VA is seeing major changes in the healthcare system as veterans flock to the South and Southwest
WASHINGTON — The U.S. Department of Veterans Affairs on Monday began the year-long process of restructuring its nationwide healthcare network, an undertaking that will require presidential and congressional approval before it can begin.
The reorganization would mean closing or merging some medical facilities, likely to draw opposition from communities and members of Congress.
Democrat Jon Tester of Montana, chairman of the US Senate Veterans Affairs Committee, said Monday that “any attempt to bring our veterans’ healthcare to its knees is a failure for me.”
“I will defend tooth and nail against any proposal that blindly seeks to restrict access to VA care or disadvantage our veterans,” Tester said.
Illinois Rep. Michael Bost, the top Republican on the US House Committee on Veterans Affairs, said he looks forward to the work the “commission will be doing in the coming months to ensure that the VA recommendations released today.” stand up to a test”.
“VA’s infrastructure has been crumbling for far too long. Veterans in every corner of the country deserve better,” Bost said.
A two-part report from the VA Secretary volumes and released Monday, predicts that the number of veterans in the Northeast and Midwest will decline in the coming years, while those settling in the Southeast, South and Southwest will grow.
“These changes are largely due to the aging of the veteran population and the predicted pattern of military segregations near military bases,” the report said.
The VA will likely continue to struggle to address the number of veterans living in rural or highly rural areas — a group that currently accounts for 33% of the VA’s enrolled population, according to the report.
The Inventory and Infrastructure Review looks at dozens of ways veterans’ health care needs will change over the coming decades and expectations for where they live so the VA can seek to place facilities, staffing and programs in the best locations.
“In some markets, the veteran population is increasing rapidly, so we are adding new medical centers, community-based outpatient clinics and other facilities to meet this ever-growing demand,” wrote VA Secretary Denis McDonough.
“In other markets, the opposite is happening — the number of veterans is declining — but even in those markets, we’re investing in new facilities that better serve the needs of the veterans living there.”
If President Joe Biden and Congress approve the final recommendations that will come from the Asset and Infrastructure Review Commission in about a year, the VA would begin implementation no later than February 2026.
But if Biden or lawmakers reject the plans through a joint disapproval resolution, the entire process will stall.
Veterans in rural areas of the US also need medical care
“While VA and community providers will continue to struggle to recruit and retain staff in rural areas – 136 rural community hospitals closed between 2010 and 2021 – VA is committed to providing accessible VA healthcare through new supply points, partnerships, telemedicine and virtual care and other modalities,” the report said.
The VA is likely to continue to face stiff competition from the private healthcare market to attract doctors and nurses, especially as shortages are expected to begin across the country.
According to the report, the VA expects that within two years there will be a “shortage of between 14,280 and 31,091 psychiatrists and 77% of counties” will have a serious shortage of mental health providers.
By 2033, according to the report, “between 21,400 and 55,200 GPs and between 33,700 and 86,700 non-GP specialists will be missing”.
“The projected bottlenecks will affect rural areas more than urban ones.”
VA will have to treat more women, people of color
But the report, which Congress is calling for to “modernize and refocus VA’s aging healthcare infrastructure,” also examines how the people the VA treats will evolve, as will the types of services the VA provides offers to these veterans.
Within the next seven years, the VA expects the proportion of women and people of color to increase and the average age of veterans to decrease.
“The profile of enrolled veterans is becoming more diverse. For example, the repeal of laws that previously resulted in a pre-Vietnam U.S. military with fewer than 2% women has resulted in women making up over 19% of the active-duty military today,” the report said.
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“As the population shifts, the health needs of VA’s enrolled veteran population may vary based not only on service-related conditions, but also on demographic differences and social determinants of health.”
However, the VA warns that not every health care need can be predicted, as many future needs depend on how the battle changes in the years to come.
For example, the VA says that the use of improvised explosive devices in the wars in Afghanistan and Iraq, combined with improvements in medicine, meant that many soldiers who would have died in previous wars were able to survive. However, these troops lived with “amputation, [traumatic brain injury]Infertility, urogenital injuries, 47 and other conditions that strained VA capacity.
“VA cannot predict service-related conditions for future veterans,” the report said. “In the face of this uncertainty, VA must be able to rapidly innovate and adapt to care for veterans, regardless of the health issues they face.”