The Iraq-Afghan War has taken on a sad new face as stories of shoddy health care given returning veterans began surfacing lately. Newsweek brought us up short with its coverage last month of the Minnesota veteran suffering from depression, anxiety, and suicidal thoughts whose runaround at the local Veterans Administration hospital ended only when he managed to hang himself. More recently, the Washington Post’s series on deplorable conditions for injured veterans at storied Walter Reed Hospital has sent high-ranking heads rolling and gotten multiple blue ribbon commissions launched.
Again, we can only shake our heads at the Bush Administration’s folly in rushing us into war without giving remotely enough thought to what it would do once “shock and awe” had leveled strategic sections of Baghdad and statues of our old ally Saddam Hussein had been toppled, quietly complimenting ourselves for opposing this mendacious, misbegotten invasion so early and so often.
But that’s not going to be enough this time. These stories have their season. A year ago, Los Angeles was abuzz with concern about our chronic homelessness problem, as if we’d suddenly discovered we have 90,000 people living on our streets—geez, who woulda thunk? After that, it was Al Gore and the environment, then renewed interest in gang violence, all elbowed aside at times by Anna Nicole and Antonella. Indeed, the new generals and oversight commissions might do a better job of fixing the immediate problems facing the VA than the old ones who clearly phoned in the job. But a year from now, and again the year after that, our attention will be elsewhere.
Yet the tsunami of physical and mental health problems resulting from the Iraq-Afghan War will dwarf the cost of war itself—both in terms of financial outlays to pay for medical and mental health care as the effects of repeated and prolonged combat play out through the lives of our veterans for decades to come and in the suffering they and their families will endure. Our experience with Vietnam War veterans tells us as much. Post traumatic stress disorder (PTSD) payouts to Vietnam veterans rose 150% from 1999 to 2005, 25 years after the last American soldier left Saigon—a warning early experience with returning Iraq War veterans only confirms.
The Iraq War is different
According to a recent article in Psychotherapy Networker, costs for the mental wounds from PTSD and traumatic brain injury form the Iraq-Afghan War will run to a couple hundred billion dollars a year for years to come. Made infamous by the Vietnam War’s aftermath, PTSD is a psychiatric disorder that can occur after experiencing a life-threatening event, with characteristics that include nightmares, flashbacks, hypervigilence, and feelings of detachment or estrangement.
As many as 31% of returning Vietnam veterans eventually suffered from some degree of PTSD. Annual costs for that care have risen to $4.5B currently, with pensions costing $2,300 a month for each fully disabled veteran. Already, more than 400,000 Iraq-Afghan war veterans will need mental health treatment by 2008, out of 1.3 million troops deployed so far. Moreover, the picture will only get much worse.
“Veterans with combat PTSD typically don’t come for treatment until 10 years after a war. They try everything to distract themselves from the symptoms: marriages, jobs, alcohol, sex. Meanwhile, the condition becomes chronic and resistant to treatment, and usually remains that way,” according to the Networker article.
So, PTSD statistics from the current war are likely to overshadow anything we saw coming out of Vietnam. In part, that’s because the experience for most of our soldiers and Marines fighting in the Mideast is so much more intense that it was for most servicemen in Vietnam. Even though at the height of the Vietnam conflict we had a half million troops “in country,” less than a fifth of those saw much actual combat.
According to a New England Journal of Medicine study from 2004, “nearly 77% of soldiers deployed in Iraq reported shooting or directing fire at the enemy, 48% reported being responsible for the deaths of enemy combatants, and 28% reported being responsible for the death of a combatant.” That’s just not how it was in Vietnam for most soldiers, and most Vietnam soldiers served a single tour of known duration, not the three and four and five routinely extended tours current troops must endure.
What can we do?
Here we are, sitting in a barroom in New Orleans in 1999, knowing full well that a killer hurricane is coming someday, knowing that the dikes won’t hold, knowing that parts of the city will flood and people will die. Do we go out and do something about it, or do we put another nickel in the jukebox? Well, we know how well we prepared for Katrina. Do we do the same for the coming flood of damaged veterans?
Here’s a thought. In recent years, for reasons that have more to do with rhetoric than reality, Democrats have been seen as somehow unpatriotic—weak on defense, not willing to stand behind our troops, not sufficiently steely-eyed. But we know that this huge problem with physically and mentally damaged veterans is looming. We also know that it’s not part of the Republican psyche to create the kind of government programs we’ll need to give our veterans the kind of care they have paid for with their blood and tears.
We Democrats—or maybe just all true patriots—can get out in front of this issue. Rather than waiting for existing programs and facilities to be overwhelmed with the problems we know are coming, we could begin putting local efforts in place designed to help returning veterans readjust to civilian life and then deal with their war-related problems as they arise. Vet centers are one particularly effective approach that have worked well in several places around the country. Believe me, a veteran is much more likely to overcome a soldier’s deep-seated aversion to therapy by talking to another veteran.
Rather than wait, let’s urge our legislators to begin putting those kinds of facilities in place—here in Highland Park and El Sereno and all the other local communities that are so heavily targeted by the economic draft that’s used to fill our military ranks.