Well, It’s Clear We Just Can’t Count

From Inside Higher Ed

Shooting the Messenger

Linda J. Bilmes, a lecturer in public policy at Harvard University, calls her latest paper “pretty dry.” That hasn’t prevented it from riling high-ranking Pentagon officials — who called her and her dean to complain about her work. When they questioned her sources of material, they ran into a bit of a problem: She did most of her research with data on federal Web sites. So what did the Pentagon do? It changed the Web sites, and now continues to trash her research.

Bilmes has become a leading expert on economic questions related to the war in Iraq, and her experience the last few weeks demonstrates how social scientists can end up in the line of political fire when their findings — however dry — offend government officials.

The story begins with a paper Bilmes wrote last year with Joseph E. Stiglitz, a Columbia University professor and Nobel laureate in economics. In their study, they found that the Bush administration has seriously underestimated the economic costs of the war in Iraq. After the study was publicized, Bilmes was approached by some experts on veterans’ benefits who said that one cost of the war hadn’t received enough attention in their work (or from the government): the costs of caring for veterans injured in the conflict.

And that’s the question that led Bilmes to prepare a 21-page study that she presented this month in Chicago at the Allied Social Sciences Association meeting. The presentation of “Soldiers Returning From Iraq and Afghanistan: The Long-Term Costs of Providing Veterans Medical Care and Disability Benefits” went off without controversy and might have escaped Pentagon notice. But Bilmes also published an op-ed version of her findings in the Los Angeles Times. The Pentagon did notice that piece.

The central argument of the new Bilmes paper is that so many soldiers are being injured that the costs of caring for them over their lifetimes is likely to be $350 billion, or up to twice that, depending on how long the war lasts. The high cost is the result of huge advances in military medicine that have greatly reduced the chances that a soldier injured in Iraq will die. As a result, the ratio of injuries to deaths — 16:1 by her estimate — is higher than in any other war in U.S. history. (By comparison, in Vietnam the ratio was 2.8:1 and in World War II the ratio was 1.6:1.)

Bilmes uses a series of calculations based on the types of care those injured will require over their lifetimes to offer various scenarios for the costs of the care, and she also argues that the current veterans’ health-care system is not ready for the influx of injured or the associated costs. She offers suggestions for streamlining the process of getting injured veterans the benefits they have earned. And while both her studies and the op-ed are critical of the Bush administration’s response (or lack thereof) to the veterans’ health needs, the tone is academic, not polemic.

What set off the Pentagon was Bilmes’ estimate for the current number of injured of 50,500. William Winkenwender Jr., assistant secretary of defense for health affairs, called the Los Angeles Times, Bilmes, and David T. Ellwood — dean of Harvard’s John F. Kennedy School of Government — to complain that the real figure is less than half that — just over 22,000. When Bilmes was asked where she got her data, she pointed out that it came from the Department of Veterans Affairs, which in turn gets its data from the Pentagon.

The Pentagon investigated further and found that the VA “misunderstood” the Pentagon’s reports, according to Cynthia Smith, a Department of Defense spokeswoman. She acknowledged that the VA had been using numbers consistent with what Bilmes reported, but said that once the Pentagon explained “the error,” the Veterans Affairs department changed its Web site so its injury numbers are consistent with those of the Pentagon.

Why the misunderstanding and the “error”? The original figures from Veterans Affairs were for “non-mortal” injuries. But that doesn’t include only those who are shot at in combat. That includes people who get sick, people who are in accidents and so forth — a group of people that is as large as those injured in combat. The Pentagon doesn’t want those people counted.

Bilmes points out that a soldier in an accident in Iraq is as entitled to health care as a soldier who is shot. And she points out that she wrote an economic analysis looking at the question of how much all of this care was going to cost. Leaving out half of those injured would have resulted in seriously flawed numbers — when the whole point of her work in this area is to help people figure out how much money will be needed for the U.S. to meet obligations it has made to its soldiers.

Read all of it here.

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