Our armed forces are our national heroes, valued for their courage and dedication to the American Promise. So naturally, their sacrifices and bravery would guarantee great veteran healthcare, right? Well… Not always.
It’s simple to enlist in the armed forces; accessing care through Veterans Health Administration is a little more complex. Upon discharge, many veterans are surprised to find that VA enrollment isn’t automatic, not even if they’ve seen combat. Instead, they must apply for benefits and take an active – even assertive – role to receive the care they require and deserve.
And they do need care, usually, because veterans tend to have significant clinical needs. Sometimes they have combat-related issues, such hearing loss, post-traumatic stress disorder, traumatic brain injury, chronic pain, sleep disorders, or illnesses caused by exposure to toxic chemicals. Older veterans are often diagnosed with diabetes, obesity, high blood pressure, and cardiac disease – conditions that require ongoing care.
But being a veteran doesn’t always mean eligibility for VA benefits, and being eligible doesn’t always mean access to care. Veterans are usually grouped according to service-connected disabilities, income levels, and their military service. They can face long wait times for appointments or find there aren’t any local providers who specialize in veteran health.
To put this in numbers – in 2023, only 9 million of 18 million veterans were eligible for VA care and only 6 million were using those benefits. When a 2021 report from the Military Family Advisory Network surveyed 8,638 military and veteran families, respondents listed VA care as one of their top concerns. They reported trouble scheduling appointments, negative provider experiences, and poor quality of care.
Rural challenges in veterans health
Compared to other Americans, veterans are more likely to live in rural areas. In 2022, about one-third of veterans enrolled in VA lived in a rural area, compared to about one-fifth of other Americans. This means rural veterans face barriers such as:
- Longer travel times to medical centers
- Fewer local specialists
- Limited access to broadband Internet
- Mental health support shortages
These factors are a few reasons that VA’s Office of Rural Health data found that only 21% of rural veterans use outpatient VA facilities compared to 79% of urban veterans. These veterans can face economic hardships too; one study found 31% of rural veterans earned less than $35,000 annually.
Veterans health and behavioral care
Perhaps the most tragic health disparity for our veterans is the lack of mental health support. Veterans have a 72% higher suicide rate than that of non-veteran U.S. adults. A 2022 report from America’s Warrior Partnership found that 40-44 service veterans die by suicide or self-injury each day. Others may turn to harmful coping mechanisms, including self-harm and substance abuse.
The Wounded Warrior Project’s 2022 survey of wounded post-9/11 veterans put their mental health struggles into stark and disturbing numbers. The survey found that:
- 76% of veterans reported experiencing PTSD
- 50% reported moderate to severe symptoms of two or more mental health conditions, such as depression and anxiety
- 28% reported having suicidal thoughts in the last year
Good mental health care is urgently needed – but the RAND Center for Military Health Policy Research found less than half of veterans in need receive proper treatment or evidence-based care.
Active-duty coverage barriers
Military families report their own barriers to receiving care on active duty. When it comes to dependents and family members, different military branches have different standards for medical care. Some bases allow spouses and children to be seen in clinic while other base clinics will only see active-duty members. In the latter case, family members must leave the military base to find urgent, primary, specialty, or emergency care.
One military family struggled after being given PCS (Permanent Change of Station) orders with short notice. The service member’s wife needed maternity care but she couldn’t see an OB in the new location until she obtained a referral from a PCP in that area – and none of the PCPs she contacted would accept new patients. By the time she connected with a new OB, she was in her third trimester and being treated by a physician who didn’t know her medical history.
So how do we improve healthcare for military members and veterans?
First, let’s celebrate some positive changes. A big one: VA expanded benefits eligibility to over 3.5 million veterans after President Biden signed the PACT Act of 2022. The VA has also launched a mobile application to centralize veteran benefits information and help them more easily navigate the VA system. More recently President Biden announced that veterans in suicidal crisis can receive free emergency medical care at any VA or private care facility.
But we still have some gaps to close. Here are 6 ideas for improving veterans health:
Support for transitioning back to civilian life
This is a big change for most veterans and it can route some of them into depression, feelings of disempowerment, social isolation, and even homelessness. Disabled veterans can be at high risk at this juncture.
Automatic enrollment in VA benefits
Immediately enrolling honorably discharged veterans into their benefits can start veterans on a positive health pathway. Also helpful: sharing clear educational materials before military separation to help veterans navigate the system.
Effective veteran suicide prevention programs
Some organizations are taking a proactive approach to veteran mental health support that includes everything from career coaching to suicide hotlines to behavioral therapy and grief support. But rural veterans may not have local programs, which brings us to….
Telemedicine and other digital health tools
In 2023, over 770,000 veterans were able to access care without leaving their rural communities. Increasing virtual care and telemedicine options can help connect veterans to quality care no matter where they live.
Better accessibility to community care provisions
When the VA cannot provide care or clinicians, community care access can connect veterans to quality treatment within a reasonable distance. But some veterans say that when they do access community care, their providers don’t always grasp their challenges.
Staffing solutions
Provider shortages are never easy to solve but partnering with staffing agencies can help reduce appointment wait times and deliver specialty care even in underserved areas.
Veterans Day is a great day to celebrate our veterans with parades and services, but it’s also an opportunity to honor their service by improving their quality of care. If you work in the healthcare industry, consider the veterans in your community – and work with your team to find ways to bring better medical and behavioral care to our service members.
Tribal Health supports our veterans! We are committed to creating a welcoming workplace where all veterans and former service members can thrive through equitable access and opportunities for success.
