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March 05, 2007

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"charging wounded veterans for their meals"

[bitter comment deleted - wit seems petty]

So the new Sec State can fire a few Army Generals and make things right...on account of Rummy being too busy to make them right before?
And the press or media that is not able to discover this story? How many soldiers put up with this treatment for how long?
Can we have an interview with Rummy on a major media network about this?
Not likely.

Anyone dying in that "care" is probably considered a "saving". [more food! vomiting on an empty stomach hurts]

charging wounded veterans for their meals

Just a note this is how it has always been. It is how the military deals with the meal issue for any member that is hospitalized and it was this way, when my husband was in the military during the 1990's.

My husband had outpatient surgery and was charged for two meals he "might" have eaten while he was in surgery, but didn't eat or even have delivered to him.

The military does screwy things, but not everything it does is some machiniation of Bush or his administration.

I always thought the charging for meals while in the hospital was a dumb thing in the 1990's, but I didn't think Bill Clinton personally designed and approved the policy.

justme, not that I'm an expert in anything military (dammit, why did Andrew have to leave us?) but my understanding is that there was a rule change under the Bush administration:

From the Army's perspective, the meal charges follow Army rules that are supposed to prohibit soldiers from getting free food as well as a separate food budget. But the only soldiers prohibited from getting both, under the new rules, are the long-term outpatients. "If they get [the cash each month] they would be expected to pay for their meals," said Vandrey, the Walter Reed spokesman. He said the hospital was "really cracking down on soldiers who are getting both."

But here's how the new rules drain hundreds of dollars a month from the pockets of soldiers: Enlisted soldiers get an extra $267.18 every month in their paychecks for food. So before this month, all soldiers at Walter Reed got free food at the chow hall and extra cash. Soldiers say they received that extra food money while they were serving in Iraq, too, and they just let their families spend it on groceries. Now, though, the outpatient soldiers forced to buy meals at Walter Reed say they could spend around $15 a day if they eat three square meals at the dining hall -- about $3 for breakfast and around $6 each for lunch and dinner. That adds up to $450 a month, $183 more than soldiers' food allowance from the military. (The situation is even worse for officers, who get only $183.99 extra each month for a food allowance.) The soldiers at Walter Reed point out that that they don't have the option of eating at home to save money because they are stuck at the hospital. (Article at Salon.com, 2005)

The follow up story in Salon.com explains the charging and mentions a proposed amendment by Senator Obama that would cap the costs of meals to the subsistence allowance.

To summarize: apparently where the army isn't providing free food, enlisted soldiers get a subsistence allowance, and the mess hall meal prices are capped so that an enlisted soldier who eats all her meals in the mess hall will pay out each month to the army just about what she get paid in subsistence allowance. The problem at Walter Reed and other VA hospitals was that the mess hall prices hadn't been capped to match the enlisted soldier's subsistence allowance, and Obama's amendment was supposed to fix that. Did it?

As this story continues, if it does continue to be front and center, I'd ask everyone to keep in mind that the biggest ongoing outrage is not mold on the walls but the mold in the system: the structural incentives for the military to downgrade disability percentages for vets with brain and mental injuries, the severe shortage of effective advocates or accompaniment for them as they negotiate the mil-med bureaucracy, and the shortages of adequate care available to them throughout the country over the long haul.

This administration has been unwilling to face, or to provide accurate information so that others could face, the true cost of the wars we're in.

One example, small but symbolic of the childish, ostrich-like denial typical of this regime's approach to the unpleasant consequences of its own policies: The recent removal of "non-hostile" injuries from the Pentagon's injury website, after researcher Linda Bilmes used their data to project Iraq and Afghan vets' healthcare costs.

What makes this a particular shame is that in the Clinton years, veterans’ health care — like the Federal Emergency Management Agency — became a shining example of how good leadership can revitalize a troubled government program.

Just another example of that stellar policy by the Bush administration -- if Clinton did it, it must be bad.

As has been pointed out in many recent threads, this is NOT about incompetence. The train wreck is the direct result of intentional policies which, even after the revelations of Katrina and VA hospitals, will not change. Privitization and cronyism remain the rule of the day with this crowd since the payoff, in their view, is apparently still greater than the embarrassment of these episodes.

Its not a bug, but a feature.

Great post, hil.

Re Katrina, and at the risk of reducing you to an even tinier molten ball of fury, did you see this quote from Newt Gingrich, speaking at CPAC?

How can you have the mess we have in New Orleans, and not have had deep investigations of the federal government, the state government, the city government, and the failure of citizenship in the Ninth Ward, where 22,000 people were so uneducated and so unprepared, they literally couldn't get out of the way of a hurricane.

From Blog for Our Future. I have been in Total Anger Mode since reading it yesterday. Read the full post
here

Privitization and cronyism remain the rule of the day with this crowd since the payoff, in their view, is apparently still greater than the embarrassment of these episodes.

Bingo. Until someone hits them in their wallets nothing will change.

As has been pointed out in many recent threads, this is NOT about incompetence.

Yes. As a reader of Josh Marshall's blog pointed out yesterday, nobody labeled the Coolidge Administration's failure to help the victims of the 1927 Mississippi River flood as "incompetence". It was the result of an intentional policy.

The problem for those administrations was that if you tell people "we're not going to help you because we don't want to," then you'll get voted out of office. If you chalk up the failures to incompetence, however, you can not only avoid getting blamed by the voters, but you can shift the blame onto the very concept of government and use that as a justification for undermining the public sector even further, ad infinitum.

Conservatives haven't changed their goals in the past 80 years. They've just changed their tactics. The explanation for all the disasters that have occurred over the past six years isn't incompetence, it's malice.

As my usual, some scatter-shot observations:

OCSteve has in the past observed that VA care is sorely lacking and even execrable. I have heard anecdotal evidence supporting that claim, especially in the eastern U.S.

He attributed this to, well, gummint, which may have some validity.

I counter this observation with my own personal anecdote about my father-in-law, who flew 32 missions over Europe in WWII and died in the late 1990s, after a lengthy decline from Alzheimers, in a new, well-run, VA hospital in Rifle, Colorado.

It was gummint: efficient, clean, caring, state-of-the-art. No one who worked there that I encountered seemed to use the fact that they were employed by the Federal government as incentive to f--k up. Nor were they understaffed, though I realize that having patients wait for hours to have their diapers changed may be a sign of efficiency by bean-counters, public and private.

