medical or mental attrition?

August 25, 2005 4:55 PM

Pentagon to close Walter Reed Medical Center

More than 3,700 doctors and other medical personnel will be moved to a new and expanded facility to be built at the Navy's National Medical Center in Bethesda, Md., a few miles away. The move will cost nearly $989 million, and is expected to save more than $301 million over 20 years as the Pentagon seeks to streamline care and provide state of the art medical treatment for wounded servicemen and women.

And saving $301 million over 20 years is better than spending a billion dollars within the next 2 years, how? And never mind those 18,000+ American casualties coming back from the M.E. I'm sure they'll be able to improvise bedrolls during the renovations up in Bethesda...
posted by vhsiv (42 comments total)

You said it, man... this makes way too much sense... it blows my mind.
posted by watercressprincess at 5:01 PM on August 25, 2005

I talked to a sysadmin friend at Walter Reed today about this:

a) this move, if approved will take place in five to six years.

b) the current facility is not large enough nor modernized enough for their current needs.

Many people working there are extremely happy about this move, and would prefer it happen sooner.

c) there's 2000 parking spaces for 9000 staff
posted by Ryvar at 5:03 PM on August 25, 2005

Ryvar, right on. These things take time, usually. It's not like getting an eviction notice. I'm typically a nay-sayer to any gov't expansion, but this looks good to me, and it's probably about time.
posted by snsranch at 5:11 PM on August 25, 2005

c) there's 2000 parking spaces for 9000 staff

So they all start thier day with a rousing game of 9000 people playing musical parking spaces? That sounds like great fun.
posted by fenriq at 5:13 PM on August 25, 2005

Sounds like a typical morning for me too. It's gotten to the point where I don't feel bad about parking in handicapped spaces anymore.

But that probably means I'm going to Hell when I die.
posted by wakko at 5:20 PM on August 25, 2005

It's actually not about expansion, but rather removing unnecessary redundancy. There's no point in having a major army and navy hospital within 20 minutes of each other. In the final sum this whole facility reduction program is a cost-cutting measure. Perhaps not in this particular instance, but on the whole . . .

"The Pentagon says the closures will save $49 billion over the next 20 years and help restructure the military from a Cold War force for one better suited to meet the demands of the war against terrorists and future strategic needs."
posted by Ryvar at 5:20 PM on August 25, 2005

Surely the $300m is the net saving, after the $989m cost has been deducted?
posted by cillit bang at 5:22 PM on August 25, 2005

Yep. The article is confusing/wrong. It's a $300 million net savings. Here is the actual quote from the DOD: (from a really big PDF, it's on page 46, bolding mine)

Payback: The total estimated one-time cost to the Department of Defense to implement this recommendation is $988.759M. The net of all costs and savings to the Department during the implementation period is a cost of $724.204M. Annual recurring savings to the Department after implementation are $99.565M with a payback expected in 10 years. The net present value (NPV) of the costs and savings to the Department over 20 years is a savings of $301.249M.

posted by smackfu at 5:23 PM on August 25, 2005

It's part of the BRAC, which was just finalized yesterday, I assume. Walter Reed is just one of the hundreds of closures and re-alignments that are mandated by the BRAC. Personally, my office is getting moved from Newport, RI to Dahlgren, VA over the next three years, even though it was moved from VA to RI last time they did a BRAC.

Anyway, the BRAC still needs to be approved by both the Congress and Bush before it gets rolling, and even then it's going to take between 3 and 6 years.
posted by SweetJesus at 5:39 PM on August 25, 2005

Ryvar: point taken.

Disregarding the dollar amounts, this particular case, as you stated, is about elimating redundancy. Which I very much like.

Typically, BRACs and RIFs are not as well thought out and have in the past, left people feeling that such decisions were just arbitrary.

