VA Hospitals Earn High Marks In New Federal Ratings

 

MILITARY.COM” By Patricia Kime

“A new quality assessment of U.S. hospitals by the Centers for Medicare and Medicaid Services gave nearly 58% of Department of Veterans Affairs medical centers the highest four- or five-star ratings — down 9% from 2023.

The Department also announced Tuesday that its hospitals outperformed non-VA facilities on patient satisfaction surveys, which gave 79% of VA hospitals four or five stars, compared with 40% of non-VA hospitals.”

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“The VA scores were still significantly higher than private medical centers, only 40% of which earned four or five stars. 

Despite the drop in overall scores from last year, VA Under Secretary for Health Dr. Shereef Elnahal told reporters Friday that the ratings were “great news” for veterans and the VA employees who treat them.

“We’re offering more care to more veterans than ever before, and we are exceeding on all metrics, both patient experience metrics and overall hospital quality and patient safety metrics, when we are comparing apples to apples with civilian-sector hospitals,” Elnahal said.

The Centers for Medicare and Medicaid Services, or CMS, examines hospital mortality, safety of care, readmission rates, patient experience, and timeliness and effectiveness of care to award stars on a five-point scale.

This year, 35 VA hospitals earned a five-star quality rating, one more than last year, and 15 of the 35 also earned five stars on CMS’ patient survey ratings.

“Veterans [are] able to see how VA hospitals are comparing to other options they may have in the civilian sector,” Elnahal said. “[If] they have Medicare or private health insurance, they can get care at both options. What this will allow is for them to compare, including — if they qualify for community care, as supported by VA — choices in the civilian sector.”

The new star ratings, which can be found on the Care Compare website, mark the second year the VA was included in the database by CMS, a federal agency within the Department of Health and Human Services. The agency gave star ratings to 109 VA facilities, with the remaining VA hospitals or medical centers not being rated, either because they don’t meet qualification thresholds or the level of metrics needed to assess them.

CMS does not assess specialty hospitals, ambulatory surgical centers, or some inpatient care facilities, such as psychiatric hospitals.

In addition to the 35 VA hospitals that earned five stars, 27 earned four stars, 23 earned three stars, 14 earned two stars and 10 earned one star — up from nine last year but with fluctuations on the one-star list.

Elnahal said the Veterans Health Administration considers these metrics, alongside its internal monitoring systems, when reviewing hospital performance.

“What we do is offer focused attention and support from our headquarters, national improvement office, to those medical centers scoring at the lowest levels on this scale and on our internal scale,” Elnahal said. “What this does is it highlights essentially more medical centers that maybe our internal system isn’t flagging, and ultimately allows us to get an up-to-date picture as more comprehensive of where we are on this.”

The facilities receiving the lowest ratings were the VA Southern Arizona Health Care System in Tucson; Bay Pines VA Health Care System and West Palm Beach VA Medical Center in Florida; Overton Brooks VA Medical Center in Shreveport, Louisiana; VA New Jersey Health Care System; Syracuse VA Medical Center and VA New York Harbor Health Care System in New York; VA Pittsburgh Health Care System; Providence VA Medical Center in Rhode Island; and VA Caribbean Health Care System in San Juan, Puerto Rico.

New to the one-star list were the VA medical centers in Tucson, New Jersey, Syracuse and New York Harbor Health Care. Those that received one star on last year’s list but have since increased their ratings include the James J. Peters VA Medical Center in The Bronx, New York; New Mexico VA Health Care System in Albuquerque; and the Memphis VA Medical Center, Tennessee, all of which are now two-star facilities.

A one-star rating signifies that the facilities performed well below the average for specific measurements, such as death rates for patients with heart failure, surgical complications and pneumonia; readmission rates for certain ailments; hospital-acquired infections; patient satisfaction; and more.

The data for this year’s star ratings was collected between July 2019 and March 2023, according to the VA.

According to CMS, its reviewers rated 4,658 hospitals in the U.S., and of those, just 8% received five stars. Star ratings are “limited in scope,” CMS officials said, by the data sources from which they are derived. 