Yes, there was high turnover, which you will find in stressful, heartbreaking Alzheimers units everywhere. I have heard rumors since 2000 that there are problems now at that facility. The coincidental factor seems to be pressure to outsource, cut staff, save money ...., you know, the usual litany of measures that need to be taken during times of scarce resources, (otherwise know as all the time by Republican administrations) when the economy is booming and tax revenues are flooding in (otherwise know as all of the time by Republican AND Democratic administrations). There's a graph on a napkin somewhere that explains all of it.

I will relate these two anecdotes as well, from the world of private medical care: Briefly, my sister died last year of complications from diabetes, six weeks after being admitted to a private hospital, though she was on Medicare, to have a leg removed. She was blind and had been on kidney dialysis for years.

Look, the situation was horrific, but my 78-year-old mother and my sister could have done without the various humiliations provided by private institutions as well, including being moved repeatedly to different rooms with no explanation, specialists (innumerable) prescribing conflicting drugs and procedures with no consultation or adequate explanation. And then came the infections, misdiagnosed, which killed her. (Yes, in a way, it was a blessing) Which you can pick up publically or privately; they don't discriminate according to ideology.

I should check the billings and see if she was charged for meals during her weeks of unconsciousness. After all, these things are profit-centers and you don't eat if you don't pay and it helps the bottom line if you pay and don't eat.

Several years ago, a brother suffered a nearly fatal heart attack. He was treated fairly well under the circumstances (after all, they saved his life) at a privately run, (ostensibly) hospital paid for by his his health insurance. Thing is, the pacemaker's electrical leads to various parts of his heart were reversed during surgery (by one of the country's top heart surgeons) and then my brother's employer fired him and stopped his health insurance. (The guy was a private contractor with only a few employees so he probably had no choice. I offer this for those who relish the hard, therapeutic truths of economic reality and feel we need more of it).

Much to the honor and horror of taxpayers and shareholders and their accountants, my brother is now on Medicare and will have his pacemaker replaced at a cost of $200,000 to the taxpayer and whatever different hospital he has found. His attorney told him he would probably be dead by the time he got the original surgeon to admit his malfeasance, let alone correct it. This surgeon, I guess, used the fact that he is in private practice as incentive to f--k up.

I've left out many details.

My conclusion is not particularly conclusive from all of this.

I can't help but think what is going on in the entire culture is related to the fact when I sit on an airplane now with my knees crammed up against the seat in front of me, the flight attendant, who I expect just learned that her or his medical and retirement benefits have been curtailed and new employees are being hired at some lesser percentage of what he or she is me making, hands me that tiny bag of peanuts, because corners needed to be cut.

Or when I call just about any institution now and need to negotiate a phone-tree to find a real human being to attend, unlike the inefficient days when my phone seemed to find that person immediately. But we needed to slash overhead to serve you better, or rather hide when you call and want to bother us with your petty needs.

See, I'm just a customer or an employee or a patient, one of the three commodities I walk around as during a normal day, as a means to an end for everyone else. I don't count, except as a means to profit the shareholders or to save money for the taxpayers, which I am also when I want to feel like someone who needs to have his assed kissed or to be demagogued about how my money is being stolen, so we need to cut costs, slash overhead, etc.

Let me show you the spreadsheets.

The President, whomever he or she is, can summon the limo at any time and show up at Walter Reed unannounced and walk the halls, kicking ass and making things happen. They don't (see how nonpartisan I am) because it would take time away from kissing the butts of the shareholders and demagoguing the taxpayers. Or, you know, being commander-in-chief with the rolled up socks shoved down the front of his pants.


I wonder what would happen if our wounded soldiers (who the Wall Street Journal editorial page and the neoconservatives have wanted sacrified so that we can feel noble and great in the cause of freedom) were allowed to keep their weapons and grenades and such when they returned stateside?

I doubt anyone would bill them for their meals.

See, I'm just a customer or an employee or a patient, one of the three commodities I walk around as during a normal day, as a means to an end for everyone else.

That may be the best thing you ever wrote.

Also, I'm sorry for your losses. My condolences.

That may be the best thing you ever wrote.

I would second that. Very moving, and angry-making. My only experience with the American healthcare system was a similar scenario.

Ancedotally speaking, of course.

So...If I'm in the U.S. military and not wounded I get fed for free; but if I'm wounded then I have to pay to get fed so I can heal.

Do I have it right?

The scandal is deeper than most people think on many levels.

Walter Reed is run by Americans, managed by Americans, funded by Americans, etc.; And it's a failure on a large scale.

The military is run by Americans, managed by Americans, funded by Americans, etc.; And it too is a failure on a large scale.

GOP says if private companies were running Walter Reed this scandal wouldn't have happened, and yet it is private companies that are causing the problems that are involved with Walter Reed.

Poor Americans.

Can't seem to do anything right any more; although they seem to be trying with a new Congress.


Well, thanks, but death happens, even though I'm completely against it.

I guess my point is that good management, supervision, and adequate staffing can happen or not happen in any venue, if a society wants it.

It's systemic. Generally speaking, despite the good works of many people, it's a loss of something, ethics perhaps, which perhaps never existed, but now even the possibility of is actively discouraged, unless there is some way to franchise it, grow it, skim it, please God with it, sell T-shirts and coffee mugs with your logos on it, and collect a fee and a tax deduction and a fee on the tax deduction and a tax deduction on the fee.

It's like when Osama Bin Laden and Dinesh D'Souza watch Maury Povich interview Anna Nicole. They seem to be having a great time, the four of them, but why can't a nurse answer a veterans buzzer within the hour?

I guess because the soldier forgot to sell advertising and make his wounds into limited partnerships. There's no upside, unlike there is for the savvy Osama, Dinesh, Maury, and Anna and their posses. They know their markets.

I see it every morning when I look in the mirror, so don't go taking it personally everyone.

John Thullen: OCSteve has in the past observed that VA care is sorely lacking and even execrable. I have heard anecdotal evidence supporting that claim, especially in the eastern U.S.
He attributed this to, well, gummint, which may have some validity.

I attributed it to experiences 20 years in the past, but yes I would say that the problems then were primarily of a bureaucratic nature. Several commenters reassured me that things had improved greatly over the years (I think you were one). I was happy to hear that.

This doesn’t bode well though:
Among the most aggrieved are veterans who have lived with the open secret of substandard, underfunded care in the 154 VA hospitals and hundreds of community health centers around the country.

This is depressing. This sounds more like the old VA I know and love (not). This sounds like its business as usual and nothing has changed in 20 years. If I try to reconcile that with your more positive experience all I can assume is that the quality must be inconsistent at best.

Unfortunately I can’t argue with anyone who wants to lay the bulk of the responsibility for this situation at the feet of this administration and Republicans in general.

Things were not entirely rosy at the end of the Clinton administration. The words 'archaic, decrepit, and inefficient' where used to describe the VA's delivery system back in 1999 hearings.

