DOD struggles with health care costs, VA faces challenges in providing care

Defense Secretary Robert Gate spoke about the need to control soaring defense costs, especially health care expenses, while Veterans Affairs Secretary Eric Shinseki responded to several health care challenges facing veterans' health care. 

In a speech in Abilene, Kan., marking the 65th anniversary of the end of the World War II in Europe, "Gates said this weekend the Pentagon is going to have to start living at least closer to its means," Marketplace reports. Gates is quoted as saying: "Leaving aside the sacred obligation we have to America's wounded warriors, health care costs are eating the Defense Department alive. The Pentagon spends $50 billion a year on health care -- more than double what it did 10 years ago. Even retired service members who could be insured by their employer get cheap government-subsidized insurance." Meanwhile, Winslow Wheeler at the Center for Defense Information said: "'Congress has layered on additional unrequested benefits for survivors, for retirees, and it's all coming home to roost.' In his speech, Secretary Gates said Congress's generosity is admirable. But now that budgets are tight, he said it may be time for troops to pick up more of their own health care tab" (Neely, 5/10). 

CNN: "Increasing health care costs, a top-heavy uniformed and civilian management force, and big-ticket weapons systems are swelling the military's budget at an 'unsustainable' rate, Gates said. In response, Gates said, he has ordered the Defense Department's military and civilian leaders to find savings of 2 to 3 percent -- more than $10 billion of the Pentagon's roughly $550 billion base budget -- and shift spending toward war-fighting costs. … The U.S. defense budget has more than doubled since the September 11, 2001, attacks on New York and Washington and the 2003 invasion of Iraq" (5/9).

The Los Angeles Times: "Perhaps the toughest cuts will be those made to the military healthcare system. Gates said care for soldiers and veterans wounded in Iraq or Afghanistan would not be cut. Past Pentagon attempts to curb healthcare costs, by raising premiums or co-payments, have been rejected by Congress" (Barnes, 5/9).

NPR reports about the changing veteran in the first of a five-part series and describes the new typical veteran in the following way: "Most are in their 20s and 30s. About 12 percent are female. Many are alive because of advances in battlefield medicine: They're surviving serious wounds, but returning with more physical problems — head injuries, missing limbs. And nearly half of them come home with some type of mental disorder, like post-traumatic stress disorder." NPR also reports that Shinseki "has received billions more dollars in funding than in the past [and] has to somehow move the cumbersome VA bureaucracy into the 21st century. ... The bad news is, Shinseki has a long to-do list. The massive backlog is on the top of the list. Hundreds of thousands of vets are waiting for a check to compensate them for their war wounds. On average, each claim drags on more than five months. ... Next on the list? Access to health care. More than one-third of all veterans live in rural areas, sometimes hours away from VA hospitals. ... The VA is creating storefront clinics outside major cities. It's purchasing medical vans to bring counselors to vets in less populated counties" but some critics say it still many issues to overcome to meet the needs (Bowman, 5/10).

CQ HealthBeat: "Witnesses at a Senate hearing credited the Department of Veterans Affairs for making strides in the treatment of traumatic brain injury among military personnel but emphasized that troubling gaps remain in government-funded services. Sarah Wade of the Wounded Warrior Project said creation of a 'polytrauma' network is among the important accomplishments of the VA in responding to brain injury, which Sen. Daniel K. Akaka, D-Hawaii, noted affects an estimated 360,000 service members who served in Iraq or Afghanistan. ... Wade also praised the greater use of contracting by VA with outside providers but said troubling gaps remain despite 'very real and tangible institutional changes and compassionate care provided by many, many dedicated clinical staff' at the VA. … But VA faces great challenges in dealing with traumatic brain injury" (Reichard, 5/10).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.