The advocacy group Physicians for Social Responsibility has made no secret about its opposition to the war in Iraq. In fact, during the run-up to the war, the organization placed full-page ads in newspapers objecting to policy that was driving the nation toward a violent conflict. A new report from the group now puts a price tag as high as $660 billion on what the country will eventually spend caring for the mental and physical damage done to those who have served in Iraq.

 

Already, nearly 4,000 U.S. military personnel have died serving in Iraq and more than 60,000 have been wounded, injured, or become ill. Improved body armor and advances in battlefield medicine have allowed many soldiers to survive injuries that would have been fatal in previous wars. At the same time, as many as 30 percent of veterans returning from Iraq will meet the criteria for serious mental health disorders, a figure that’s higher than past conflicts in part because of the multiple deployments many military personnel have faced.

 

Currently a U.S. veteran (without spouse or dependents) who is 100 percent disabled and unemployable receives $2,471 per month in compensation payments from the Veterans Administration. Over a 50-year period, this could total more than $1.4 million for one individual, without adjustment for inflation.  

 

Physicians for Social Responsibility Northwest Regional Director Evan Kanter, author of the report called “Shock and Awe Hits Home: U.S. Health Cost of the War in Iraq,” is a specialist in post-traumatic stress disorder. A psychiatrist and neuroscientist on the faculty of the University of Washington in Seattle, he serves as a staff physician at the Puget Sound VA.
 

Kanter recently spoke to The Journal of Life Sciences Web Editor Daniel S. Levine about the war’s physical and mental toll on veterans, the long-term cost of caring for those who served, and why the situation is worse than in previous conflicts. Edited excerpts follow.

 

A: As a physician’s group we have been acutely aware of the health costs of the war and how significant they are and I think the costs of war are usually limited to what’s reported as the military operational costs. There have been from a number of sectors people who have done some work trying to reflect on what are some of the larger, long-term costs—essentially providing medical care and disability payment for veterans. So we felt compelled as a physician’s organization to bring this to people’s attention.

 

A: Yes. That is true in a number of ways. My specialty is post-traumatic stress disorder. That’s not a new phenomenon, but there are elements of this conflict that really heighten the risk of PTSD, including the fact that there’s no front line anymore—there’s absolutely no place in the theater that’s a safe place. You can be driving a vehicle around and get blown up at anytime. The psychological environment that creates is one that produces a lot of PTSD.

 

A: The multiple deployments are happening at a fairly unprecedented rate—more than half a million. There are a lot of factors related to the risk of contracting PTSD and how bad the systems are. The single most important factor is the intensity and duration of the trauma. There’s a dose response effect to the trauma. It’s very common for me to see someone after one deployment who may be sub-threshold for a diagnosis of PTSD or they may have PTSD, but they have fairly good coping. Then you see them after a subsequent deployment and they are completely unable to function in civilian society. It’s pretty dreadful. These multiple deployments are a grave concern from a psychiatric perspective. Anyone who has worked with Vietnam veterans knows what it means to be a two-tour or a three-tour vet.