Lack of health coverage among US veterans from 1987 to 2004.
OBJECTIVE
Veterans Administration health care enrollment is restricted to veterans with service-connected problems and those who are poor. We sought to determine how many veterans were uninsured, trends in veterans' coverage, and whether uninsured veterans lacked access to medical care.


METHODS
We analyzed annual data from 2 federal surveys, the Current Population Survey for the years 1988 to 2005 and the National Health Interview Survey for 2002 to 2004.


RESULTS
Nearly 1.8 million veterans were uninsured and not receiving Veterans Administration care in 2004. The proportion of working-age veterans lacking coverage peaked in 1993 at 14.2%, fell to 9.9% in 2000, and rose steadily to 12.7% in 2004. Uninsured veterans had substantial access problems; 51.4% had no usual source of care (vs 8.9% of insured veterans), and 26.5% reported failing to get needed care because of the cost (vs 4.3% of insured veterans).


CONCLUSIONS
Many US veterans are uninsured and lack adequate access to health care. Expanded funding for veterans' care is urgently needed; only national health insurance could guarantee coverage to both veterans and their family members.
Himmelstein
David U
DU
Department of Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, Mass 02139, USA. david_himmelstein@hms.harvard.edu
Lasser
Karen E
KE
McCormick
Danny
D
Bor
David H
DH
Boyd
J Wesley
JW
Woolhandler
Steffie
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage / Q000639:trends; D016015:Logistic Models; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data