The Veteran Health Care Crisis
The Scope of the VA
The US Department of Veterans Affairs, commonly referred to as the VA, operates the largest health care system in the country. The Veterans Health Administration provides care for over 9 million veterans annually. However, this only represents about half of the veteran population, as there are about 19 million veterans across the country. In addition, roughly 200 000 active-duty service members make the transition to civilian life every year.
While studies indicate that the transition from military to civilian life is highly stressful, it is likely only one of several obstacles veterans face after serving. A 2022 survey performed by the Wounded Warrior Project found that 50 percent of participants in the survey reported symptoms of at least two mental health conditions. Over 75 percent experienced post-traumatic stress. The suicide rate among veterans is a major concern, with at least 40 veterans dying by suicide every day, according to a 2022 report. In addition to the medical challenges presented, affordable housing and employment are also aspects of transition that veterans have to navigate and potentially struggle with.
Barriers Within the VHA 
While the VA’s budget has continually grown over the past several years, many disparities and obstacles persist. These challenges are affecting veterans’ access to and quality of health care. Veterans enrolled within the VHA may be eligible for multiple benefits, services, and specialized health care programs. There are currently 171 VA medical centers and 1113 outpatient sites across the country. However, the difficulty of navigating the health care system has been troublesome. For example, current research shows that less than half of veterans who are in need of mental health services receive treatment. Of that amount, less than 1/3 receive proper care.
Long wait times have been a consistent issue, as well as poor access in rural areas. In a 2021 report from the Military Family Advisory Network, access to the VA health care system was a top concern. Specific challenges included trouble scheduling appointments, negative experiences with providers, and poor quality care. Inconsistencies in data reporting within the VA have made it difficult to assess the extent of the problem with wait times. A report from the Government Accountability Office (GAO) earlier this year confirms the unique barriers rural veterans face, largely due to staffing shortages and transportation issues.
Additional Disparities and Challenges
Additional disparities and challenges exist for veterans beyond those living in rural areas. Racial and ethnic disparities persist even with comparable care. Research has shown that veterans identifying as Black or Hispanic have both a higher occurrence of chronic illness, as well as a higher utilization of VA health care. In a survey published earlier this year, the CDC found that over 1/3 of veterans surveyed were at least somewhat worried about being able to afford medical bills. While the rate of veteran homelessness has steadily decreased in the past two decades, they comprise at least 10% of the adult homeless population. At the beginning of 2022, the number of homeless veterans was estimated at over 30 000.
Ways to Address VA Health Care Challenges
Although reports show significant challenges within the VHA, there are ways to combat these disparities and work towards improvement. In the past couple of years, some steps have already been taken. The GAO published a report earlier this year outlining problems associated with VHA staffing and suggestions for improvement. This includes, but is not limited to, utilizing tools to access the specific needs of different VA medical facilities and integrating mental health services within primary care settings. In addition, the GAO emphasized facilities ensuring the accurate and timely completion of employee onboarding data. This data, when completed adequately, can give insights into staffing and facility needs. Programs expanding access to information regarding benefits for veterans have also been created.
Since 2022, legislation has expanded benefits eligibility with the PACT Act. The full name of this law is The Sergeant First Class (SFC) Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act. This law seeks to provide additional benefits to veterans exposed to different toxic substances while serving. In addition, this year the Advancing Uniform Transportation Opportunities For Veterans (AUTO) Act gave disabled veterans more assistance with purchasing modified vehicles. Ensuring proper implementation of the MISSION Act will also help with improvements. The VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018 expanded health care options for veterans. This law includes specific criteria regarding wait times and access to facilities. Addressing the veteran suicide rate is a pertinent issue for the VA. Improving access and quality of mental health services is a critical component to this and should be a top priority moving forward.
Veteran Resources
**Veteran Crisis Line: Dial 988 then press 1
For veteran resources including helplines and finding treatment, visit SAMHSA’s veteran resource page here.
For additional support and resources, visit https://www.va.gov/resources/
This blog was written by STM Learning’s editorial staff for educational purposes only. It is not intended to give specific medical or legal advice. For expert information on the discussed subjects, please refer to STM Learning’s publications.