The VA health care mission has never faced greater challenges than it does right now. Repeated budget reductions for many medical centers leads to extremely difficult management decisions and reduction in service.
As health care delivery evolves rapidly, the VA is caught up, appropriately, in the shift from in-hospital to ambulatory services. This cost-effective strategy, as well as those of consolidation, appropriate mission change, and realignment, comprise a centerpiece of the bold view and plan of Dr. Kizer to modernize the VA health care enterprise.
This rationalization of the operations of the VA health care system is hampered by aging facilities, mandates from above to keep facilities open and their staffing levels up even though their activities have drastically diminished.
Efforts to develop appropriate ambulatory sites of care are inhibited by an inability to free up funds sequestered in hospital budgets. Consolidation and integration of programs and facilities are blocked by constituents and their elected representatives who fear that integration of facilities and programs will impose hardships on the veteran community by requiring some veterans to travel longer distances for services.

So Bush didn’t actually inherit a well oiled machine. At the time it seemed clear that realignment and consolidation were critical. They were spending 1 out of every 4 dollars operating and maintaining ancient facilities, many of which were underutilized. But of course they did not know about the wars to come.

But then this administration went ahead with CARES in 2004. I don’t know how many of the recommended closures and consolidations recommended actually happened or what impact they had concerning the situation today. But eliminating any beds in the middle of two wars seems counterintuitive to say the least. Bush did increase their budget over his term (until this latest budget), but apparently not enough. I also recall claims that the increase was actually at the cost of cuts to the medical programs.

Congressional Republicans get plenty of blame. They blocked Democrat’s attempts to increase VA funding in mid 2005.

In 2003 - H.R.1720:
To authorize the Secretary of Veterans Affairs to carry out construction projects for the purpose of improving, renovating, establishing, and updating patient care facilities at Department of Veterans Affairs medical centers, and for other purposes.

It appears it died a quiet death in the Senate Committee on Veterans' Affairs after being unanimously voted out of the House. That would be my old buddy Arlen Specter.


But most recently:
Across the country, some military quarters for wounded outpatients are in bad shape, according to interviews, Government Accountability Office reports and transcripts of congressional testimony.

So Congress was already aware of this? I’m going to have to track down those hearings to determine what and when. But why did they do nothing until this exposure?

For years, politicians have received letters from veterans complaining of bad care across the country. Last week, Walter Reed was besieged by members of Congress who toured the hospital and Building 18 to gain first-hand knowledge of the conditions. Many of them have been visiting patients in the hospital for years, but now they are issuing news releases decrying the mistreatment of the wounded.

Again, why did they do nothing until this exposure? They get letters from veterans about it or even have first-hand knowledge of the conditions, but do nothing about it until now. Pathetic.

So...If I'm in the U.S. military and not wounded I get fed for free; but if I'm wounded then I have to pay to get fed so I can heal.

Do I have it right?

Not exactly.

It charges everyone for their meals. Soldiers are paid BAS on a monthly basis. Note that it is meant to offset the cost of meals. Is $280 per month too little? It’s based on what it costs to eat at the mess hall. If you live in the barracks, you are expected to take your meals at the mess hall and the Army essentially deducts that amount and gives you a meal card. If you are married and live off post you get the cash. If you then eat lunch at the mess hall you pay for it out of pocket. It is similar with the DOD hospital. As an inpatient you don’t pay for your meals in terms of pulling out your wallet – you just don’t get the BAS. As an outpatient, you get the BAS and if you eat at the hospital mess you pay cash for it.

As Jes pointed out, the real issue is that the mess hall at Walter Reed is charging far more than normal. I have no idea why that should be - 20 years ago the meal cost exactly the same in any mess hall in the country. I never heard of an individual mess hall charging differently than others. In any case, Obama’s amendment should have resolved it. The question is was it stripped from the final budget or does it not take effect for some time (or what)?

OCSteve:

That's all relevant stuff about bad stuff.

Thanks. There is more blame to go around than there is medical care. Luckily, we won't need to triage the blame. ;)

Just for the record, as a taxpayer I think soldiers should be provided room AND board, on my ticket, wounded or not. I can't think of a reason why they are charged at all for meals unless we as a Nation believe soldiers are captive, indentured employees, like mining companies treated their employees in the late 19th century.

Here's your check for $12 dollars. Now, that'll be three bucks for food, four bucks for the bunk, two bucks for bullets, and two bucks for breathing my oxygen. Thanks for your service.

You are wrong about one thing: it's always about the money. What else explains an entire chain of command deliberately under-serving fellow citizens and soldiers to boot?

I've added wrong. You received $12 dollars and I took back only $11.

You owe me a buck.

Typical Army paymaster.

Just for the record, as a taxpayer I think soldiers should be provided room AND board, on my ticket, wounded or not. I can't think of a reason why they are charged at all for meals unless we as a Nation believe soldiers are captive, indentured employees, like mining companies treated their employees in the late 19th century.

Absolutely – no disagreement. That is what happens in reality, I’m just not explaining it well.

Come at it from the other direction. Every soldier gets 3 hots a day period. They never have to pay a penny out of their base pay. This assumes that they eat in the mess hall for all meals. A soldier willing to do that will never spend a penny of their base pay on a meal.

Voluntarily, you can take “separate rations”. In that case the Army pays you the cash equivalent of a month’s worth of meals in the mess hall. This is extra pay, above and beyond your base pay. You take the cash value of the mess hall meals. That could be because you are married and prefer to eat at home with your family, or you could have permission to live off post for some other reason. Once you take that money you are on your own to provide your own meals. If you do eat in the mess hall you pay for the meal the same as if you had gone to McDonalds instead.

Now the separate rations ($280/month) obviously doesn’t cover a month’s worth of meals beyond the mess hall door. But it would not be fair to offer more than the cash value of what the soldier who eats in the mess hall for all meals is getting. It’s actually very fair and most people are grateful to have the option not to be stuck with the mess hall for all meals.

This case seems special in that the mess hall is charging a lot more than normal. I don’t know how or why they can do that. There is also the question of whether the soldiers have no option except separate rations for some reason. They should be able to forgo separate rations and eat all meals in the mess hall. At this point I’m wondering if it is truly a military mess hall or some other operation.

OCSteve: about the VA generally: Kevin Drum emailed the author of the Washington Monthly article about the VA that I linked to earlier, and posted his response. After pointing out that Walter Reed is not a VA hospital, he says:

"Look, the VA has its problems. Because the White House and Congress won't give it the funding to honor past promises to veterans, it now has to limit new enrollments to vets who have service-related illness or who can meet a strict means test. It's also having trouble ramping up to meet the needs of the unexpectedly large number of young vets diagnosed with mental illness. But despite these challenges, the fact remains that the VA enjoys the highest rate of consumer satisfaction of any American health care system, public or private.