Among the criticisms of the rankings from advocacy groups and industry associations such as the American Association for Physician Leadership, is that they don’t take into account the socioeconomic status of patients or the surrounding community, which may not have access to routine health care and have worse health outcomes for acute and chronic conditions.

CMS also crunches the numbers in a way that may put smaller facilities or hospitals that have a low number of cases or incidents that meet its eligibility criteria at a disadvantage when it comes to the ratings.

VA officials have noted, however, that surveys of veteran patients not only show positive response to VA services but that trust in VA health care remains high.

“Our most recent outpatient survey results show that 92% of veterans trust the care that they get in our clinics and ambulatory settings, so both inpatient and outpatient trust are at all-time highs, and we are beating the private-sector averages on inpatient trust,” Elnahal said.

In a statement released Tuesday, VA Secretary Denis McDonough said the metrics help the VA convey its message that it provides quality health services.

“We’ve made millions more veterans eligible for VA health care under the PACT Act –– and now, we want to make sure that every one of them gets timely access to the world-class care they deserve,” McDonough said. “Whenever a veteran sets foot in a VA facility, we want them to know that they are getting the very best care this nation has to offer — and we won’t ever settle for anything less.”

ABOUT THE AUTHOR:

Patricia Kime focuses on military personnel and veterans issues for Military.com, reporting on health care, military families, justice and benefits. She has covered military issues for decades, reporting on combat-related illnesses and injuries, the Defense Department and the Department of Veterans Affairs. 

 

War Veterans’ Advice On The ‘Mother’ Of All Bad Ideas – The JR-15 Children’s Assault Rifle

     "Wee 1" JR 15 Children's Assault Rifle

THE ‘WEE 1 TACTICAL’ ‘JR 15’ A FULLY FUNCTIONAL ASSAULT WEAPON, marketed for use by children and identical to the AR 15, but reduced in size and caliber.

At 2 pounds it is chambered for Long Rifle 22 Caliber Ammunition and functions in all other respects identical to the AR 15 Assault Firearm. 22 Caliber Long Rifle Ammunition can kill a human being up to a mile away.

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OUR VIEW: As  former military men and security specialists who have taken lives in combat, we assure you of the following:

If you or your child are considering a weapon of this nature or its full sized brother, and you are NOT one of the following:

1. A soldier on active duty
2. A policeman or a duly authorized security officer on duty
3. A licensed hunter of wild animals in the woods
Then consider you may become part of the problem of guns in our society today – and not part of the solution.

FURTHER:

If your child has an interest in this style of weaponry and warfare, we suggest you educate he or she on the history of this country and wars in general, as well as the role of weapons in the destruction of others lives as we are now seeing in Ukraine

If the child’s interest continues to age 18, we recommend you guide the young person to a military recruiter, where the role of a soldier is fully available through a lifestyle that includes the skilled use of weaponry in the defense of our country.

Acclimating a child to assault weapons designed for mass killing is not entertainment, recreation or sport - it is a dangerous element of real life with potential permanent consequences. 

Military Veteran Satire Writers Once Again Propose "The Department of Warfare" As A Business

CLICK IMAGE TO ENLARGE  By Tony and Friends On Rose Colored Glasses

We recommend, due to the age of this 17 year old piece, that you click on the image to enlarge. Let Tony, a winner of the “Thinking Blogger Award”, know what you think about “How war can be made FINANCIALLY profitable for the taxpayer.

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There is a prevalence of warfare in the current era. The U.S. tax payer finances military equipment/technology for our country and many others. The tax payer also donates soldiers to go in harms-way.   

Tony and his friends revisited our archives from 2007 on this subject. 

Not much has changed, other than the national debt has grown several orders of magnitude and the faces and places are different. 

With the above in mind we hereby propose, for the second time in the last 17 years, a discussion with your congressional representative a proposal to make war financially profitable for the taxpayer.

A Fiscal Crisis: The West is on the Wrong Side of Cost Curve

“REAL CLEAR DEFENSE” By Matthew Van Wagenen & Arnel P. David

“An axis of aggressors has embarked on a new strategy to defeat the West: relentless attacks with inexpensive weapons, produced at scale, to provoke a global response.

