Tag Archives: military

DoD spent nearly $363 million on weight-loss surgeries in past decade

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Reporting for KIRO-Seattle, Chris Halsne used FOIA requests to find out how much the military’s TriCare plan is paying for weight-loss surgeries for soldiers and their dependents. Including post-surgery tummy tucks, Halsne calculates (PDF) that the government was on the hook for at least $362,971,831 for such procedures over the past decade.

The military defends the expenditures by pointing to the long-term savings of having healthier TriCare enrollees, though Halsne found those savings difficult to prove, as 86 percent of soldiers and their families leave the plan before they qualify for lifetime benefits.

Halsne found that even some active-duty personnel are getting bariatric procedures, which are officially off limits to them as they are required to stay fit through diet and exercise to remain in the military.

While analyzing Defense Department records on health-related costs, KIRO Team 7 Investigators also discovered the military continues to pay for some weight loss surgery for active duty personnel. Records show $2,400,000 worth since 2001. The military banned bariatric procedures for active duty soldiers and sailors in 2007, yet it appears they approved around 57 of them after that.

Tricare, the military’s health insurance program funded by federal taxpayers, declined KIRO’s repeated questions for an interview.

Reporter FOIA’s database further exposing the toll war takes on returning vets

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Writing for the Bay Citizen and The New York Times, Aaron Glantz brings a new, data-based take on the mental and physical toll the wars in Iraq and Afghanistan have taken on returning veterans, thanks to what he calls “an obscure government database called the Beneficiary Identification Records Locator Subsystem death file,” which he obtained via FOIA.

The database, which reveals a high rate of suicide and fatally risky behavior, lists all veterans who earned Veterans Affairs benefits since 1973.

Records from that database, provided to The Bay Citizen under the Freedom of Information Act, show that the VA is aware of 4,194 Iraq and Afghanistan veterans who died after leaving the military. More than half died within two years of discharge. Nearly 1,200 were receiving disability compensation for a mental health condition, the most common of which was post-traumatic stress disorder.

Names were redacted, but Glantz nonetheless managed to identify a number of veterans, including a troubled 26-year-old man who threw himself under a train just three days after being turned away by the VA. In the course of his investigation, Glantz has managed to fill in some of the gaps in the federal records, a process which has shown just how lacking the VA’s data can be.

In October, The Bay Citizen, using public health records, reported that 1,000 California veterans under 35 died from 2005 to 2008 — three times the number killed in Iraq and Afghanistan during the same period. At the time, the VA said it did not keep track of the number of Iraq and Afghanistan veterans who died after leaving the military.

The VA database does not include veterans who never applied for benefits or who were not receiving benefits at the time of their death, according to the agency. The VA said it also did not keep track of the cause of death.

When confronted with his agency’s shortcomings, a VA representative responded in a manner that belied his agency’s lack of focus on recordkeeping.

David Bayard, a VA spokesman, said the agency was working hard to treat veterans with mental health issues. “VA has some pretty fine programs,” Mr. Bayard said, “but unfortunately we aren’t always successful.”

Dallas Morning News explores effects of war on military families

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

For the paper’s series on military families, Dallas Morning News reporter Dave Tarrant has spent four months investigating what he calls the “relentless cycle of crisis and stress” that affects soldiers’ loved ones. The broad series touches on everything from the Fort Hood suicides to the Army’s preventative measures to Tarrant’s latest, “Wife faces life-or-death decision for her war-injured husband.”

Most of the content is behind the Morning News paywall, but there’s enough on the landing pages to, at the very least, help you understand where Tarrant’s investigation has taken him and just how wide-ranging the health effects of prolonged war can become.

Pentagon reluctant to provide therapy for TBI

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

After a lengthy investigation, ProPublica’s T. Christian Miller and NPR’s Daniel Zwerdling found that, in their words, the “battle over science and money has made it difficult for wounded troops to get a treatment recommended by many doctors for one of the wars’ signature injuries.”

