Any idea how much military medical spending has grown?

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The news is out that President Trump is looking to spend $54bn more on defence On a $600bn odd military budget (China c. $250bn). I’m sure the press will be moaning about how this is about being bent on waging new wars. Looking at the most recent Quadrennial Defence Review (2014) medical related spending for the military has jumped from $19bn in 2001 to $49bn in 2014. The sad thing is most people do not understand defence budgets. Let’s start with some fast facts in no particular order in the US.

-The US defence budget has been slashed from over 4.2%~4.7% of GDP under previous administrations over the last 30 years to around 3.5%~3.7% under Obama. Trump’s plan would aim to get it back in the 4% range, nothing out of line with predecessors.

-80% of the defence budget is spent on wages, housing, education and maintenance of the war machines. The remaining 20% is spent on RDT&E (reseearch, development, testing and evaluation) and procurement.

-If a budget is cut and you want to maintain force numbers you can’t procure as much. Simple maths. If you cut force size you risk reducing it to levels that may impact capability.

-War is bad for defence budgets. Transporting 100,000 troops, feeding, housing, providing medical care, maintaining hardware on the ground takes huge wedges out of what can be left to “procure” new equipment. Bullets, bombs and missiles aren’t replaced 1 for 1. They have stockpiles which are calculated on likely usage projections.

-the US Navy is larger than the next 11 navies combined despite a surface fleet 1/20th of what it was 70 years ago and the smallest number for a century.

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-The US Forces are the single biggest consumer of oil period. Retiring the USS Kitty Hawk saved 2% of the gross fuel budget.

-War today is more about capability than raw numbers of equipment. Cyber warfare can switch off an enemy’s basic utilities and crush a country without dropping ordinance. Fighters that can see you before you can see them have the advantage but that costs a fortune to stay at the head of the pack. A US tank battalion in the first Iraq War took out 250 Iraqi tanks from a hidden position because satellite imagery pinpointed where they needed to fire. US losses were zero.

-To date most wars have been conventional. Now they are asymmetrical. Fighting terrorism does not require ballistic missile submarines (SSBNs). It needs agile fast reaction capability (i.e. V-22 Osprey) which can land a special unit in an inaccessible hot zone. However defence forces have to target what engagements they will face and what is required to defeat it. That requires a radical overhaul of defence forces – in equipment, development and training. Development can take 10-15 years to meet threats that may or may not exist in 25 years often with technology that doesn’t yet exist.

Just ask the Quadrennial Defence Review 2014‘s General Mark E. Dempsey:

“My greatest concern is that we will not innovate quickly enough or deeply enough to be
prepared for the future, for the world we will face 2 decades from now. I urge Congress—
again—to move quickly to implement difficult decisions and to remove limitations on our
ability to make hard choices within the Department of Defense. The changes required for
institutional reform are unpleasant and unpopular, but we need our elected leaders to work with  us to reduce excess infrastructure, slow the growth in military pay and compensation, and retire  equipment that we do not need. Savings from these and other reforms will help us modernize,  will add to research and development investments, and will provide needed funds to recover  readiness. The lack of will to do what is necessary may drain us of the will to pursue the more  far-reaching ideas promised in the QDR.

The true risk is that we will fail to achieve the far-reaching changes to our force, our plans, our  posture, our objectives, and our concepts of warfare. I believe that dramatic changes will be  needed in all of these by 2025. Some of these changes are well-known and outlined in the  QDR. Some of these changes are only dimly perceived today and need encouragement and  direction. Innovation is the military imperative and the leadership opportunity of this  generation. It’s a fleeting opportunity.

When we commit America’s sons and daughters into combat, we must ensure that they are the  best-trained, best-equipped, and best-led fighting force on the planet. That takes time, it takes  money, and it is perishable.”

Make no mistake. The increase in spending would have occurred under any GOP president. The sad thing is that because of the budget cuts, the military forces have relied more on operational leases from the defence contractors. In order to have a military capability the defence arms have had to “borrow” because the budget cuts have been too deep. So there we have it – not only is the private and public sector debt at record levels, we now have the military filling in credit forms…

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