VCS Reveals Estimated One Million Veteran Patients Treated by VA by End of 2013, with Cost of $1 Trillion Over 40 Years
July 27, 2011 (VCS) – In a written statement to Senators on the Committee for Veterans Affairs, VCS urges Congress to order VA and DoD to reveal true costs of wars in Iraq and Afghanistan.
Written Statement for the Record
Paul Sullivan, Executive Director
Veterans for Common Sense
For the Committee on Veterans’ Affairs, United States Senate
Hearing on Examining the Lifetime Costs of Care for Our Newest Generation of Veterans
Veterans for Common Sense (VCS) thanks Committee Chairman Patty Murray, Ranking Member Richard Burr, and Senators on the Senate Committee on Veterans’ Affairs for allowing us to submit this written statement for the record for your hearing, “Examining the Lifetime Costs of Care for the Newest Generation of Veterans,” specifically the enormous escalating human financial consequences of the Iraq and Afghanistan conflicts for the United States.
VCS is a non-profit based in Washington, DC, focusing on the causes, conduct, and consequences of war. We provide public relations and government relations advocacy for our service members, veterans, and families.
VCS continues leading the national effort uncovering the human and financial costs of the Iraq and Afghanistan wars. Our service members, veterans, families, and the American public have a right to know the facts about the costs of war. In their groundbreaking book published in 2008, The Three Trillion Dollar War: The True cost of the Iraq Conflict, Linda Bilmes and Joseph Stiglitz wrote:
By now it is clear that the U.S. invasion of Iraq was a terrible mistake…. Understanding the costs of the war has not been easy, and it would not have been possible without the help of many. The fact that so much of the data and information that should have been publicly available was not meant that some critical pieces of information have had to be obtained through the Freedom of Information Act (FOIA). We thank Paul Sullivan of Veterans for Common Sense, who helped us to understand the situation facing returning Iraq and Afghanistan war veterans, and who provided us with crucial data from the Defense Department and Department of Veterans Affairs obtained under FOIA.
In the past year, VCS was honored to provide DoD and VA reports to Catherine Lutz at Brown University for her larger study on the costs of the Iraq and Afghanistan wars. Please see the web site http://costsofwar.org/ for further details.
Key Facts: One Million Patients by 2013, with a 40-Year Cost of $1 Trillion
VCS begins by presenting the Committee with the most current and salient official government statistics about the human and financial costs of the current conflicts. These are facts VA and DoD refuse to provide on a consistent, complete, or transparent manner to the Congress or the public.
As of December 2010, VA reports reveal 654,384 new, first-time veteran patients were treated VA hospitals and clinics since 2001. Based on an average of nearly 10,000 new patients each month, VCS estimates the count of new Iraq and Afghanistan war veteran patients treated by VA will exceed 720,000 on July 31, 2011, and reach as many as one million by December 31, 2013.
According to their September 30, 2010, testimony before the House Committee on Veterans’ Affairs, Linda Bilmes and Joseph Stiglitz now estimate the financial cost of the Iraq and Afghanistan wars to be in the trillions of dollars. Bilmes and Stiglitz have criticized the government for failing to collect current and future cost data. Using data obtained by VCS, it is estimated that:
Taking these costs into account, the total budgetary costs associated with providing for America’s war veterans from Iraq and Afghanistan approaches $1 trillion.
VCS Request for Action by Congress
VCS has two major requests today. We urge Congress to pass a new law mandating the Administration collect robust, consistent, and accurate data in a transparent manner so DoD, VA, and Congress can accurately estimate, monitor, and plan for the influx of post-war casualties from the current wars as well as any future wars.
Furthermore, VCS urges Congress to establish a Trust Fund so future generations of veterans are protected from unwarranted assaults on funding for VA healthcare and benefits.
Recent Official Statistics
Government statistics pieced together from several reports paint a disturbing picture of enormous human suffering among our Iraq and Afghanistan war service members and veterans. VCS obtained the following facts from DoD and VA using FOIA:
According to DoD:
• At the end of June 2011, a total of 6,098 U.S. service members died in the Iraq War and Afghanistan War combat zones; this includes 289 confirmed suicides.
• At the end of June 2011, a total of 100,600 U.S. service members wounded in action or medically evacuated due to injuries or illnesses that could not be treated in the war zones.
• The grand total of U.S. battlefield casualties reported by DoD is nearly 107,000.
According to VA:
• As of December 2010, VA treated and diagnosed 654,384 new, first-time Iraq War and Afghanistan War veteran patients. Based on our analysis of 10,000 new patients per month, VCS estimates VA will have treated 720,00 patients as of July 31, 2011.
