Walter Reed and the Limits and Dangers of a Bipartisan Commission

In the wake of loads of negative press, three (and counting) Congressional hearings and now the announcement of a bipartisan commission to investigate active duty and VA health care, the chances of coming to a resolution and a getting any real changes implemented have now dropped to near zero. Of course something needs to be done and probably something will be done, but in all likelihood, that solution will be temporary or cosmetic.

Make no mistake, providing proper health care is not at issue with Walter Reed, no one has argued that the level of care at Walter Reed is substandard, indeed it is in all likelihood quite cutting edge. Rather, what is at issue is the quality of housing for outpatient care. But the current press line is "Bush said Friday that he was forming the commission to carry out a "comprehensive review" of care for the nation's war wounded." But the scope of the Commission's task is to look beyond the housing at Walter Reed and perhaps other Army/military hospitals. By looking into the care at VA hospitals, which has long been decried as a bureaucratic nightmare, can lead to some very uncomfortable revelations for both the Bush Administration and previous administrations.

But looking solely at Walter Reed, here is what I think will ultimately be found. The details may change or be a little different but this will likely be the story. Some time in the past, it was determined by the Army that houseing for outpatient soldiers at Walter Reed was in short supply, but the base, which is already crowded, lacked space to build new outpatient housing. The determination was made to acquire a facility outside the based, in this case a former hotel.

Walter Reed Hospital is not in the tony part of Washington, DC. It is not in Georgetown, Downtown or in some other fancy part of town, but in a part of Washington DC that can best be described as depressed, if not blighted. The hotel the Army acquired, therefore, is not some top of the line Marriott or even a mid-priced Motel 6, but probably a nearly abandoned hotel the owner had neglected to maintain and was all to happy to sell to the Army. Once purchased the Army probably needed to repair and upgrade teh facility, but lacked the funds to do so. So some cosmetic changes were made to the facility, but over time, the Army lacked funds to truly modernize the building.

Now the fact that Army personnel sometimes live in marginal or even very old buildings is not particularly new. Military facilities tend to be older and remain in service long past the time when the general public would consider the facility ancient. But this hotel, at the time of purchase, was probably considered on par with other facilities. But the difference is this hotel was being used to house wounded/sick soldiers and needed to be in better condition.

Giving the Army the benefit of the doubt, it is likely that they requested funds to be appropriated to upgrade the hotel/barracks. But somewhere along the line one of two things happenened. The appropriations request was either killed by the Pentagon (and woe unto the Administration that did so) or the appropriation was killed by Congress (and woe unto the Congress that did so). In either case, blame for the failure to upgrade the facility will be appropriately placed in some place other than the Army.

Now that the President is forming a Commission, it probably won't take long, even in bureaucratic time, to discover any paper trail regarding the upgrade/maintenance of the outpatient barracks. But the Commission is hampered by both time, fiscal and ultimately political constraints. Such a commission takes time to build and commence an investigation, then the Commission has to take testimony and that testimony is going to be tainted by a desire of both political parties to avoid the ultimate blame. After all the information is accumulated, then the Commission must write a report and make recommendations. At each stage, decisions will have to be made to determine what lines of investigation to pursue, what witnesses to call, and what conclusions and recommendations are to be included. The result is that America still won't have a good idea of what went wrong and what ultimately should be done to fix the problem. The worst part is that the Commission will take at minimum a year to do its job and could take two, pushing the decision well into an election year, when the political firestorm will make the Sun look cool.

Thus the very "benefit" of a bipartisan commission, that it is supposedly "free" or above politics is an utter lie. If the Bush Administration and Congress were serious about actually fixing the problem at Walter Reed, the quickest solution would be to appoint some general, tell him to get bids on fixing the place and then pick a bid and get the work done. The bipartisan commisison will give the GOP and Democratic Administrations going back decades the political cover for bureaucratic failings. In the end, the answer will lie not with particuarly leadership or lack thereof, but rather with the bureaucratic beast, which feeds itself and cares for itself.

But the bipartisan commission will not conclude with what the real answer is--that government run health care sucks. Looking strictly into the Walter Reed mess doesn't require a bipartisan commission, but looking into the VA will find out the basic truth, that if left to its own devices, a bureaucracy is largely incapable of a quick decision and largely resistent to change.

In the end, the outpatient barracks will be finally upgraded to what should have been done years ago. But the real cause--buraucratic inertia, will not be blamed.