Morale: The Hidden Costs Of War And Peace

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After 2001 the United States entered its first period of sustained combat since the 1960s and began to realize that the costs of war lasted far longer than the fighting and overseas deployments. Many of the hastily recruited troops developed long-term medical disabilities that would require treatment for decades. In cases were the subject was given a medical discharge and suffering from more than 30 percent disabled a monthly payment was made for life. The amount of that payment depended on degree of disability plus the rank and years of service of an injured veteran. Those with less than 30 percent disability got a bonus payment when discharged and medical benefits for life or until medically certified as no longer disabled.

In an effort to reduce these long term injuries, and the number of disabled veterans (and thus save billions in medical costs), analysts have been examining the experience since 2001 when millions of personnel were sent overseas to fight or provide combat zone support. There were many changes made to recruiting standards after 2001 and all that data since 2001 provided an opportunity to see which screening decisions did, or could have, kept volunteers out of the military or at least out of jobs that would lead to long-term disability and early discharge. Much insight was gained from research done on employees of commercial firms doing work similar to what many military support personnel do (like equipment maintenance, logistics and medical care).

Some military jobs are unique, like the 15 percent of personnel who actually engage in combat. Their working conditions have changed considerably with fewer troops killed but more of them disabled by the additional physical stress of carrying more weight (much of it protective gear that reduces casualties enormously). But most of the disabled are not combat troops. One recent study of 1.7 million recruits found that four percent were medically retired and two percent were medically discharged during their first eight years of service. Many of these medical retirements and discharges could have been avoided if those involved had not been recruited in the first place or had been given a different job. Thus the physical exam for new recruits now pays more attention to the physical capabilities of volunteers and their demonstrated susceptibility to some diseases (a new capability based on recent developments in medical sciences.).

The provision of organized and government supported lifetime care of disabled veterans was a largely 20th-century development and the United States had established the Veterans Administration in 1930. That bureaucracy was much needed by 1945 and the end of World War II, because while there were four million World War I veterans (none of whom served more than 18 months in wartime), there were 16 million World War II vets. During World War II many served for years in exotic and disease ridden parts of the world and developed long-term disabilities. The medical experience with all those World War II vets provided the first insights into establishing recruiting standards for volunteers joining a peacetime force. The American military was usually all-volunteer in peacetime but that changed for the first time with the revival of conscription in 1950. The high demand for troops during the Vietnam War (1965-72) led to lowering of standards and, when conscription ended in 1972, the army found itself with a lot of troops who wanted to stay in but were later found to be unfit for peacetime service in general and an all-volunteer service in particular.

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