The Obfuscation Report

Injured Troops Struggle to Get Health Care

by Joseph Shapiro

All Things Considered, April 20, 2007 · When service members are forced to leave the military by war injuries or illness, they face a complex system for getting health and disability benefits. Sometimes, health care gets cut off when new veterans find they need it most. Some retired soldiers and their families say they are worried that the Pentagon won't spend enough money to give the injured the care they deserve.

'10 Percent Disabled'

Tim Ngo almost died in a grenade attack in Iraq. He sustained a serious head injury; surgeons had to cut out part of his skull. At Walter Reed Army Medical Center in Washington, D.C., he learned to walk and talk again.

When he got back home to Minnesota, he wore a white plastic helmet to protect the thinned-out patches of his skull. People on the street snickered, so Ngo's mother took a black marker and wrote on the helmet: U.S. ARMY, BACK FROM IRAQ. On this much, everyone agrees.

But here is the part that is in dispute: The Army says Tim Ngo is only 10 percent disabled.

"I was hoping I would get at least 50 or 60 or 70 percent," Ngo says. "But they said, 'Yeah, you're only going to get 10 percent'... And I was pretty outraged."

When a service member is retired for medical reasons, the military's disability rating makes a difference. If Ngo had been rated 30 percent disabled or higher, he would have gotten a monthly disability check instead of a small severance check. He also would have stayed in the military's health-care system.

Instead, Ngo enrolled with the Department of Veterans Affairs. Typically, there's a waiting period for the VA.

In October, while he was uninsured, Ngo had a seizure, caused by his war injury. He remembers being outside and blacking out; he fell to the ground on the driveway.

"My girlfriend was freaking out because she didn't know what to do," Ngo says. "She didn't know if I was going to die because I had hit the wrong side of my head."

An ambulance took Ngo to the nearest emergency room for treatment. It cost him $10,000. Ngo says that today, the bills for the incident are still unresolved.

Shrinking Numbers

Since that day, Ngo has gotten health coverage through the VA. Earlier this month, the VA said it would pick up his leftover bills from the emergency room.

The VA has been more generous than the Army all around. It rated Ngo as 100 percent disabled compared with the Army's 10 percent rating.

The VA gives him a monthly disability check, which helps with his finances; his head injury and post-traumatic stress disorder have prevented Ngo from holding on to even a simple job since he returned home.

Ngo's mother, Hong Wyberg, says the Army gives soldiers such as her son low disability ratings to save money.

"I don't fully think they were prepared for the length of time this war is going to last," Wyberg says. "They had no idea of how many injuries or the type of injuries that were going to come out of this."

Michael Parker retired from the Army in October, and he thinks Wyberg's suspicion is correct.

"The more I looked into it, I realized that this system does not have the soldier's back at all," says Parker.

Parker was a lieutenant colonel when he retired last year. Today, he has a disabling condition similar to rheumatoid arthritis. Parker was able to get the Pentagon's lifelong health coverage for himself and his family; he had been in the military long enough — for at least 20 years.

But Parker saw that a lot of other soldiers weren't as lucky, and it inspired him to become an advocate.

"I started posting questions and concerns and opinions on various blogs," he says, "and it just kind of mushroomed from there."

Parker started digging through Pentagon data, and the numbers he found shocked him. He learned that the Pentagon is giving fewer veterans disability benefits today than it was before the Iraq war — despite the fact that thousands of soldiers are leaving the military with serious injuries.

"It went from 102,000 and change in 2001... and now it's down to 89,500," says Parker. "It's counterintuitive. Why are the number of disability retirees shrinking during wartime?"

A 'Cost-Saving Device'?

Retired Army Lt. Gen. James Terry Scott heads a commission, set up by Congress, to study veterans' disability benefits. At a Senate hearing last week, Scott said that his commission had compared the way the Pentagon and the VA rated the same soldiers.

"The Department of Defense records were matched with VA records on 2.6 million veterans receiving disability compensation," Scott said. "Those rated zero, 10 or 20 percent [disabled] by the Department of Defense were rated in the 30 to 100 percent range by VA more than half the time."

In other words, troops often get small disability checks and no military health care when rated by the Pentagon's disability boards. But when they go to a VA board — with the same injuries — they get much more.

Scott said one reason is that the military's ratings determine whether a person is fit for duty, whereas the VA looks at all conditions that create health problems for a veteran. So the VA ends up rating more disabilities per retired service member.

But Scott said another reason may be that the Pentagon wants to keep down its costs.

"It is also apparent that the Department of Defense has a strong incentive to rate less than 30 percent, so that only severance pay is awarded," Scott said.

These numbers yielded some tough questions for Pentagon officials at the Senate hearing, such as Deputy Defense Secretary Gordon England.

"How do you respond to [the] assertion [that] the Department of Defense reduces disability ratings as a cost-savings device?" asked Sen. James Inhofe (R-OK).

