Access to VA Health Care

VA has undergone a well-documented evolution in the past 25 years, dramatically increasing its quality of care beyond that of the private or public sectors. An equally well-documented problem, however, is access to that high-quality care. Access to VA care continues to be restricted in many ways, including:
• The adverse effect on veterans as a result of the budget-driven suspension of Priority Group 8 veterans from new enrollment in the VA health-care system, which was in opposition to the Veterans Health Care Eligibility Reform Act of 1996. Last year, VA reopened its doors to more than 250,000 veterans who fit the Priority Group 8 definition,
but the nation’s top veteran health-care services are still not available to all veterans. The American Legion continues to advocate for the elimination of priority groups and to open access to the VA health-care system to all veterans.
• Care for female veterans. The American Legion agrees with recent reports stating that primary-care settings should promote routine care within primary care, or be linked with specialized women’s clinics to enhance coordination and comprehensiveness and, thus, reduce fragmentation of care or potential overuse of care across health systems. However, due to that fragmentation of care, it is reported that 49 percent of women veterans have been pushed back to seek comprehensive care outside the VA
health-care system.
• Long waiting times for appointments drive away veterans in overburdened VA markets. Waiting times for VA doctor appointments can stretch into months. At one point in recent years, more than 300,000 veterans were waiting 30 days or more for primary care appointments. The waiting time to see a VA specialist is typically even more frustrating, often taking months.
• Construction. Although construction has begun in many areas, more VA facilities await in areas where veteran populations have grown and where the structures no longer meet today’s medical services environment. The Capital Asset Realignment for Enhanced Services (CARES) decision of 2004 identified urgent needs across the country for new VA hospitals and clinics in growth areas. While facilities are now under construction in Orlando, Fla., New Orleans and Las Vegas, many other underserved
areas are in need. The average VA medical facility is over 50 years old and was not built with the proper infrastructure to support today’s health-care technology.
• Adequate staffing. VA health-care facilities must be adequately staffed with healthcare providers who receive competitive compensation. In too many markets across the country, doctor, nurse and technician shortages lead VA to seek more expensive and less efficient services from outside providers. Inadequate staffing prevents VA from keeping
timely appointment schedules, and drives veteran patients away in many markets.
• Contractor dependence. Restricted access unnecessarily sends veterans to private contractors for health care formerly available to them in VA facilities. Particularly for long-term care and mental health services, VA increasingly relies on outside contractors who do not understand the unique needs of veterans consistently suffering from such conditions as combat-related post-traumatic stress disorder, traumatic brain injury, Agent Orange exposure and other service-connected problems.
• Rural health care. Veterans in rural areas are often denied access by the sheer distance between their homes and the VA medical centers equipped to serve them. Manyplans have been piloted to enhance care for rural veterans, but significant improvement – aside from recent mileage-reimbursement increases – has yet to be realized. Without greater VA clinical presence in many areas of the country, access is denied to these veterans.