the healthcare equality gap among veterans,
Abstract
This paper explores the healthcare equality gap among veterans, especially on mental health access. Mental healthcare is a persistent concern which the US government is making every effort to address. More than 20,000 of the Afghanistan and Iraq war veterans need mental healthcare following trauma, PTSD, and depression. Furthermore, their families also need support where they develop stress following condition s of their relatives. Despite the need, there is no equal supply of healthcare to the veterans, including inadequate community centers, staff, and resources. This study finds that the government has come up with an initiative for community-centered care for the veterans. There is also a specialized Phoenix healthcare system that serves the veterans only. The initiative got a boost through the Veterans Choice Act of 2014 that saw provisions to increase medical staff, facilities, proper management, and insurance plan for the veterans. Assessment of the initiative and the regulation reveals that they are effective in addressing healthcare equality of the war veterans, especially in mental health.
Keywords: War Veterans, Mental Health, Health Care, Equality, Access, Initiative, Regulation
Regulation
Current Regulation
The current regulation on Patient-Cantered Community Care for veterans is the Veterans’ Access to Care through Choice, Accountability, and Transparency Act of 2014 simplified as the Veterans Choice Act. Among the provisions in the law is increasing the number of nurses and doctors who serve veterans and construction of more 26 facilities through the increased budget by $2 billion. Another provision is the facilitation of veterans who live far from veteran health clinics to access healthcare from other private and public facilities near their rural areas. The law also provides the Secretary of Veterans Affairs with more power to dismiss senior executives when they fail to address veteran healthcare needs. Through the regulation, the veteran’s private insurance program bears the burden of medical treatment. In general, the law ensures that there are enough staff and facilities for the veterans while enabling them to access healthcare through private insurance programs and reduced distances.
The veterans Choice Act developed as a result of increased delays for the veterans to access healthcare where some died while in the queue. According to the Veterans Office of the Inspector General [VOIG] (2014), the Phoenix Health Care System (HCS) had a history of mismanagement of resources alongside criminal misconduct that led to reduced efficiency. The Phoenix HCS was the healthcare system set aside to address the war veteran’s needs. However, in April 2014, news emerged from media such as CNN that around 40 war veterans’ had died in the Phoenix HCS while others more waited for over 90 days for treatment contrary to the recommended 14 (CNN, 2014). The news necessitated investigations in the veteran’s internal affairs with a report from the VOIG confirming the initial allegations. Among the findings were delays in scheduling veterans in the system, extended scheduled time to access care for an average of 115 days, inappropriate hiring and, sexual harassment. Following the reported scandal, the veterans Choice Act found its way to the House of Representatives to address the care gap.
This Veterans Choice Act is essential to control healthcare programs for the veterans to ensure equality. The regulation provides guidelines to solve barriers that prevent veterans’ access to healthcare like other populations due to their extreme conditions like PTSD. It addresses all the three factors affecting access to healthcare, including timeliness, insurance coverage and, availability of providers and services. Through the regulations, the government and healthcare providers can provide personalized care for the veterans to meet the standards of other people.
Regulatory Level for the Existing Initiative
The Veterans Choice Act is addressing the existing initiative at the economic level. It provides for increased budget allocation to meet the high demand for staff and facilities. Another indicator of the economic regulation level is the provision for private insurance for the veterans. However, there are other regulatory levels, such as safety. The law provides for more power to the secretary of Veterans Affairs to dismiss executives who mismanage the various facilities and healthcare systems. Provision for proper management ensures the safety of the veterans, for example, ensuring no risk to sexual harassment and the availability of needed consumable and non-consumable items. There is also the social regulation level where increased healthcare workers can meet the veterans and their families at a rural location.
Conclusion: Explain the effectiveness of the existing initiative and associated regulations in addressing this gap in the delivery of healthcare to the target
Conclusion
The existing initiative and regulations are effective in addressing the equality gap for the war veteran’s health by addressing timeliness, insurance coverage and, availability of providers, and services. Most veterans are disabled to access healthcare facilities that are far physically. Their needs, on the other hand, are long term requiring regular clinic, an incidence that increases demand. However, the initiative and the regulation increases healthcare providers and facilities to meet the high demand. There are nurses undertaking home and rural care to reduce the barrier of facility overload and physical disability for the veterans. The increased facilities and healthcare staff is lowering the wait time that would have made some veterans die or give up with the service. Provision of the private insurance plan, on the other hand, allows all veterans from humble and wealthy backgrounds to access healthcare without cost barriers. The initiative and regulation, as a result, address equality effectively by making the care timely, quality, available, and accessible through special insurance for veterans.
There exists an alignment between the regulation and the initiative to address another gap of stigmatization. Initially, as the VOIG provide, there was poor management of the veterans’ healthcare system due to stigmatization. The responsible persons did not mind-expanding the facilities and staff to attend the high demand. However, the regulation through the guide to increase healthcare facilities and staff support the initiative to expand access and hence reduce stigmatization through veteran empowerment. Furthermore, the law recommends expanding healthcare access within rural areas similar to the initiative where nurses are attending veterans in their homes and remote regions. Expansion of care to the rural regions addresses stigmatization empowers veterans to live a healthy life and hence get off the label of useless people in families and communities.
The Patient-Cantered Community Care for veterans had a conflicting interest as the VOIG reports where the executives were mismanaging the system with financial gains. They hired a few staff and failed to resource the facilities with the aim of proofing from the services. However, the regulation addresses the conflict of interest by decentralizing power to fire such managers.
Veterans Office of the Inspector General [VOIG] (2014). Veterans Health Administration, Interim Report. Review of Patient Wait Times, Scheduling Practices, and Alleged Patient Deaths at the Phoenix Health Care System. Retrieved from https://www.va.gov/oig/pubs/VAOIG-14-02603-178.pdf
CNN (2014). A fatal wait: Veterans languish and die on a VA hospital’s secret list. Retrieved from https://edition.cnn.com/2014/04/23/health/veterans-dying-health-care-delays/
Veterans Access, Choice and Accountability Act of 2014