"I can tell you... there's no incentive to do that, senator," England replied. "I mean, maybe that's read into that. But I can tell you, we try to treat people fairly and accurately. And so there's certainly no incentive."

Pentagon officials conceded that the disability system doesn't work as well as it should. They admitted it is too bureaucratic and too often adversarial. They said they would listen to suggestions for change.

Navigating the System

But change in the future will come too late for many soldiers.

April Croft was serving in Afghanistan when she was diagnosed with leukemia. She was treated for a year at Walter Reed. The cancer seemed to go into remission and she was sent home.

"They told her that she was only eligible for a 10 percent rating with the illness of leukemia," says her husband, Mark Croft. "She was livid. She's actually contested that situation about three times already."

The Army never increased its 10 percent rating, but the VA rated her 100 percent disabled.

Croft spoke from his wife's room in a VA hospital in Seattle, where she recently underwent a bone-marrow transplant.

"The VA originally gave her 50 percent and upped it to 100 percent once... she got sicker," Mark Croft explains.

The VA provided the life-saving operation April Croft needed, but the low rating from the Army still mattered: The VA only covers veterans, not their families. It is the military health-care system that will insure an entire family — but only if the vet has a disability rating of 30 percent or more. April Croft has two young children, who are living with their grandparents in California.

Her kids eventually did get military health care — but only recently, after their mother married Mark, who is still in the Army. Mark and April wed in Reno in March. Afterward, he was given leave from the Army. Instead of taking off for a honeymoon, the newlywed couple drove to Seattle and checked into the hospital.

It's the kind of complicated arrangement that many veterans must make to navigate the military's complicated disability system

Labels: bullshit, Bush Administration, support the troops

How a Three-Word Mantra Has Undermined America

By Zbigniew Brzezinski
Sunday, March 25, 2007; B01

The "war on terror" has created a culture of fear in America. The Bush administration's elevation of these three words into a national mantra since the horrific events of 9/11 has had a pernicious impact on American democracy, on America's psyche and on U.S. standing in the world. Using this phrase has actually undermined our ability to effectively confront the real challenges we face from fanatics who may use terrorism against us.

The damage these three words have done -- a classic self-inflicted wound -- is infinitely greater than any wild dreams entertained by the fanatical perpetrators of the 9/11 attacks when they were plotting against us in distant Afghan caves. The phrase itself is meaningless. It defines neither a geographic context nor our presumed enemies. Terrorism is not an enemy but a technique of warfare -- political intimidation through the killing of unarmed non-combatants.

But the little secret here may be that the vagueness of the phrase was deliberately (or instinctively) calculated by its sponsors. Constant reference to a "war on terror" did accomplish one major objective: It stimulated the emergence of a culture of fear. Fear obscures reason, intensifies emotions and makes it easier for demagogic politicians to mobilize the public on behalf of the policies they want to pursue. The war of choice in Iraq could never have gained the congressional support it got without the psychological linkage between the shock of 9/11 and the postulated existence of Iraqi weapons of mass destruction. Support for President Bush in the 2004 elections was also mobilized in part by the notion that "a nation at war" does not change its commander in chief in midstream. The sense of a pervasive but otherwise imprecise danger was thus channeled in a politically expedient direction by the mobilizing appeal of being "at war."

To justify the "war on terror," the administration has lately crafted a false historical narrative that could even become a self-fulfilling prophecy. By claiming that its war is similar to earlier U.S. struggles against Nazism and then Stalinism (while ignoring the fact that both Nazi Germany and Soviet Russia were first-rate military powers, a status al-Qaeda neither has nor can achieve), the administration could be preparing the case for war with Iran. Such war would then plunge America into a protracted conflict spanning Iraq, Iran, Afghanistan and perhaps also Pakistan.

The culture of fear is like a genie that has been let out of its bottle. It acquires a life of its own -- and can become demoralizing. America today is not the self-confident and determined nation that responded to Pearl Harbor; nor is it the America that heard from its leader, at another moment of crisis, the powerful words "the only thing we have to fear is fear itself"; nor is it the calm America that waged the Cold War with quiet persistence despite the knowledge that a real war could be initiated abruptly within minutes and prompt the death of 100 million Americans within just a few hours. We are now divided, uncertain and potentially very susceptible to panic in the event of another terrorist act in the United States itself.

That is the result of five years of almost continuous national brainwashing on the subject of terror, quite unlike the more muted reactions of several other nations (Britain, Spain, Italy, Germany, Japan, to mention just a few) that also have suffered painful terrorist acts. In his latest justification for his war in Iraq, President Bush even claims absurdly that he has to continue waging it lest al-Qaeda cross the Atlantic to launch a war of terror here in the United States.

Such fear-mongering, reinforced by security entrepreneurs, the mass media and the entertainment industry, generates its own momentum. The terror entrepreneurs, usually described as experts on terrorism, are necessarily engaged in competition to justify their existence. Hence their task is to convince the public that it faces new threats. That puts a premium on the presentation of credible scenarios of ever-more-horrifying acts of violence, sometimes even with blueprints for their implementation.

