We have asked VA to explain what security concerns led to its decision and provide an estimate as to when it will resume production of the reports.”
Miller added: “I hope VA will resolve this issue quickly, because with more than 100 outstanding requests for information from the committee currently pending, the department already has more than enough issues with transparency."
Previously, Veterans Affairs published reports four times a year on how many patients that had served in Afghanistan’s Operation Enduring Freedom and Iraq’s Operation Iraqi Freedom and Operation New Dawn were seen for the first time in VA health care system. The most recent report was released in March 2013, reflecting numbers from the previous December. Nothing in June. Nothing in September.
VA stopped preparing and releasing these reports on health care use and disability claims involving the 2.6 million U.S. service members who have been deployed to Iraq and Afghanistan without warning, claiming unspecified “security” reasons.
A statement buried on an unpublicized VA web page reads, “VA and the Department of Defense are currently enhancing their existing security arrangements for the delivery of the data VA uses for these reports. At this time, it is unknown when the next reports will be released."
[Update: hours after our story was published on Friday, the statement was updated to: "VA and the Department of Defense have enhanced their existing security arrangements for the delivery of the data VA uses for these reports. The 2nd Quarter FY 2013 reports should be released in November 2013."]
Some believe privately that the enormity of the 1 million injured figure, which advocacy groups like the Veterans for Common Sense say has already been surpassed, is responsible for the reticence of VA and the Obama administration, both of whom are hoping to avoid a public relations fiasco. And several veterans advocates including Michael Zacchea, a director at the Veterans for Common Sense, suggest that there may have been some sort of data transition compromise between DoD and VA -- two agencies that have never communicated very effectively. It's even possible that VA was hacked. But no one who would know is talking.
Phil Budahn, a VA spokesman, says the department was “unable to get an answer” for this story. But veterans’ advocates, lawmakers and others agree that the information VA is currently withholding is important information that Americans have a right to know. And it isn’t just a matter of acknowledging -- or refusing to acknowledge -- a shocking numerical milestone: It could also influence the treatment programs, for which funding must be quantified, and provide useful data for reducing future injuries.
Zacchea sees the potential for disrupting veterans' programs as unacceptable. “VA must release information about patients and claims among our newest generation of veterans for the year 2013 so Congress makes sure VA has enough funding,” he says.
Linda Bilmes, a Harvard professor and author of "The Three Trillion Dollar War," who has testified before Congress about the cost of war, agrees.
“We need accurate data on casualties in order to make decisions about treatment, research, operations and budget,” she says. “But we also need to know how much of our medical effort should be devoted to specific conditions such as psychiatric, pain relief, physiotherapy, substance abuse, etc. And regionally, we need to know where the demand for services is outstripping supply.”
Bilmes adds that in addition to helping determine how much money the government should spend and where it should be spent, these reports help the nation study and draw conclusions from the current war effort.
“Sadly, this is unlikely to be our last war,” she says. “Those of us who study the long-term effects of conflict depend on the government to collect and make available these reports that will help us to analyze what happened during this one.”
A House Veterans Affairs Committee staffer who asked not to be named because he is unauthorized to speak to the press said, however, that while the reports are important and should be shared by VA with the public, they are “not essential” for budgetary submissions.
“The committee has information within VA’s budget on the number of users of the health care system broken down by era, etc.,” says the staffer. “Further, there are stats on OIF/OEF [Operation Iraqi Freedom and Operation Enduring Freedom] claims activity in the budget submissions as well.”
Does that mean there is enough information in these budget submissions? In 2005, Veterans Affairs officials testified before Congress that the department was doing just fine, that it had enough money. Just a few months later, then-VA Secretary James Nicholson went back to Congress, hat in hand, and asked for billions more in emergency funding to keep the department’s doors open. This was due in part to the flood of Iraq and Afghanistan patients. Zacchea, a retired Marine lieutenant colonel who fought in Iraq, says that could easily happen again. He notes that in 2007, Veterans for Common Sense sued VA, alleging the department was unprepared to handle the tidal wave of patients and claims. The case made it all the way to Supreme Court, where the court announced in January, without further comment, that it would not hear arguments in the lawsuit. It died.