Western militaries, which cling to outdated and excessively expensive weapon systems and platforms (that take too long to develop and replenish, and regularly exceed their budgets), are being systematically bled dry”

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“In simple financial terms, the West is on the wrong side of the cost curve. Imagine the defense industry as a normal business. In economics, a cost curve illustrates the relationship between production costs and quantity. Successful businesses achieve economies of scale, reducing costs through efficiency. But the West’s defense enterprise is operating on the wrong side of this curve. Production costs are high, and output is low, pushing Western nations into diseconomies of scale.

The recent aerial attack on Israel and the war in Ukraine expose this vulnerability. Iran’s 300 plus airborne weapons that targeted Israel amounted to less than $200 million dollars whereas the Western response exceeds billions of dollars. In Ukraine, multi-million dollar weapons platforms are destroyed by uncrewed aircraft systems (UAS) that range from hundreds to thousands of dollars, and Russia’s prized Black Sea Fleet has been devastated by inexpensive maritime drones. Defense analysts estimate the cost ratio is easily 100:1.

A Call to Action

A new revolution in military spending is underway. It is a radical change in the way nations procure and integrate military capabilities.  The innovation and changes in Ukraine has been described by General Mark Milley as “the most significant fundamental change in the character of war ever recorded in history.” Consequently, this is not a military issue alone; it is a societal one. In democracies like the United States, we the people are responsible for our common defense. We cannot afford to ignore this unsustainable cost mismatch. Every defense dollar matters when there are competing demands for resources to address aging populations, health care, migration challenges, and myriad other social services.

Traditional procurement models in the West, to include the U.S. and NATO, are no longer fit for purpose. They are failing. Decades-long development cycles are obsolete in a world of rapidly evolving threats and disruptive technological change. Let’s say an adversarial nation has a four year cycle to produce a capability and, in the West, it takes ten years. In this scenario, in twenty years’ time the adversary-to-West ratio for innovation and capability development is 5:2. This all but guarantees that our adversaries will field a greater range of innovative capabilities, potentially leading to overmatch.

Rapid technological advancements are outpacing the military’s long-term development programs, rendering them obsolete as cheaper, more effective alternatives emerge. Program managers, those with the responsibility, authority, and personnel to deliver programs (e.g., ships, planes, software), lack both the incentive and the means to adapt to this fast-changing landscape. The ingrained culture of preserving existing programs stifles innovation and adaptability. It is unlikely a program manager will kill their program for the greater good.

Likewise, the political representatives of states where these programs sit will lobby heavily to keep these programs (i.e., jobs) alive irrespective of any negative strategic impact.

To overcome this, the military and the broader defense enterprise must urgently rethink their approach. Early and aggressive testing, integration, and prototyping of innovative warfare concepts are essential to gain an edge in modern conflicts. SpaceX’s rapid trial and error prototyping to develop rockets and OpenAI’s early release and testing of ChatGPT are examples of this approach to develop capability faster.  Waiting for “perfect” solutions, or clinging to lengthy development cycles, leads to unpreparedness on the ever-evolving battlefield. Keeping this approach is akin to relying on horse cavalry in the era of mechanized warfare.

A Glimmer of Hope

There is movement in the right direction. Nations like Estonia, Latvia, Lithuania, Poland, Norway, and Finland are leading the way. Their “drone wall“ initiative leverages affordable, networked sensors to safeguard their sovereignty. They will do this by keeping costs down to achieve economies of scale.

The U.S. Department of Defense is also taking steps in the right direction with its Replicator initiative. Thousands of drones have been delivered, demonstrating a shift toward rapid, warfighter-centric innovation. This could be the necessary spark to ignite essential change.

Other promising initiatives in NATO are the Defence Innovation Accelerator for the North Atlantic (DIANA) and the NATO Innovation Fund (NIF). Both complementary initiatives provide access to deep tech start-up communities, but the challenge for these programs will be transition. How do they transition capability into warfighters’ hands to be relevant going forward? As expressed above, it cannot take decades.