That America has become insecure and more paranoid is hardly debatable. A recent study reported that in 2003, Congress identified 160 sites as potentially important national targets for would-be terrorists. With lobbyists weighing in, by the end of that year the list had grown to 1,849; by the end of 2004, to 28,360; by 2005, to 77,769. The national database of possible targets now has some 300,000 items in it, including the Sears Tower in Chicago and an Illinois Apple and Pork Festival.

Just last week, here in Washington, on my way to visit a journalistic office, I had to pass through one of the absurd "security checks" that have proliferated in almost all the privately owned office buildings in this capital -- and in New York City. A uniformed guard required me to fill out a form, show an I.D. and in this case explain in writing the purpose of my visit. Would a visiting terrorist indicate in writing that the purpose is "to blow up the building"? Would the guard be able to arrest such a self-confessing, would-be suicide bomber? To make matters more absurd, large department stores, with their crowds of shoppers, do not have any comparable procedures. Nor do concert halls or movie theaters. Yet such "security" procedures have become routine, wasting hundreds of millions of dollars and further contributing to a siege mentality.

Government at every level has stimulated the paranoia. Consider, for example, the electronic billboards over interstate highways urging motorists to "Report Suspicious Activity" (drivers in turbans?). Some mass media have made their own contribution. The cable channels and some print media have found that horror scenarios attract audiences, while terror "experts" as "consultants" provide authenticity for the apocalyptic visions fed to the American public. Hence the proliferation of programs with bearded "terrorists" as the central villains. Their general effect is to reinforce the sense of the unknown but lurking danger that is said to increasingly threaten the lives of all Americans.

The entertainment industry has also jumped into the act. Hence the TV serials and films in which the evil characters have recognizable Arab features, sometimes highlighted by religious gestures, that exploit public anxiety and stimulate Islamophobia. Arab facial stereotypes, particularly in newspaper cartoons, have at times been rendered in a manner sadly reminiscent of the Nazi anti-Semitic campaigns. Lately, even some college student organizations have become involved in such propagation, apparently oblivious to the menacing connection between the stimulation of racial and religious hatreds and the unleashing of the unprecedented crimes of the Holocaust.

The atmosphere generated by the "war on terror" has encouraged legal and political harassment of Arab Americans (generally loyal Americans) for conduct that has not been unique to them. A case in point is the reported harassment of the Council on American-Islamic Relations (CAIR) for its attempts to emulate, not very successfully, the American Israel Public Affairs Committee (AIPAC). Some House Republicans recently described CAIR members as "terrorist apologists" who should not be allowed to use a Capitol meeting room for a panel discussion.

Social discrimination, for example toward Muslim air travelers, has also been its unintended byproduct. Not surprisingly, animus toward the United States even among Muslims otherwise not particularly concerned with the Middle East has intensified, while America's reputation as a leader in fostering constructive interracial and interreligious relations has suffered egregiously.

The record is even more troubling in the general area of civil rights. The culture of fear has bred intolerance, suspicion of foreigners and the adoption of legal procedures that undermine fundamental notions of justice. Innocent until proven guilty has been diluted if not undone, with some -- even U.S. citizens -- incarcerated for lengthy periods of time without effective and prompt access to due process. There is no known, hard evidence that such excess has prevented significant acts of terrorism, and convictions for would-be terrorists of any kind have been few and far between. Someday Americans will be as ashamed of this record as they now have become of the earlier instances in U.S. history of panic by the many prompting intolerance against the few.

In the meantime, the "war on terror" has gravely damaged the United States internationally. For Muslims, the similarity between the rough treatment of Iraqi civilians by the U.S. military and of the Palestinians by the Israelis has prompted a widespread sense of hostility toward the United States in general. It's not the "war on terror" that angers Muslims watching the news on television, it's the victimization of Arab civilians. And the resentment is not limited to Muslims. A recent BBC poll of 28,000 people in 27 countries that sought respondents' assessments of the role of states in international affairs resulted in Israel, Iran and the United States being rated (in that order) as the states with "the most negative influence on the world." Alas, for some that is the new axis of evil!

The events of 9/11 could have resulted in a truly global solidarity against extremism and terrorism. A global alliance of moderates, including Muslim ones, engaged in a deliberate campaign both to extirpate the specific terrorist networks and to terminate the political conflicts that spawn terrorism would have been more productive than a demagogically proclaimed and largely solitary U.S. "war on terror" against "Islamo-fascism." Only a confidently determined and reasonable America can promote genuine international security which then leaves no political space for terrorism.

Where is the U.S. leader ready to say, "Enough of this hysteria, stop this paranoia"? Even in the face of future terrorist attacks, the likelihood of which cannot be denied, let us show some sense. Let us be true to our traditions.

Zbigniew Brzezinski, national security adviser to President Jimmy Carter, is the author most recently of "Second Chance: Three Presidents and the Crisis of American Superpower" (Basic Books).

Labels: bullshit, War on Terror