Military Hospitals Meet New Realities

By Steve Vogel
Washington Post Staff Writer
Monday, February 11, 2008

When Pentagon planners first proposed consolidating military hospitals in the Washington region, it was aging infrastructure, not casualties from Iraq and Afghanistan, that drove the decision.

But the outcry last year over conditions at Walter Reed Army Medical Center has forced the Pentagon to rethink how it will care for troops in the Washington region, the hub for wounded service members returning to the United States.

As the Defense Department moves forward with a $2 billion undertaking that includes a massive expansion of the National Naval Medical Center in Bethesda and the construction of an Army hospital at Fort Belvoir, the scale and the cost of the projects have grown in direct response to the fallout from Walter Reed.

"Certainly, the amount going into building infrastructure wouldn't be as high without it," said Rear Adm. John M. Mateczun, commander of a joint task force set up to oversee the hospitals.

Overall costs for closing Walter Reed and moving its services to Bethesda and Fort Belvoir have risen 71 percent since the initial 2005 projection, making this "the largest infrastructure investment that has ever been made in military medicine," Mateczun said.

Advanced neurological equipment for troops with brain injuries, a rehabilitation center for amputees, more space for visiting families, even renovated hospital rooms will come with Bethesda's expansion. In addition, a nonprofit group plans to build a state-of-the-art center for troops suffering from traumatic brain injury or post-traumatic stress disorder.

At Fort Belvoir, a 120-bed hospital will be built faster and will accommodate some wounded troops with orthopedic and mental health concerns. The Army will begin pouring the foundation this month for a facility three times the size of DeWitt Army Community Hospital.

The decision to close Walter Reed was approved by the Pentagon's base realignment and closure commission in 2005. The focus was on replacing the aging Walter Reed with a premier medical center at Bethesda, saving money in the long term and streamlining Army, Navy and Air Force medical care in the region, said Charles Battaglia, executive director of the 2005 BRAC Commission.

But even as the proposal was approved by Congress and President Bush in 2005, wounded soldiers were pouring into Walter Reed at the rate of about 1,000 a month.

A year ago, a series in The Washington Post documented poor living conditions for veterans recovering from wounds there, as well as red tape that left many of the soldiers trapped in bureaucracy.

"The BRAC world didn't really think about the war in Iraq or the patient load," said David K. Oliveria, BRAC program manager for the Navy hospital. "It's kind of like driving a race car while it's racing down the track, and saying, by the way, I need two new tires."

The need to rethink the new hospital's design led the Navy to delay completion of its draft environmental impact study from July, then October, before finally releasing it in December.

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