The Path Forward

To survive, the West must revolutionize its military procurement and production processes. We need a laser focus on swift prototyping and deployment of cutting-edge technologies. These systems must be affordable, easily updated, interoperable, and adaptable to new threats. The era of billion-dollar projects that risk obsolescence must end. A more diverse approach is not just needed, it is compulsory if we want to win wars and preserve peace.

The conflict in Ukraine serves as a stark warning. Clinging to expensive, slow-moving defense systems will leave the West vulnerable. We must out-innovate, not outspend, our adversaries. Our Alliance, made up of free and democratic nations, must unleash the creative capital present within our societies to find cost wise off-sets that can be immediately integrated into our collective defense system.

The future of warfare demands a fusion of accessible technology, rapid innovation, and scalable production. The West must adapt or face the consequences of falling behind an axis of aggressors who are united in their pursuit of strategic advantage and wish to see the West decline.”

 Real Clear Defense – Fiscal Crisis

Matthew Van Wagenen is a major general in the U.S. Army currently serving as the Deputy Chief of Staff for Operations (DCOS OPS) in the NATO Supreme Headquarters Allied Powers Europe (SHAPE).

Arnel P. David is a colonel in the U.S. Army currently serving as the director of the Strategic Initiatives Group (SIG) in the NATO Supreme Headquarters Allied Powers Europe (SHAPE).

The views and opinions expressed are those of the authors and do not reflect any entity or organization of the U.S. Government or NATO.

Navy Admiral’s Bribery Charges Expose Greater Rot In Government Procurement System

“RESPONSIBLE STATECRAFT” By WILLIAM HARTUNG AND BEN FREEMAN

“The indictment of four-star Navy Admiral Robert Burke on bribery charges late last month raised eyebrows about the extent of corruption in the Navy and beyond. 

But this is just part of a pernicious system of corrupt dealings and profiteering in Pentagon procurement practices, and much of it is completely legal.”

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“The indictment of four-star Navy Admiral Robert Burke on bribery charges late last month raised eyebrows about the extent of corruption in the Navy and beyond. The scheme was simple. Burke allegedly steered a $355,000 Pentagon contract to a small workforce training firm — described unhelpfully in the Justice Department’s description as “Company A.” Less than a year later he took a job at Company A in exchange for a $500,000 annual salary and 100,000 stock options.

The Burke indictment comes on the heels of Washington Post writer Craig Whitlock’s illuminating book on the Fat Leonard Scandal, the biggest, most embarrassing corruption scheme in the history of the U.S. Navy. In the words of his publisher, Simon Schuster, Whitlock’s book reveals “how a charismatic Malaysian defense contractor bribed scores of high-ranking military officers, defrauded the US Navy of tens of millions of dollars, and jeopardized our nation’s security.”

Obviously, the Navy needs to clean up its act, and, if found guilty, Burke should face consequences for his participation in a blatant case of old school corruption.

But this is just part of a pernicious system of corrupt dealings and profiteering in Pentagon procurement practices, and much of it is completely legal. It involves campaign contributions from major weapons contractors to key members of Congress with the most power to determine the size and shape of the Pentagon budget, and job blackmail, in which companies place facilities in as many congressional districts as possible and then stand ready to accuse members of cutting local jobs if they vote against a weapons program, no matter how misguided or dysfunctional it may be.

It also involves the revolving door, in which arms industry executives often do stints in top national security posts, even serving as secretary of defense, or, on the other side of the revolving door, when high ranking Pentagon and military officials go to work for weapons makers when they leave government service.In fact, this is, by far, the most common path for retired senior military officers. As a Quincy Institute analysis found, over 80% of four-star generals and admirals that have retired in the last five years (26 of 32) went on to work in the arms sector. In short, most retiring four-stars, like Burke, go on to lucrative positions in the arms industry. Unlike Burke, they follow the rules, so this is all perfectly legal corruption.

The revolving door from the Pentagon is also spinning feverishly to foreign governments. A Washington Post investigation found that more than 500 former Pentagon personnel, including many high ranking generals and admirals, have gone on to work for foreign governments known for political repression and human rights abuses, like Saudi Arabia and the United Arab Emirates.

