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<DIV style="MARGIN-LEFT: 1em; MARGIN-RIGHT: 1em"><A
href="http://www.latimes.com/news/opinion/la-oe-bilmes5jan05,0,6627236.story?track=tothtml">http://www.latimes.com/news/opinion/la-oe-bilmes5jan05,0,6627236.story?track=tothtml</A><BR>
<H1>The battle of Iraq's wounded</H1>
<DIV class=storysubhead>The U.S. is poorly equipped to care for the tens of
thousands of soldiers injured in Iraq.</DIV>By Linda Bilmes<BR>LINDA BILMES
teaches public finance at the Kennedy School of Government at Harvard
University. She is the coauthor, with Joseph Stiglitz, of the report, "The
Economic Cost of the Iraq War: An Appraisa<BR><BR>January 5, 2007<BR><BR>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.<BR><BR>That means we
now have more than 50,000 wounded Iraq war soldiers. In one sense, this reflects
positive change: Better medical care and stronger body armor are enabling many
more soldiers to survive injuries that might have led, in earlier generations,
to death. But like so much else about this war, the Bush administration failed
to foresee what it would mean, failed to plan for the growing tide of veterans
who would be in urgent need of medical and disability care. The result is that
as the Iraq war approaches its fourth anniversary, the Department of Veterans
Affairs is buckling under a growing volume of disability claims and rising
demand for medical attention. <BR><BR>So far, more than 200,000 veterans from
Iraq and Afghanistan have been treated at VA medical facilities — three times
what the VA projected, according to a Government Accountability Office analysis.
More than one-third of them have been diagnosed with mental health conditions,
including post-traumatic stress disorder, acute depression and substance abuse.
Thousands more have crippling disabilities such as brain or spinal injuries. In
each of the last two years, the VA has underestimated the number of veterans who
would seek help and the cost of treating them — forcing it to go cap in hand to
Congress for billions of dollars in emergency funding.<BR><BR>The VA system has
a reputation for high-quality care, but waiting lists to see a doctor at some
facilities now run as long as several months. Shortages are particularly acute
in mental health care. Dr. Frances Murphy, the VA's deputy undersecretary for
health, recently wrote that some VA clinics do not provide mental health or
substance abuse care, or if they do, "waiting lists render that care virtually
inaccessible." <BR><BR>The VA also runs Vet Centers — 207 walk-in neighborhood
help centers that provide counseling to veterans and their families. These
popular, low-cost centers have already treated 144,000 new veterans. But they
are so understaffed that nearly half are sending veterans who need individual
therapy into group sessions or placing them on waiting lists, according to a
recent report by the House Veterans' Affairs Committee. <BR><BR>At the same
time, wounded veterans trying to obtain disability checks are being tied up in a
bureaucratic nightmare. The Veterans Benefits Administration has a backlog of
400,000 pending claims — and rising. Veterans must wait from six months to two
years to begin receiving the money that is due to them while the agency plods
through paperwork. The staff eventually helps veterans secure 88% of the
benefits they ask for — but in the interim, thousands of veterans with
disabilities are left to fend for themselves.<BR><BR>The situation is about to
go from bad to worse. Of the 1.4 million service members involved in the war
effort from the beginning, 900,000 are still deployed on active duty. Once they
are discharged, the demands for medical care and counseling will skyrocket, as
will the number of benefit claims. The Veterans for America organization
projects that VA medical centers may need to treat up to 750,000 more returning
Iraq and Afghan war veterans and that half a million veterans may visit the Vet
Centers. <BR><BR>And then there is the cost. After the Persian Gulf War in 1991,
half of all veterans sought VA medical care, and 44% filed disability claims.
Assuming that this pattern is repeated, the lifetime cost of providing
disability payments and healthcare to Iraq and Afghan war veterans will likely
cost U.S. taxpayers between $300 billion and $600 billion, depending on how long
the war lasts.<BR><BR>President Bush is now talking about spending more money on
recruiting in order to boost the size of the Army and deploy more troops to
Iraq. But what about taking care of those soldiers when they return home? The
VA's solution is to hire an additional 1,000 claims adjudicators to cut the
backlog.<BR><BR>A better idea would be to stop examining each application and
instead automatically accept all disability claims, then audit a sample (like
the IRS does for tax filings) to weed out fraud. Or at a minimum, simple claims
should be fast-tracked and settled within 60 days. We should also place more
counselors and more claims experts in the Vet Centers and harmonize
recordkeeping so veterans can move seamlessly from the Army's payroll into VA
hospitals and outpatient care. <BR><BR>One of the first votes facing the new
Democratic-controlled Congress will be another "supplemental" budget request for
$100 billion-plus to keep the war going. The last Congress approved a dozen such
requests with barely a peep, afraid of "not supporting our troops." If the new
Congress really wants to support our troops, it should start by spending a few
more pennies on the ones who have already fought and come home.
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