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Sunday, February 04, 2007

NPR's All Things Considered Considers DoD Casualty Counts and Costs

Joseph Shapiro files a report for NPR's All Things Considered examining the Pentagon's recent sizable downsizing of the official Iraq War casualty count. Listen to today's update on the story. Then click over to NPR's interactive Toll of War presentation.

Click on 'Article Link' below tags for more coverage...

The NYT reported on the erratic official casualty figures released to the public via DoD and VA websites:

  • 50,508 - total reported OIF troops wounded
  • 21,649 - revised by the DoD in early January
  • 18,586 - original figure before erroroneous update
In January, this 50,000 figure was used by Harvard Professor Linda Bilmes in a professional paper prepared for presentation at the ASSA meeting, 2007, Soldiers Returning From Iraq and Afghanistan: The Long-term Costs of Providing Veterans Medical Care and Disability Benefits [pdf].

It began:

THE NEW YEAR brought with it the 3,000th American death in Iraq. But what's equally alarming — and far less well known — is that for every fatality in Iraq, there are 16 injuries.

That's an unprecedented casualty level. In the Vietnam and Korean wars, by contrast, there were fewer than three people wounded for each fatality. In World Wars I and II, there were less than two. That means we now have more than 50,000 wounded Iraq war soldiers.

I first came across Bilmes in March 2006, when I recommended reading her earlier paper (co-authored by Nobel aureate economist Joseph Stiglitz), The Economic Costs of the Iraq War: An Appraisal Three Years After the Beginning of the Conflict [pdf].

The expected costs are staggering of our recent wars.

"The first Gulf War in 1991 was a short war — it only lasted four or five weeks — and there was a relatively low number of injuries and fatalities," she says. "However, we currently spend $4 billion a year for disability for soldiers who fought in that first Gulf War."

Bilmes says that when soldiers came back from that first Gulf War, 44 percent applied for VA disability benefits. And more than half now use the VA medical system as their main source of health care. Based on that, and current injury numbers, she estimates that the lifetime health-care costs for veterans of Afghanistan and Iraq will be $250 billion to $650 billion.

For her purposes, Professor Bilmes said, the higher figure was the relevant one because she was writing about the future demands that wounded veterans would place on the veterans’ health care system. Many of the veterans would be treated in the system regardless of whether they had been injured in combat or in vehicle crashes.

That 50,000 figure would soon be adjusted:

The 50,508 figure caught the attention of the Pentagon when Prof. Linda Bilmes of Harvard mentioned it in an opinion article on Jan. 5 in The Los Angeles Times. A few days later, said Professor Bilmes, who teaches public finance, she had a call from Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, challenging the number.

Professor Bilmes explained that she had used the government tally, the one on the “America’s Wars” page of the veterans’ department Web site. She faxed him a copy. A few days later, the number on the Web site was changed. A spokeswoman for Dr. Winkenwerder confirmed that he had called the veterans’ department to have the figure corrected and that the worker had misunderstood the Defense Department figures.

Now, if a DoD employee is confused over what the military considers a wounded casualty these days, imagine how confused the rest of us are. From NPR, the military responds:

Dr. Michael Kilpatrick runs the Pentagon office in charge of protecting the health of troops. He says the Pentagon and VA already have a pretty good sense of what returning soldiers need.

"What we're seeing is about a third of those people leaving active-duty service are going to the VA," Kilpatrick says. "And the big categories are for pain in the muscles, bones and joints, which is what we see most commonly in veterans. That's about a third. Another third is for mental health. And that, to us, again is not surprising."

Either way, Bilmes points out that it doesn't matter how the injuries occurred, how they're classified, because we're going to have to find a way to pay for the cost of their care either way.

One returning Iraq veteran offered this to the mix:

Patrick Campbell served as a medic with a National Guard infantry brigade. He lost some of his hearing in Iraq, the result of being too close to too many IEDs. And he's had mental health issues that are common of returning war veterans. ...

He says it doesn't matter to him that his own injuries weren't counted on some Pentagon Web site. He just wants to make sure there will be health care for him and other veterans when they need it. "These types of injuries might not be so bad now. But in 10, 20, 30 years — when people get older and those injuries start to aggravate and they turn into disability for the VA — those injuries become a big deal," Campbell says.

As previously noted, however, the DoD's own definition for 'casualty' includes these types of injuries and more. From the Department of Defense Dictionary of Military and Associated Terms (last updated on January 5, 2007) [pdf]:

Casualty: Any person who is lost to the organization by reasons of having been declared dead, missing, captured, interned, wounded, injured, or seriously ill.

Random Iraq War stats from her works:

  • $250 billion to $650 billion - lifetime health-care costs for veterans of Afghanistan and Iraq
  • $6.1 million - government assigned value for prime age male
  • 144,000 - returning vets who've accessed healthcare
  • 400,000 - backlog of VA healthcare claims awaiting processing
  • 20% - traumatic brain injury (TBI) portion of overall WIA
  • $35 billion - projected lifetime TBI treatment costs

Related Documents
The Economic Costs of the the Iraq War: An Appraisal Three Years After the Beginning of the Conflict - pdf
Soldiers Returning From Iraq and Afghanistan: The Long-term Costs of Providing Veterans Medical Care and Disability Benefits - pdf

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