Last, but certainly not least, there are the lobbyists. Last year alone, Pentagon contractors spent nearly $138 million on lobbying and had 905 lobbyists working on their behalf, according to OpenSecrets. That’s almost two lobbyists for every member of Congress, and more than 600 of them had gone through the revolving door —previously working at the Pentagon, Congress, or the Executive branch.

All of the above is about money and jobs, not crafting an effective defense strategy or buying weapons systems that are appropriate for carrying out that strategy. A case in point was a hearing last October to review a report on America’s strategic (meaning nuclear) posture from a Congressional commission, almost all the members of which have financial ties to the arms industry.

First off, the commission co-chair who testified at the hearing was former Arizona Senator Jon Kyl, a lifelong opponent of nuclear arms control who also did a stint as a lobbyist for Northrop Grumman, which makes nuclear bombers and land-based nuclear missiles. Surprise, surprise, Kyl recommended that Congress pony up more for nuclear weapons on top of the Pentagon’s current $2 trillion, three decades long nuclear weapons “modernization” program.

But surely the gathered members of the Senate Armed Services Committee would ask some tough questions before accepting the commission’s proposals for an accelerated nuclear buildup. Think again. The bulk of the questioners essentially touted nuclear-related missiles or facilities in their states and asked a variation on the penetrating question, “shouldn’t we spend more on this wonderful weapon [or facility] in my state?”

What wasn’t mentioned at the hearing was the fact that defense contractors — including Northrop Grumman, which makes the nuclear weapons in question — are some of the top campaign contributors to members of the Committee, according to OpenSecrets.

It fell to Sen. Elizabeth Warren (D-Mass.) to bring the discussion down to earth by asking how much the commission’s ambitious plan would cost. With a straight face, Kyl said that the commission hadn’t calculated a cost, since the investments proposed were so urgently needed. This seems highly unlikely given that the United States already deploys over 1,700 nuclear warheads that can hit targets thousands of miles away, with thousands more in reserve.

But Kyl’s statement went largely unchallenged in the rush by members to flak for their local weapons of choice.

If skipping a serious conversation on the future nuclear policy of the United States to engage in pork barrel politics isn’t a case of blatant corruption and dereliction of duty, what is? If even a conversation that touches on the future of the planet can’t rouse money-conscious Senators to engage in an actual debate, what will? And isn’t this dereliction of duty ultimately more dangerous than trading cash or a cushy job for doing the bidding of a weapons contractor?

It’s great that our legal system is seeking to hold participants in illegal schemes to account. But when will members of Congress who place shilling for special interests above crafting an effective defense policy face the music? If not soon, we can expect much of the tens or hundreds of billions of new money likely to be thrown at the Pentagon in the next few years to go to waste. If that’s not a scandal of the highest order, we don’t know what is.”

William Hartung

William D. Hartung is a senior research fellow at the Quincy Institute for Responsible Statecraft. His work focuses on the arms industry and U.S. military budget.

Ben Freeman

Ben Freeman is Director of the Democratizing Foreign Policy program at the Quincy Institute. He investigates money in politics, defense spending, and foreign influence in America. He is the author of The Foreign Policy Auction, which was the first book to systematically analyze the foreign influence industry in the United States.

 

Critical Skill Incentive Awards Improperly Paid To 75 Percent Of VA’s Entire Senior Executive Staff

“INSPECTOR GENERAL FINDING 1. The blanket award of Critical Skill Incentives to 357 VA executives was inconsistent with VA policy. INSPECTOR GENERAL FINDING 2. VA’s internal controls were ineffective in preventing improper awards”

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Executive Summary

“On September 13, 2023, VA Secretary Denis R. McDonough was alerted by the Assistant Secretary for Management and Chief Financial Officer (CFO) Jon Rychalski that the Office of Management had detected unusual payment activity relating to senior executives. The preliminary data provided to Secretary McDonough by Mr. Rychalski indicated that VA had paid 367 senior executives more than $19.7 million over two pay periods in September with another 21 remaining to be processed (about 75 percent of VA’s entire senior executive staff).Mr. Rychalski identified these payments as critical skill incentives (CSIs).

