If there is one thing that unites such disparate politicians, not to mention 2008 presidential contenders, as Hillary Clinton, John McCain, John Edwards, Bill Richardson, Chris Dodd, Joe Biden, Barack Obama, Sam Brownback, Mitt Romney, Tommy Thompson, and others it is this timeworn cliché, America should support its troops.

But, speaking of clichés one of the oldest, when it comes to politicians and troops is this one; “Nothing is too good for our boys so that what we’ll give them. Nothing.” So in that regard, speaking as both a citizen and a veteran I’d like to make this suggestion: put your money where your mouth is. Talk is cheap but action is another matter altogether.

In the interest of full disclosure I should mention that I am not an altogether dispassionate observer on this issue. In a century now past, I did veterans advocacy on behalf of Vietnam era veterans. I saw men and women wounded both physically and emotionally from their service. Compared to the need we helped far too few of them but I thought that at least never again would America fail to step up to the plate when it came time to help those who had served their country with their blood, limbs, and minds.

Well, some things never change. We may, at least rhetorically, pay better lip service to helping physically and mentally wounded troops try to readjust back to civilian life but the resources are lacking.

In that regard let’s tale a look at a little noted paper released this month by the J.F. Kennedy School of Government at Harvard University. Authored by lecturer in public policy Linda Bilmes it analyzes the long-term needs of veterans returning from the Iraq and Afghanistan wars and the consequences of these needs. Among its conclusions:

the Veterans Health Administration(VHA) is already overwhelmed by the volume of returning veterans and the seriousness of their health care needs, and it will not be able to provide a high quality of care in a timely fashion to the large wave of returning war veterans without greater funding and increased capacity in areas such as psychiatric care; 

the Veterans Benefits Administration (VBA) is in need of structural reforms in order to deal with the high volume of pending claims; the current claims process is unable to handle even the current volume and completely inadequate to cope with the high demand of returning war veterans; 

Another point her paper made was the unprecedented number of US soldiers who have been injured. As of September 30, 2006, more than 50,500 US soldiers have suffered non-mortal wounds in Iraq, Afghanistan and nearby staging locations – a ratio of 16 wounded servicemen for every fatality1. This is by far the highest killed-to-wounded ratio in US history. For example, in the Vietnam and Korean wars there were 2.6 and 2.8 injuries per fatality, respectively. World Wars I and II had fewer than 2 wounded servicemen per death.

We never hear that number cited in the media. Why not? Biles notes that:

The VA defines non-mortal wounded as those who are “medically evacuated from theatre”. The Pentagon has several definitions, but the daily casualty reports on its website use a narrower definition referring to those wounded by shrapnel, bullets, etc. Using this narrow definition, the Iraq conflict has a ratio of 8 wounded per fatality – still much higher than any previous war in US history.

It should not be hard to understand the need. War is always a nasty, horrible, activity, reaping a terrible toll. For example, the Army’s top medical officer, Army Surgeon General Kevin Kiley, speaking at a hearing on military medical readiness before the House Defense Appropriations Subcommittee, said has said it is estimated that about 17 percent of returning fighters have post-traumatic stress disorder or severe anxiety and depression, compared with about 6 percent or 7 percent of the general population.

Put another way, more than 73,000 soldiers returning from Iraq and Afghanistan have been diagnosed with post-traumatic stress disorder (PTSD) and with problems such as drug abuse and depression. That’s enough people to fill a typical NFL stadium.

The Veterans Administration reports that more than 600,000 veterans are waiting to have their medical claims processed.

Consider this question, asked at the confirmation hearing for now Secretary of Defense Robert Gates:

News accounts indicate that soldiers and marines suffering from post
traumatic stress disorder are being separated from the service with Other
Than Honorable Conditions discharges for misconduct such as alcohol and drug abuse, which are classic symptoms of post traumatic stress disorder. The characterization of their discharges can lead to a denial of VA benefits
needed to treat their post traumatic stress disorder condition.

Bilmes’ report notes that the largest unmet need is in the area of mental health care. The strain of extended deployments, the stop-loss policy, stressful ground warfare and uncertainty regarding discharge and leave has taken an especially high toll on soldiers. Thirty-six percent of the veterans treated so far — an unprecedented number — have been diagnosed with a mental health condition. These include PTSD, acute depression, substance abuse, and other conditions.

On March 4, 1865 President Lincoln gave his second inaugural address.  In the speech’s final paragraph, the president delivered his prescription for the nation’s recovery:

“With malice toward none, with charity for all,
with firmness in the right as God gives us to see the right,
let us strive on to finish the work we are in,
to bind up the nation’s wounds,
to care for him who shall have borne the battle
and for his widow, and his orphan,
to do all which may achieve and cherish
a just and lasting peace among ourselves and with all nations.”

With the words, “To care for him who shall have borne the battle and for his widow, and his orphan,” President Lincoln affirmed the government’s obligation to care for those injured during the war and to provide for the families of those who perished on the battlefield.

But today, as Bilmes notes, “the US is not adequately prepared for the influx of returning servicemen from Iraq and Afghanistan.”