The challenges faced by the veterans health care system have been compounded by Medicare’s continuing crisis.
Many private doctors, frustrated by low reimbursement rates, are refusing to accept new Medicare patients, including elderly veterans. Faced with rapidly rising prescription drug costs, Medicare HMOs and some employer-sponsored health plans covering military retirees have stopped paying for certain classes of drugs. Others are requiring higher prescription copayments.
In this environment, the Veterans Administration (VA) has become the default drug store for veterans seeking low-cost prescription medicines. “As some HMOs have gone out of business, we have seen a shift to the VA,” explained Dr. Frances M. Murphy, who served as acting under-secretary for health until Robert Roswell’s confirmation in March.
The strain on the veterans health care system adds pressure to Congress’s efforts to adopt a drug benefit for Medicare beneficiaries. The potential cost of such a benefit—by some estimates, as much as $800 billion over 10 years—has been an enormous hurdle.
Dr. Gail Wilensky, who heads a presidential task force on veterans’ health care and was a Medicare administrator in the first Bush administration, believes a new Medicare drug benefit is “at least a couple of years off.” Such a benefit might be enacted after the Presidential election of 2004 or 2008, she predicts, when a political consensus has been forged.