“We [VCS] are suspicious that VA’s reports on patients and claims ceased shortly after the Supreme Court's action early this year,” Zachea says.
Whatever the reason, VA’s reluctance to share this non-fatal war casualty information raises questions. How many patients has Veterans Affairs treated in 2013? How many more disability compensation claims does it expect to need processing? Does VA need more funding to hire doctors and nurses to treat veterans suffering from traumatic brain injury (TBI) or post-traumatic stress disorder (PTSD)?
The department’s lack of transparency has generated frustration and even anger among lawmakers on both sides of the aisle. Congress recently held hearings on the issue of VA transparency and even created awebsite that keeps a running record of outstanding information requests made to the department by both Democrat and Republican members of the House Veterans Affairs Committee, commonly referred to as HVAC.
“The leisurely pace with which VA is returning requests – and in some cases not returning them – is a major impediment to the basic oversight responsibilities of the committee,” the site notes.
VA’s woeful track record persists despite a memo sent by President Obama to federal agencies shortly after taking office for a second term promising, “We will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration.”
VA is also under fire for its backlog of veterans’ disability claims. The House passed a bill this week calling for the establishment of a 15-member commission that would examine ways to expedite the painfully slow claims process.
According to VA numbers, 1.4 million new, reopened and appealed claims were pending as of October 28. The average time for VA to process a claim is one year, and the department makes mistakes in 30 percent of claims. The average time for processing an appealed claim is four years.
The House also passed a bill this week that would limit the amount VA can spend on executive bonuses each year, mandating a 14 percent cut to the department’s performance awards.
And a House panel is examining VA spending on extravagant conferences. The Washington Post reportedthis week that the department held two events in Orlando near Walt Disney World that cost taxpayers at least $6.1 million, according to VA inspector general (IG). The expenses included $50,000 for a 15-minute video spoofing the Oscar-winning movie “Patton.”
Five VA officials involved have resigned or retired since the IG faulted their roles the training events in Orlando, according to a newly released congressional report.
But VA’s biggest and most important challenge remains caring for the onslaught of veterans returning from 12 years of war. At the end of last year, the department reported a staggering 56 percent health care usage among 1.6 million recent war veterans eligible for VA treatment.
If the same 56 percent rate is applied to the remaining 1 million service members who went to war and are expected to be discharged and become eligible for VA care in the coming years, VA may eventually treat 1.5 million Iraq and Afghanistan war veteran patients.
Among these veterans, some sources revealed last year that the PTSD rate exceeds 30 percent, and one Stanford University study puts the PTSD rate at 35 percent. If accurate, that means a total of between 780,000 and 910,000 Iraq and Afghanistan war veterans may return home with PTSD, which is often debilitating.
This week, legislators and several veterans’ service organizations called for VA programs to be funded one year in advance to improve planning and avoid service disruptions in any future government shutdowns.
“As we saw earlier this month, in the event of a prolonged shutdown, VA would not have been able to issue disability compensation, pension payments, or education benefits,” said Senate Veterans’ Affairs Committee Chairman Bernie Sanders, I-VT, at a news conference on Wednesday. “That outcome would have been reprehensible."
Congress currently funds only the medical care portion of VA’s discretionary budget – about 86 percent of the total – one year in advance. VA hospitals and clinics continued operating without interruption during the 16-day partial government shutdown earlier this month but other VA programs and services, including claims processing, scaled back operations.
In Sanders view, the lack of casualty data could be mitigated through better collaboration between the Pentagon and Veterans Affairs, particularly by integrating electronic health records to provide real-time access to relevant military medical and personnel files. “It’s no secret that the exchange of personnel and medical records between the departments of Defense and Veterans Affairs has faced a number of challenges,” Sanders told IBTimes.
On Thursday, as this article was being prepared for publication, Sanders spokesman Michael Briggs offered a telling footnote. After being contacted by IBTimes, Briggs said, Sanders' office got in touch with VA, and the department "told us they're going to start putting up these numbers again soon. We raised the question with them, and they told that they will be forthcoming. The senator believes VA should be transparent about these numbers, and he now has assurances that they will be.”
It remains to be seen whether VA will follow through with the promised release, explain why the information was withheld in the first place, and clarify whether any plans or programs have been affected by the lapse.
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