U.S. Navy/Lt. j.g. Haraz N. Ghanbari For every one of the 866,181 soldiers officially counted injured casualties in Iraq and Afghanistan, the government is expected to spend some $2 million in long-term medical cost.

The total of $1.7 trillion is based on a widely cited March 2013 paper by Linda Bilmes at Harvard’s Kennedy School. It includes $800 billion already spent on injured veterans along with the cost of long-term care for an additional 50,000 current casualties counted by the Pentagon.

Since 2001, the VA has spent $134.3 billion to care for veterans. VA spokesperson Genevieve Billia said the department does not produce cost estimates over decades, but that the VA “plans to spend $6.9 billion in 2013, $7.6 billion in 2014 and $8.0 billion in 2015.”

The $2 million per casualty figure is in no way an attempt to quantify how much each individual life is worth. But it does serve as a stark reminder of how the United States and its veterans will be suffering from choices made in Afghanistan and Iraq for decades to come.

It also is a reminder that the U.S. financial commitment to the wars does not end with troop withdrawal. Soldiers might be leaving, but they’re taking with them injuries that will take years to treat. In many cases, they’ll be dealing with them for the rest of their lives.

"The years of conflict have left America still burdened with heavy costs, even with the ground combat phase drawing to a close," Bilmes wrote in the report. "These costs include the immediate requirements to provide medical care for the wounded, as well as the accrued liabilities for providing lifetime medical costs and disability compensation for those who have survived injuries."

COST DRIVERS

The first major driver of cost is the number of people who are eligible for and claiming veterans’ benefits. In earlier research, Bilmes suggested that roughly 40 percent of soldiers would use them. But as veterans return home, she’s found her original estimates to be too low. She now believes that 56 percent of all Iran and Afghanistan veterans will apply for veterans’ assistance at some point in their lives.

“Of those who had been discharged, about half of them have applied for disability benefits and more than half have been treated in the Veterans Administration system,” Bilmes told The Fiscal Times.

Disability costs are also on the rise. According to Bilmes, 783,623 soldiers –"one out of every two veterans from Iraq and Afghanistan,” she writes – have already applied for long-term disability payments. More than 670,000 have already been granted, while only 15,521 have been denied.

Bilmes said that the nature of injuries suffered in Iraq and Afghanistan, including amputation and PTSD, likely means the 1 million soldiers still in the military are more likely to seek disability payments in the future.

“We’ve seen so far that there’s been an enormous increase from previous wars for those claiming disability,” Bilmes said. In Vietnam the typical compliant would cite three disabling conditions. The average claim now has 8 disabling conditions.”

Lastly, the premium cost of TRICARE, the health care program for active duty soldiers and their families is far below the price on the open market. Bilmes illustrates this in the chart below

Because it’s so cheap, more and more soldiers are using the plan, as shown below.

“There’s a huge increase in the cost of Tricare driven in large part by the substantially higher demand from medical services,” Bilmes said. As she wrote in her report, “TRICARE is now the fastest growing federal health program -- growing at a faster rate than Medicare, Medicaid, or VA health care.”

Bilmes estimated these cost until 2053. She determined that Veterans Affairs medical costs will be $287.6 billion and Veterans Affairs disability will cost $419.7 billion. Throw in another $128.9 billion for Social Security benefits and the cost of running the VA, plus the $800 billion the government has already spent on TRICARE and the $134.3 billion its already paid in VA benefits, and you get $1.7 trillion.

In other words for every soldier officially or unofficially counted as injured in Iraq and Afghanistan, the government will pay roughly $2 million dollars.

NEARLY IMPOSSIBLE TO REIGN IN

To date, there hasn’t been the political will to make the tough choices to modify these programs. Lawmakers continue to push back against DOD’s request to increase the cost of military benefits.

Jason Peuquet, research director at the Center for a Responsible Federal Budget at the New America Foundation, said that without political action, these problems are intractable.

“Even assuming the DOD overall budget can continue to go up, it’s tough to see that it will go up at the rate that health care and retirement costs are going up,” he said. “That means we have less budget flexibility to spend on other things that are important to us.”

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