The costs of war are staggering. After nearly a decade of combat on two battle fronts, the United States is now calculating its bill. According to Pentagon estimates, medical costs incurred by the 9.6 million military troops, dependents, and retirees insured through the Federal TriCare program are exploding at twice the nation’s overall health care spending. In the past two years, TriCare enrollment has swelled by an additional 370,000 beneficiaries.

In 2001, TriCare medical costs tallied $19 billion. Pentagon officials now project that in 2011, the U.S. will spend $50.7 billion in TriCare costs. That’s a 167 percent increase. Military health care costs are escalating at a clip rate. The U.S. health care spending trend pegged at an 84 percent increase, was only half of the military health care costs for the same period.

Like other taxpayer funded health programs including Medicare and Medicaid, with Tricare, the Federal government contracts with private health plans. In turn, these health insurance companies contract with civilian physicians, hospitals, psychiatrists and other health care providers to treat soldiers and their families.

TriCare costs comprise 9 percent of all defense spending, an increase of 3 percent and climbing. While testifying before Congress in February 2010, Defense Secretary Robert Gates stated that the surging upward trend of military health care costs is “beginning to eat us alive.”

Since 9/11, 1.7 million U.S. soldiers have served in Afghanistan and Iraq. The brisk tempo of repeated deployements coupled with compressed downtime between deployments, have stressed the physical and mental health of U.S. troops. The mental auguish of combat is at an all time high. One in three soliders are diagnosed with some type of mental health or behavioral health condition when he or she return from the combat zone. Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) are two of the signature war wounds of Operation Enduring Freedom and Operation Iraqi Freedom.

Since 2004, behavioral health counseling sessions for soldiers and their families have increased by 65 percent. Children of soldiers are at greater risk for mental health problems resulting from repeated deployments. In addtion, studies now reveal that there are significant adjustment challenges for children when a parent returns home as well. Mental health counseling sessions for children are on the rise by 42 percent.

Orthopedic wounds are the top physical medical condition for returning soldiers. Injuries to the legs, back, and joints are now common place. In 2009, there were 3.9 million health care visits to a physician or clinic because of these types of physical wounds. A related phenomenon to orthopedic injuries is the associated dependence of soldiers to pain medications. A record number of soldiers are now addicted to these prescription drugs.

The raw reality of a decade of combat is that a new generation of soldiers will continue to require Federal fiscal spending at an unprecedented rate. We can expect that military health care costs will outspend overall health care outlays both near term and long term unless significant policy, program, and process changes interrupt this trend.