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What We Need
Extravagance and Shortages in America's Military
| Author: Barrett TillmanFormat: Hardcover, 256 Pages Item: 144281 ISBN: 9780760328699 Publisher: Zenith Press Specs Size: 5.5 x 8.5 Weight: 0.938 lb. Edition: First Published: September 15th 2007 DC: AP List Price: $27.95 $20.96 All discounts based on list price. No trade discounts available from sale price. In Stock |
In early 2006 the Army chief of staff reported about $440 billion in expenditures. A dollar bill is a smidgen over six inches long. If 440 billion greenbacks are placed end to end, they would extend 220 billion feet, or 41,600,000 miles. That is 1,664 times around the equator. If the greenbacks had Andy Jacksons picture instead of George Washingtons, that line still would run well over 2,000,000 miles. That is about four trips to the moon and back. So, then..... |
Contents Preface Chapter 1: War? What War? Chapter 2: We Need People Chapter 3: We Need Training Chapter 4: We Need Logistics Chapter 5: We Need Guns and Gear Chapter 6: We Need Objectivity Chapter 7: The China Syndrome Chapter 8: Some Suggestions Chapter 9: Guessing the Future Glossary |
An excerpt from Chapter 8 "Some Suggestions" The historical irony holds that while battlefield lethality has increased tremendously, combat deaths have declined. Throughout World War II, one-third of battlefield casualties were killed or died of wounds. That figure dropped to one-quarter in Korea and Vietnam and now hovers around 12 percent. With an eight-to-one WIA-KIA ratio, today the system is often overloaded. The situation places further burdens on requirements for transportation, facilities, near and long-term care, and rehabilitation. But the bottom line remains: more critically wounded troops are surviving. A big factor is jet transport aircraft. The worst injured service members from Iraq can be rolled into an operating room in the United States in as little as thirty-six hours. A DoD study of nonmortal casualties from Iraq through early 2007 showed 23,400 wounded, of whom 7,000, or 30 percent, required medical air transport. But the 16,400 who were not medevaced were more than offset by 25,500 noncombat cases, including 18,700 victims of various diseases. The balance had been injured in vehicle or machinery accidents, negligent weapon handling, and a myriad of other causes. To summarize: of 32,500 military personnel requiring evacuation from 2001 to early 2007, barely one-fifth were combat casualties. Therefore, if peace is established in Iraq at noon tomorrow, accidents and disease will continue inflicting thousands of hospital cases upon the medical system as long as Americans are deployed there. Furthermore, thousands of routine injuries will continue stateside, as they always have, especially when teenagers operate complex equipment. (More military personnel are killed in automobile wrecks than all other noncombat causes combined.) In 2004 SecDef Rumsfeld mandated a 50 percent reduction in accidents over the next two years. To many service members it was a grandly optimistic expectation, partly because the personnel and even equipment losses already were fairly low. For example, the Navy and Marine Corps had averaged one noncombat death per month over the previous eighteen years. When the 2006 the results were posted, the figures had improved only marginally. Far from a 50 percent accident reduction, the Army's overall safety record showed an 11 percent improvement between FY 2004 and 2006, while fatalities were down about 9 percent. In the Navy, total mishaps (aviation, ashore, and afloat) increased 6 percent in those two years, while the rate of mishaps also increased. Clearly, DoD's mandated improvements were unrealistic, as predicted by operating forces at the time. Whatever the result of attempts to impose safety by dictate, the injured still require treatment. With the DoD medical system facing a greater influx of patients than anytime in more than thirty years, innovation was called for. And many organizations and individuals rose to the challenge. In a prime example of medical "jointness," marine casualties from Bethesda Naval Hospital often are seen at Walter Reed Army Medical Center and vice versa. The two centers frequently swap casualties according to the needs of individuals, and one observer writes, "In that regard, bureaucratic turf doesn't seem to exist, a great example of interservice cooperation. Hoo-rah!" However, throughout the system patients still report many bureaucratic hoops, including endless forms to be filed, onerous waiting periods, lost records, and repeated procedures or mixed-up schedules. Concludes a combat infantry vet, "In the long run the soldier usually gets screwed by The System, so read Kipling's Tommy." Says a National Guard NCO with partial paralysis, "At Fort Bliss they didn't seem to care when I got my evaluation and release as long as they knew where I was most of the time. So I became an ace at crossword puzzles and read every science fiction novel I could find. Finally, I guess my name worked its way to the head of the line and they let me leave." Among other concerns, there's a new category of patients. Due to rapid response and advancing medical technology, people are surviving wounds that would have been fatal a few years ago. That poses new challenges for the "downstream" aspects of treatment and care. In just one instance among dozens, a visitor to Walter Reed described meeting a young woman whose skull was partially destroyed, and with it part of her brain. "She's walking around, talking, sometimes even joking," says my contact. "But the docs don't know if she'll be able to learn new skills or hold a job," If we can influence others who are genuinely interested in helping the current cro |
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