TUESDAY, Oct. 30 (HealthDay News) -- Almost 2 million veterans are without health insurance, along with 3.8 million members of their households, a new study finds.
Among the 1.8 million uninsured veterans, 12.7 percent are under 65. In addition, the number of uninsured veterans has increased by 290,000 between 2000 and 2004, according to the report in the Oct. 30 online edition of the American Journal of Public Health.
"The Bush Administration has been sending Americans overseas asking them to fight for their country, and yet, when people come home, they have no guarantee of health care," said study co-author Dr. Steffie Woolhandler, an associate professor of medicine at Harvard Medical School and a member of the advocacy group Physicians for a National Health Program. "The most basic human right of health care is being denied to our veterans, along with other Americans -- and that's a disgrace."
"Over 1 million veterans have no health insurance and no access to veterans' hospitals," Woolhandler added. "I think that's shocking to most people. It was certainly shocking to us."
Many of these veterans were members of working families that earned too much to qualify for programs such as Medicaid or Veterans Administration care, Woolhandler said. "Yet, they earned too little to be able to afford private coverage," she said.
Woolhandler noted that the Veterans Administration health-care system is not open to all veterans. Many uninsured veterans can't get any VA care because the Bush Administration stopped enrollment of most middle-income veterans in 2003, she said.
"Any veteran with a service-connected disability can get access to the VA," Woolhandler said. "That's a minority of veterans. For everybody else, VA care is means-tested -- veterans earning more than $30,000 a year will not be eligible for VA care."
According to the U.S. Department of Veterans Affairs Web site, the financial income threshold is $27,790 for a veteran with no dependents and the range graduates upward to $38,948 for four dependents. Each additional dependent raises the annual income ceiling $1,866.
In the study, Woolhandler and her colleagues analyzed data from U.S. government surveys from 1988 and 2005. Veterans were classified as uninsured if they didn't have health insurance or receive care at Veterans Health Administration hospitals or clinics.
A preliminary review of 2006 data shows little change in the number of uninsured veterans since 2004, Woolhandler noted.
Woolhandler's team found that 645, 628 uninsured veterans were old enough to have served in Vietnam. More than 1 million (1,105,891) served at other times, including in Iraq and the first Gulf War -- 56.5 percent were older than 44.
Among uninsured veterans, 26.5 percent said they couldn't get medical care because of costs, 31.2 percent delayed care due to costs, and 49.1 percent hadn't seen a doctor within the past year. In addition, two-thirds didn't receive preventive care. Yet, almost two-thirds were employed, the researchers found.
Others reasons veterans can't get VA care include waiting lists at VA hospitals, high co-payments for VA specialty care and a lack of a VA facility in their community, the researchers noted.
"Veterans deserve a right to health care," Woolhandler said. "We think that every American deserves a right to health care."
One expert thinks that the uninsured veterans are in no worse shape than the rest of the uninsured population.
"I don't think the VA was ever supposed to be a health insurance program for all veterans," said Greg Scandlen, the founder of Consumers for Health Care Choices. "I don't think the VA is doing something it's not supposed to do."
"Veterans face the same problems as everyone else," Scandlen said. "They don't get any special treatment when it comes to private coverage," he said.
Attempts by HealthDay to reach Veterans Administration officials for comment were unsuccessful.
For more on eligibility for VA health-care benefits, go to the U.S. Department of Veterans Affairs.
SOURCES: Steffie Woolhandler, M.D., associate professor, medicine, Harvard Medical School, Boston; Greg Scandlen, founder, Consumers for Health Care Choices, Hagerstown, Md.; Oct. 30, 2007, American Journal of Public Health online