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JULIETTE KAYYEM: The sense and cents of war

by jkayyem@globe.com on April 08, 2013 10:20 AM

Under the Constitution, only Congress has the power to “declare” war. In practice, presidents have initiated military interventions, both large and small, on their own. The “declare” power is clearly open to interpretation. But maybe rather than Congress or the president, we should give some “declare” authority to the Department of Veterans Affairs. After all, its ability to manage the burdens of any new war should be taken into account. There are many reasons not to go to war, but surely our inability to care for those who fought should be one of them.

Just as the 10th anniversary of the Iraq war came and passed, a series of congressional hearings into the Department of Veterans Affairs exposed just how bad the backlogs are for those seeking compensation and care. On average, the claims of first-time filers from the Iraq and Afghanistan wars take over 300 days to process. That’s shocking, and obviously leaves many veterans alone and frustrated.

To be fair, there is no evidence of systemic delays for the care itself, just the processing of claims. Veterans are given five years of medical treatment at no cost after leaving military service. In addition, the sheer number of people entering the system — 940,000 veterans were added since 2009 — and the increase in the conditions being treated (including new Agent Orange claims from the Vietnam War and increased reporting of post-traumatic stress disorders in more recent ones) are putting new burdens on the system.

Long-neglected computer upgrades are coming on line, but the VA’s promises that the backlog will be overcome by 2015 seem specious given that 97 percent of all claims are still made in paper. Continued delays aren’t only concerns for those who’ve already fought. They could discourage new recruits. The Defense Department is well aware that its ability to recruit troops to an all-volunteer force is made more difficult if veterans’ services are being neglected.

This controversy over claims processing should be correctable, but further strains on the system are emerging. The financial burdens that are coming down the pike have no historical comparison. The cost of wars shouldn’t be viewed only as a number. But, if we must, it would be somewhere between $4 trillion to $6 trillion, according to Linda Bilmes of Harvard’s Kennedy School, whose calculations of the financial legacy of Iraq and Afghanistan are the most rigorous assessments of the true price of conflicts.

As Bilmes pointed out, the “single largest accrued liability of the wars in Iraq and Afghanistan is the cost of providing medical care and disability benefits to war veterans.” Those debts have yet to come to fruition. The claims of World War I veterans peaked 50 years after that war ended; today, the chances that requests for care will continue to spiral are even greater, because veterans are applying for assistance faster and surviving longer with conditions that only a generation ago might have killed them. “One out of every two veterans from Iraq and Afghanistan has already applied for permanent disability benefits,” she writes.

If there is any promising news from these recent disclosures, it’s that they might force an overall reassessment of veterans services. Well before these wars, the system was becoming obsolete. Without universal conscription, the military family is now a small segment of society. Today, if we were to create a program to assist the fewer than 1 percent of Americans who serve, it wouldn’t be a centralized bureaucracy administered at geographically inconvenient hospitals.

While erasing the backlog is important, the long-term goal must be to permanently take the burden off of Veterans Affairs and place it on local health facilities and community care programs. This will not only help veterans and their families transition better to civilian life, but will reduce costs in the process.

Maybe the controversy over who gets to “declare” war will never be resolved. But however they start, wars never end. We will be paying for these recent wars for at least another 80 years, backlog or not.

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