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Veterans Health Administration

Myth: The Veterans Health Administration (VA) is a model for reforming the U.S. health care system and outperforms commercial insurance

Fact: These claims rest on distortions, out-of-date information, and self-serving analyses of data that equate checklist medicine with good medicine and ignore the long waiting lists.

In 2007, the VA’s medical facilities were found to “suffer from hundreds of problems,” some small and cosmetic but others with the potential to negatively impact the health of patients. They have also been found to be poorly equipped for female veterans who are rapidly growing in number.

The biggest deficiency in the VA is the burgeoning waiting lists. The VA apparently had 400,000 cases that were still being processed in March 2007.¹ Claims routinely took 177 days and lost or mislaid paperwork were common. ² Mental health care remains an area with particularly long waiting lists. Furthermore, the VA has used semantics and numbers games to obfuscate the extent of the waiting lists.

Like other government programs, the VA faces chronic cost overruns, compounded by the high number of injured soldiers from Iraq and Afghanistan. In 2009, the program will include 330,000 soldiers hurt in these two conflicts, both wounded in action and with “non-combat illnesses.” With that comes a hefty price tag of $1.3 billion, for these veterans alone, part of a total of $41.2 billion for all veterans.³ This not only impacts care but the ability to recruit high quality doctors.

Studies cited to show that the VA outperforms commercial insurers are often out-of-date and frequently have authors who are tied to the VA or funding from the program. In other cases, these studies are mischaracterized or distorted. The analyses cited also reward compliance over quality, urging programs to follow guidelines 100 percent of the time rather than look at patients individually and determine the best treatment.

1. ¹ “Average 2008 Employee Out-of-Pocket Costs for Family Health Care to Increase 10.5%, According to Milliman Index,” Medical News Today, 16 May 2008, http://www.medicalnewstoday.com/articles/107699.php.
2. ² Kevin Sack, “Clinton Details Premium Cap in Health Plan,” The New York Times, 28 March 2008.
3. ³ Jay Lehr, “Canadian Health Care is No Model for U.S.: Claims That Canada’s Single-Payer Health System Is More Efficient or More Compassionate than Ours Are Just Plain Untrue,” Health Care News, 1 June 2004, available at http://www.heartland.org/Article.cfm?artId=15034&CFID=4911814&CFTOKEN=64059852.