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The True Cost of War
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Injury count in Iraq disputed
Sunday, January 28, 2007
Washington- Officially, more than 23,000 U.S. troops have been wounded in combat in Iraq. But more than double that number have fallen ill or been injured in what the Pentagon considers "nonhostile" action, a way of counting that critics say hides the war's full toll.
If the Pentagon also counted soldiers who were hurt in crashes or circumstances not directly involving skirmishes with the enemy, and those so sick that they required air transport, the figure would come to about 50,000, the Pentagon's own figures show.
Either figure represents a historically high injury rate for Americans in any war, although both also are testament to the fact that military medical care is better than ever and saves more lives. Even so, more than 3,000 American troops have died from wounds or injuries in Iraq, fighting a war that has dragged down President Bush's approval ratings, cost Republicans control of Congress and prompted anti-war demonstrations such as the one in Washington on Saturday.
But which figure of the wounded accurately reflects the war's human cost?
The Pentagon keeps records on all wounds, all injuries that require air transport and all cases of disease that likewise require medical transport by helicopter or plane. But when it gives figures on the number of soldiers "wounded in hostile action," it excludes the sick and those whose injuries weren't directly caused by bullets or bombs. That's how it gets the figure of 23,000-plus, a figure cited in most media reports.
To some, that's misleading.
"It doesn't make a difference whether you were hit by enemy fire or injured because your vehicle crashed, or got sick because of serving in a war zone," Sen. Barack Obama, Democrat of Illinois, said in a statement Friday. "The effects on the soldiers and their families are the same."
Stephen Robinson, a Washington-based veterans advocate and former Army officer, said the Pentagon purposely misleads the public with its counting methods. For example, he said, the Pentagon has not counted some injuries from chain-reaction crashes as combat-related, even when the crashes resulted from an insurgent's attack on another vehicle in a convoy. By counting them as motor-vehicle accidents, Robinson said, the Pentagon avoids adding injuries to the war's combat toll.
"It might be semantics to the Department of Defense, but it masks the full extent of the consequences of the war and who's getting hurt," said Robinson, director of veterans affairs for the group Veterans for America.
A Pentagon spokesman, responding via e-mail, provided a list of injury classifications but did not respond to questions about crashes such as those cited by Robinson.
Harvard researcher Linda Bilmes, who with Nobel economics laureate Joseph Stiglitz has done research on the cost of the war, insists the 50,000-wounded figure is the most accurate. That's a ratio of 16 wounded service member for every death.
"That's the highest killed-to-wounded ratio in U.S. history," she said in a research paper this month.
The Pentagon clearly is displeased with the use of this number, which Bilmes also cited in a guest column in the Los Angeles Times on Jan. 5. Pentagon spokeswoman Cynthia Smith called it a "gross distortion" of the extent of war wounds.
"On a month-to-month basis, between 55-70 percent of the personnel wounded in action are returned to duty within three days," she said in an e-mail Friday.
Yet an even bigger number can be used to cite the human and economic impact of the Iraq war on U.S. soldiers. Thirty-two percent of all veterans of the Iraq war and the war in Afghanistan - 205,097 of the 631,174 troops who had returned and been discharged as of November - have sought medical care from the Department of Veterans Affairs.
This comes from the VA itself.
Mental disorders accounted for nearly 36 percent of the VA cases, and diseases related to muscle, joints and bones for another 43 percent, according to the VA.
A full 25 percent of the returning veterans have filed claims for some level of disability benefits, and they have been approved so far at a rate of 88 percent, says Bilmes. The VA already has a backlog of claims, and it is likely to grow much worse as many more troops return.
"I'm very concerned what this means, not just in the next five years, but in the next 50," said Sen. Sherrod Brown, the Ohio Democrat on the Senate Veterans Affairs Committee. "It's going to be very expensive, and there's been no looking into the future on what we ought to do on taking care of these benefits."
Bilmes, speaking at a luncheon last week sponsored by Harvard's Shorenstein Center on the Press, Politics and Public Policy, said it is nearly certain that there will be a "surge" in disability claims that will tax the VA physically and financially.
The Pentagon maintains that this exaggerates the severity of claims and future strains. Smith cited the number of service members suffering from brain or spinal cord injuries as of Dec. 2: 1,705. Of those, she said, 65 percent of the injuries were considered mild.
"Personnel with massive injuries such as amputations number in the hundreds, not the thousands," Smith said.
With polls showing deep public skepticism about the war, the Pentagon could soon find itself having to explain its numbers not only to researchers and reporters but also to Congress.
Obama, a Democrat with presidential aspirations and a member of the Veterans Affairs Committee, and Maine Republican Sen. Olympia Snowe have introduced a bill to improve veterans' benefits and better track the war's impact on returning soldiers. Brown, the Ohio senator on the committee, said he and colleagues have intense interest in the subject.
"The Pentagon and VA," said Obama, "need to come clean on the true costs of the Iraq war on our troops."
To reach this Plain Dealer reporter:
skoff@plaind.com, 216-999-4212
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