Newspaper article MinnPost.com

'Back Home': Health Care Costs Mount as Injured Veterans Survive Longer

Newspaper article MinnPost.com

'Back Home': Health Care Costs Mount as Injured Veterans Survive Longer

Article excerpt

Editor's note: This report is part of a project on post-9/11 veterans in America produced by the Carnegie-Knight News21 program.

Eighth in a series of articles.

Jerral Hancock wakes up every night in Lancaster, Calif., around 1 a.m., dreaming he is trapped in a burning tank. He opens his eyes, but he can't move, he can't get out of bed and he can't get a drink of water.

Hancock, 27, joined the Army in 2004 and went to Iraq, where he drove a tank. On Memorial Day 2007 -- one month after the birth of his second child -- Hancock drove over an IED. Just 21, he lost his arm and the use of both legs, and now suffers from post-traumatic stress disorder. The Department of Veterans Affairs pays him $10,000 every month for his disability, his caretakers, health care, medications and equipment for his new life.

No government agency has calculated fully the lifetime cost of health care for the large number of post-9/11 veterans of the wars in Iraq and Afghanistan with life-lasting wounds. But it is certain to be high, with the veterans' higher survival rates, longer tours of duty and multiple injuries, plus the anticipated cost to the VA of reducing the wait times for medical appointments and reaching veterans in rural areas.

"Medical costs peak decades later," said Linda Bilmes, a professor in the Kennedy School of Government at Harvard University and co-author of "The Three Trillion Dollar War: The True Cost of the Iraq Conflict."

Injuries worsen with age

As veterans age, their injuries worsen over time, she said. The same long-term costs seen in previous wars are likely to be repeated to a much larger extent.

Post-9/11 veterans in 2012 cost the VA $2.8 billion of its $50.9 billion health budget for all of its annual costs, records show. And that number is expected to increase by $510 million in 2013, according to the VA budget.

Like Hancock, many veterans returning from Iraq and Afghanistan have survived multiple combat injuries because of military medicine's highly advanced care. Doctors at Brooke Army Medical Center in San Antonio repaired Hancock's body with skin grafts and sent him to spinal-cord doctors for the shrapnel that ultimately left him paralyzed. He still has his right arm, but he can only move the thumb on his right hand.

Injuries like Hancock's likely will lead to other medical issues, ranging from heart disease to diabetes, for example, as post-9/11 veterans age.

"So we have the same phenomenon but to a much greater extent," Bilmes said. "And that drives a lot of the long-term costs of the war, which we're not looking at at the moment, but which will hit in 30, 40, 50 years from now."

Veterans like Hancock with polytraumatic injuries will require decades of costly rehabilitation, according to a 2012 Military Medicine report that analyzed the medical costs of war through 2035. More than half of Iraq and Afghanistan veterans are between the ages of 18 and 32, according to 2011 American Community Survey data. They are expected to live 50 more years, the Institute of Medicine reports.

About 25 percent of post-9/11 veterans suffer from post- traumatic stress disorder, and 7 percent have traumatic brain injury, according to Congressional Budget Office analyses of VA data. The average cost to treat them is about four to six times greater than those without these injuries, CBO reported. And polytrauma patients cost an additional 10 times more than that.

Post-9/11 veterans use the VA more than other veterans and their numbers are growing at the fastest rate. Fifty-six percent of Iraq and Afghanistan veterans use the VA now. and their numbers are expected to grow by 9.6 percent this year and another 7.2 percent next year, according to a VA report from March 2013.

Polytrauma care system

In response to multiple injuries suffered by Iraq and Afghanistan veterans, the VA established its polytrauma care system in 2005, creating centers around the country where veterans are treated for multiple injuries, ranging from TBI and PTSD to amputations, hearing loss, visual impairments, spinal-cord injuries, fractures and burns. …

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