VA Health Care

Demand for inpatient services offered by the Department of Veterans Affairs (VA) could drop by about 18 percent if employers nationwide were required to either provide health insurance for their workers or pay a tax that would be used to obtain coverage. Similarly, demand for VA outpatient services could drop by about nine percent. Demand for VA-sponsored nursing home care, however, would be largely unaffected because most reform proposals provide limited long-term care coverage. Under a nationwide universal health plan, the impact could be even greater, with demand for VA inpatient care plummeting by about 47 percent. Likewise, use of VA outpatient care could drop by about 41 percent. The actual decrease, including the impact on nursing home usage, could vary significantly depending on the type of universal coverage program adopted. Although many veterans would continue to seek VA treatment, the magnitude of the likely decrease in demand for VA-sponsored health care--should either employer mandates or universal coverage be enacted--suggests that the VA health system should be included in any debate on American health care reform.

GAO found that: (1) a 1987 survey estimated that 463,000 veterans used VA hospitals, and 66,000 veterans were not covered by private health insurance; (2) universal health insurance coverage or employer-mandated insurance could reduce VA inpatient services by 18 percent; (3) a universal health insurance plan could result in a 47-percent decrease in demand for VA hospital care and a 41-percent decrease in outpatient care; (4) implementing employer-mandated coverage would not result in a reduction in VA-sponsored nursing home services; (5) universal health coverage could reduce the demand for VA nursing home care if the plan provided coverage of long-term care services; and (6) VA health care systems should be included in discussions on nationwide health care systems.