Feds still struggle to care for Oregon veterans

Willamette University College of Law Federalist Society

Despite last year’s well publicized VA scandal, the federal government continues to provide our nation’s veterans with inadequate access to healthcare. Veterans – in many cases as a result of being tragically overinsured – are left to navigate a confusing patchwork of government medical coverage plans which can limit their ability to see a doctor.

Luke, a fellow Willamette Law Federalist Society member, is retired military and a disabled veteran. He receives government provided healthcare from three separate sources: Medicare, TRICARE, and the VA. In theory, Luke has this odd triple-coverage arrangement to ensure that: (1) his out of pocket expenses are minimized; (2) he receives more medical services; and (3) he retains access to more doctors. In practice, however, Luke is pinned between multiple government programs, incentivized to shift costs away from themselves, thus limiting the quality and quantity of healthcare to which he has access.

The problem is that, under the current Medicare-TRICARE-VA coverage web, young disabled veterans, like Luke, can be left to fall through the cracks. Here’s how.

As a disabled veteran Luke has learned that, despite the new voucher program, getting a VA appointment and seeing a doctor are still two entirely different things. Likewise, Luke’s experience with Medicare doctors has led to equally disappointing results. For example, many of his in-network Medicare providers only accept patients 65 and older and Luke, 31, is nowhere near that age.

TRICARE also is not any better. Most Medicare docs also accept TRICARE, however, under federal law a doctor commits fraud if, while rejecting Medicare patients under 65, she then turns around and accepts new younger TRICARE patients. As a result, Luke is usually left to drive many miles to the closest military ER and wait several hours before seeing a doctor.

After the sacrifices Luke has made, this is morally reprehensible.

There is however a better way. If Luke and the thousands of other Oregon veterans had access to “medical savings accounts,” they would have no problem getting in to see a doctor. Instead of juggling three separate overlapping plans (which is wasteful, inefficient, and can result in unacceptable gaps in coverage) the dollars the government already spends on Luke’s medical coverage would be deposited into a tax free personal medical account that he could draw upon to pay his healthcare costs.

Bottom up approaches to healthcare like this would empower veterans by granting them more healthcare choices. Besides, those seeking treatment are best situated to know exactly what type of coverage does and does not work for them. More choices inevitably would result in more access because account holders would be free to select any local doctor, plan, or procedure that works specifically for them. Allowing Washington to make these decisions by rationing out care may keep the current system running, but it has also resulted in the subpar access for Luke and the thousands of other Oregon veterans like him.

The views and opinions expressed in this article are solely those of the Willamette University College of Law Federalist Society. These views and opinions do not necessarily represent Willamette University, its faculty, or its student body.