First Class Sacrifice, Second Class Care

June 18, 2007— -- Wounded veteran Jason Estes, 21, waited at the door. He peered from his wheelchair into the proceedings of a presidential commission mandated to fix a patchwork healthcare system for Vets like him -- severely injured servicemen and women who defy standard care formulas.

"There's no question that there's no system here for continuing care when there are complex wounds, both a combination of mental health and physical," said the Commission Co-Chair Donna Shalala, the former Secretary of Health and Human Services during the Clinton administration.

Monday's emotional family testimony underscored the Pentagon's recent findings about the "woefully inadequate" mental healthcare services for the nearly 40 percent of soldiers, a third of Marines and half of the National Guard members who show symptoms of post traumatic stress disorders.

High numbers of traumatic brain injuries caused by shock waves emitted from improvised explosive devices common in Iraq and Afghanistan also add to the strain on the mental healthcare system.

Wounds of War

The crown of Jason's head is a white knot of scars not from the blast that caused him to have to learn to speak again, but from a bedsore sustained during his three-month long coma while he healed from burns covering 60 percent of his body.

In an aside, Jason's dad, Mike Estes, told ABC News, "Now everything centers on Jason. It's like having a 170 pound infant."

The Baltimore VA hospital referred the Estes family to a private company called Humanim, which Dad called the "one stop shop." A Humanim counselor even came to the house to help Jason and his 15 year-old sister work through issues.

Even so, Jason has three government case managers and the family has asked for another to coordinate tapping into charities and programs available in his community.

Many injured vets remain on the outside. Often their families are the ones fighting to have them fully brought into the conflicting world of military hospitals, Veterans Affairs hospitals and private healthcare providers, all offering some services and not others, some for a fee and others free.

Secretary Shalala took aim at the inequity: "It's a very complex system in which the world's greatest experts seem to be their mothers and grandparents."

Sarah Wade quit college and lost her job when her husband Ted came home from Iraq with an amputated arm with a closed-head brain injury. The emerging reality of a wounded soldier pairs brain trauma with more traditional wounds like missing or broken limbs, or burns.

"Being my husband's advocate, attendant, driver, case manager, and of course, spouse, is more than a full time job," she said.

Tears welled in Mrs. Wade's eyes during several portions of her testimony.

"As far as the Army was concerned my husband wasn't alive," she told the Commission in reference to learning that her husband had been temporarily retired without their knowledge -- the Army did not ask for his signature on the papers claiming he wasn't available.

The couple from Chapel Hill, N.C. ran a car into the ground traveling up and down the mid-Atlantic coast, accessing different specialty centers for each of Ted's wounds.

'Seamless' Care for Nation's Soldiers

Co-Chairs Shalala and former Senator Bob Dole, R-Kan., said the challenge of the president's commission was to remove such segmentation and make care "seamless."

The mandate grew from controversy over squalid facilities and the mismanagement of patient care at Walter Reed Medical Center for returning troops from Iraq and Afghanistan. Final recommendations will be delivered to an expectant White House and Congress next month.

The Pentagon responded with a Mental Health Task Force that plans to hire 200 more personnel, a 25 percent jump in counselors. Field trainings to reduce the stigma of post-traumatic stress disorder are also outlined.

"The Task Force arrived at a single finding underpinning all others: The Military Health System lacks the fiscal resources and the fully-trained personnel to fulfill its mission to support psychological health in peacetime or fulfill the enhanced requirements imposed during times of conflict," the report said.

The presidential commission also seeks to find ways to reduce the burden on families who are often forced into the role of care coordinators due to a lack of sound communication between the different healthcare systems vets can access, said the leadership.

"We've heard over and over again that families need to give up their jobs, move to the place where their soldier can get the best possible care. Their lives are changed forever," said Shalala. "We need to put a different system in place that relieves these families, but more importantly someone with complex illnesses can get that help and get it in a seamless way over a very long period of time."

After Jason's family positioned his wheelchair before the panel, Dole leaned across the table and thanked Jason for his service.

After 18 months of pained recovery from numerable serious injuries, he responded simply, telling Dole, himself wounded in World War II, "No problem."

ABC News' Lisa Chinn and Radia Kirit contributed to this report.