Veterans' Health Care:

Implications of Other Countries' Reforms for the United States

HEHS-94-210BR: Published: Sep 27, 1994. Publicly Released: Sep 27, 1994.

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Pursuant to a congressional request, GAO reviewed the veterans health care systems in Australia, Canada, Finland, and the United Kingdom, focusing on: (1) why these countries implemented universal health care; (2) how eligibility for veterans health care benefits in these countries compares to that in the United States; (3) how the age and status of U.S. veterans compare to the veteran populations in the other countries; (4) the effects of changes to the countries' veterans health care systems; and (5) the potential effects of health reform on the U.S. veterans health care system.

GAO found that: (1) the four countries have implemented universal health care systems primarily to improve access to care and control health care costs; (2) although three of the four countries operate health financing systems, the United Kingdom still operates a direct delivery system; (3) although the four countries generally limit veterans' health benefits to those with military service-related injuries, U.S. veterans are universally eligible for health benefits after 2 years of military service; (4) the veteran populations in the four countries are aging and declining more rapidly than in the United States because veteran eligibility is linked to wartime service and these countries have not been engaged in major military conflicts since the end of World War II; (5) the four countries' veterans health systems no longer focus on delivering direct acute hospital care because their veteran populations no longer require these services; (6) three of the four countries have preserved and enhanced their veterans health benefits without maintaining a direct delivery system; (7) U.S. health care reform proposals that allow veterans to choose between veterans or community services will likely decrease the demand for a U.S. direct delivery system; and (8) the changing demographics and needs of the veteran population should prompt reform of the U.S. veteran health care system regardless of whether health care reform is enacted.

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