According to the Census Bureau, the United States is home to 21.8 million veterans, which amounts to a sizeable 7 percent of the country’s total population. After serving the nation under the most testing work environments imaginable, many of our veterans remain woefully underserved on their return. Many of them are unable to meet even their basic needs – one of these being proper health coverage.
Multi-faceted challenges faced by our veterans
Our veterans return from deployment to hostile domestic conditions. Inadequate compensation, unaffordable housing, skills gap that make them uncompetitive, poorly understood health challenges such as post-traumatic stress disorder (PTSD), substance abuse problems, and a lack of community support – all militate against their integration into regular civilian life.
The National Coalition for Homeless Veterans cites government statistics to estimate that at any given time, we have in our midst 50,000 homeless veterans, with 1.4 million more on the verge of becoming homeless. To expect people living in these conditions to fend for themselves is expecting the impossible.
The role of government in supporting veteran health care
Our veterans depend on the government to provide them with adequate medical coverage and medical facilities. The Veteran Affairs (VA) Department provides resources for the medical care of 9.1 million veterans, but has woefully fallen short of their mandate.
VA hospitals remain embroiled in major controversies and problems ranging from falsified wait times for treatment, outdated patient management systems, and inability to deal with mental health conditions (e.g. PTSD) caused by the changing nature of modern warfare.
A complicated qualification processes means that many veterans do not end up qualifying, or know that they qualify, for VA care. Finally, when medical and disability claims take over a year to simply process, one cannot help but take refuge in the cliché, “justice delayed is justice denied.”
The Medicaid insurance gap and how it affects veterans
According to research from the Urban Institute, about 600,000 veterans are projected to be uninsured in 2017, many of them falling into the “Medicaid gap” – which essentially means that they are not old enough to qualify for Medicare, but have not been insured because of a lack of expansion of state-specific Medicaid programs.
However, all is not bleak. In recent years, The Affordable Care Act has resulted in a drop in the uninsurance rate of nonelderly veterans by an estimated 42 percent, falling from 11.9 to 8.5 percent between 2013 and 2015. Lesser reports of unmet medical needs also demonstrated improvement in coverage conditions.
Assessing social determinants and medical homes for veterans
Meanwhile, ensuring the availability of health safety net resources for our most vulnerable segments of our veterans is essential. A recent study conducted by researchers at the VA Medical Center in Providence, Rhode Island studied 33 Veteran Health Administration (VHA) facilities with homeless medical homes and patient-aligned care teams, serving more than 14,000 veterans. More than 96% of the veterans were receiving VHA homeless services. Some of these services include hygiene care, transportation, pantry, kitchen, and laundry facilities.
This is not just statistics – this is real
Just last week, I spoke with a veteran who was suffering from a thyroid condition. Her physicians at the VA refused to have lab work done because they didn’t feel she met the criteria. She paid privately for her labs that identified her thyroid condition.
When she presented the lab results to the VA, they refused to accept the outside lab report and denied payment for her medication. They also continued to refuse to run labs for her at the VA facility. Her husband, also a veteran, has rheumatoid arthritis. He is only able to receive his medication by a VA specialist who rotates through the VA facilities on an infrequent basis. The VA refuses to permit any of their own providers from administering the injection. Needless to say, he is not able to receive his injections as therapeutically required.
In December 2016, Kaiser Health News highlighted a private initiative committed to filling the VA shortfalls in providing mental health treatment for veterans. The Cohen Veterans Network clinics provide services to both veterans and their families in five cities currently, with the plan to expand to add twenty more clinics over the next five years.
These challenges and stresses faced by our veterans are real. Without putting the focus on the problem, the pain and suffering faced by our veterans is bound to continue. Continued efforts to advocate for filling the medical care gaps in our social safety net are needed for us closer to the goal of proper health coverage for our veterans.