April 18, 2006: American military personnel are the highest paid on the planet, with the average pay and benefits now closing in on $120,000 per person. Two years ago it was under $100,000. But only about half of that is salary. The rest is benefits, and the fastest growing of these expenses is medical care. The cost of health care has doubled in the last five years, and, despite strenuous efforts to contain growth, the cost is expected to double again within ten years. Part of the reason is that over half the troops are married. But there are other reasons as well.

While some of the health cost increases in the past five years are war related, because of nearly 20,000 casualties in Iraq and Afghanistan, and many more illnesses caused by service in those unfamiliar regions, the main reason is the rapid growth in new medical technology. This is not just a result of American innovation, but because of uniquely American attitude towards medical care. For whatever reason, since colonial times, American health care has been noted for its aggressiveness. The rest of the world is more resigned in the face of illness or injury. But not Americans. While this has caused medical costs to increase to about 15 percent of GDP (and delivered a life expectancy no better than that of other Western nations that spend half as much per capita), it is great for the troops in combat. In Iraq, the availability of American health care is a real morale boost for Coalition and Iraqi troops who get wounded. The foreigners have seen American medical television dramas, and know all about the frantic, skillful and high-tech American approach to medical care. Especially in emergencies.

The aggressive American approach to medical care has saved thousands of American lives in Iraq and Afghanistan. Consider, for example, that the ratio of dead to wounded in Iraq and Afghanistan is approaching one killed for every ten wounded. This is a dramatic increase from Vietnam, where it was one and five. That was itself an improvement from World War II, where it was one and four, and earlier wars where is was one and three.

One side effect of all this, mainly driven by the increasing cost of medical care, is the growing automation of the armed forces. This, in particular, is showing up on the battlefield. An increasing number of robots are being used. These range from UAVs (Unmanned Aerial Vehicles) and small (under fifty pound) robots for the infantry. These bots take the lead going into dangerous places (especially buildings and caves) and for investigating possible roadside bombs. More of these robots are pulling guard duty, and some robots are being armed. The increased automation is allowing the navy and air force to shed tens of thousands of troops, even during wartime. While this has gone unnoticed, the heavy use of robots and automation has enabled army troops in Iraq to do the same work today, that would have required thousands more troops a decade or two ago.