And outside experts agree that the VA deserves this high rating from its patients. A RAND Corporation study published in the The Annals of Internal Medicine concludes that the VA outperforms all other sectors of American health care in 294 measures of quality. In awarding the VA a top prize in 2006 for innovation in government, Harvard's John F. Kennedy School of Government gushed that "While the costs of healthcare continue to soar for most Americans, the VA is reducing costs, reducing errors, and becoming the model for what modern health care management and delivery should look like.""

The thing is: he's right about all the awards etc. And these are not specifically liberal groups: RAND has a liberal reputation solely in virtue of not being a specifically conservative think tank, and the various medical groups are just, well, professional medical organizations, the same ones that spent most of their history bitterly fighting "socialized medicine".

If this were not the week from hell, I would go back over all the news stories about the VA specifically that I could find and over the various citations and studies, discard the complaints about not getting access (which I take to be a different problem from the quality of care at VA hospitals), and ask: are the big problems largely in some specific area? Offhand, they seem to involve outpatient care in which people are provided rooms to stay in, and some are specific to the Medhold program (or whatever it's called: where they keep you in the army while you recover), but I'd want to check that.

Then I'd ask: what percentage of patients are in those programs? Is it possible that the reason for the high ratings is that stuff is generally quite good, but these specific programs are really bad, but since most people either end up as inpatients or as (what you might call) REAL outpatients -- living at home and coming in for appointments -- that badness doesn't show up in a general survey? Is there some other explanation of this, besides all the studies being full of it?

I wish I had the time, but I don't. But that's where I'd look: at the study methodologies compared to the news accounts. One way or another, I suspect the reason for the disparity is lurking there, and if the studies give enough methodological detail, one could find it.

Googling around some – it is definitely a military dining facility. I still can’t figure out how they could charge differently than any other Army dining facility. It’s also weird that I see “average” cost per day mentioned in places. That would indicate that prices vary per meal which is also something I’ve never heard of. (A military dining hall has the same price for breakfast and the same price for lunch and dinner and it is that price every single day no matter what is being served or what you actually choose to eat.)

No inpatients are charged. It sounds like all outpatients get separate rations. They must not have the option to forgo separate rations and eat all meals at no out of pocket cost in the dining facility. Maybe it is something to do with that type of environment – given the mix of active duty, patients, civilian relatives, etc. they just don’t operate in the normal manner. Maybe in terms of rehabilitation they don’t want to tether them to the facility that way. I don’t know.

The controversy seems to stem from the fact that they allow them (outpatients) to eat free for 90 days. They only have to start paying after that. Ironically it seems to be a case of no good deed going unpunished.

In any case, while I think this is the least of the issues, I’m sure it will be addressed along with the others.

Got it.

That beats going to the ballpark, (I think) where you are searched for and have beer and cheetos confiscated on the way in for security reasons so that you can buy the $6 hot dogs and $7 beers inside from people making $5.25 an hour and watch Barry Bonds sit.

Happily, the Army hasn't been completely privatized.

Still, I think you owe me a buck if we count change like Moe Howard: you gave a ten and the price was two --- one, two, four, seven and 12 cents.

Hilzoy: I’d tend to agree with you that the issues with Walter Reed seem to be specific to the medical hold program. There are probably similar issues at other DoD hospitals – overwhelmed by the numbers and stuck with antiquated facilities.

I agree that the VA system is a whole different animal. I’d be curious to know what specifically led to that one line:

Among the most aggrieved are veterans who have lived with the open secret of substandard, underfunded care in the 154 VA hospitals and hundreds of community health centers around the country

I’m aware (now) of those studies and awards. I thought that most of the issues were related to access as well – but this reads as substandard medical care. I’d really like to know the basis for that. (Assuming its something beyond ‘reporter pulled it out of their arse'…)

OCSteve, it also sounds like you can be formally an "outpatient" at Walter Reed, yet still living on base. Which means you have no choice but to eat at the mess hall, but you have to pay for the meals there out of your pocket. (Thanks for the more detailed explanation about how subsistence pay/base pay works, btw.)

And that, honestly, sounds to me like what would happen if the mess hall at Walter Reed had been privatized - because I've worked places with a staff canteen. At one place, a big company with a couple of thousand staff, when I first started there, the canteen staff were directly employed by the company. The company had had a takeover only a couple of months before I joined.

A month or so after I started working there, it was announced that from now on, the canteen was going to be run by a new independent company. What had happened, we discovered from the gripevine, was that the new big company had outsourced the canteen - they'd decided they simply didn't want to be running a canteen as part of their business. All the canteen staff, who had been employees of the big company, were suddenly given the option of losing their jobs or changing their employer. Mostly they opted to change employer. Also, we got a new colourful sign on the wall that told us we were now eating at the Somethingorother Restaurant, and the other canteen down at the other end of the building was now the Otherorsomething Cafe. Also, the prices went up. From being a non-profitmaking benefit to staff - the canteen was expected not to make a loss, but was really run as a means of letting staff get a hot breakfast and lunch on the premises - suddenly, it was a profitmaking venture for someone. We provided the profits.

OCSteve: in my fantasies, journalists write in such a way that we don't have to be piecing this sort of thing together with tiny snippets of prose from here and there. In my even more fantastic fantasies, the actually link to their sources, when those sources are documents or studies.

In the year and a half that I've been blogging, I've gotten a lot better at finding stuff, but it annoys me when (for instance) I read that there was a vote in the house on issue X, and I have to go nosing around the web trying to figure out what was the bill, and what did it actually say, and who voted for it, when it would be so easy for them to just link to the roll call.

OCSteve: I really, really appreciate the effort you're putting into this. It's been a huge help to me in getting more overall perspective. Hilzoy, likewise for your research - it seems like you and Steve are goading each other on in a good way.

As Jes pointed out, the real issue is that the mess hall at Walter Reed is charging far more than normal. I have no idea why that should be - 20 years ago the meal cost exactly the same in any mess hall in the country. I never heard of an individual mess hall charging differently than others.

All mess halls charged the same when my husband was in the Navy in the 1990's.

Also, only the service member gets their meals paid for, not their families. When my husband went to sea, we lost the food allotment that was normally part of his check. When he was in port, the money was once again part of his check, and if he opted to eat his meals on the ship when he was working, he had to pay for them.

