On Veterans, Healthcare and Single Payer

November 14, 2013

Brattleboro Reformer

How very wonderful and appropriate for newspapers, TV and radio to share Veterans Day stories and photographs of veterans who have risked their health and lives for their country.

What troubles me is our government’s uneven response to veterans’ post-war health care needs. Many vets may be unaware that they are not automatically covered by Veterans Administration health care. They must apply, and "qualify" in numerous ways, over and above serving their country. (They are covered for service-connected disorders.)

Today, approximately a third of veterans are enrolled by the VA. A low-income vet who is rejected by the VA may apply for and qualify for Medicaid. Then he is insured until he gets employed and becomes "over-income." Then he is dropped by Medicaid. Without job insurance, he must "spend-down" to again qualify for Medicaid. He is now on the familiar and discriminatory Medicaid revolving door treadmill. Off again, on again, because of job-related or other income uncertainties.

Some states (not Vermont) may reject new Medicaid patients. And some physicians will not accept Medicaid insurance.

Another option for uninsured vets is Federally Qualified Health Centers, which now operate in some but not all counties. They accept uninsured patients from that county. They provide primary care and dentistry but not specialists. Windham County has no FQHC. As I understand it, Brattleboro has a VA Outpatient clinic available to veterans who are enrolled in the VA system.

These uninsured veterans are examples/and victims of the fragmented insurance non-system we have, full of loopholes and uncertainties. This system is also are veryexpensive.compared to single payer programs in other countries which use a single payer system or variant of same.

These needy and deserving veterans, as well as all Americans, would benefit from a national single payer for all health care system, integrated, and funded through progressive taxation, that covers everyone from birth to death, is valid in all states, is independent of employment, and which insures all citizens irrespective of income.

An improved Medicare-for-All would do this. But citizens, including doctors and grateful Medicare beneficiaries, must speak up and demand it from our representatives in Congress. (I am a retired and grateful Medicare recipient.)

Margaret Newton, MD,
Brattleboro, Nov. 12