Broad changes in vet care urged

WASHINGTON — The recommendations had just come out from a presidential commission on how to improve military health care when the White House began warning against quick action.

"In that report, there are a lot of things that the executive branch of government can do, the Veterans Administration, Department of Defense," President Bush said Wednesday.

Yet his spokesman said to expect delays as the ideas are reviewed, pondered and integrated into other efforts under way by the administration.

Bush ordered Defense Secretary Robert Gates and outgoing VA Secretary Jim Nicholson — who abruptly announced last week that he would step down by Oct. 1 — to take a look "so that we can say with certainty that any soldier who has been hurt will get the best possible care and treatment that this government can offer."

He declined to set a timeline.

After three months of investigation, the nine-member presidential panel led by former Sen. Bob Dole, R-Kan., and Donna Shalala, health and human services secretary in the Clinton administration, urged broad changes to veterans' care.

They include better benefits for family members helping the wounded; creating an easy-to-use Web site for medical records; and overhauling the way disability pay is awarded.

The 29-page report recommended stronger ties between the Pentagon and the private sector to improve treatment for traumatic brain injury and post-traumatic stress disorder.

The commission presented its report to Bush in the Oval Office. Earlier Wednesday, the Senate addressed some of the issues by passing legislation that would expand brain screenings, reduce red tape and raise military pay.

Shalala said about six of the 35 proposals require legislation. The rest suggest, primarily by the Pentagon and the VA. The expected cost for all the recommendations is about $500 million each year; added costs could push that total to $1 billion in later years.

The report offered an indirect rebuke of the VA: It urged Congress to "enable all veterans who have been deployed in Afghanistan and Iraq who need post-traumatic stress disorder care to receive it from the VA."

Only recently has the VA acted to add mental health counselors and 24-hour suicide prevention services at all facilities, after high-profile incidents of veterans who committed suicide. In the past, the VA had failed to use all the money for mental health that was allotted to it.

"Making the significant improvements we recommend requires a sense of urgency and strong leadership," the report read. "The experiences of these young men and women have highlighted the need for fundamental changes in care management and the disability system."