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Charles M. Sennott chat transcript

Charles M. Sennott chatted with Boston.com readers about his series "A Promise to Keep," which investigates the lack of care soldiers returning from Iraq and Afghanistan receive.
Charles M. SennottThis is Charles Sennott of The Boston Globe here to try to answer questions about our series of reports on the Department of Veterans Affairs titled: "Straining to Keep a Promise."
Charles M. SennottThe series focused in on how the VA failed to plan for increased capacity that would be needed to handle health care and disability claims for returning veterans of the wars in Iraq and Afghanistan.
Charles M. SennottLooking forward to your questions.
Charles M. SennottCS
howie Do you think the Walter Reed fallout will lead to better care among vets?
Charles M. SennottYes, I think the story highlighted problems in delivery of medical treatment to veterans and the response has been immediate and profound. That's a good thing for veterans. But I would also point out that the issues raised by the Washington Post were actually first reported in Salon.com in 2005. Walter Reed is the crown jewel of military hospitals and it is not run by the VA. The Washington Post story stands as a very important piece of journalism, but the issues -- and the strain on the system -- go far beyond the one building No. 18 that the Washington Post highlighted. The VA and veterans in need of treatment are struggling with a much deeper systemic failure to plan to provide care for the 1.5 million veterans of Iraq and Afghanistan. Many tens of thousands are returning home with complex physical and mental wounds and will need long term care and disability payments which the VA is straining to provide. The bigger question we tried to raise in our series is: Why didn't the Bush administration plan for this strain on the VA system?
Big_D Hi Charles, love the work you've been doing to bring this important issue to light. How did the people in your stories react to the latest news at the Walter Reed Medical Center? Do they feel vindicated?
Charles M. SennottI think the veterans we have been speaking to for months across the country and all over New England feel relieved that the country is finally taking notice. There is some sense of vindication for researchers, particularly Harvard's Linda Bilmes. Her excellent research highlighting the hidden long term costs of providing for veterans ($400 to $700 billion over the next generation) was questioned by the VA. But now it is clear it is standing up as was evidenced by her testimony before congress yesterday.
Stephen I'm a Vietnam Vet, I understant the VA hospitals now give better care than the private sector. Isn't it confusing to talk about returning soldiers as veterans because they are still in the military and have a different health care system?
Charles M. SennottYes, you touch on a very important issue: when does a soldier become a veteran? For soldiers who are returning with disabilities many are being held at "medical hold" facilities on military bases. But particularly reservists are ending up thrust into the VA system and left to navigate their care through a thicket of bureaucracy.
unknown_soldier Are there any donations or agencies or any other way for me to help the hurt soldiers who aren't getting the care they deserve?
Charles M. SennottThere are many advocacy groups forming for veterans. And there are also many support networks for families of veterans. For everyone in on this chat, I would suggest you visit the website the Globe has set up (www.boston.com/veterans) where there are some links to veterans' groups there and research as well as our stories and multi media presentations.
Stephen Isn't the VA delivering better care than the private sector? Isn't it clouding things to call wounded active duty soldiers vets?
Charles M. SennottThe VA delivers excellent care to many people every day. They have been praised by Harvard Business School and Business Week as one of the best health care providers in the country. But as WWII veterans age and more people are without health care, the demands on VA services are rising. And they are rising just as a surge of Iraq and Afghanistan veterans are coming home in need of treatment. These forces are conspiring to strain the VA system in a way that critics say could have been avoided if the VA had planned ahead and predicted the strain. The VA secretary Nicholson profoundly disagrees and believes the system has adequate funding. But again the veterans we are speaking with disagree with Nicholson's optimistic assessment.
