Attrition: Veterans Fading Away In Pain

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November 21,2008: The U.S. has about 24 million military veterans. Six percent are women, and about half are from World War II, Korea and Vietnam. While only five percent of World War II veterans were women, that is closer to 20 percent today. Medical, disability and other benefits for veterans cost close to $100 billion a year. Because the military went all-volunteer after Vietnam, and shrank after the Cold War ended in 1991. The veteran population will shrink to less than half its current size in the next generation.

About 3.5 percent of Iraq/Afghanistan veterans were wounded, and many of them require regular treatment by VA medical facilities. That's about the same percentage as previous wars.

Better protection, equipment and tactics has kept the death rate down to less than half what it was in past wars, but the VA is discovering that a lot of war injuries take a long time to manifest themselves. For example, the VA had thousands of World War II vets come in with knees and elbows, damaged, and repaired, during the war, that were now giving out. This was not unexpected. Athletes, professional and amateur, commonly have minor sports injuries became major problems later in life. But now, decades after the war injury, there are more new treatments available. Many World War II veterans got replacement knees for joints that were damaged and patched up four decades earlier. Today, Iraq veterans are being told what to expect down the road, and what is being done to deal with coming sight, hearing or mobility problems.

If reconstructive medicine continues to progress, as it has for the last half century, then wounded veterans of the current war will have treatments that can keep up with the long term, but often hidden, damage from combat. Particularly worrying are all those vets who were close when a roadside bomb went off. There are now medical diagnosis tools (MRI and so on) that can detect the early, and generally unfelt, damage. By tracking these "quiet injuries" from the start, the prospects of treating them successfully improve quite a lot. Then there is the growing number of women who have been injured in combat. As medical innovators have increasingly discovered, women are different, when it comes to how they react to many dieses and types of injuries.

Despite the ragging the VA gets in the mass media, veterans, in surveys, express approval for the job the VA does. Part of this is due to the fact that many VA employees are veterans themselves, or have close family who are.