/PRNewswire/ -- In the wake of yesterday's unexpected Pentagon announcement about gays in the military, experts say the "don't ask, don't tell" policy may be on the brink of irreversible change that would speed up its demise. After speaking with President Obama last week, Defense Secretary Robert Gates has asked military lawyers to explore how to modify enforcement of the policy in ways that are "more flexible until the law is changed." The President Monday reiterated his intention to end discrimination against gay troops, saying he is working with Congress and the military to do so.
Christopher Neff, political director of the Palm Center, said the remarks by Secretary Gates marked the first time the Defense Secretary has made clear that the Pentagon is onboard with the President's determination to lift the ban. "'Don't ask, don't tell' is a package -- both a law and a policy -- that hasn't been penetrated for fifteen years," Neff said. "This is a crack in humpty dumpty, and it gets the ball rolling for a political solution since it gives cover to lawmakers who have been waiting for a nod from the Pentagon."
Neff said that even a small change in how "don't ask, don't tell" is enforced could represent a seismic political shift, even if it does not have a substantial operational impact on most gay troops, who would still be subject to discharge. If the military stops applying certain provisions of the policy, as Gates says it is considering, it would send a signal to Congress about the inevitability of change. "That's why executive action is the key to unlocking the political stalemate," said Neff. "Even the statements themselves, although they do await follow-up action, have changed the political landscape."
Last month, the Palm Center published a report which outlined several legal and political rationales for executive branch discretion in regulating, and even halting, discharges provided for by federal statute. One of those rationales is closely linked to the new review announced by Secretary Gates. According to the Palm Center study, "the 'don't ask, don't tell' policy itself, as codified by Congress, also grants authority to the Department of Defense to determine the procedures under which investigations, separation proceedings, and other personnel actions under the authority of 10 U.S.C. Section 654 will be carried out ... The Secretary of Defense has discretion to determine the specific manner in which 'don't ask, don't tell' will be implemented." Prior to the release of the Palm Center's report, most observers had assumed that only Congress or the federal courts end the firings of gay troops.
Amidst mounting public pressure, White House press secretary Robert Gibbs said this week that he thought "don't ask, don't tell" would be repealed by the end of the President's first term. Nathaniel Frank, senior research fellow at the Palm Center, said this week's developments were politically significant. "Serious discussions have been launched by the President himself," said Frank. "Obama has said this is a failed policy that harms national security, so these measures are not just fixes, but may be the beginning of the end." Frank added that any regulatory changes that fall short of halting all discharges will be "window-dressing," but he focused on the implications for further political change. "This means the hot potato party may finally be over, as the President understands where the buck stops."
In the wake of this week's developments, the Palm Center announced that it is preparing a more extensive legal analysis of administrative options for relaxing the application of certain provisions of "don't ask, don't tell." Neff said that the Defense Department should invite public input as the rules are re-drafted, which would be consistent with past processes when military regulations have been changed. "This review should be no different," he said.
Organizations and individuals who have endorsed or endorsed consideration of the use of executive action based on the legal theories outlined in the Palm Center's study include Secretary Gates, 77 members of Congress, the New York Times editorial page, Center for American Progress, Human Rights Campaign, Servicemembers Legal Defense Network, Hendrik Hertzberg of the New Yorker, the political consultant Robert Shrum, and former White House aide Richard Socarides.
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Showing posts with label pentagon. Show all posts
Showing posts with label pentagon. Show all posts
23 January 2008
Defense Department Works to Eliminate Gaps in Medical Care
The trauma care that U.S. servicemembers receive is the best in the world, but the Defense Department must continue to eliminate gaps in the medical process as patients move from DoD facilities to the Department of Veterans Affairs and to private hospitals, a senior Pentagon medical official said.
Dr. Stephen L. Jones, principal deputy assistant secretary of defense for health affairs, said the military health system's future hinges on how it will become more efficient and how it will be more transparent to patients and families.
The Defense Department and the Department of Veterans Affairs are working closely together to share medical records, Jones said.
"We have been working to ensure we have secure, global reach of electronic health records," he explained. "The DoD and VA records would be integrated so when you saw that health provider in the VA, he would have access to the records from when the patient first entered the system."
Groups appointed to study the system identified the need to fix seams between military and VA medical care, Jones said.
"All of the task forces and commissions said we needed more integration and cooperation between the DoD and VA, and we've made tremendous strides," he said. "Are we where we need to be? No, because health records are a bit more complicated than financial institutions or airlines and such. Many more components have to be included – radiology, nutrition, provider nodes – all of the various aspects that touch you when you are in the health care field."
Record-sharing may be only the beginning, Jones said. "We are looking, for example, at whether it would behoove us to have one in-patient system that would be used by DoD and the VA," he said. "That study is under way now, and we will have recommendations in March."
Another gap that needs to be closed is between government and private-sector health officials, Jones said. Many private health care providers are not as far along as DoD and VA in keeping electronic patient records, he explained, so the records from a beneficiary's visit to a private physician may not make it into his or her military medical record.
"We need to build a system that will allow the folks working with patients and military families access to the records – whether it be DoD, VA, the state or a private institution," Jones said. Private-sector health care providers and the government are working to set information technology standards for health care records, he added.
