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Todd Bowers

Todd Bowers, Iraq and Afghanistan Veterans of America, Director of Government Affairs

Mr. Chairman, Ranking Member and distinguished members of the Committee, on behalf of Iraq and Afghanistan Veterans of America, and our tens of thousands of members nationwide, I thank you for the opportunity to testify today regarding this important subject.  I would also like to point out that my testimony today is as the Director of Government Affairs for the Iraq and Afghanistan Veterans of America and does not reflect the views and opinions of the United States Marine Corps.

The tremendous advancements in front-line medical care have made many combat injuries more survivable.  In Vietnam, the mortality rate for combat injuries was 1 in 4, while the mortality rate in Iraq is 1 in 10.  That means today’s battlefield medicine has saved approximately 6,000 American lives that would have been lost if we were still using Vietnam-era medical techniques.  This is a tremendous success story for the DOD medical system.  

But the corollary of the improved survival rate is an increase in the number of severely-wounded troops returning home.  As the Independent Budget states, “We are seeing extraordinarily disabled veterans coming home from Iraq and Afghanistan with levels of disability unheard of in past wars.”  Many of these young, wounded veterans will require long-term care, not just at Walter Reed and Bethesda, but in their communities across this country.  At the VA, these veterans with Traumatic Brain Injury and blast injuries are confronting a system designed to treat diabetes and Alzheimer’s.

The DOD and the VA have already taken some crucial steps to improve inpatient care for these young, severely-wounded patients.  There are four major Polytrauma Rehabilitation Centers, in Tampa, FL, Richmond, VA, Minneapolis, MN, and Palo Alto, CA, which use teams of physicians and specialists that administer individually tailored rehabilitation plans, including full-spectrum care for Traumatic Brain Injuries.  These centers are also part of the Defense and Veterans Brain Injury Center network.  


These key centers offer cutting-edge treatment for the severely-wounded troops who are receiving inpatient care.  But what is available to troops near their homes?  As of 2003, according to the GAO, “more than 25 percent of veterans enrolled in VA health care—over 1.7 million—live over 60 minutes driving time from a VA hospital.”  This number is likely higher today, because the mission in Iraq has relied heavily on recruits from rural areas often underserved by VA hospitals and clinics. This places a tremendous burden on the families and also the veteran.  With the current gasoline prices and many treatment centers hours away, treatment is often impossible to facilitate.  Imagine if you will that your loved one has returned from combat wounded and it is your responsibility to make sure they are receiving the proper treatment.  This is too much to ask of our service members and veterans’ families.

In response, the VA has created regional network sites that work with the major Polytrauma centers to cater to patients closer to their homes.  The VA is also planning to add new Polytrauma Support Clinics to provide follow-up services for those who no longer require inpatient care but still need rehabilitation.  The 75 Polytrauma Support Clinic Teams help veterans get access to specialized rehabilitation services closer to their home communities, and also are responsible for ensuring that these patients don’t “fall through the cracks” after leaving full-time care.   For hospitals without a Polytrauma Support Clinic, a single person has been designated as the “point of contact” to coordinate care for local veterans with polytraumas.

These are good first steps, but much more must be done to get these wounded veterans the care they need.  A “point of contact” that can offer referrals to distant hospitals and clinics is simply not an adequate response to a wounded veteran’s health care needs.  IAVA joins the other IB-VSOs in calling for increased funding for home and community-based care, and a detailed plan from the VA regarding their long-term response to the needs of today’s veterans.