Report Questions Quality of Medical Care for Workers in War Zones

An increasing number of federal employees are serving in Iraq and Afghanistan, but it is not clear that the government's policies go far enough to ensure they receive the best medical care or the most appropriate benefits, according to a congressional report released yesterday.

The report was issued by the House Armed Services Committee oversight and investigations subcommittee, which looked into the incentives and medical coverage being provided to civil service employees.

Rep. Vic Snyder (D-Ark.), the subcommittee chairman, and Rep. Todd Akin (Mo.), its ranking Republican, told reporters that the review turned up a number of concerns.

The Defense Department, for example, has issued a memo that provides medical care for injured Defense civil service employees at the same level and scope of that provided to military personnel. But that directive may not be sufficient or properly implemented, the report said.

"The Walter Reed experience demonstrated you need to have a very reliable system of a medical case coordinator for uniformed people who are in a very disciplined environment," Snyder said. "This may not be the situation for our civilian folks who are injured or hurt."

Federal employees also may not have access to the latest medical advances for treating combat wounds, he said.

"If you are a Department of Agriculture person and you have some kind of severe wound, when you come back to the states, the expectation is that you are going to be taken care of through your normal health care system," Snyder said. "Well, the best experts in the world may be in the military treatment facilities to which you are not going to have access."

About 10,000 federal employees have volunteered for duty in Iraq and Afghanistan, the subcommittee estimated. The Defense Department has about 3,000 civilian employees in the two countries now.

The numbers are likely to increase if the departments of State and Defense continue with stabilization and reconstruction plans. President Bush's fiscal 2009 budget also would pull together more than 2,000 federal employees from 15 agencies for a "response corps" and would create a civilian reserve corps of about 2,000 drawn from state and local governments and nonprofit organizations.

Snyder said the report grew out of an investigation of Provincial Reconstruction Teams, the joint military-civilian teams that help rebuild communities in Iraq and Afghanistan, often in dangerous conditions.

Congress expects that all government agencies are going to work closer together and that successful cooperation hinges on how people are treated, Snyder said. "And if we are not treating them in an adequate and equitable manner, then that is part of the flaw that we have in our interagency process," he said.

In examining the reconstruction teams, Akin said the subcommittee learned that "we really don't have a system to create any incentives to get these people to volunteer."