CSIs are a type of recruitment and retention incentive pay newly authorized for VA by Congress under the PACT Act, which dramatically expanded access to VA health care and benefits formillions of veterans exposed to toxic substances.

In anticipation of a significant increase in new healthcare enrollments and benefits claims, the PACT Act included CSIs as a tool to enhance VA’s ability to meet the projected staffing requirements. CSIs are available to an employee who “possesses a high-demand skill or skill that is at a shortage” at a rate up to 25 percent of basic pay. VA’s first CSIs were approved in March 2023 for human resources specialists to support increased hiring.

In the days following the CFO’s disclosure to the Secretary on September 13, more data were gathered to confirm details regarding the CSIs and determine next steps. On September 22, 2023,VA provided a statement to members of Congress, veteran service organizations, and others indicating that the Veterans Health Administration (VHA) and Veterans Benefits Administration(VBA) had awarded CSIs to nearly all of their respective senior executives. This statement reported that the CSIs included payments reportedly totaling $9.7 million to 170 senior assigned to headquarters functions at the VA central office (VACO).

VA also indicated that these payments to senior executives would be canceled because VA had made a “policy error” and “was overly broad in the way [it] implemented and executed this authority.”VA did not cancel the approximately 200 CSI awards made to “field executives”—that is, senior executives based outside of headquarters, including regional office and district directors in VBA,as well as medical center directors and Veterans Integrated Service Network (VISN) directors inVHA. That same day, Secretary McDonough also notified VA Inspector General Michael Missal of the cancellations and requested that the VA Office of Inspector General (OIG) review the facts and circumstances surrounding the issuance of the CSIs.

During the investigation, OIG staff also received information through interviews and document reviews regarding the subsequent cancellation and announced recoupment of these payments, and this feedback is briefly summarized in this report. Because the recoupment is ongoing and its impact is not fully realized, an in-depth examination was outside the scope of this investigation.” executives assigned to headquarters functions at the VA central office (VACO).

VA also indicated that these payments to senior executives would be canceled because VA had made a“policy error” and “was overly broad in the way [it] implemented and executed this authority. ”VA did not cancel the approximately 200 CSI awards made to “field executives”—that is, senior executives based outside of headquarters, including regional office and district directors in VBA,as well as medical center directors and Veterans Integrated Service Network (VISN) directors inVHA.

That same day, Secretary McDonough also notified VA Inspector General Michael Missal of the cancellations and requested that the VA Office of Inspector General (OIG) review the facts and circumstances surrounding the issuance of the CSIs.

A few days later, the chairmen and ranking members of the House and Senate Committees on Veterans’ Affairs responded to VA’s statement. They stated that using “incentives . . . to boost pay of senior executives at VA rather than bolster staffing for critical shortage positions requiring highly skilled individuals” was “contrary to congressional intent.” They also supported the Secretary’s request for the OIG to conduct a full review.

The OIG initiated its oversight work on September 28, 2023, to examine VA’s compliance with law and policy in the issuance of CSIs to VACO senior executives at VHA and VBA. The investigation also included determining the rationale for the CSI payments and the chronology of decisions by the individuals accountable for implementing the incentives that VA subsequently determined were improper. During the investigation, OIG staff also received information through interviews and document reviews regarding the subsequent cancellation and announced recoupment of these payments, and this feedback is briefly summarized in this report. Because the recoupment is ongoing and its impact is not fully realized, an in-depth examination was outside the scope of this investigation.”

READ ENTIRE REPORT:   Administrative Investigation 23-03773-169

Global Military Spending Surges Amid War, Rising Tensions And Insecurity

 

“STOCKHOLM INTERNATIONAL PEACE RESEARCH INSTITUTE”

“World military expenditure rose for the ninth consecutive year to an all-time high of $2443 billion. 

