The US presidential commission investigating the plight of the soldiers wounded in the killing fields of Iraq and Afghanistan has focused on efforts to enable the GIs receive proper treatment in their own homes.
During its seventh and last hearing Friday, the Commission admitted today's veterans are more likely than those of previous conflicts to suffer from "polytrauma," including burns, brain injury and shrapnel from explosives, making their treatment more complicated.
The health care system should also take into account the strain that puts on family members, commissioners said, and should make more use of contractors who can help in out-patient care.
Because today's wounds are different and the families of the veterans are different — many are older, with homes and spouses to return to — more veterans should be allowed to return home for treatment, they said.
Returning patients to their homes can relieve the strain on some families, said commissioners, who reported that some relatives must now leave their homes and jobs to assist with their service members' treatment in distant hospitals run by the Departments of Defense or Veterans Affairs.
But caring for injuries at home requires support from the V.A., they said, and support offered now is often insufficient.
Another consideration is that the patients' physical wounds are also accompanied by post-traumatic stress disorder, commissioners said.
Senator Carl Levin, Democrat of Michigan and chairman of the Senate Armed Services committee said the Senate's veterans bill, which is scheduled for the floor, seeks to improve medical record sharing between the military and the Department of Veterans Affairs as well as address discrepancies in the disability ratings each department uses to determine how much in benefits a service member is paid each month.
Representative Steve Buyer, Republican of Indiana and the ranking member of the House Veterans' Affairs Committee, said he was concerned that the departments did not adequately use private contractors to provide outpatient treatment, which could allow patients to receive care at home rather than have to travel to a veterans hospital.
"If we're patient-centric, we should allow the transition of that patient to occur," Mr. Buyer said.
The commission, led by Donna E. Shalala, a Democrat and former secretary of health and human services, and Bob Dole, the Republican presidential nominee in 1996, was established in March after articles in The Washington Post described poor conditions at the Walter Reed Army Medical Center here.
"We're very solution-driven," Shalala said of the panel. "We will not be issuing a report that points fingers."