They’re writing, of course, about traumatic brain injury, a consequence of roadside bombs in Afghanistan and Iraq. Their work revolves around a method of treating TBI and rehabilitating victims that has gained wide acceptance among civilian physicians and health plans but has not been embraced by the military’s insurance provider.

During the past few decades, scientists have become increasingly persuaded that people who suffer brain injuries benefit from what is called cognitive rehabilitation therapy — a lengthy, painstaking process in which patients relearn basic life tasks such as counting, cooking or remembering directions to get home.

Many neurologists, several major insurance companies and even some medical facilities run by the Pentagon agree that the therapy can help people whose functioning has been diminished by blows to the head.

Tricare provides health insurance for about 4 million active duty and retired soldiers, and “despite pressure from Congress and the recommendations of military and civilian experts,” it still refuses to cover cognitive rehabilitation therapy for the thousands of American soldiers afflicted by TBI.

Five of the 12 largest insurers cover the therapy, and an expert panel has recommended that the military do the same.

For its part, Tricare points to an assessment it conducted that put the effectiveness of cognitive rehabilitation therapy into doubt. I’ll let Miller and Zwerdling take it from there.

An investigation by NPR and ProPublica found that internal and external reviewers of the Tricare-funded assessment criticized it as fundamentally misguided. Confidential documents obtained by NPR and ProPublica show that reviewers called the Tricare study “deeply flawed,” “unacceptable” and “dismaying.” One top scientist called the assessment a “misuse” of science designed to deny treatment for service members.

The therapy would cost $15,000 to $50,000 per soldier, and the reporters found that, in private, Pentagon officials had expressed concerns about the massive cost of providing it to every suffering soldier. A few soldiers with political connections or ultra-motivated family members have managed to get the therapy, but its essentially off limits for most folks covered by Tricare.

Finally, a quick parenthetical mention answers a question that most health reporters are asking at this point. How did they get those internal studies and documents?

HINT: It involved finding a slightly less formal way to fulfill some of their FOIA requests.

(NPR and ProPublica obtained a copy of the ECRI reports through the Freedom of Information Act. However, Tricare denied access to reviews of the reports. ProPublica and NPR have appealed the request, but obtained copies of the reports and information on the reports from sources.)

Bagram airfield a leading lab for trauma medicine

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

NPR’s Quil Lawrence reports that Afghanistan’s Bagram airfield, the primary stop for seriously wounded soldiers before they’re stabilized and transported to Germany or America for long-term care, has served as an opportunity for forging broad advances in emergency medicine.

“At the beginning of this conflict, we were taking the best trauma medicine from the civilian sector, and we brought it to Iraq and Afghanistan,” says U.S. Air Force Col. Chris Benjamin, the hospital commander. He says now his doctors tell him it’s the other way around.

“Here we are seven, eight years later, taking what we’ve learned in these conflicts to teach them the advances that we’ve made with this data collection here in theater,” he says.

Thanks to body armor and advances in battlefield trauma like the increased use of tourniquets, more soldiers are arriving alive, but with serious, traumatic injuries. When they pass through Bagram, the volume and severity of their wounds “continues to yield new data that are helping to save lives in ways that were impossible only a few years ago,” Lawrence writes.

DoD: No condolence letter if soldier committed suicide

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

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Photo by Chris_Lott via Flickr

Writing on the NPR health blog, Whitney Blair Wyckoff writes that while American soldiers who commit suicide receive full military honors, their families don’t receive a letter of condolence from the White House. It’s a substantial omission because, as Wyckoff notes, “the number of soldiers who committed suicide in the U.S. military rivaled those who were killed on the battlefield in Afghanistan this year.”

Suicide prevention and mental health advocates are circulating petitions to reverse the policy, which is gaining media attention at a time when the military’s attempting to destigmatize mental illness. The administration’s only reply was an e-mail from the Department of Defense stating that “Under the current program, the Secretary of Defense does not send condolence letters to next-of-kin of members who commit suicide.”