For Gamal Awad, the son of a Sudanese immigrant, the costs of war are measured in credit-card debt and persistent thoughts of suicide. Memories of rocket attacks and violence during his deployment to Iraq broke him, the California resident told an Associated Press reporter recently. His health care bills keep him down. Yet advocates for wounded soldiers like Awad say it’s the Department of Veterans Affairs (VA)—often the only financial lifeline for soldiers returning from war—that bears much of the blame. VA officials insist their “prime motivation” is to help disabled veterans. Critics, however, are unconvinced. “The wounded and their families no longer trust that the government will take care of them the way they thought they’d be taken care of,” observes Mary Ellen Salzano, a veterans’ advocate.
Six years and two wars since 9/11, the health-care system for U.S. veterans is in disarray, advocates and experts say. The Bush administration disagrees and President Bush made that clear in visits to wounded Iraq and Afghanistan veterans ahead of the Veterans' Day holiday. Still, the numbers are daunting. Congressional analysts say 1.6 million service members have deployed to Iraq and Afghanistan, with nearly half now eligible (PDF) for VA health care benefits.
Of those, thirty thousand troops have been injured in action and over 4,200 have died in both wars. Statistically these are good figures for military medicine; soldiers are surviving at rates never before seen in war. But costs associated with treating the wounded are skyrocketing, putting historic strains on the VA. The Congressional Budget Office estimates the agency’s medical expenditures could top $9 billion by 2017, with an additional $4 billion in survivors’ benefits. Linda Bilmes, an expert in public policy at Harvard University’s John F. Kennedy School of Government, estimates (PDF) disability compensation and medical care costs could reach $700 billion over the lifetime of these soldiers.
For Washington the numbers are especially tragic, and increasingly political. Sen. Patty Murray (D-WA), used the Democrats’ weekly radio address November 3 to accuse Bush of failing to adequately fund the Veterans Affairs Department. But three days later Republicans were accusing Democrats of playing politics with veterans’ health by including the VA appropriations package in “a sprawling, pork-laden, domestic spending bill.” “Funding for the nation's veterans should not be held hostage while Congress attempts to add billions in unrelated spending,” said (AP) a White House statement.
Political squabbling aside, experts agree the VA’s diagnosis is grim. The scope of the epidemic was highlighted most dramatically in February 2007 when the Washington Post detailed substandard treatment of injured soldiers at the Walter Reed Army Medical Center. But Walter Reed is now seen as just the tip of an emerging health care crisis. The Congressional Research Services estimates sixty thousand troops have been treated for traumatic brain injuries, while the Congressional Budget Office reports 37 percent of all veterans receiving VA care have been seen for mental health problems. And a U.S. Senate analysis finds the influx of returning veterans has created a backlog (PDF) of 400,000 claims and has increased waiting time for claims processing to nearly six months.
Reforming veterans’ health care isn’t the only long-term challenge the military will face as the wars in Iraq and Afghanistan churn on, as this Backgrounder explains. But it may be the most emotional. “Is there really any doubt that the system for funding VA health care is broken?” Joseph A. Violante, legislative director for the Disabled American Veterans, asked lawmakers in October 2007. “In our judgment a change is warranted and long overdue.” But as Retired Army Col. Daniel Smith writes, real change will hinge on politicans' ability to close the gap between paying for war and caring for those who fight them.