• Please note that VA’s report excludes veterans who sought private care, retired veterans treated by the military, and student veterans treated at campus clinics. VA’s count also excludes medical treatment for wounded, injured, or ill civilian contractors from the U.S. deployed to the war zones.
• As of December 2010, VA received 552,215 disability compensation and pension claims filed by our Iraq War and Afghanistan War veterans.
• When VA and DoD reports are viewed side-by-side, VA data reveals more than 100 new, first-time veteran patients for each battlefield death reported by DoD.
• At the current rate of nearly 10,000 new veteran patients and claims entering the VA medical and benefits systems each month, VCS estimates a cumulative total of one million patients and claims by the end of 2013.
DoD, “Global War on Terrorism – Operation Enduring Freedom, By Casualty Within Service, Oct. 7, 2001, Through Jul 5, 2011″ (Afghanistan War).
DoD, “Global War on Terrorism – Operation Iraqi Freedom, By Casualty Category Within Service, Mar. 19, 2003, Through Jul 5, 2011″ (Iraq War, Mar. 2003 through Aug. 2010).
DoD, “Global War on Terrorism – Operation New Dawn, By Casualty Within Service, Sep. 1, 2010 Through Jul 5, 2011″ (Continuation of Iraq War since Sep. 2010).
VA, “VA Benefits Activity: Veterans Deployed to the Global War on Terror,” Through Sep. 2010, Feb. 2011.
VA, “Analysis of VA Health Care Utilization Among US Global War on Terrorism Veterans, 1st Quarter, Fiscal Year 2011,” Apr. 2011.
VA, “VA Facility Specific OIF/OEF Veterans Coded with Potential PTSD Through 1st Quarter FY 2011,” Apr. 2011.
Missing Facts Prompt Need for Reports
In order for VA and DoD to properly manage the human and financial cost of providing medical care for our casualties, more robust data must be collected by the Administration and then and analyzed immediately by the Administration, Congress, academics, and advocates in a transparent and easy to understand manner. In short, the best policies for our service members and veterans are designed, implemented, and then evolve over time with the best available information.
• VA must be able to answer simple, straightforward questions. For example, what is the total number of unique deployed Iraq and Afghanistan war veterans who have received any VA benefit since returning home? The list of benefits includes, but is not limited to healthcare at VA clinics and hospitals, counseling at VA Vet Centers, disability compensation, life insurance benefits, home loan guaranty, and vocational rehabilitation. VCS remains highly alarmed VA remains incapable and unwilling to answer these easy questions. Congress can and must fix this now with a new law mandating reports.
• DoD and VA must prepare an official accounting of the financial costs for VA benefits. What did taxpayers pay for treatments and benefits? For the past several years, VCS has requested this information from VA and DoD using the Freedom of Information Act. VA has not provided any cost data. Starting in 2001, VA employees urged VA leaders to begin tracking war-related benefit use and costs, and nearly all requests were refused by political appointees of the previous administration.
• DoD must provide an accounting of all discharges by type and branch of service, sorted by year, to monitor trends for both deployed and non-deployed service members since 1990. Two prior hearings by Congress documented how the military improperly discharged tens of thousands of service members. In many cases these veterans were at high risk of readjustment challenges due to Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD). As the number of less than fully honorable discharges increases, additional highly vulnerable veterans flood into society. Many of these veterans either don’t seek VA assistance or are refused VA help, instead turning to private, state, local, or university campus programs for assistance that should have been provided by the Federal government. VCS also believes the military, in many cases, releases service members from active duty with less than fully honorable discharges in an effort to avoid long-term healthcare and disability benefit costs.
• VA should monitor negative post-deployment outcomes, such as homelessness, suicides, divorce, and crime, as well as state, local, and privately funded expenditures on veterans. The most important oversight remains the Administration’s inability to provide complete and accurate active duty, Reserve, National Guard, and veteran suicide data. Every year DoD has set new, and highly disturbing, records of active duty suicides. Most of the initial monitoring began with FOIA requests from advocacy organizations or journalists investigating patterns of disturbing developments such as suicides, homicides, unemployment, and homelessness. VA and DoD only began limited monitoring and research after repeated advocacy organization, media, and Congressional inquiries.
• The Department of Labor should monitor unemployment and underemployment, both for veterans and families. Veterans often move from the military installation to their home town shortly after discharge. Often, these cross-country moves uproot spouses from their jobs. The use of the Post-9/11 GI Bill, legislation introduced by Senator Jim Webb of Virginia, by hundreds of thousands of Iraq and Afghanistan war veterans may be masking already alarming reports of high unemployment among returning veterans.
