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Veterans Without Health Care
The New York Times
November 9, 2007
Although many Americans believe that the nation's veterans have ready
access to health care, that is far from the case. A new study by
researchers at the Harvard Medical School has found that millions of
veterans and their dependents have no access to care in veterans'
hospitals and clinics and no health insurance to pay for care
elsewhere. Their plight represents yet another failure of our
disjointed health care system to provide coverage for all Americans.
The new study, published in the American Journal of
Public Health, estimated that in 2004 nearly 1.8 million veterans were
uninsured and unable to get care in veterans' facilities. An additional
3.8 million members of their households faced the same predicament. All
told, this group made up roughly 12 percent of the huge population of
uninsured Americans.
Most of the uninsured veterans were working-class
people who were too poor to afford private insurance but not poor
enough to qualify for care under a priority system administered by the
Veterans Affairs Department. Some were unable to get care because there
was no V.A. facility nearby, or the nearest facility had a long waiting
list, or they could not afford the co-payments required of some
veterans.
There is little doubt that lack of coverage was
deleterious to their health. Like other uninsured Americans, the
uninsured veterans report that they have delayed or forgone care
because of costs. Half had not seen a doctor in the past year, and
two-thirds got no preventive care.
And the situation has been getting worse. Despite a
shrinking population of working-age veterans, the number of uninsured
veterans increased by 290,000 between 2000 and 2004, propelled by a
steady erosion of health care coverage in the workplace and a
tightening of enrollment criteria for veterans' care.
The V.A. has long focused on caring for recent
combat veterans, those with service-connected disabilities or special
needs and the poorest veterans. Other veterans were served to the
extent that resources were available. Unfortunately, in recent years
enrollment of higher-income, nondisabled veterans shot up so fast that
long waiting lists developed and budgets failed to keep pace, forcing a
freeze on enrollments in this category.
One solution would be to make all veterans eligible
for care in appreciation of their service to the nation. Bills pending
in Congress would end the freeze, opening the way for hundreds of
thousands of veterans, possibly even a million or more, to qualify for
V.A. care at a cost that could reach above $1 billion the first year
and almost $9 billion over five years. An even better solution would be
some form of universal health coverage for all Americans. Then even
veterans who live far from a V.A. facility, and a host of dependents
who are not now eligible, could get the care they need.
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