The possibility of an increased American military presence in Iraq has recently sparked political debate, but according to a new study, the country should focus less on sending more men into battle and more on how those men will be cared for once they return home.

Presented by Kennedy School of Government lecturer Linda J. Bilmes ’80 at the annual meeting of the Allied Social Sciences Association in Chicago, the study explored the economic and logistical strain imposed upon the Department of Veterans Affairs (VA) by the volume of soldiers returning from Iraq and Afghanistan seeking medical care, disability benefits, or both.

According to Bilmes, the nation’s costs of fulfilling its obligations to these veterans could run between 300 and 700 billion dollars over the next four decades.

Bilmes said the problem can be explained statistically. While the United States recently counted its 3000th fatality in the war on terror, nearly 16 times that many have suffered non-mortal wounds.

By contrast, the ratio of those wounded to those killed during the Vietnam War was 2.6:1, and the two World Wars saw less than two men wounded for every fatality.

The statistical swing, according to Bilmes, can be attributed to modern medical procedures and improved protective equipment. But although the numbers spell progress in one sense—the prevention of deaths that would have been inevitable in previous campaigns—they also entail setbacks for the VA, which is swamped by increasing numbers of soldiers seeking care.

Bilmes’ study pinpoints the natures of these setbacks as they relate to each of the VA’s two divisions.

On the one hand, there is the struggle of the Veterans Health Administration (VHA), the part of the organization devoted to providing medical care to injured veterans.

Of the 1.4 million servicemen that have been deployed to date in the war on terror, some 200,000 have sought treatment at VA medical centers. The number is far enough beyond the VA’s previously projected figures that those seeking care have found themselves facing massive waiting lists.

The VHA itself, meanwhile, has been running out of money in the attempt to keep pace with those seeking aid.

Equally formidable are the problems hampering the Veterans Benefits Administration (VBA), the second branch of the VA.

Charged with dispensing benefits checks to servicemen filing for disability after their tours of duty, the VBA’s system of processing claims has accumulated a back-up that still includes veterans from campaigns as far distant as Vietnam.

Bilmes’ study presents some possible solutions. In the case of the VBA, it recommends that the bulk of disability claims be accepted simply and immediately, without the red-tape that currently hampers the process.

Bilmes also suggests higher levels of funding to address the ills of the VHA.

“On the medical side, they basically need more money,” Bilmes said. “There’s no way around it. But you’re basically talking about giving another five billion dollars a year on the medical side, and that’s about what we spend on combat in two weeks.”

A failure to allocate such funds in favor of increasing troop presence would be irresponsible, said Bilmes.

“It’s wrong to spend all this money necessary to do a surge when we’re not coughing up the money to help these guys when they come home,” she said.

The VA itself has been publicly skeptical of the new study, with one of their spokesmen stating to United Press International that the research appeared to be “misleading” and included “stale recommendations.”

Bilmes herself was slow to take offense, recognizing that the VA has lately been under pressure from several quarters, including Congress and various other veterans’ organizations. But no matter how the issue is approached, she says, there is no escaping the fallout that the VA’s current difficulties will spell for returning servicemen.

“I think we have a problem with not meeting our obligations to veterans—a lot of unhappy veterans,” she said. “You will have more veterans who will fall through the cracks in one way or another.”

—Staff writer Christian B. Flow can be reached at cflow@fas.harvard.edu.