Eric Shinseki resigned last Friday as head of the Department of Veterans Affairs, stating that “the VA needs new leadership”. This comes in the wake of scheduling issues at VA medical centers leading to extended delays for veterans’ healthcare—issues he now recognizes as a “systemic lack of integrity” involving a widespread cover-up. According to a new VA audit report prompted by a series of CNN investigations, deadly delays in care were being suppressed by clinics driven to meet performance targets. The VA report concluded that the 14-day wait time performance target was “simply not attainable,” and it called for a “long-term, comprehensive reset” of the broken system. While Shinseki acknowledges these problems, how reasonable is it to expect his successor to fix them? Research shows that scheduling issues are only one barrier among many to veterans’ accessing care.
When predicting which people will seek care, sociologists take into account patients’ prior experiences with the system such as health outcomes and customer satisfaction. Poor service doesn’t just hurt the veterans who seek care—it may keep them from seeking care in the first place!
- Ronald M. Andersen, 1995. “Revisiting the behavioral model and access to medical care: does it matter?.” Journal of health and social behavior 36(1): 1-10.
Some veterans are eligible for both Medicaid and VA services. The largest group of these vets relies on Medicaid rather than VA care or a combination of the two.
- Denise M. Hynes, Kristin Koelling, Kevin Stroupe, et al. 2007. Veterans’ access to and use of Medicare and Veterans Affairs health care. Medical care, 45(3): 214-223.
Issues with gender in the military also have an effect. Female veterans have less access to VA healthcare relative to males, with 19% of women reporting delayed health care or unmet needs. Knowledge gaps about VA care, perceptions that providers are not gender-sensitive, and a history of military sexual assault predicted women’s likelihood to delay or forgo treatment.
- Donna L. Washington, Bevanne Bean-Mayberry, Deborah Riopelle, and Elizabeth M. Yano. 2011. “Access to care for women veterans: delayed healthcare and unmet need.”Journal of general internal medicine 26(2): 655-661.