The U.S. Department of Veterans Affairs, which oversees pensions, education, health care and other benefits for veterans and their families, faces allegations about treatment delays and falsified records at its hospitals around the country.
The aging network of hospitals and clinics - the VA opened its first new medical center in 17 years in 2012 - is one of the world's largest integrated health care systems.
WHERE CAN VETERANS SEEK HEALTH CARE?
The Veterans Health Administration, by far the VA's largest arm, operates about 1,700 health care sites, including medical centers, community clinics and counseling centers. A system that traces its roots to Philadelphia's Naval Home, built to provide medical care for disabled veterans in 1812, has grown from 54 hospitals in 1930 to 150 medical centers, with at least one in each state, Puerto Rico and the District of Columbia. Reforms in the 1990s saw a shift to decentralization and from a focus on inpatient to outpatient care, along with an emphasis on measuring performance. In 2003, a nationwide Web-based portal was launched to help vets track their records and give them access to health information.
One medical center in Washington, D.C., has a staff of 1,700 and treats more than 500,000 outpatients every year. Another in Denver will soon be replaced by a multimillion-dollar complex that has run into construction delays and cost overruns. After the recent allegations, Veterans Affairs Secretary Eric Shinseki announced more veterans will be able to get care at private hospitals and clinics.
WHO PROVIDES CARE?
The VA health system has more than 275,000 fulltime employees. Its specialists conduct research in such areas as PTSD, prosthetics, spinal-cord injury and exposure to Agent Orange.
WHO IS ELIGIBLE?
Veterans of any military branch, unless they were dishonorably discharged, as well as reservists and National Guard members in some cases. Dependents and children of veterans also can receive benefits. In most cases, veterans must apply for enrollment. Nearly 9 million - up from just under 8 million in 2008 - are enrolled in a program that is struggling to keep up with the number of vets returning from Iraq and Afghanistan, while Vietnam veterans need more care as they age. The VA system saw 5.5 million patients in 2008; that grew to 6.5 million in 2012-2013.
The VA says its commitment to providing better care increased a disability claims backlog but that it hopes to eliminate the backlog in 2015. It processed about 1 million claims a year from 2010 to 2013.
The VA estimates the U.S. has more than 21 million veterans, men and women who fought in World War II through the war on terror. Vietnam War veterans are the largest group, followed by Gulf War veterans. While most today are white men, that is changing, with women expected to make up a fifth of the veteran population and nonwhites a third in 30 years. The changes will present the VA with new challenges in terms of reaching vets and diversifying the services offered.
IS IT FREE?
Health care is free for some veterans, including those whose incomes are low, former prisoners of war and those with severe disabilities as a result of their service. Veterans who served in a combat zone are eligible for free VA hospital care, outpatient services and nursing home care for two years after leaving active duty because of an illness or injury that may be linked to service. For others, co-pay charges are $15 for a basic visit and $50 to see a specialist such as a surgeon or optometrist or for certain tests. The co-pay for a stay at the hospital can be as low as $236 for the first 90 days.
WHAT DOES IT COST THE US?
The VA's medical care budget was about $55.6 billion in fiscal year 2013 and is estimated at about $57.3 billion this year. The 2015 estimate is nearly $60 billion.
Source: U.S. Department of Veterans Affairs