Tuesday, February 3, 2009

Budget Cut: Military Healthcare Costs

The Defense Department has to cut some money in its FY10 budget. It's not much of a cut, though. DoD will make most of the cut by not keeping up with inflation. Regardless, this is the start of the budget reckoning I have talked of before. If you are interested in the Defense budget, you should check out Holding the Line, edited by Dr. Cindy Williams. The book is a product of the 1990-era strategic confusion, so there's a lot of maintaining status quo, aka "Holding the Line". However, the authors made a nice case of where we can cut and hedge our strategic bets.

Over at Abu Muqawama, I made a comment on the military healthcare costs. The military healthcare is the fastest rising sector of defense spending, just like the rest of the US economy. In FY09, the DoD requested $42.8 billions for the Defense Health Program. If you add in the Veterans' Administration, it will be even bigger. The brass are having to decide between guns (weapon acquisition) and butter (personnel cost) directly now. [As opposed to just DoD vs everybody else.]

This may be unfortunate for those of us in the military-industrial complex, and for the generals and admirals. However, this healthcare problem is largely the result of the military culture. The brass has known about the problem for years, but ignored it because it's not sexy.

For example, back in the '80s and '90s, the most common cause of injury (or conditions preventing duty performance) for male soldiers is intramural sports. During physical training or unit-wide sports competition, they played too hard and hurt their knees or break bones. [Don't have the data but the sports injuries should be true for the Regular Army pre-AVF as well.] This directly drives up our healthcare cost because:
1: Soldiers are getting medical treatment for something that's prefectly preventable.
2: They will develop chronic conditions later on, requiring knee surgeries and other expensive treatments.
3: Due to reduced mobility from the chronic injuries, they will get fat and develop type 2 diabetes.

So, all because the leaders are having too much fun on the sports field, we now do not have enough money to buy the F-22, FCS, etc.

Or, to take another example: Hearing loss. We do a lot of loud stuff, firing weapons, drive tanks, blow stuff up. However, the leadership does not do a good job with hearing protection. These days, they at least hand out foam earplugs and make an effort to raise hearing awareness, but back in the day, they did not even do that much. For years, the Army has said that electronic hearing protection is too expensive, even though they would be more effective than foam earplugs. Yet when OIF started, Army suddenly had enough money to buy the electronic ear muffs for the line units. Years later, the now veterans file for disability because of military duty-related hearing loss, and the brass has to pay for it.

So, to the American people: Please demand better accountability from your generals and admirals when they come to you asking for more money. Make them find money from smarter healthcare decisions. It is their own stupidity that their healthcare cost is eating up their budget pie.

Edited to Add: Here are a couple of articles that add to this: Andrew Exum's article on soldier's load, and 3 years later, his predictions coming true.

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