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There is something to be said for those who answer their nation’s call to service. And there is something else altogether to be said for a nation’s duty to serve those veterans upon their return.
On that count, state Department of Veterans Services Deputy Secretary Lou Helwig has some good news, some dangerously stretched budgets and some advice for a nation that needs to prepare for health care costs that could, long-term, outstrip the tallies of both the Iraq and Afghanistan conflicts.
“We really haven’t even seen the tip of the iceberg yet,” Helwig said of the 26,000 New Mexicans returning from Iraq and Afghanistan. “The most apparent issue is the prostheses they’re wearing, but that’s not the main issue.”
The larger issues are post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI).
“The average veteran has had seven concussions,” Helwig said. “And many are much more than a concussion. With these IEDs (improvised explosive devices), you can get a mild concussion being a mile away.”
Because the symptoms of TBI are new and because they mimic those of PTSD, the medical profession is scrambling to develop treatment protocols – including accurate diagnoses. To their credit, Helwig said, health care professionals are devising innovative solutions.
“Out of war comes some of the most amazing medical things,” he said, “but it’s a heckuva way to get them.”
Nationally, the toll is grim. One in five veterans suffers from depression or a stress disorder, and less than half of the 300,000 affected are getting help. More than 70,000 are paying too much for rent and are at risk of homelessness. At least 430 veterans have committed suicide.
The VA’s count is not a complete one, however. It does not include members of the military who returned from Iraq and then killed themselves before being discharged from the service – people like Sgt Brian Rand, who shot himself in the head after returning home from his second tour.
It also doesn’t include the deaths of people like Sgt. James Dean, who was shot by Maryland state troopers after he barricaded himself in his father’s farmhouse. Observers call those deaths “suicide by cop.”
And it doesn’t include the deaths of people like Sgt. Gerald Cassidy, a 32-year-old Indiana National Guardsman who died at Fort Knox five months after returning from Iraq with brain damage from a roadside bomb.
How many more American deaths continue to go uncounted?
It’s not as if no one saw it coming. In 2007, Linda Bilmes of the John F. Kennedy School of Government at Harvard, analyzed the state of care available for returning vets. Her conclusions:
(a) 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; (b) 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; and (c) the budgetary costs of providing disability compensation benefits and medical care to the veterans from Iraq and Afghanistan over the course of their lives will be from $350 – $700 Billion, depending on the length of deployment of US soldiers, the speed with which they claim disability benefits and the growth rate of benefits and health care inflation. Key recommendations include: increase staffing and funding for veterans medical care particularly for mental health treatment; expand staffing and funding for the “Vet Centers,” and restructure the benefits claim process at the Veterans Benefit Administration.
Although rarely addressed, one other problem faced by 16 percent of veterans – women – is sexual trauma.
“Women veterans are having many sexual-trauma issues,” Helwig said. “It’s much higher than their male counterparts. The military plays that down, but the result is we’re treating more and more of them.”
Helwig praised George Marnell, director of the local Veterans Affairs Healthcare System, for being “a magician” at juggling his budget to provide care. But it hasn’t been enough.
Through a collaboration with 14 agencies and Presbyterian Medical Services, the state has provided crisis-intervention telehealth program for veterans and their families, which includes a walk-in center at PMS’s Rio Rancho site.
“We’re expanding that this year and opening new offices in Farmington and Cuba,” Helwig said. “Next year, we expect to open ones all over New Mexico. We’re trying to fill the gaps the federal government can’t take care of.”
Through its Web site, the Iraq and Afghanistan Veterans of America attempts to direct people to even more assistance.
Returning veterans are guaranteed health care – a benefit that sometimes pushes veterans of other wars further down the priority list. They can also take advantage of expanded education stipends that in some cases extend to their children.
In his visits to the Walter Reed Army Medical Center, Helwig has seen the consequences of carnage. But he’s also seen hope.
“One positive thing is that they seem to be coping with their disabilities and working through them,” he said. “Another is the fact that they are so focused on their dreams. These are 19- and 20-year-old kids right out of high school. But they seem to still have a grasp on how important their dreams are.”
Today, Helwig will be among the state’s veterans paying respect to their fellow men and women who came home — and the ones who could not.
Going forward, he hopes the Obama administration will change the way the nation funds veterans’ health care to avoid potential crises like the one two years ago where the bank nearly ran dry midway through the fiscal year. Besides compromising care for existing veterans, such by-the-book budgeting threatens to cut out spikes in the growing needs of new veterans.
“The spike right now,” he said, “is war.”