And like I said, when he had outpatient surgery, he was charged for two meals that he couldn't have eaten and weren't delivered to him, those meals were charged, simply because he was in the hospital at the times when those two meals would have been served. We complained and tried to fight it, but to no avail, the Navy hospital got to keep the money for those meals. That was in 1995.

Also, my husband was discharged due to disability in 1996 (it took about a year to proccess the paperwork to determine his disability and at that time the military was just as cruddy about downgrading the seriousness of the disabilities-that isn't anything new either, they just probably have a lot more applicants to the medical board), the VA care was never all that good, which is one reason I never got all the bloggers who were in favor of universal healthcare touting the VA system as the example we should be following.

It is my understanding that the larger more metropolitan VA hospitals often have better more efficient care, but our esperience in rural NH leaves a lot to be desired. Waiting 6 to a year for a doctors appointment isn't exactly what I hold up as good care. Also quality of physicians is often hit or miss-some docs are excellent while others leave little to be desired, the problem though, is the veteran doesn't have a lot of say in which one he gets to see.

I also can't say our experience with the military healthcare system was all that wonderful, we eventually opted to take our daughters to a private pedatrician, because their military care was terrible. Although, the military system for care delivery has changed since my husband got out, so it isn't exactly the same program.

Definitely: thanks, OCSteve.

On another topic entirely: if anyone isn't reading Josh Marshall and the story of the US attorneys being fired, they're missing very good journalism. The latest.

And: Hillary's alleged southern accent explained.

OCSteve, it also sounds like you can be formally an "outpatient" at Walter Reed, yet still living on base. Which means you have no choice but to eat at the mess hall, but you have to pay for the meals there out of your pocket.

This scenario is actually pretty plausible, and more a hallmark of the lack of efficiency in the beauracracy itself, and it isn't anything new.

I wouldn't be surprised if some of the people complaining, weren't in this kind of situation, or one where the paperwork didn't actually catch up to them-something that is also very common in the military, or at least it was back in the 1990's.

This actually sounds like it would be a paperwork error problem-and the military has never been real good about paperwork. The standing joke was when the military realized they screwed up and gave you too much money, they were quick to take it all back (and they would clip out of a paycheck all at once-which could be very painful for many enlisted guys with families), but if they made an error and didn't pay you enough it would often take months for you to get your money back (this happened to us, when my husband was supposed to be getting sea pay, but the screwed up and didn't give it to him-it took almost 6 months for them to give us the money they owed).

just me -- thanks a lot. Speaking for myself: I have never been cared for in a VA hospital, for the very good reason that I'm not a veteran, so I can only go by things like satisfaction and quality surveys by reputable groups. It's immensely helpful to hear from people who have (or have loved ones who have) been there.

I wonder why there is all this bureaucracy. I can imagine answers like: the traits the army values most highly don't have much to do with being able to design a really nifty accounting and payroll system, and streamlining the bureaucracy is not the way to career advancement, etc. But that would all be total, complete, pull it out of etc. guesswork.

Some military dining facilities are ala carte. Madigan Hospital at Fort Lewis is that way. If you buy the recommeded meal, it is still the army price, but if you want a bunch of extra stuff, you pay extra. But that is a good deal compared to not getting enough food, as happens in some dining facilities that don't offer that option.

Deployed soldiers and soldiers mobilized for deployment get both free food and their BAS. They also get tax benefits for being in a war zone, hazardous duty and imminent danger pay, family separation, and a few other benefits that you do not get when serving in a regular duty status. My pay will effectively go up by about 5-10 thousand dollars when I get to Iraq, though currently my food is free in a predeployment status.

Military health care is abysmal, and is one of the primary reasons I left active duty in 2000. Off post doctors are reimbursed at a rate equal to medicare, and any doctor who accepts military health care must accept medicare. Many good doctors are unwilling to do so. On post is even worse, where I have had to take my 2 year old daughter away from a 19 year old specialist who thought he was going to give her an IV...I made a nurse do it, but never took her back to an army facility again.

Now that I am back in the system, I think it is better than when I left, in part because of automation and record keeping, but also because the facilities are better: Madigan at Fort Lewis is state of the art, and not over crowded.

I am also currently training a buch of soldiers to return to Iraq, who deployed before. I just had one get sent home for PTSD against his will (he wanted to return) and am likely to lose another (who also wants to go). Both will be eligible for VA benefits, neither wanted to go home, and both would have been an asset to me and the army. It is unlikely that either will be replaced before we deploy, so we will be working shortmanned. They both likely have issues that need to be resolved though, and the Army is making them resolve them before they get to deploy again.

So while I think military healthcare sucks, it has not suffered since the last time I was in the system, and I am not seeing any lack of willingness to send a soldier to treatment despite his unwillingness to go, and the needs of the army.

John, go find John Ralston Saul's nonfiction and start reading. I think you'll like him.

Oh, and privatization works. There is no soldier in the Army that wishes to have army cooks rather than a contract staff. Sometimes the two facilities will be right next to each other, and the contract facility will have a line. At Fort Riley where I am now, we have great contract staff, but they rotate with army units that are either filling in, or maintaining proficiency, or maybe reservists doing AT, but there is a clear change in quality when the contract staff leaves, and the army comes in.

And don't get me started on Haliburton...Those buggers know how to run a messhall. I have never been fed as well as I have been in Iraq and Kuwait.

jrudkis: Oh, and privatization works. There is no soldier in the Army that wishes to have army cooks rather than a contract staff.

Well, according to at least one soldier who did 12 months in Iraq (2004/5), in Iraq the army-run bases are greatly preferred to the Halliburton-run bases, because the facilities for soldiers are far better at the army-run bases. So it is certainly not true that "no soldier in the Army" wants contract staff rather than army cooks, though I would imagine that standards vary throughout.

See, this is what I love about this blog.

I start a thread sick to my stomach over events and by the end of the diversity of opinion, I'm dying of hunger.

At this rate, if they privatize all of the Veteran's hospitals, it might be desirable to get my butt shot off just for the meals.

I'm sorry, I just don't get the seemingly human trait that says I can be a competent warrior and win wars, but I need special, privately funded incentives to make some good meals for someone, or whatever the job is.

Incidentally, jrudkis, thanks for your service.

I think you need to give me more information on that, on whether he was talking about bases, or mess halls. I don't believe it is true of either, but I have never been to a better mess hall than I have been to run by Haliburton. The biggest threat with those guys is that you will come home really fat. The saying is that in Iraq, you either come home benching 300 pounds, or weighing 300 pounds. And I think you would have to look really hard in Iraq to find a messhall that is not contracted out, at least today.

