Each year, the U.S. military recruits some 175,000 young Americans. At the heart of its pitch is a sacred promise to take care of those who serve—what President Abraham Lincoln described in his second inaugural address as the national duty “to care for him who shall have borne the battle and for his widow and his orphan.” Today, this promise is enshrined in the ethics of each service: members of the U.S. Army, Navy, Air Force, Marines, and Coast Guard pledge to never leave a fallen comrade behind. After their service, the Department of Veterans Affairs (VA) works to fulfill this same promise on behalf of a grateful nation, enabled by a budget larger than those of the State Department, the Department of Homeland Security, and the entire U.S. intelligence community combined.
Most national security discussions focus on strategy or policy. To the extent that ways and means get considered at all, the talk tends to center on weapons systems, budgets, bases, and buildings. These matter, but people matter, too. Service members are an irreplaceable component of U.S. national security. And because the United States relies on an all-volunteer force, how the country treats its troops during and after their service matters when it comes to sustaining this critical component of national strength.
The wars in Afghanistan and Iraq saw incredible advances in body armor, battlefield medicine, and medical evacuation, all of which dramatically improved the likelihood that soldiers would survive injuries. Deaths from nonbattlefield injuries and illnesses, historically far more deadly than combat, have also fallen greatly, thanks to aggressive public health efforts and fitness requirements for troops. In this respect, the United States is keeping its most sacred pledge to those it sends into harm’s way: to bring them home.
But despite some recent improvements, the VA and other federal agencies struggle to keep other promises to active service members and veterans after they come home. Aging bureaucracies struggle to meet the needs of
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