Veterans' Health Care: Challenges for the Future
Highlights
GAO discussed the future of the Department of Veterans Affairs' (VA) health care system. GAO noted that: (1) VA hospitals' workload has decreased 56 percent during the last 25 years and will probably decrease further as more veterans die and delivery settings and health care plans change; (2) the demand for nursing home care has increased for veterans 85 years of age and older; (3) VA and other public and private health benefit programs cannot meet all veterans' health care needs, notably for specialized and long-term care; (4) to meet such needs, VA could reduce services to certain veterans and use those funds to purchase private-sector health care services for other eligible veterans or increase the availability of specialized care; (5) VA could increase veterans' access to care by improving its facility resource allocations and the consistency of its coverage decisions; (6) other countries have closed veteran hospitals and integrated veterans' health care into their general health care systems; (7) VA could increase hospital workloads by attracting more veterans or extending coverage to veterans' dependents or nonveterans on a reimbursable basis; (8) converting VA hospitals to long-term care facilities is feasible, but operating costs would be higher than the cost of purchasing private-sector nursing home care unless cost-sharing arrangements are included; and (9) alternatives to the VA direct delivery system include purchasing more services directly from the private sector, issuing vouchers for private insurance, and covering veterans under other existing federal health benefit programs.