John,

The difference comes from how the Army operates. First, we have a duty to soldiers to educate and prepare for promotion, which means a lot of their duty time is preparing for thier next job. The Army has specialized schools for each promotion, regardless of whether you are a cook or a pilot. That is not a recipe for efficiency if you are trying to keep down costs of serving eggs. Soldiers who become cooks are generally not the top of the barrel, and so the leadership throughout that specialty is often weak. Because they are cooks, they have terrible hours that makes their military skills suffer (being a baker is even worse). Keeping cooks in the army therefore suffers both because they had poor leaders, and because they are forced out by failing standard military skills. But it takes a long time a nd a lot of effort to fire a soldier who simply can't fry an egg, or fry enough of them fast enough to feed a lot of people.

There are simply some things that it is better and more efficient to hire a company with leadership that specializes in that one area, does not have to comply with military training, and can hire and fire at will. Other things, that require someone with 15 years of experience to be proficient at (like an Infantry platoon sergeant) cannot be efficiently hired from the outside.

Right now, I am competing with private companies for the job of Personal Security Detail. My guys will be paid half or less of what the private guys will make, so you would think we would be competitive, but this is an area where it is also better in the private sector, because in reality, it is not a specialty where soldiers can have a career in terms of the army, so we piece meal it as a special duty. My guys will not be as good as Blackwater. But they wiil get good experience that will help them later in their careers in their primary jobs. And then later when they apply to Blackwater, they will be able to become good at it, and make big bucks.

As long as we're talking about military health care, I'd like to put in my $0.02.

My girlfriend's father was a pediatric neurologist in the military. Even though he was in the air force, he saw many patients from the army and navy because there are very few pediatric neurologists in general, let alone in the military.

I've seen the man work and he's simply a gifted doctor; he's a brillian diagnostician and he loves kids. Working as a military doctor was his dream job, but he had to retire because the military doesn't allow officers over 65 to serve.

Now, I can understand why that rule exists, but in the case of a very specialized physician who works stateside, it just seems crazy. He suffers, and lots of active duty personnal who have sick kids suffer as well.

jrudkis:

That's a rational explanation if I've ever heard one.

One question though: Is it true that the Army can take a below-par short order cook from the population and make him or her into a good, competent warrior, but they can't take a soldier who is not up to snuff and make them into a decent chef?

Don't bother answering. I ask existential questions which have no answer. ;)

Thanks for the info. I've learned something.

This is why our lives should not be run by only the federal government. Would a private hospital competing for health care dollars have been better than Walter Reed?

Is all the blame for a natural disaster on the Federal government? Is there no state responsibilty, city responsibilty, personal responsibility?

I wonder why there is all this bureaucracy.

Walter Reed is single payer medicine. The beauracracy exists and does not depend on results.

Nationalize goods and services, and there is no alternative. Give people a choice, some competition and quality will improve.

jrudkis: I think you need to give me more information on that, on whether he was talking about bases, or mess halls.

He? Bases, not specifically mess halls. I learned about the failure of Halliburton's subsidiary to provide soldiers with food safe to eat via national news, not via her sporadic letters to her friends: her comments about the Halliburton-run bases were general grumbles about how they ran everything on a shoestring, the quality and quantity of the facilities provided - even basic stuff like showers, latrines for women soldiers, and clean water for brushing teeth - was so much better on regular army bases than on Halliburton-run bases. I don't have stats or details - I'm just telling you what she was telling me over the 12 months in Iraq. This is anecdote not data, but I assure you, it is personal information coming directly from a soldier who was serving in Iraq for 12 months.

But, here's good news: the Committee on Oversight and Government Reform has subpoenaed Major General George Weightman.

Committee Chairman Henry Waxman and subcommittee Chairman John Tierney asked Weightman to testify about an internal memo that showed privatization of services at Walter Reed could put “patient care services at risk of mission failure.”

The power of Congressional committees to subpoena witnesses is one that Republicans chose not to use to investigate the administration's failures and the repeated evidence suggesting corruption. The army didn't want to let Weightman testify: congress has the power to compel him to do so. Yay.

DaveC: This is why our lives should not be run by only the federal government. Would a private hospital competing for health care dollars have been better than Walter Reed?

If you follow the link I just posted, Dave, it appears that problems arose precisely because Walter Reed was becoming a private hospital that didn't have to compete for health care dollars: private companies were getting fat government contracts on the faith-based supposition that private companies paid by the government are so much better at providing services than a government department.

Which is nonsense. In a free market - which health care and the military are not - private companies compete to sell their products or their services, and need to improve their services/their prices against other private companies. This does not, however, mean that a private company handed a large sum of money by the government will just naturally do better than a government department at anything the government department has been doing for 20 years.

Though conservatives often seem to deny it, there really is such a thing as a sense of public service, a sense of duty - a feeling of personal obligation to do the best you can. The idea that instilling and inculcating this sense of public service in government workers is less effective in providing health care services than making use of a private company that first and foremost wants to makes a profit is just wrong - as Walter Reed, and other private health care services, show.

DaveC: “This is why our lives should not be run by only the federal government. Would a private hospital competing for health care dollars have been better than Walter Reed?

Is all the blame for a natural disaster on the Federal government? Is there no state responsibilty, city responsibilty, personal responsibility?

I wonder why there is all this bureaucracy.

Walter Reed is single payer medicine. The beauracracy exists and does not depend on results.

Nationalize goods and services, and there is no alternative. Give people a choice, some competition and quality will improve.”


Err no. This is what happens when you put people in charge of a system who have an almost religious faith in the notion that the system can not work, so rather than try to make it work, they try to exploit it for their own political purposes. After all, since government can’t work, we might as well get some use out of it in keeping ourselves in power?

Instead, the VA during the Clinton years provided an excellent example of how a system can work better if you put a manager in charge who both has a clue and does not believe “Its government, it can’t work”. See these articles, and note while the Washington Monthly may be a liberal magazine, I don’t think that’s true of Business Week.

http://www.washingtonmonthly.com/features/2005/0501.longman.html

http://www.businessweek.com/magazine/content/06_29/b3993061.htm

Money quote from Business Week

...
LOWER COSTS, HIGHER QUALITY
Roemer seems to have stepped through the looking glass into an alternative universe, one where a nationwide health system that is run and financed by the federal government provides the best medical care in America. But it's true -- if you want to be sure of top-notch care, join the military. The 154 hospitals and 875 clinics run by the Veterans Affairs Dept. have been ranked best-in-class by a number of independent groups on a broad range of measures, from chronic care to heart disease treatment to percentage of members who receive flu shots. It offers all the same services, and sometimes more, than private sector providers.