Also consider, and it may be the case with Walter Reed, that often the BRACs position the gov to sell off prime real estate as happened in San Diego a few years ago. So they are not just saving money but also building local economies in other ways.
posted by snsranch at 6:09 PM on August 25, 2005

If you guys want to get indignant about a BRAC closure, may I suggest you do some research on the closure of Brunswick Naval Air Station in Brunswick, Maine. BNAS is the last remaining active airbase in the Northeast. The closure of this station (in addition to putting some 400 civilians out of work and doing untold damage to the economy of a small town) will mean that the air response time for any surveillance/response to an incident in the North Atlantic changes from 5-15 minutes to over 3 hours.

No, its true we don't really need to look for Submarines in the North Atlantic any more, but that doesn't mean that there aren't other things out there in the ocean we shouldn't be keeping our eyes open for.....
posted by anastasiav at 6:13 PM on August 25, 2005

Way to do your research and think things through, before dropping essentially a single-link news FPP with half-baked editorialization on us.

I need some midol.
posted by drpynchon at 6:19 PM on August 25, 2005

Sorry if my previous post came out snippy, sns. Anyways, yeah, to sum this thread thus far:

It seems like a good move for staff, patients, and taxpayers.
posted by Ryvar at 6:20 PM on August 25, 2005

The closure of this station (in addition to putting some 400 civilians out of work and doing untold damage to the economy of a small town) will mean that the air response time for any surveillance/response to an incident in the North Atlantic changes from 5-15 minutes to over 3 hours.

Holy shit. As someone living in the Northeast that sounds (and this is purely at first glance) like a fairly bad idea. I know we didn't vote for Bush in the elections and we have the temerity to treat homosexuals like human beings, but still . . .

In any case. not all redundancy is bad - redundant shipyards are certainly useful in case one of them is seriously damaged, or if we find ourselves in a situation where we need to start cranking out ships in short order. But to tie this back to the topic at hand, I can't see how that applies to major medical hubs.
posted by Ryvar at 6:28 PM on August 25, 2005

anastasiav writes "If you guys want to get indignant about a BRAC closure, may I suggest you do some research on the closure of Brunswick Naval Air Station in Brunswick, Maine. BNAS is the last remaining active airbase in the Northeast."

I think most people would consider that payback for not voting the "right" way in 2004...
posted by clevershark at 6:30 PM on August 25, 2005

but that doesn't mean that there aren't other things out there in the ocean we shouldn't be keeping our eyes open for.....

Muslim sharks?
;)
posted by matteo at 6:37 PM on August 25, 2005

When I heard about the BRAC Closures yesterday, my kneejerk liberal reaction was "Ah, they're 'privatizing' a lot of military jobs with benefits and pensions, to make more work for Halliburton." Am I wrong?
posted by tizzie at 6:37 PM on August 25, 2005

I hear you Ryvar, it probably needs to be done, but I still want to know which of Cheney's friends get construction contracts.

And I want to know why it has to be a military hospital. Let me cop now to seeing the U.S. military as a bloated tool of evil.

And about "c) there's 2000 parking spaces for 9000 staff", doesn't the DC area have subways and buses? And don't most hospitals work in shifts, at least for patient care, so they never have all 9000 there at once? And how many of those vehicles are big heavy things that somehow fit only one occupant, the driver?
posted by davy at 6:38 PM on August 25, 2005

Not at all Ryvar, I'm more worried about our being indignant.

anastasiav: As a civil servant (Navy) I have been both BRACed and RIFed. This case of BNAS is a good example of the arbitrary nature of BRAC. In this particular case, Walter Reed, everyone wins. No lost jobs, perhaps more jobs, better care and better, newer facilities.

BNAS and Walter Reed are apples and oranges. But I do agree with your assessment.
posted by snsranch at 6:40 PM on August 25, 2005

And about "c) there's 2000 parking spaces for 9000 staff", doesn't the DC area have subways and buses? And don't most hospitals work in shifts, at least for patient care, so they never have all 9000 there at once? And how many of those vehicles are big heavy things that somehow fit only one occupant, the driver?

