title: Can the Veterans Affairs health care system continue to care for the poor and vulnerable?
abstract: Can the Veterans Affairs (VA) health care system, long an important part of the safety net for disabled and poor veterans, survive the loss of World War II veterans--once its largest constituency and still its most important advocates? A recent shift in emphasis from acute hospital-based care to care of chronic illness in outpatient settings, as well as changes in eligibility allowing many more nonpoor and nondisabled veterans into the VA system, will be key determinants of long-term survivability. Although allowing less needy veterans into the system runs the risk of diluting services to those most in need, the long-run effect may be to increase support among a larger and younger group of veterans, thereby enhancing political clout and ensuring survivability. It may be that the best way to maintain the safety net for veterans is to continue to cast it more widely.
authors.affiliation: Department of Medicine, VA Connecticut Health Care System, Yale University School of Medicine, West Haven, Conn., USA.
authors.forename: John S
authors.initials: JS
authors.lastname: Hughes
mesh_terms: D002908:Chronic Disease / Q000191:economics; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000706:statistics & numerical data*; D004608:Eligibility Determination / Q000191:economics / Q000639:trends; D006297:Health Services Accessibility / Q000191:economics* / Q000639:trends; D006787:Hospitals, Veterans / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D009937:Organizational Objectives; D011203:Poverty; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000145:classification*; D035862:Vulnerable Populations