• VA and DoD should monitor and report on the positive post-combat, post-deployment, and post-military outcomes of our veterans. For example, new businesses started by veterans, higher wages earned by veterans, diplomas earned by veterans, increased homeownership among veterans, and other signs of a vibrant post-war adjustment to civilian life. We ask for this information because our nation remains woefully ignorant of the tremendous positive benefit of the Post-World War II “GI Bill” social programs that provided government funded assistance for higher education and home purchases, creating a post-war economic recovery that lasted decades.
• VA and DoD are urged to sort the data. For example, National Guard and Reserve status are often overlooked as key demographic factors among returning veterans. In addition, standard sorting methods, such as age, gender, rank, and branch of service should be available, too.
Urgent Need for Trust Fund and National Plan
In September 2010, VCS testified before the House Committee on Veterans’ Affairs in support of a National Trust to provide care and benefits for veterans. We believe our nation must learn from the past so we do not repeat mistakes. VCS endorses the Vietnam Veterans of America, when they remind us that, “Never again shall one generation of veterans abandon another.”
This is why Veterans for Common Sense fully endorses the proposal by Linda Bilmes and Joseph Stiglitz to create a Trust Fund to make sure our veterans receive the healthcare and benefits they earned.
As a non-profit advocacy organization, VCS uses FOIA to obtain data from DoD and VA to monitor and publicize the needs of our veterans. VCS was honored to provide our data to Linda Bilmes and Joseph Stiglitz for their book. The authors called for the creation of “A Veterans Benefit Trust Fund . . . so that veterans’ health and disability entitlements are fully funded as obligations occur.” In their book, the experts stated:
There are always pressures to cut unfunded entitlements. So, when new military recruits are hired, the money required to fund future health care and disability benefits should be set aside (“lockboxed”) in a new Veterans Benefit Trust Fund. We require private employers to do this; we should require the armed forces to do it as well. This would mean, of course, that when we go to war, we have to set aside far large amounts for future health care and disability costs, as these will inevitably rise significantly during and after any conflict (“Reform 12,” page 200).
The issue of establishing a Trust Fund is timely because we have now endured nearly ten years of war in Afghanistan, and more than seven years of conflict in Iraq. In 1995, Congress was forced to intervene and appropriate $3 billion in emergency funding for VA. One of the main reasons cited by VA for the funding crisis was the unexpected and unanticipated flood of Iraq and Afghanistan war veterans. Thanks to the strong pro-veteran leadership of Senator Patty Murray, the daughter of a World War II veteran, VA was given additional resources to meet the tidal wave of new, first-time Iraq and Afghanistan war veteran patients flooding into VA. With her leadership, and the efforts of this Committee and staff, there has been a sustained and deeply appreciated effort to fund VA at a higher level to meet the obligation of our country to our veterans.
The threat against veterans in Congress is real. As recently as July 2011, Senator Tom Coburn introduced an amendment to eliminate the presumption of service connection for Vietnam War veterans exposed to the poison Agent Orange. Fortunately, for veterans, the proposal was defeated. Similarly, in January 2011, Representative Michele Bachmann proposed cutting $4.3 billion from VA’s healthcare and benefits budget. After an outcry from veteran organizations led by VCS, she withdrew her plan.
Prior Administration Failures
The significant post-deployment statistics about our veterans must be contrasted with serious mistakes made during 2002. Nine years ago the previous Administration prepared no casualty estimate for the Iraq War. There was no plan to monitor or estimate fatal or non-fatal casualties, even though VA staff sought to create such systems. There was no plan to provide long-term medical treatment and disability compensation for non-fatal casualties.
Honoring and remembering our fallen, our wounded, our injured and ill, VCS quotes the eloquent poetry of Archibald MacLeish, a World War I veteran and former head of the Library of Congress. During World War II, MacLeish wrote:
They say, We leave you our deaths: give them their meaning: give them an end to the war and a true peace: give them a victory that ends the war and a peace afterwards: give them their meaning.
As an organization of war veterans, Veterans for Common Sense is here today to give meaning to all of our nation’s fallen, wounded, injured, and ill who deployed to Southwest Asia since 1990: Our Nation must learn the painful lessons from prior wars and take care of our veterans who enlist in our military to protect and defend our Constitution, even when the American public does not support the war. This also means monitoring post-war activity among veterans so their needs are promptly met.