According to a Rand Corp. study, the VA system provides two-thirds of the care recommended by such standards bodies as the Agency for Healthcare Research & Quality. Far from perfect, granted -- but the nation's private-sector hospitals provide only 50%. And while studies show that 3% to 8% of the nation's prescriptions are filled erroneously, the VA's prescription accuracy rate is greater than 99.997%, a level most hospitals only dream about. That's largely because the VA has by far the most advanced computerized medical-records system in the U.S. And for the past six years the VA has outranked private-sector hospitals on patient satisfaction in an annual consumer survey conducted by the National Quality Research Center at the University of Michigan. This keeps happening despite the fact that the VA spends an average of $5,000 per patient, vs. the national average of $6,300. ...


Note, the Business Week piece is a little off. Join the military for the best care after you you get out. Walter Reed Army Medical Center (WRAMC) is not part of the VA.

Also, I have had some contact with military health care and it is generally better than this. The problems here are mainly due to WRAMC trying to deal with a patient, and especially outpatient, load it has not dealt with in years. The high end of the care is in the wards they show the Congressional visitors. They just do not have the resources to deal with all of the other patients and that means substandard facilities like building 18 get used.

On a more personal note, both my father (a WW 2 vet) and myself have received care within the last 3 years in an east coast VA facility and it was excellent. I have also been hospitalized in a non-VA facility and the care was good, but I am still trying to resolve the billing issues.

DaveC, I would agree that free markets and capitalism are generally the best choice for most economic issues. That does not mean they are always the best choice for every issue. Health care is an especially knotty problem because of severe demand inelasticity and information asymmetries. I think we need to get some form of national level coverage for funding health care, probably a single payer basic system, with options for private purchase of additional coverage. Health care providers could be public, private, or non-profit. I would prefer something like the French system, which covers everybody but allows you to see any doctor you want, over the Canadian system which does not allow private providers.

A couple of other points. On military dining facilities (DFACS aka mess halls), I have heard of their charging multiple prices, but it depended on the nature of your orders. If for example, I was stationed at Ft McCoy, WI as permanent party and living in the barracks, I would get a meal card and would not pay to eat in the DFAC, or I could get separate rations and pay the SR price (say $4 for dinner). On the other hand, if I was coming to Ft McCoy for a 3 day conference, I would probably have temporary duty (TDY) orders that would authorize me a per-diem that could be $30-40 per day for meals (additional money for lodging). I would show my orders to the DFAC and they would charge me a higher price (say $10 for dinner). I am not really losing anything, since I already got the per-diem to pay for the added cost.

I suspect that something like this has been happening at Walter Reed and some of the other facilities. The fastest way to fix this would be to put all of the out-patients who do not live in the area on TDY orders and authorize per-diem, or go contract with local hotels for long-term room blocks. This was suggested by Phillip Carter at Intel Dump, which has IMHO some pretty good coverage on this issue.

http://www.intel-dump.com/posts/1172092000.shtml


Jesurgislac:

jrudkis: I think you need to give me more information on that, on whether he was talking about bases, or mess halls.

"He? Bases, not specifically mess halls. I learned about the failure of Halliburton's subsidiary to provide soldiers with food safe to eat via national news, not via her sporadic letters to her friends: her comments about the Halliburton-run bases were general grumbles about how they ran everything on a shoestring, the quality and quantity of the facilities provided - even basic stuff like showers, latrines for women soldiers, and clean water for brushing teeth - was so much better on regular army bases than on Halliburton-run bases. I don't have stats or details - I'm just telling you what she was telling me over the 12 months in Iraq. This is anecdote not data, but I assure you, it is personal information coming directly from a soldier who was serving in Iraq for 12 months."


I have just spent the last 8 months (4 months to go) in a KBR (Haliburton) run facility in southern Iraq and think they have done a pretty good job. The food is good institutional, although the menu can get fairly monotonous (you have gone through all the variations by then the middle of month 2). I am a little surprised at comments favoring US military run bases because I don't think there are that many, in theater.

Jesurgilac, I suspect your friend may have been located on a smaller KBR run FOB, and she may be under the impression that the US runs services on the larger FOBs like Camp Victory or Anaconda. THey are bigger, and probably better, but the services are still run by KBR. I would be interested in knowing the FOB she was at.

Also, I think most of the US only bases are very close to insurgent locations


Well, I'll tell her about this discussion, and leave it up to her if she wants to comment here. She herself was fairly close-mouthed at the time about *where* she was serving in Iraq, and I haven't queried her about details like that afterwards.

I'm the soldier Jesurgislac was talking about and I most definitely wasn't on a small FOB. When the Easter Uprising happened, KBR workers whined that the soldiers who rolled in to help save our asses created more work, and they wouldn't so much as put out more latrines---in the midst of battle----without petty paperwork. They reserved all the nice accomodations for themselves, and served the soldiers shit---when, that is, they weren't harassing the female soldiers. After moving to a larger base, some of the same conditions applied. We had to beg for resources, and so we wound up hiring locals, because they did the job well and cheaply, and weren't arrogant about it, either.

I don't know about the rude part (but that has not been my experience), but the paperwork issue is a command responsibility. Contractors don't get paid if there are no documents, and the FOB commander has a responsibility to plan for contingencies and prepare resourcing. We see complaints from GAO about unaccounted for funds in Iraq fairly often, and it is because people are engaging contractors without a paper trail. Expecting and preparing for additional soldiers is not something that should have surprised anyone.

jrudkis: Thanks a lot for the up to date information. Definitely some changes since my time. On the ala carte issue – that explains a lot and is the piece I was missing. In my time there was no limit to what you ate in the dining facility – so no one ever left hungry. In fact, as you noted, putting on weight was the biggest danger of eating too many meals at the dining facility.

I was also remiss in not mentioning that I always found the food to be pretty good. Breakfast was my favorite and the selection and quality rivaled most civilian breakfast buffets – for a couple of bucks (I want to say $1.65 but it was a long time ago). I’m still searching in vain for the civilian equivalent of chow hall SOS :)

On the privatization issue – that was occurring back in the early 80s as well. One of my wife’s earliest jobs was a NAF KP position at the post dining facility (and she would tell you still today the worst job she ever had in her life). The Army concluded that it just was not efficient to have soldiers miss a day of duty to work in the dining facility, and it was not efficient for the dining facility staff to have to break in a new batch of soldiers every morning.

On the medical care – again not a VA hospital – my experiences with a military dentist were so horrendous that to this day just thinking about going to a dentist makes me break out in a cold sweat. I pretty much need general anesthesia for a cleaning.


Donald Clarke: Your comment on resolving this by putting them on TDY orders sounds like a perfect solution to this. Medical hold is temporary by definition so giving them permanent orders doesn’t even make sense.

