NASA’s Astronaut Health Care System - Results of an Independent Review

Opening Statement By Chairman Mark Udall (Space and Aeronautics)

Good morning. I first want to welcome all of our witnesses to today’s hearing. We appreciate your service to the nation and your assistance to this subcommittee as we carry out our oversight responsibilities.

In particular, I would like to thank Col. Bachmann and his review committee for their efforts to provide NASA and the Congress with an independent assessment of NASA’s astronaut health care system.

I’d also like to thank Administrator Griffin for his willingness to ask for such a review – I think it was a good decision that reflects well on the agency.

It is clear to me that NASA’s astronauts represent the nation’s best and brightest. We all respect their skill and bravery. In carrying out their challenging missions, they often make it look so easy that we can sometimes forget that they are human beings who face the same medical and behavioral issues that the rest of us have to deal with, along with the added rigors of high-stress jobs, long hours of training, extended absences from families and friends, and high-risk space flights.

It thus is critically important that NASA ensure that the astronauts be provided the best possible medical and behavioral care throughout their careers.

In addition, NASA astronauts, flight surgeons, and support personnel need to be confident that the lines of communication within the agency are open and responsive so that concerns can be quickly identified and addressed in a manner that maintains the level of trust so vital to safety and optimal performance.

I don’t think anyone inside NASA would disagree with those goals.

That is why after reviewing Col. Bachmann’s committee’s report I decided that this subcommittee needed to hold a hearing to examine the report’s findings and recommendations. However, my decision was not made for the reason you might think.

While there has been a great deal of attention given to the finding related to alcohol use – and I have little doubt that there will be discussion of that finding at today’s hearing too – I think we do a real disservice to the independent review committee if we ignore the warning flags they are raising about the state of communications within the agency on both medical and behavioral matters affecting the astronauts.

Let me read just a few of the findings from the report that I think should concern us all:

“Many anecdotes were related that involved risky behaviors by astronauts that were well known to the other astronauts and no apparent action was taken. Peers and staff fear ostracism if they identify their own or others’ problems.”

“Several senior flight surgeons expressed their belief that their medical opinions regarding astronaut fitness for duty, flight safety and mission accomplishment were not valued by leadership other than to validate that all (medical) systems were “go” for on-time mission completion. Instances were described where major crew medical or behavioral problems were identified to astronaut leadership and the medical advice was disregarded. This disregard was described as “demoralizing” to the point where they said they are less likely to report concerns of performance decrement. Crew members raised concerns regarding substandard astronaut task performance which were similarly disregarded.”

“As the review progressed, it became apparent that major vulnerabilities, underlying root causes, and contributing factors extend well beyond the specific medical aspects of NASA operations…These issues are so ingrained and longstanding that it will take senior leadership action to remediate them.”

“There is no periodic psychological evaluation or testing conducted on astronauts. Once selected as an astronaut candidate, astronauts have no psychological evaluation for the remainder of their careers unless selected for long duration missions.”

“Astronaut medical and behavioral health care is highly fragmented…”

I don’t think anyone can listen to those findings and think all is well with NASA’s astronaut health care system.

This subcommittee needs to hear from Col. Bachmann the basis for his review panel’s findings.

Equally importantly, this subcommittee needs to hear from NASA management their plans for addressing the concerns raised by the independent review – not just the alcohol-related ones.

Whatever the merits of focusing the agency’s attention on trying to get employees to publicly verify or refute reports of alcohol use that those employees had provided in confidence to the independent review committee, I think it runs the risk of unintentionally worsening a communications environment at NASA in which, to quote the independent review committee: “Peers and staff fear ostracism if they identify their own or other’s problems.”

Instead, it may be more appropriate to take the “disconnect” between what is being said in private and what is being said in public by NASA personnel as another indicator that the broader issues raised by the independent review committee warrant close and sustained attention.

I hope that will be the approach taken in the days and weeks ahead.

Well, we have a great deal to examine today. I again want to welcome our witnesses, and I look forward to your testimony.

Opening Statement By Chairman Bart Gordon

Thank you, Chairman Udall, for yielding to me. I will be brief.

When NASA released the report of the independent review panel that examined NASA’s astronaut health care system, it provoked a bit of a firestorm due to the report’s references to astronauts and alcohol use.

Unfortunately, that firestorm has all but eclipsed what to me are some of the most important findings in the report – namely, the findings that indicate that flight surgeons and astronauts have faced difficulties in getting adequate attention paid to medical and behavioral problems.

When I read statements in the report such as:

“Many anecdotes were related that involved risky behaviors by astronauts that were well known to the other astronauts and no apparent action was taken. Peers and staff fear ostracism if they identify their own or other’s problems.”

And “Instances were described where major crew medical or behavioral problems were identified to astronaut leadership and the medical advice was disregarded. This disregard was described as ‘demoralizing’ to the point where they are less likely to report concerns of performance decrement...”

…those statements trouble me.

Getting to the bottom of the concerns raised by the panel is what I think NASA leadership needs to focus its attention on. And in getting to the bottom of those concerns, I hope NASA will heed the advice contained in Col. Bachmann’s written testimony:

“NASA must ensure that people can identify such safety and human performance concerns within NASA without fear of reprisal or career injury. Public statements that such things are simply impossible, challenging the veracity of these findings rather than acknowledging how difficult raising such concerns can be, do not encourage openness and safety.”

To my way of thinking – and with all due respect to Administrator Griffin – disparaging a finding in the independent review panel’s report as an “urban legend” doesn’t do much to encourage that needed openness…especially when the chair of that same independent panel is prepared to testify that the finding is based on voluntary interviews with eyewitnesses to the incidents.

I hope NASA can move beyond such statements and instead turn its attention to giving the findings and recommendations of Col. Bachmann’s panel the attention that they deserve.

He and his committee have done NASA and the nation a service in identifying a number of issues that need attention and in offering recommendations to improve NASA’s astronaut health care system.

NASA certainly doesn’t have to agree with all of those findings and recommendations. But I hope that the agency will take them seriously.

We all recognize the bravery and dedication of nation’s astronauts. We need to do our part to ensure that we give them the best astronaut medical and behavioral health care system possible.

Thank you, and I yield back my time.

Witnesses

Panel 1

1 - Col. Richard E. Bachmann
Chair, NASA Astronaut Health Care System Review Commander, School of Aerospace Medicine U.S. Air Force Commander, School of Aerospace Medicine U.S. Air Force
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2 - Dr. Richard S. Williams
Chief Health and Medical Officer National Aeronautics and Space Administration National Aeronautics and Space Administration
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4 - Mr. Bryan O'Connor
Chief, Safety and Mission Assurance National Aeronautics and Space Administration National Aeronautics and Space Administration
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3 - Dr. Ellen Ochoa
Director, Flight Crew Operations Johnson Space Center National Aeronautics and Space Administration Johnson Space Center National Aeronautics and Space Administ
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Panel 2

1 - Dr. Michael Griffin
Administrator National Aeronautics and Space Administration National Aeronautics and Space Administration
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