VCS tried to inform our nation about past government mistakes. On March 10, 2003, as our Nation prepared to re-invade Iraq, VCS petitioned for calm and reason. As war veterans who actually served on Iraqi battlefields during 1991, VCS wrote a detailed letter to President George W. Bush co-signed by 1,000 veterans:
Over the long term, the 1991 Gulf War has had a lasting, detrimental impact on the health of countless people in the region, and on the health of American men and women who served there. Twelve years after the conflict, over 164,000 American Gulf War veterans are now considered disabled by the U.S. Department of Veterans Affairs. That number increases daily…. Further, we believe the risks involved in going to war, under the unclear and shifting circumstances that confront us today, are far greater than those faced in 1991. Instead of a desert war to liberate Kuwait, combat would likely involve protracted siege warfare, chaotic street-to-street fighting in Baghdad, and Iraqi civil conflict. If that occurs, we fear our own nation and Iraq would both suffer casualties not witnessed since Vietnam.
We regret to inform you the White House never answered our letter. Our veterans who raised serious, legitimate concerns about escalating the Gulf War with another invasion of Iraq were brushed aside in the rush to war. This must not happen again.
Earlier, on October 12, 2002, our VCS Executive Director, Charles Sheehan Miles, published an editorial criticizing the Congressional Budget Office (CBO) for failing to estimate the cost of caring for war and post-war casualties. The decorated Gulf War veteran wrote:
In a surprisingly rosy cost estimate of something which can’t be accurately estimated, the Congressional Budget Office Monday released an analysis of what Gulf War II might cost in real dollars paid by U.S. taxpayers. Only they left out the most important part: the casualties. The CBO estimate is naïve and unrealistic when you consider the kind of war we are preparing to enter – an open-ended war of regime-change and occupation and empire building that may involve heavy casualties in an urban setting such as Baghdad. The CBO report is illuminating and instructive for what it avoids. CBO uses the word “assume” 30 times, “uncertain” 8 times, “unknown” 4 times. Finally, twice it says there is “no basis” for an estimate on key items. In other words, it’s a wild guess: kind of like taking your broker’s advice to buy Enron or WorldCom last summer. CBO states up front: “CBO has no basis for estimating the number of casualties from the conflict,” therefore, any discussion of casualties was simply excluded.
VCS advocates pre- and post-deployment exams, as required by the 1997 Force Health Protection Act (PL 105-85) as well as hiring more DoD medical professionals to provide exams and treatment. VCS believes early evaluation and treatment are best because treatments are the most effective and often the least expensive. Recently published medical research conducted by Dr. Susan Frayne, of the VA Palo Alto Health Care System and Stanford University supports our VCS advocacy. Dr. Frayne told Businessweek on September 24, 2010:
Looking to the future, the impetus for early intervention is evident. If we recognize the excess burden of medical illness in veterans with PTSD who have recently returned from active service and we address their health care needs today, the elderly veterans of tomorrow may enjoy better health and quality of life.
As of July 2010, the military began implementing the Force Health Protection Act on a limited basis. VCS urges full DoD compliance with the law: universal face-to-face medical exams and prompt treatment for our service members when needed. We also thank the President for sending condolence letters to the families of our service members who completed suicide in the war zone. President Barack Obama has improved understanding of war-related mental health conditions and reduced stigma and discrimination against veterans with a stroke of his pen.
There are very serious lessons to be learned from the Administration’s failure to monitor returning veterans. As of 2009, the widely respected and credible Institute of Medicine, part of the National Academy of Science, estimated as many as 250,000 Gulf War veterans remain ill after exposures to toxins while deployed to Southwest Asia during Desert Shield, Desert Storm, and Provide Comfort between 1990 and 1991. This research, mandated by the “Persian Gulf Veterans Act of 1998,” is confirmed by VA’s Research Advisory Committee on Gulf War Veterans’ Illness. If DoD and VA had not fought so viciously against Gulf War veterans and scientific research, then facts and research would have been found sooner. Sadly, despite extensive scientific researcher, a few top officials at DoD and VA still deny the existence of Gulf War illness.
Thank you for the opportunity to submit this statement for the record. VCS hopes to hear from this Committee as well as individual Senators about how they intend to force DoD and VA to prepare reports about the consequences of the war. We also hope to hear from Senators about establishing a Trust Fund so veterans never again face attacks to cut our earned healthcare and benefits.
If we are to truly demonstrate our nation cares for our veterans, then we must do more than provided funding, care, and benefits. Our nation must also assure our service members, veterans, families, and citizens the government is constantly paying attention to the needs for those who protect and defend our Constitution. VCS wants future generations of Americans to want to serve our nation and know our nation will care for them when they return home.