Oh, and privatization works. There is no soldier in the Army that wishes to have army cooks rather than a contract staff.

Is it also cost effective? You may have answered this already jrudkis, so forgive the repitition, but I think this is an important aspect of the story.

Many of the complaints about Halliburton and KBR have had to do with the amounts they have charged - or overcharged.

Would a private hospital competing for health care dollars have been better than Walter Reed?

Not to belabor the obvious, but in a for-profit situation, "competing for health care dollars" usually shakes out to "prioritizing the least-sick people and charging them more than is reasonable." Ain't no profit in treating brain trauma patients, particularly not from military action, since they're unlikely to have a great deal of means.

Is all the blame for a natural disaster on the Federal government? Is there no state responsibilty, city responsibilty, personal responsibility?

No, there is no state, city or personal responsibility for soldiers having been injured in Iraq, Dave.

Ginmar: "I'm the soldier Jesurgislac was talking about and I most definitely wasn't on a small FOB. When the Easter Uprising happened, KBR workers whined that the soldiers who rolled in to help save our asses created more work, and they wouldn't so much as put out more latrines---in the midst of battle----without petty paperwork. They reserved all the nice accomodations for themselves, and served the soldiers shit---when, that is, they weren't harassing the female soldiers. After moving to a larger base, some of the same conditions applied. We had to beg for resources, and so we wound up hiring locals, because they did the job well and cheaply, and weren't arrogant about it, either."

Pardon, it is fine if you do not want to disclose where you served. Could you please give me an example of one of the US run facilities that, according to Jesurgislac, you preferred? I spent my first tour in Kuwait and at Camp Victory. I am on a pretty large FOB in Southern Iraq right now. At all of theses locations, the services were run by KBR.

Thanks for serving. It sounds like you had a much more "interesting" tour than either of mine (cross fingers, knock on wood - since I am still here).

Donald, my thanks to you for serving.

My son had no complaints about the food services, etc while he was over there. He was at Taji (I have no problem mentioning this since he is no longer there and the whole world knows we have a base there.)

His base also included a Starbucks and a Cinnabon as well, I am sure of other food chains.

I am fairly sure the KBR and Halliburtons of the world, in general, serve higher quality food than the normal mess hall run by army cooks. However, as Eric points out, how much are we paying for this? I have no problem with some of these services being privatized, but when they are handed out on a no bid basis and if we are being charged an exorbitant rate, then I do have a problem.

All of which goes to the whole question of privatization. It is more the question of how contracts are handed out and how much is being paid. This is a potential problem under any administration, although this one seems particularly prone to overpay for no-bid contracts.

Thanks to everyone from the military who has posted here. And thanks to all of us who do what we can for our country, even though for most of us it doesn't involve risking our lives.

According to me, we civilians have an absolute obligation to make sure that our political leadership does right by people who are willing to risk their lives for us, at the command of the people we elect. (We also have an obligation to make sure that the people we elect do right by everyone, whatever 'doing right by' means; but it's especially obvious in this case.)

Eric,
The cost to feed a soldier in Iraq is something like 30 dollars a day, which far exceeds the cost at home. Part of it is the quality of food, amount and variety of food, and the cost of securing the food getting into country. The servers get paid far less than equivalent soldiers doing the work, as most are third worlders from the Phillippines, etc. I am sure that KBR is making a killing doing it. I don't think the Army would do it as well.

Everytime a Congressman goes over there, they beat up the Army about quality of life, and the lickies and chewies get increased. KBR does not provide that stuff for free. But I do not think the army could do it as well.

In the states, I think it is cost effective, for the reasons I mentioned above. The Army expects a short order cook to have the same career advancement potential as a helicopter mechanic: same pay, same schools, etc. When we contract out, we get people for whom frying an egg is a career. It is hard to sort out the money involved, because it includes health care, pay, retirement, schools, billetting, vs one contract, but I think it is unlikely that we are paying more for fried eggs from the contractors than we did when we ran it ourselves.

I've been on US bases pretty much all over the country where the food was served adn prepared by army cooks. On the first base I was at, the cooks and servers were very nice people but KBR treated them so badly they went on strike and quit. I genuinely liked some of these guys, but the KBR guys seemed to think of soldiers as things that made them work. While we were out running patrols during an uprising----and subsequently got ambushed by a force so large that survival seemed impossible----they literally complained about the extra work.

Are you suggesting that soldier cooks went on strike and quit because of KBR?

I think you're misreading -- she's saying that KBR maltreated its own employees badly enough that they went on strike.

Probably. I was having trouble tracking.

but the KBR guys seemed to think of soldiers as things that made them work. While we were out running patrols during an uprising----and subsequently got ambushed by a force so large that survival seemed impossible----they literally complained about the extra work.

Welcome to the sharp end of the Principle-Agent problem, ginmar.

Thanks jrudkis,

But I'd still like to see the side-by-side comparisons of cost. Actually, given the malfeasance on the part of Halliburton and its many subs, I guess I'd rather see a more competitive bidding process - or side by sides of what another firm could do.

Perhaps privatization is the way to go (you make compelling arguments about the training, specialization, etc), but as John Miller pointed out, this administration doesn't view privatization the way a good CEO does.

Rather than a free market exercise in efficiency, it is a patronage mill. Either way, I'm glad to hear that at least the product delivered to the soldiers is superior. The least they deserve.

PS: Glad to hear you're doing OK...last time I heard from you was over at Legal Fiction, I believe, and you told us you were heading out. So it's nice to get an update from time to time.

Stay safe.

at least the product delivered to the soldiers is superior

That hasn't been universally the case, though I'm glad to hear jrudkis' experience has been good.

There was a KBR incident with contaminated water that's featured in "Iraq for Sale", and at least one with spoiled food (don't have time to look that up, but maybe later tonight if no one comes up with it before then).

There are also numerous cases of KBR's overcharging of the govt and consistent pattern of outright abuse of imported workers.

True Nell. And Ginmar's experience was somewhat different.

But the overcharging part, I believe, I acknowledged upthread.

I read a blog of a Dutch soldier in Afghanistan the other day (I guess that's not much different from Iraq) who said the KBR mess food was great, but rather limited (culture clash I think, Americans would probabely hate our food). He also said that they employed quite a few civilians, who received a bonus of 300 dollars for every 'real attack' - last month only two, but the month before there were 17.

Somewhat different? I rather suspect anybody on that base would differ. Then again, the KBR boss was only sexually harassing female soldiers.

There is the old saying the better the army the worse the food often replied by didn't know how good this army was ;-)

Apologies ginmar: entirely different. Pardon the imprecise lexicon. You know, I write these comments while I'm working, so I don't always express myself with exactitude.

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