Improved efficiency in Tricare and other third-party insurance payments is another goal for the military health system, Jones said. He also pointed out that Congress has told the Defense Department to address changes in Tricare cost shares. While private insurance plans are indexed to keep pace with inflation, the cost-share portion of Tricare has not changed since 1996, he explained.
As military medicine moves forward, more and more work is going into how the system treats traumatic brain injuries and post-traumatic stress disorders. The department is moving out on these and other aspects of psychological health, Jones said, and Congress has funded additional research into these disorders. "Exciting things are happening and will happen in that area," he said.
The department has added specialists closer to the front to help warriors with psychological wounds. Jones said the military has come a long way toward eliminating the stigma associated with seeking mental health help, but more needs to be done.
"Let's erase the stigma associated with psychological wounds," he said. "Whether it's a wound to your body or a wound to your mind, it's the same thing. You need to get assistance."
Jones said substandard conditions found at Walter Reed Army Medical Center last year gave the department "a black eye." He noted that the problems at Walter Reed were not in trauma care, but in follow-on care and administrative processes.
"The department has made tremendous strides in trying to improve the care around the wounded warriors and their families," he said.
At the Military Health Services annual conference here next week, Jones will host a discussion on the future of military health care. This year's conference theme is "Caring for America's Heroes." More than 3,000 attendees are expected.
The conference is an attempt to communicate ideas throughout the force, and also provides an opportunity for DoD leaders to get input from the field, Jones said.
But it all begins with people, Jones said, and the nation's wounded warriors are in the best possible hands. From the medics and corpsmen on the ground to the doctors at the combat support hospitals to the specialists at Walter Reed and the National Naval Medical Center at Bethesda, Md., all are providing the best trauma care in the world, he said.
"Without that team, without that system, we would not be able to do the job that we are doing," Jones said. Servicemembers who would have died of their injuries in the past are now surviving, thanks to the commitment, training and medical know-how of those personnel, he said.
By Jim Garamone
American Forces Press Service
Dr. Stephen L. Jones, principal deputy assistant secretary of defense for health affairs, said the military health system's future hinges on how it will become more efficient and how it will be more transparent to patients and families.
The Defense Department and the Department of Veterans Affairs are working closely together to share medical records, Jones said.
"We have been working to ensure we have secure, global reach of electronic health records," he explained. "The DoD and VA records would be integrated so when you saw that health provider in the VA, he would have access to the records from when the patient first entered the system."
Groups appointed to study the system identified the need to fix seams between military and VA medical care, Jones said.
"All of the task forces and commissions said we needed more integration and cooperation between the DoD and VA, and we've made tremendous strides," he said. "Are we where we need to be? No, because health records are a bit more complicated than financial institutions or airlines and such. Many more components have to be included – radiology, nutrition, provider nodes – all of the various aspects that touch you when you are in the health care field."
Record-sharing may be only the beginning, Jones said. "We are looking, for example, at whether it would behoove us to have one in-patient system that would be used by DoD and the VA," he said. "That study is under way now, and we will have recommendations in March."
Another gap that needs to be closed is between government and private-sector health officials, Jones said. Many private health care providers are not as far along as DoD and VA in keeping electronic patient records, he explained, so the records from a beneficiary's visit to a private physician may not make it into his or her military medical record.
"We need to build a system that will allow the folks working with patients and military families access to the records – whether it be DoD, VA, the state or a private institution," Jones said. Private-sector health care providers and the government are working to set information technology standards for health care records, he added.
Improved efficiency in Tricare and other third-party insurance payments is another goal for the military health system, Jones said. He also pointed out that Congress has told the Defense Department to address changes in Tricare cost shares. While private insurance plans are indexed to keep pace with inflation, the cost-share portion of Tricare has not changed since 1996, he explained.
As military medicine moves forward, more and more work is going into how the system treats traumatic brain injuries and post-traumatic stress disorders. The department is moving out on these and other aspects of psychological health, Jones said, and Congress has funded additional research into these disorders. "Exciting things are happening and will happen in that area," he said.
The department has added specialists closer to the front to help warriors with psychological wounds. Jones said the military has come a long way toward eliminating the stigma associated with seeking mental health help, but more needs to be done.
"Let's erase the stigma associated with psychological wounds," he said. "Whether it's a wound to your body or a wound to your mind, it's the same thing. You need to get assistance."
Jones said substandard conditions found at Walter Reed Army Medical Center last year gave the department "a black eye." He noted that the problems at Walter Reed were not in trauma care, but in follow-on care and administrative processes.
"The department has made tremendous strides in trying to improve the care around the wounded warriors and their families," he said.
At the Military Health Services annual conference here next week, Jones will host a discussion on the future of military health care. This year's conference theme is "Caring for America's Heroes." More than 3,000 attendees are expected.
The conference is an attempt to communicate ideas throughout the force, and also provides an opportunity for DoD leaders to get input from the field, Jones said.
But it all begins with people, Jones said, and the nation's wounded warriors are in the best possible hands. From the medics and corpsmen on the ground to the doctors at the combat support hospitals to the specialists at Walter Reed and the National Naval Medical Center at Bethesda, Md., all are providing the best trauma care in the world, he said.
"Without that team, without that system, we would not be able to do the job that we are doing," Jones said. Servicemembers who would have died of their injuries in the past are now surviving, thanks to the commitment, training and medical know-how of those personnel, he said.
By Jim Garamone
American Forces Press Service
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