po_boy Is poor treatment of vets indicative of a larger problems with the US military
Charles M. SennottWell, it is an interesting question to ponder. The US for the first time in its modern history is undertaking two wars with an all volunteer army. That puts a strain on the soldiers, their families and the military. If they want to keep the soldiers in the military and inspire new recruits, they will have to live up to the promise that the country makes to care for its wounded. We have heard many military families express their outrage and disappointment that the VA did not provide adequate services for their sons and daughters. And one could wonder how that will affect the families making these extraorddinary sacrifices? Will they do so in the future? The father of Minnesota veteran Jonathan Schulze, who took his own life after waiting for help from the VA, was himself a Vietnam veteran. His other living son is a Marine who served in Afghanistan. They have a large extended family with a history of service. But that father, Jim Schulze, who lost his son is now furious at the military and at the VA for failing to be there when his son needed the support those institutions are supposed to provide.
po_boy If these mental issues are so complex, isn't it likely that soldiers from every previous war suffered from them as well?
Charles M. SennottPTSD, or post traumatic stress disorder, is as old as warfare itself. It was defined as a clinical term in the 1980s. But the idea of soldiers suffering mental anguish upon returning from war dates back to Achilles. For American veterans, it stretches through the American civil war, WWI, WWII, and, of course, Vietnam. It's been called different things, including "battle fatigue" and "Vietnam syndrome." But the suffering by veterans is similar. The difference now is that researchers understand it better than they did before and are coming up with advanced methodologies for treatment.... I might also add, however, that there are unique aspects of the war in Iraq against an insurgency using terrorist tactics which has yielded what some researchers believe is a higher number of mental wounds than in some previous wars.
jose_can_u_see Has modern medicine caught up with the serious mental and physical conditions injured soldiers face?
Charles M. SennottIt hasn't completely caught up, but advances in treatment for physical and mental wounds are extraordinary. The advances in combat trauma care certainly contribute to the fact that the killed-to-wounded ratio is higher in Iraq than it has even been in the history of military conflict for America. The ratio is 1:16, that is one soldier killed for every 16 wounded. That is a much higher ratio of wounded than WWII and Vietnam...
original_fire Aren't these VA problems just a microcosm of America's faulty healthcare system in general?
Charles M. SennottGood question. The VA system is almost a form of nationalized medicine for veterans. I think those who work within it would say the VA is strained by the fact that so many veterans no longer have jobs that provide them with private healthcare. That has meant more veterans without health care are seeking more help from the VA than they ever did in the past. The VA is also increasingly foisting familiar things like "copayments" on veterans, a restriction of services that all of us who have private health care know all too well. So I hope it is not splitting hairs to suggest that the VA problems are a reflection -- not necessarily a microcosm -- of problems within the wider American health care system.
Ray9704 I am interested in receiving cognitive therapy from the VA. I have a TBI with post-concusive syndrome from a bad car accident.
Charles M. SennottThe key question here is: are you a veteran? The VA is for veterans. I do not know if they accept private patients, but certainly the VA has some of the world's greatest experts on TBI ... You might want to visit the VA website and see if you can find an answer to that question.
Stephen Those groups should use their resources to pressure government to fix the system rather than to try to help injured servicemen directly. The latter approach eases the pressure, supports the status quo and lets officials "off the hook" doesn't it?
Charles M. SennottI can understand -- and respect -- your word of caution in this regard. The private groups who want to help veterans are doing so to express their gratitude for the sacrifices soldiers make for our country. That is a great thing. But you are correct in pointing out that it should in now way relieve the federal government of its responsibility to live up to the promise that was first spoken by Abraham Lincoln and that is etched in bronze at the entrance to the VA in Washington: "To care for him who shall have borne the battle."
Charles M. SennottI am signing off. Thanks for your questions and please keep them coming on our web page at boston.com (boston.com/veterans) If you go to this page, there is a place to post comments (publicly and privately.) We are particularly interested in hearing the points of view of veterans who may have stories to share about the VA and about the process of returning home. At this page (boston.com/veterans) you can also read our stories and watch multi media presentations of veterans' lives. So, please, let's keep the conversation going. CS

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