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Comment by Lavery | Hacker News Reader

While I'd tend to agree with your larger point, when looking at decades- or centuries-old wars it's worth keeping in perspective that the falling death rates have much more to do with improvements in evacuation time and trauma care. Even beyond the obvious improvements in things like antibiotics, soldiers are now living through wounds that would have been fatal to them as recently as twenty years ago.

The cynic in me says that the way that this continues to be reported--as military dead instead of military casualties--is meant to deliberately obscure this fact. How many people returning from these modern wars will need full-time medical care for the rest of their lives?

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Indeed. Our troops now also wear really serious body armor, a lot of Kevlar designed to stop fragments and 9 mm bullets, plus at least 2 rifle plates, front and back. Also to a degree I'm not familiar with two small side plates. I've read that the big rifle plates have been saving a lot of lives from normal accidents. And modern helmets are very good, although there's only so much impact one can take without necessarily harming the wearer's head, so we're talking more about grazing rifle hits. But saves also add up---but echoing your point about casualties, they turn some number of deaths into traumatic brain injuries.

The sort of grim side effect of all this is that trauma medicine makes great strides during wars, I seem to remember we've been learning a lot about treating traumatic brain injuries due to the current unpleasantness.

It's not that distorted. Antietam had a wounded:killed ratio of 4:1, Meuse-Argonne was 4:1, Vietnam had 6:1, Iraq had 8:1. Bulge was a particularly deadly sample at 2.5:1 (If you include all allied forces and not just US military, Iraq drops back down to ~5:1). Basically you could convert 4500 US casualties in Iraq into deaths as a pseudocontrol for 'ye olde medicine' to bring the ratio back into line, and it wouldn't particularly change the numbers above.

I also think that total casualties needs to be taken with more care than total deaths, as a casualty is anything from a nicked ear that takes you out for only a day, right on up to an amputation. Death is unambiguous. Casualties are far more mutable - witness the presidential candidate who had a successful smear campaign run against him because he supposedly 'wasn't wounded enough' to merit a Purple Heart...

How many people returning from these modern wars will need full-time medical care for the rest of their lives?

Probably much less as a proportion than previous wars, though it's really anyone's guess. 'Full-time' medical care is a big thing; it basically means hospitalisation for the rest of your life. Remember also that while some soldiers would survive who previously wouldn't, treatment overall is superior - someone who previously would have been left with a lifelong crippling disability may have a much reduced effect in the modern day. It's not like modern medicine improves the lot of only those patients who are at death's door.

"witness the presidential candidate who had a successful smear campaign run against him because he supposedly 'wasn't wounded enough' to merit a Purple Heart..."

You misstate that part of the case against Kerry: in short, he transferred to the riverine force not knowing it would soon be sent into serious combat, and thanks to the three Purple Hearts was able to leave that duty Real Soon after the third, see e.g. http://www.snopes.com/politics/kerry/service.asp for confirmation of the basic latter facts.

Wikipedia lists [1] under 40K total casualties in Iraq for US armed forces as of 2012. If that is taken at face value, that is a 1.6% casualty rate over a remarkably long duration operation.

[1] http://en.wikipedia.org/wiki/Casualties_of_the_Iraq_War#U.S....

Do you have any references to support your claims? I'm really not sure how much has changed in 20 years, for example.

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