Shifts, the metro, and car pools are all used, but it's still a significant problem, I'm told.
posted by Ryvar at 6:45 PM on August 25, 2005

Having lived in DC I would say the reason for this is that DC has no vote in Congress and therefore is getting screwed by the nearby folk who want to bring home the pork barrel. Fed office after fed office gets plopped in MD or No Va.
posted by dances_with_sneetches at 6:51 PM on August 25, 2005

We've learned a heck of a lot in the past 20 years about how to build a hospital. One of the problems with older hospitals is that the nurse and physician workflow areas are designed for paper charts, when in fact much nurse and physician work these days requires keyboard, screen and mouse access to a computer. Another problem is that beds and equipment are larger and higher tech; there aren't enough power plugs, ether jacks, etc. Older hospitals do not have the benefit of state-of-the-art air and water filtration units, so important with the rise in ICU days and the emergence of superpathogens. You can't retrofit good ICU and OR HVAC - it has to be designed in. A good hospital these days, in addition to bacteria-free hot and cold running water and power, will deliver at the wall variously: air, O2, nitrous oxide, vacuum, ethernet, in-wall video and 128-lead EEG telemetry; radio cardiac telemetry; and who knows what else. All this stuff has to be accessible without breaking the nursing staff's back.

I could go on.

...point being, the better it is, the better we can take care of patients. A 20 year old hospital building in 2005 is terribly obsolete and harms its patients and the people who have to work there.
posted by ikkyu2 at 7:54 PM on August 25, 2005

Damn! Imagine all the money they would save if there wasn't a war! Imagine what money they'd save if they could account for the 32 tanks that disappeared.
posted by Balisong at 7:54 PM on August 25, 2005

matteo: (quoting anastasiev) " but that doesn't mean that there aren't other things out there in the ocean we shouldn't be keeping our eyes open for.....

Muslim sharks?
;)"

Yeah - with frickin laser beams on their heads!
posted by John Smallberries at 7:57 PM on August 25, 2005

OOps!! It was more than a few tanks.
It was a TRILLION FUCKING DOLLARS! Where did that go?
So closing these bases is probably in the best interest, but if you are looking for waste, you are looking in the wrong places.
posted by Balisong at 8:02 PM on August 25, 2005

Balisong (butterfly-knife:))- I totally agree. We're not happy closing bases, not happy opening new ones, not happy if we DON'T open new ones. It seems to come down to the fact that ANYTHING done under this administration is basically stupid.

Loosely quoting Bush: "It's not the responsiblility of the U.S. to promote freedom and democracy, It's God's job."

So essentially, he's saying the U.S. is doing the "Lord's" work.

Just like the fucking terrorists.
posted by snsranch at 8:18 PM on August 25, 2005

DOOD, I'm not ALWAYS a Butterfly-Knife.
You can just call me Balisong as a handle...
posted by Balisong at 8:23 PM on August 25, 2005

I quoth yet again my comparison:

George Bush the Midas President - in reverse.

Everything he touches turnes to shit.
posted by Balisong at 8:25 PM on August 25, 2005

Balisong: I don't say this to many people, but I like you.
posted by snsranch at 8:37 PM on August 25, 2005

(spread it around...)
posted by Balisong at 8:41 PM on August 25, 2005

I'll try not to derail here, but I'd like to mention NAS Brunswick. I've been there, on 'in and out' flights for a good deal "Lobster Run", but also in order to attend SERE School (Survial, Evasion, Resistance Escape). It's the home base for one of the military's Prisoner of War Schools. Granted, I've never had the misfortune of actually BEING a prisoner of war, but the school is - in my opinion - INVALUABLE nonetheless. The environment afforded by the Brunswick area is unique.
posted by matty at 8:48 PM on August 25, 2005

Also... I posted the wrong SERE sight. Here's the not quite so cool Brunswick sight (as best as I can find on the internets....)
posted by matty at 8:53 PM on August 25, 2005

matty: I dig your feeling about it, but clearly that is not the only SERE school "campus". We have one in San Diego, Ft. Bragg and as you linked, Texas, and I'm sure there are more. And a new one is DEST. I don't have a link handy but it is a new one in S.D. specifically for desert survival, I hope you can get in on that one too!