For the first time since 2009, military expenditure went up in all five of the geographical regions defined by SIPRI, with particularly large increases recorded in Europe, Asia and Oceania and the Middle East.”

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“Total global military expenditure reached $2443 billion in 2023, an increase of 6.8 per cent in real terms from 2022. This was the steepest year-on-year increase since 2009. The 10 largest spenders in 2023—led by the United States, China and Russia—all increased their military spending, according to new data on global military spending published today by the Stockholm International Peace Research Institute (SIPRI), available at www.sipri.org. 

Read this press release in Catalan (PDF), French (PDF), Spanish (PDF) or Swedish (PDF).

Click here to download the SIPRI Fact Sheet.

Military expenditure increases in all regions

The unprecedented rise in military spending is a direct response to the global deterioration in peace and security,’ said Nan Tian, Senior Researcher with SIPRI’s Military Expenditure and Arms Production Programme. ‘States are prioritizing military strength but they risk an action–reaction spiral in the increasingly volatile geopolitical and security landscape.

Military aid to Ukraine narrows spending gap with Russia 

Russia’s military spending increased by 24 per cent to an estimated $109 billion in 2023, marking a 57 per cent rise since 2014, the year that Russia annexed Crimea. In 2023 Russia’s military spending made up 16 per cent of total government spending and its military burden (military spending as a share of gross domestic product, GDP) was 5.9 per cent. 

Ukraine was the eighth largest spender in 2023, after a spending surge of 51 per cent to reach $64.8 billion. This gave Ukraine a military burden of 37 per cent and represented 58 per cent of total government spending.

Ukraine’s military spending in 2023 was 59 per cent the size of Russia’s. However, Ukraine also received at least $35 billion in military aid during the year, including $25.4 billion from the USA. Combined, this aid and Ukraine’s own military spending were equivalent to about 91 per cent of Russian spending.

USA remains NATO’s major spender but European members increase share

In 2023 the 31 NATO members accounted for $1341 billion, equal to 55 per cent of the world’s military expenditure. Military spending by the USA rose by 2.3 per cent to reach $916 billion in 2023, representing 68 per cent of total NATO military spending. In 2023 most European NATO members increased their military expenditure. Their combined share of the NATO total was 28 per cent, the highest in a decade. The remaining 4 per cent came from Canada and Türkiye.

‘For European NATO states, the past two years of war in Ukraine have fundamentally changed the security outlook,’ said Lorenzo Scarazzato, Researcher with SIPRI’s Military Expenditure and Arms Production Programme. ‘This shift in threat perceptions is reflected in growing shares of GDP being directed towards military spending, with the NATO target of 2 per cent increasingly being seen as a baseline rather than a threshold to reach.’

A decade after NATO members formally committed to a target of spending 2 per cent of GDP on the military, 11 out of 31 NATO members met or surpassed this level in 2023—the highest number since the commitment was made. Another target—of directing at least 20 per cent of military spending to ‘equipment spending’—was met by 28 NATO members in 2023, up from 7 in 2014.

China’s rising military expenditure drives up spending by neighbours

China, the world’s second largest military spender, allocated an estimated $296 billion to the military in 2023, an increase of 6.0 per cent from 2022. This was the 29th consecutive year-on-year rise in China’s military expenditure. China accounted for half of total military spending across the Asia and Oceania region. Several of China’s neighbours have linked their own spending increases to China’s rising military expenditure. 

Japan allocated $50.2 billion to its military in 2023, which was 11 per cent more than in 2022. Taiwan’s military expenditure also grew by 11 per cent in 2023, reaching $16.6 billion.

‘China is directing much of its growing military budget to boost the combat readiness of the People’s Liberation Army,’ said Xiao Liang, Researcher with SIPRI’s Military Expenditure and Arms Production Programme. ‘This has prompted the governments of Japan, Taiwan and others to significantly build up their military capabilities, a trend that will accelerate further in the coming years.’

War and tensions in the Middle East fuel biggest spending increase of past decade

Estimated military expenditure in the Middle East increased by 9.0 per cent to $200 billion in 2023. This was the highest annual growth rate in the region seen in the past decade. 

