Karen Brodkin’s submission (“Cost of war does
domestic harm,” May 12) described numerous areas affected by
the United States’ apparent readiness to use war as a
solution to world conflicts rather than as a last resort. She
connected the dots into a larger picture of what we might call
“collateral damage at home.” Now, we want to focus on
one of these dots: public health.
Ignoring the cost in health currently being paid by the Iraqi
beneficiaries of the Pentagon’s splendid war machine
(cholera, dysentery, cluster-bomb amputations and blindings,
psychological stress, and the long-term effects of the weapons that
blasted the United States and Britain to victory in three short
weeks), I want to focus on the cost to Americans.
First, let’s focus on the veterans who fought on the
ground. Will they return home with the same problems that beset the
Gulf War I (GWI) veterans? Will their mortality rate in traffic
accidents dramatically increase in the first two years after their
return, as the American Legion claims happened with GWI
veterans?
Will 29 percent of the some 250,000 soldiers deployed come down
with debilitating illnesses or be disabled because of their wounds,
as Professor Suzanna Hecht says happened to GWI veterans? Will the
rate of amyotrophic lateral sclerosis ““ more commonly known
as Lou Gehrig’s disease ““ spike among these new vets, as was
the case with GWI vets?
According to the American Legion, 187,294 GWI veterans are
entitled to disability benefits or compensation for service-related
illnesses and injuries, and new studies are desperately needed to
find out why so many are suffering. As American Legion National
Commander Ronald F. Conley said last November, “The
government needs to show those troops sacrificing for freedom today
that our government is ready, willing and able to treat whatever
conditions they might develop.”
Instead, President Bush’s proposed 2004 budget cuts $6.2
billion in veterans’ funding over the next 10 years. This is
symptomatic of the government’s greater interest in war and
force rather than in social programs aimed at protecting the
American way of life.
Health care for non-veterans is equally at risk in these times
of increasing military budgets.
Forty-one million and growing. That’s the number of
Americans who lack access to health care through health insurance.
While both Republicans and Democrats promise health care reforms,
war and nation-building abroad continue to relentlessly drain
resources needed to correct a deficiency that weakens all
Americans. A National Academy of Sciences committee theorizes that
financial pressures on state and local governments related to the
fact that many are uninsured may require additional local taxes,
new federal dollars, or budget cuts elsewhere.
Of the 34 to 38 billion dollars in care delivered to uninsured
persons in 2001 ““ that was not paid for by the uninsured
themselves ““ the public sector is estimated to have financed
up to 85 percent.
The cost of paying for the care of the uninsured in emergency
rooms and in nonprofit neighborhood clinics is especially high and
threatens the closure of some facilities. The impact worsens as the
economy weakens and military expenditures grow. What’s more,
fears rise that employers who do provide insurance will cut back on
benefits and shift costs to employees. The cost of health insurance
rose 13 percent in 2003, following a 10 percent increase during the
previous year. Efforts to contain or shift costs have imposed
higher co-insurance payments and deductibles for those with health
insurance.
Meanwhile, the uninsured continue to suffer. UCLA’s Center
for Health Policy Research points out that the uninsured often go
without recommended cancer screening, resulting in delayed
diagnoses. Adults with problems such as hypertension or HIV
infection lack regular access to medications. Women and their
newborns receive less prenatal care and are more likely to have
poor outcomes during pregnancy; and delivery often results in
infant death and babies with low birth weights.
Uninsured children use fewer medical and dental services and are
less likely to receive routine preventive check-ups and
immunizations. Many uninsured children have not had a
doctor’s visit in the past year. All this is at a time when
the richest nation in the world continues to increase military
expenditures by billions of dollars. Even the elderly ““ who
enjoy limited coverage through Medicare ““ face new problems
as the price of uncovered prescriptions grows to heights
unaffordable for some patients.
The very poor can count on health care provided by Medicaid
(MediCal in California), jointly financed by the federal and state
governments. But many uninsured and others are not poor enough to
qualify; and California legislators threaten to cut benefits for
those who do qualify, as state expenditures climb and income
falls.
Rural areas and parts of Southern California have particularly
high uninsured rates. The sheer number of uninsured persons in an
area can add to the community burden of disease and disability,
according to the National Sciences Committee. It hypothesizes that
since more disease may result both from the poorer health of
uninsured residents and from spillover effects onto other
residents. These spillover effects can happen through the spread of
communicable disease from un-vaccinated or ill individuals,
shortages of health care providers, and the loss of local capacity
to deliver essential health care services.
In short, Americans and the U.S. health care system could
greatly benefit from funding being spent elsewhere.
Katherine Callen King is a professor of comparative literature
and classics. Harry Nelson is a retired medical writer for The Los
Angeles Times.