Woolhandler testimony on uninsured veterans
Statement of Stephanie J. Woolhandler, MD, MPH, FACP, Associate Professor of Medicine, Harvard Medical School, and Co-Founder, Physicians for a National Health Program
House Committee on Veterans’ Affairs
June 20, 2007
Uninsured Veterans: A Stain on America’s Flag
Summary/Oral Testimony
In my written testimony I present detailed information on the health insurance coverage and problems in access to health care of America’s veterans, based on analyses of multiple years of data from two annual national surveys carried out by the government: The Current Population Survey and the National Health Interview Survey.
I will address two questions: (1) How many veterans are currently uninsured? And (2) Do uninsured veterans suffer problems in access to care — similar to other Americans who are uninsured?
In 2004, 1.8 million military veterans neither had health insurance nor received ongoing care at Veterans Health Administration (VHA) hospitals. Note that the surveys asked veterans if they had health insurance, and if they had veterans or military health care. We counted them as uninsured only if they answered no to both questions. The number of uninsured veterans has increased by 290,000 since 2000. The proportion of non-elderly veterans who were uninsured rose from less then one in ten (9.9%) in 2000 to more than one in eight (12.7%) in 2004.
An additional 3.8 million members of veterans’ households were also uninsured and ineligible for VHA care.
Virtually all Korean War and World War II veterans are over age 65 and hence covered by Medicare. However, 645,628 Vietnam-era veterans were uninsured (8.5% of the 7.56 million Vietnam-era vets). Among the 8.6 million veterans who served during “other eras” including the Persian Gulf War, 12.9% (1,105,891) lacked health coverage.
Almost two-thirds (64.3%) of uninsured veterans were employed and nearly nine out of ten (86.4%) had worked within the past year. Most uninsured veterans, like other uninsured Americans were in working families. Many earned too little to afford health insurance, but too much to qualify for free care under Medicaid or VA means testing.
Uninsured veterans have the same problems getting the care they need as do other uninsured Americans. Moreover, many uninsured veterans have serious illnesses requiring extensive care. Among uninsured veterans older than 45 years, nearly one in five (19.1%) were in fair or poor health. Nearly one in three uninsured veterans (of all ages) reported at least one chronic condition that limited their daily function.
A disturbingly high number of uninsured veterans reported needing medical care and not being able to get it within the past year. More than a quarter (26.5%) of uninsured veterans failed to get needed care due to costs; 31.2% had delayed care due to costs. Among uninsured veterans, 44.1% had not seen a doctor or nurse within the past year, and two-thirds failed to receive preventive care. By almost any measure, uninsured veterans had as much trouble getting medical care as other uninsured persons.
The VHA is a rare success story in our health care system. The VHA offers more equitable care and higher quality care than the average care in the private-sector, and has become a medical leader in research, primary care, and computerization.
While we support opening VHA enrollment to all veterans, this would still leave many veterans unable to access care because they live far from VHA facilities. Moreover, even complete coverage of veterans would leave 3.8 million of their family members uninsured. Hence, my colleagues and I support a universal national health insurance program that would work with and learn from the VHA system in covering all Americans.
Full oral and written testimony:
http://veterans.house.gov/hearings/schedule110/june07/06-20-07/6-20-07woolhandler.shtml
And…
Study Finds 1.8 Million Veterans Are Uninsured
By Christopher Lee
The Washington Post
June 21, 2007
Stephanie J. Woolhandler, the Harvard Medical School professor who presented her findings yesterday before the House Committee on Veterans Affairs… is a well-known advocate of guaranteeing access to health care for all Americans through a government-run national health insurance program. Republican lawmakers seized on that association to question whether she was trying to advance that goal with her study.
“The difficulty would be that because of your desire for universal health care, that could influence how you felt about veterans,” Rep. Cliff Stearns (R-Fla.) said.
Woolhandler said the data are sound. She has firsthand experience with the issue as well, she said, because as a physician she has seen uninsured veterans with untreated high blood pressure, diabetes and other conditions.
“It breaks my heart,” she said.
Comment:
By Don McCanne, MD
Mine too.