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Veteran Heath Care Costs High and Rising

Christian Science Monitor
July 1, 2005

Veterans of the wars in Iraq and Afghanistan will be much on the minds of their countrymen this Independence Day weekend. Marching in town parades. Lauded in speeches.

But the pride and the bunting are also a reminder that the price - and cost - of war go on many years after the fighting stops, that "to care for him who shall have borne the battle and for his widow and his orphan," as Abraham Lincoln put it, is as much an issue of national security today as are armored Humvees and trustworthy translators of Arabic.

The Senate got into a bipartisan snit over funding for veterans this week, Republicans and Democrats both raising alarms over a $1 billion shortfall for the Department of Veterans Affairs this fiscal year. On Wednesday, the Senate approved $1.5 billion in emergency funding for the VA. But the funding issue raises questions about the VA's ability to handle an increased workload as a result of the war.

With nearly 240,000 employees, the VA is larger than all other federal departments except the Pentagon. But even before the "war on terrorism" began, it had to scramble in dealing with the needs of 7.5 million enrolled vets, including a large number of homeless - 33 percent of homeless men in the U.S. are veterans.

Now, thousands of Iraq war vets are being added to the rolls, including many who have been wounded and will require lifelong care.

"Clearly, VA is not ready for this," says Dan Smith, a retired U.S. Army colonel and Vietnam veteran.

Since the U.S.-led invasion of Iraq began, an average of 474 U.S. service members a month have been wounded, injured, or become ill in the war zone. As of last week, the Defense Department put the total at 13,074.

But the total number of vets who still need help is much larger than that, and it's growing. As of February, VA officials reported, 85,857 of the 360,674 veterans of the wars in Afghanistan and Iraq who had separated from active duty - 24 percent - had sought health care from the VA. This included treatment for both physical injuries and mental health problems.

"The bottom line is there is a surge in demand in VA services across the board," Veterans Affairs Secretary James Nicholson told a House panel this week.

Earlier this year, Mr. Nicholson told lawmakers the VA had used 2002 estimates when assuming that 23,553 veterans of Iraq and Afghanistan would need medical care in 2005. Since then that number has been revised upward more than fourfold to 103,000. Part of the reason is the changing nature of war and the casualties it produces.

As helicopters did so prominently in Vietnam, new means of transporting and treating the wounded in Iraq are saving lives. But this also means a higher portion of overall casualties will need extended government benefits. During the wars of the 20th century, the ratio of wounded to killed in action was about 3 to 1. In Iraq that ratio is more than 9 to 1.

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