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May 9, 2012
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National Security
Defense spending accounted for about 20 percent of total federal spending in 2012. CBO analyzes the budgetary effects of proposed legislation related to national security and assesses the cost-effectiveness of current and proposed defense programs. CBO also evaluates federal programs and issues related to veterans.
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Models Used by the Military Services to Develop Budgets for Activities Associated with Operational Readiness
Highlights
The Military Services Use Models to Inform About Two-Thirds of Their Budget Request for Operating Forces
The Congress directed CBO to review the modeling techniques that the military services use to generate their budget request for activities associated with operational readiness. CBO focused on identifying models used to inform the operating forces portion of the services' base budgets for operation and maintenance. CBO included only those models used at the services' headquarters.
CBO found that:
- Models were used to inform about 67 percent ($53 billion) of the services' $79 billion budget request for the active-duty component of operating forces in 2012,
- Operating forces (also known as budget activity 01) accounted for 14 percent of DoD's $554 billion budget request in 2012, and
- Models are one of many inputs to the budgeting process.
Using models does not guarantee good budgeting; not using them does not equate to bad budgeting.
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The Amount of Modeling Varies Among the Services
- The Army uses models to inform the largest portion of its budget request for operating forces (82 percent of the request); the Air Force models the least (45 percent).
- Most services model large portions of their budget requests for training and for peacetime operations.
- The services vary widely in the degree to which they use models to generate their budget requests for day-to-day operations at their facilities and bases.
- All services model most of their budget requests for maintenance conducted at the depot level.
Operating forces is the largest budget activity within the services' budgets for operation and maintenance. Funding for operating forces pays for the training of combat and support units, as well as the maintenance and operation of most service installations. CBO did not review budget models outside of the operating forces activity.
Definitions and Scope
For the purposes of this study, CBO defined a model as:
a set of mathematical relationships or similar logical expressions that link a military service's activities, such as training and maintenance, to the cost of those activities.
Additionally, CBO:
- Relied on the services themselves to identify and characterize any models used in forming their budget requests for operating forces, and
- Did not compare, audit, or validate the services' models or attempt to identify any deficiencies in them.
The Veterans Health Administration's Treatment of PTSD and Traumatic Brain Injury Among Recent Combat Veterans
Highlights
Through September 2011, about 740,000 veterans from overseas contingency operations in Iraq and Afghanistan had been treated by the Veterans Health Administration (VHA). That number is slightly more than half of all recent veterans eligible for care by VHA.
VHA spent about $2 billion in fiscal year 2010 to provide medical care to all recent combat veterans.
One in Four Recent Combat Veterans Treated at VHA from 2004 to 2009 Had a Diagnosis of PTSD; 7 Percent Had a Diagnosis of TBI
Using data for recent veterans treated by VHA from 2004 to 2009, CBO found that:
- 21 percent were diagnosed with post-traumatic stress disorder (PTSD) but not traumatic brain injury (TBI),
- 2 percent were diagnosed with TBI but not PTSD,
- An additional 5 percent had both PTSD and TBI, and
- The remaining 72 percent had neither diagnosis.
Treating Recent Combat Veterans Diagnosed with PTSD, TBI, or Both Was Much More Expensive Than Treating Other Recent Veterans
| Average Costs for First Year of Treatment | |
| Recent Veterans | |
| With PTSD | $8,300 |
| With TBI | $11,700 |
| With PTSD and TBI | $13,800 |
| Recent Veterans with Neither Condition | $2,400 |
Those amounts do not include initial care provided by the Department of Defense (DoD) or care by other providers outside of VHA. For comparison, VHA estimates that the average cost of care in 2011 for veterans of all eras will be $9,100.
VHA’s average costs for patients were highest during the first year of their care and declined and then stabilized in subsequent years. In the data CBO analyzed, VHA’s average costs for patients with TBI (including those with both TBI and PTSD) appear to increase in the third and fourth years. That result is probably generated by a policy change (occurring in the middle of the period CBO analyzed) related to screening for mild TBI. Without that change, costs for those patients would probably also have been highest during the first year of care and declined and stabilized thereafter.
Those results exclude about 500 patients with severe multiple injuries that received treatment in VHA's polytrauma centers; costs for those patients were significantly higher.
VHA’s Experience May Not Reflect the Rates of (or the Costs of Treating) PTSD or TBI in the Overall Population of Recent Combat Veterans
CBO’s study examines data from veterans who sought treatment at VHA. Those data may not be representative of the overall population of recent veterans. A great deal of uncertainty surrounds the prevalence of PTSD and TBI within the population that deployed to Iraq and Afghanistan.
Other researchers have estimated that:
- Between 5 percent and 25 percent of those deployed to Iraq and Afghanistan may have PTSD when screened for the disorder after returning from deployment, and
- Between 15 percent and 23 percent have experienced a TBI (the vast majority of which are mild TBIs, also known as concussions), though the proportion still symptomatic when screened after returning to the United States is much lower—between 4 percent and 9 percent—because most mild TBIs get better within a few months.
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An Analysis of the Navy's Amphibious Warfare Ships for Deploying Marines Overseas
Highlights
The Number of Amphibious Warfare Ships Falls Short of the Navy's Goal in 15 of the Next 30 Years
The Navy established a goal for a fleet of 33 amphibious ships in its 2012 30-year shipbuilding plan. Those ships are designed primarily to carry marines and their equipment into combat but also to perform other missions.
Under the current plan, between 2012 and 2041, the Navy will:
- Purchase 20 amphibious ships at a cost of about $50 billion,
- Retire 22 amphibious ships, and
- Meet or exceed the 33-ship goal between 2017 and 2031 but fall below the goal the rest of the time.
At any given time:
- About 30 percent of the total force of amphibious ships is deployed overseas conducting operations;
- About 74 percent is "deployable"—that is, in good material condition and with the crew sufficiently trained to perform a variety of missions;
- About 90 percent could be made available for an amphibious assault if the Navy had about three months to prepare.
Amphibious Force Meets Combatant Commanders' 2007 Request for Overseas Presence but Not Their 2010 "Unconstrained" Demand
In 2007, the combatant commanders requested nine ships for routine deployment. That request could be accommodated with the existing fleet.
By 2010, the combatant commanders asked for 18 ships. (The number increased because the combatant commanders were being asked about "unconstrained" demand—how many ships they wanted in the absence of any fiscal or force structure constraint.)
Meeting the request for 18 ships with the existing force would substantially increase deployment time and reduce time in ships' home ports.
Over a 27-month (117-week) operating cycle:
- Deployment time would more than double—from 26 weeks to 62 weeks.
- Time in home port would fall from 57 percent to 36 percent, well short of the Navy's goal of 50 percent.