Six years into the "global war on terror," the Bush
administration, Congress, and federal agencies are scrambling to
address the health needs of battlefield veterans back from Iraq and
President Bush acknowledges that the current means of caring for
wounded and traumatized vets is "an antiquated system that needs to
be changed." A bipartisan commission says the need for fundamental
improvements in care management and the disability system "requires
a sense of urgency and strong leadership."
As a result, Mr. Bush has proposed administrative action and
legislation that would streamline the system for providing postwar
medical services and disability compensation to wounded veterans and
The numbers are daunting:
* Of the more than 1.4 million service men and women who have
served in the two war zones, nearly 700,000 have become eligible for
Department of Veterans Affairs (VA) medical care, of whom about
230,000 have sought such care since 2002.
* Depending on future force deployments, VA medical costs
associated with Iraq and Afghanistan could total between $7 billion
and $9 billion over the next decade, according to Congressional
Budget Office (CBO) projections. Disability compensation and
survivors' benefits could add another $3 billion to $4 billion.
* A total of about 30,000 troops have been wounded in action. The
survival rate of those wounded is higher than it was in Vietnam and
much higher than World War II, due to body armor, advances in
battlefield medical procedures, and more rapid evacuation.
Put another way, this means the number of those killed is a
relatively smaller portion of overall casualties. It also means
concern is growing about injuries and ailments that have come to
mark this war: amputations, traumatic brain injuries (TBI), and the
mental and emotional shock of combat.
"Of the [Iraq/Afghanistan] veterans who sought care from VA,
about 38 percent have received at least a preliminary diagnosis of a
mental health condition, and 18 percent have received a preliminary
diagnosis for PTSD [post-traumatic stress disorder], making it the
most common, but by no means, the only mental health condition
related to the stress of deployment," Michael Kussman,
undersecretary of the Veterans Health Administration, told a House
Committee on Veterans' Affairs hearing last week.
According to the Congressional Research Service, between 2003 and
2007 about 60,000 troops were diagnosed with either PTSD or TBI.
The VA is one of the largest federal bureaucracies, operating
more than 1,500 facilities providing help for veterans and their
families and employing about 200,000 people, including some 13,000
doctors and nearly 55,000 nurses.
Despite this, one concern is the growing need for medical
specialists to help war veterans.
In recent congressional testimony, Joseph Wilson of the American
Legion cited federal studies showing that by 2020, projected
retirements will create a shortage of about 24,000 physicians and
almost 1 million nurses nationwide. …