Experts Tally Iraq War's Health Cost

By Kavita Mishra
The San Francisco Chronicle

Thursday 10 May 2007

Few saw it coming, but six years into combat in Iraq and Afghanistan, health care providers are overwhelmed by the demand of returning veterans suffering from mental health stress or traumatic brain injury.

Few understood the financial impact war would have on the Veterans Affairs medical system, projected by a Harvard economist's study earlier this year to be as much as $600 billion.

But Linda Bilmes, a professor at the Kennedy School of Government and author of the study, said Wednesday that disability claims were slamming the system, with more than 25 percent of returning veterans filing. Roughly 180,000 claims needed to be addressed - on top of 400,000 pre-existing claims from veterans of past wars, many of whom are experiencing post-traumatic stress disorder.

At a teach-in at UCSF on Wednesday about the health effects of the Iraq war, Bilmes calculated that the loss of income and economic contribution from those veterans and the dead, in addition to the current and future expenses of the war, could cost the United States as much as $1 trillion to $2 trillion.

Because of the increasing use of body armor in this war, wounded soldiers mostly experience injuries to the head, neck and extremities. An estimated 24,000 soldiers have been injured since combat began in Afghanistan and Iraq.

But what health care providers say surprises them most is the ballooning number of soldiers experiencing closed head injuries - damage to the brain from movement within the skull - because of the widespread use of improvised explosive devices. Many soldiers have experienced delayed pain, memory lapses and other problems months after returning from the war.

About 1,700 U.S. soldiers have suffered traumatic brain injuries in combat so far, which are likely to cost the United States $20 billion over the next 20 years, Dr. William Schecter, chief of surgery at San Francisco General Hospital, told 300 UCSF faculty, staff and students who attended Wednesday's symposium.

Veterans have already been seeking mental health help in droves. Of more than 100,000 U.S. veterans from Iraq and Afghanistan, 25 percent received one or more mental health diagnoses, the majority of them involving complex, multiple diagnoses that require more time and treatment, said Dr. Karen Seal, a physician at the San Francisco Veterans Affairs Medical Center.

Health professionals worry about the war's long-term impact in Iraq, noting that Iraqi children have the lowest rate of survival to age 5 in the world. One in 8 dies between the ages of 1 and 5, many as a result of combat or diseases, including treatable infections and cholera. Roughly 270,000 children have received no vaccinations since the start of the war, and 68 percent of the population cannot access safe drinking water.

Dr. Dahlia Wasfi, whose family lives in Iraq, argued that Iraqi women and children are victims of the war along with the military personnel, facing not only fear for their lives, but diminished living conditions and intrusion by soldiers searching their homes.

Medical personnel have known the truth all along, said Robert Scheer, the symposium's keynote speaker and a USC communications professor. Scheer, who writes a column for The Chronicle, urged health care providers to speak up about the evidence of the damage the war has done to their patients.

The cases of Jessica Lynch and former NFL football player Pat Tillman, he said, were examples of delayed exposure of the actual circumstances in instances where providers probably knew the truth initially.

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