BTW, just curious, what branch of service are you in? I'm former Army working for the Navy. Yea we clash alot!
posted by snsranch at 9:05 PM on August 25, 2005

No, its true we don't really need to look for Submarines in the North Atlantic any more, but that doesn't mean that there aren't other things out there in the ocean we shouldn't be keeping our eyes open for.....

Gotta keep an eye on those shifty Dutch, and their Zwaardvises...

Zwaardivi?
posted by SweetJesus at 9:16 PM on August 25, 2005

I think most people would consider that payback for not voting the "right" way in 2004...

*shrug* The BRAC decision doesn't seem to be political, because everything else in our region got saved. In fact, they are adding 250 jobs to the Defense Finance Accounting Service in Limestone and not only did they save the Shipyard in Kittery but they went out of their way to praise the facility.

The BNAS decision is, in fact, based on a DoD recommendation (sort of), but an inexplicable one, at best. The DoD wanted to move all the aircraft out, but keep the base open with a skeleton crew "just in case" but the BRAC seemed to feel it was better just to close the station all together, so that the State could have the opportunity to redevelop it (they're talking about making it an airport) and thus have a shot at not taking such a large economic hit.

Here's some good info on NAS Brunswick is important. Feel free to forward that link on to your Federal Representatives.

Here's a kind of short local article on the closure

matty, you must know all about Fatboy's Drive In, then. My sweetie's dad was stationed there for almost 10 years (its interesting to think that my sweetie and I would never have met if not for BNAS), but I never knew they ran a POW school there....
posted by anastasiav at 9:20 PM on August 25, 2005

Here's some good info on NAS Brunswick is important. Feel free to forward that link on to your Federal Representatives.

Won't do any good, to tell you the truth. The BRAC vote will be for all or nothing, and Maine doesn't have enough clout to do anything about it. From what I've been hearing, the reason both submarine base in Groton, Conn and the shipyard in Portsmouth, Me were saved, is because the representatives basically threatened to vote no on ever military bill from now until the rapture if they were. The idea being that it doesn't matter to them if the bills fail, because they're not going to get any of the money anyway.

The time for negotiation has passed.
posted by SweetJesus at 9:33 PM on August 25, 2005

When I heard about the BRAC Closures yesterday, my kneejerk liberal reaction was "Ah, they're 'privatizing' a lot of military jobs with benefits and pensions, to make more work for Halliburton." Am I wrong?

Yes.
posted by fixedgear at 3:48 AM on August 26, 2005

b) the current facility is not large enough nor modernized enough for their current needs

I think this is the point that should be dwelled on a bit longer.
posted by Civil_Disobedient at 6:18 AM on August 26, 2005

Still choking on my breakfast after reading about Muslim sharks with frickin' laser beams. Brilliant.
posted by Ber at 7:08 AM on August 26, 2005

I'm still pondering why the submarine base in New London was going to close -- there was, according to its defenders, a lot of synergy with General Dynamics/Electric Boat submarine yard in nearby Groton. I'm also unclear on whether they were talking about closing down and moving the Submarine School that all US Navy submariners attend before they go to their first boat; was the Navy going to move that down to Norfolk along with the squadron of SSNs based out of New London?
posted by alumshubby at 8:12 AM on August 26, 2005

Walter Reed isnt closing, it's moving and expanding. The headlines are sensationalist. It really only matters in that the original buildings and location will be closed.


Hopefully they will build a mega shopping and apartment complex on the old grounds, that would be sweet, we dont have enough of those in Bethesda. The hidden cost to taxpayers: sprawl.
posted by stbalbach at 8:25 AM on August 26, 2005

local comment: I keep rereading stbalbach's comment "we don't have enough of those in Bethesda"....you're kidding, right? Though redevelopment of the base in DC will probably be good for the city.
posted by metoo at 2:19 PM on August 26, 2005