Israel’s military spending—the second largest in the region after Saudi Arabia—grew by 24 per cent to reach $27.5 billion in 2023. The spending increase was mainly driven by Israel’s large-scale offensive in Gaza in response to the attack on southern Israel by Hamas in October 2023. 

‘The large increase in military spending in the Middle East in 2023 reflected the rapidly shifting situation in the region—from the warming of diplomatic relations between Israel and several Arab countries in recent years to the outbreak of a major war in Gaza and fears of a region-wide conflict,’ said Diego Lopes da Silva, Senior Researcher with SIPRI’s Military Expenditure and Arms Production Programme. 

Military action against organized crime pushes up spending in Central America and the Caribbean

Military spending in Central America and the Caribbean in 2023 was 54 per cent higher than in 2014. Escalating crime levels have led to the increased use of military forces against criminal gangs in several countries in the subregion.

Military spending by the Dominican Republic rose by 14 per cent in 2023 in response to worsening gang violence in neighbouring Haiti. The Dominican Republic’s military spending has risen steeply since 2021, when the assassination of Haitian President Jovenel Moïse threw Haiti into crisis.

In Mexico, military expenditure reached $11.8 billion in 2023, a 55 per cent increase from 2014 (but a 1.5 per cent decrease from 2022). Allocations to the Guardia Nacional (National Guard)—a militarized force used to curb criminal activity—rose from 0.7 per cent of Mexico’s total military expenditure in 2019, when the force was created, to 11 per cent in 2023.

‘The use of the military to suppress gang violence has been a growing trend in the region for years as governments are either unable to address the problem using conventional means or prefer immediate—often more violent—responses,’ said Diego Lopes da Silva, Senior Researcher with SIPRI’s Military Expenditure and Arms Production Programme.

Other notable developments

• India was the fourth largest military spender globally in 2023. At $83.6 billion, its military expenditure was 4.2 per cent higher than in 2022.

• The largest percentage increase in military spending by any country in 2023 was seen in the Democratic Republic of the Congo (+105 per cent), where there has been protracted conflict between the government and non-state armed groups. South Sudan recorded the second largest percentage increase (+78 per cent) amid internal violence and spillover from the Sudanese civil war.

• Poland’s military spending, the 14th highest in the world, was $31.6 billion after growing by 75 per cent between 2022 and 2023—by far the largest annual increase by any European country.

• In 2023 Brazil’s military spending increased by 3.1 per cent to $22.9 billion. Citing the NATO spending guideline, members of Brazil’s Congress submitted a constitutional amendment to the Senate in 2023 that aims to increase Brazil’s military burden to an annual minimum of 2 per cent of GDP (up from 1.1 per cent in 2023).

• Algeria’s military spending grew by 76 per cent to reach $18.3 billion. This was the highest level of expenditure ever recorded by Algeria and was largely due to a sharp rise in revenue from gas exports to countries in Europe as they moved away from Russian supplies.

• Iran was the fourth largest military spender in the Middle East in 2023 with $10.3 billion. According to available data, the share of military spending allocated to the Islamic Revolutionary Guard Corps grew from 27 per cent to 37 per cent between 2019 and 2023.

For editors

SIPRI monitors developments in military expenditure worldwide and maintains the most comprehensive, consistent and extensive publicly available data source on military expenditure. The annual update of the SIPRI Military Expenditure Database is accessible from today at www.sipri.org.

All percentage changes are expressed in real terms (constant 2022 prices). Military expenditure refers to all government spending on current military forces and activities, including salaries and benefits, operational expenses, arms and equipment purchases, military construction, research and development, and central administration, command and support. SIPRI therefore discourages the use of terms such as ‘arms spending’ when referring to military expenditure, as spending on armaments is usually only a minority of the total.”

https://www.sipri.org/media/press-release/2024/global-military-spending-surges-amid-war-rising-tensions-and-insecurity

Media contacts

For information or interview requests contact Mimmi Shen (mimmi.shen@sipri.org, +46 766 286 133) or Stephanie Blenckner (blenckner@sipri.org, +46 8 655 97 47).

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