6 Reasons Veterans are Left Without the Critical Health Care They Need

With healthcare from the U.S. Department of Veterans Affairs and insurance programs like TRICARE, it’s easy to assume that all veterans get the health services they need after military service.

But that’s not the reality.
 
In truth, half of post-9/11 veterans are not enrolled in Veterans Administration health care. This is despite the fact that nationally, 36% of post-9/11 veterans have a service-related disability and 50% of returning service members report some type of mental health issue.

Many veterans aren’t receiving services from the US Department of Veterans Affairs (VA) and are not getting the health care they need.

1. Access to Services has Been a Commonly Known Barrier for Veterans

Access to health services is the most well-known reason veterans aren’t getting critical health services. Inconvenient locations and long wait times can be a barrier to healthcare.

But we’ve all had frustrating moments with getting to appointments, getting needed insurance coverage, or having to wait longer than we’d like for an appointment with our provider.

It turns out, there are other, less commonly understood reasons why veterans aren’t getting help.

2. Cost of Healthcare Vary Widely Depending on Veteran Benefits

The majority of veterans, service members, and their families qualify for healthcare coverage from the VA, their employer, or Medicare. The extent of insurance coverage often depends on health issues incurred during military service, the status of a veteran’s health at the time their military service ends, and their income level.

Some veterans still struggle to afford health care because:

• Their type or duration of service doesn’t qualify for government insurance.
• Their discharge status does not qualify for government insurance.
• Even with insurance, not all needed services, copays, and other out-of-pocket expenses are covered or affordable.

3. Veterans Continue to Carry Heavy Stigmas, Particularly About Mental Health

One of the most frequently reported barriers to seeking help amongst military members is public stigma—negative stereotypes—related to mental health and disability.

When individuals internalize these negative public stereotypes, the result is self-stigma. Self-stigma lowers our self-esteem and motivation to seek help. Here are some examples of how negative public stigma can inhibit help-seeking behavior among service members and veterans:

• They may believe that their military values of self-sufficiency and prioritizing needs mean they are better off solving health problems on their own. 

• They may falsely believe that certain labels or diagnosis (such as “PTSD” or “disability”) are to be avoided or minimized.

• They may worry that seeking mental health treatment may damage their career or cause them to be treated differently by leadership.

Self-stigmas formed during military service can be difficult to ignore even after service has ended.

4. Historical Government Policies Limit Healthcare Access for LGBTQ+ Community

From 1994 to 2011 the Don’t Ask Don’t Tell law prohibited gay, lesbian, and bisexual Americans from serving in the armed forces and created an environment where discrimination was acceptable.

Despite the law’s repeal, many veterans who were discharged under Don’t Ask Don’t Tell (or who witnessed peers discharged by the policy) still struggle with the loss of service time, access to veteran benefits, recognition, and social acceptance.
 
LGBTQ+ veterans who served under Don’t Ask Don’t Tell may not fully use government health services because they don’t believe they’re eligible or they fear continued mistreatment.
 
Some LGBTQ+ veterans who do use government health services continue to hide their identity out of fear that being open would disqualify them from vital benefits and disability compensation.

5. Veterans are Selflessly Trained to Put the Needs of Others Before Their Own

Some veterans worry that if they use a support service, then that service won’t be available to a fellow veteran who is also in need. That’s not necessarily the reality, but it’s a testament to the training veterans receive to protect their comrades no matter the personal cost to themselves.

In addition, some veterans rationalize that they don’t deserve treatment for their conditions or disabilities because:

• They served in the military for a shorter period of time than others.

• The location of their post was less intense than others.

• They carry invisible wounds (such as PTSD or other traumas) that some believe are less important than physical wounds, even though that’s not always the case.

6. Veterans Struggle to Find Trusted Providers Who Understand Military Culture

Military veterans share a culture and subcultures with their own values, standards, customs, and traditions. Yet health care professionals are often not equipped to deliver culturally competent care to veterans.

When it comes to finding a provider they can trust, many service members and veterans don’t want to explain military culture and the unique challenges of military life to their health providers. They feel more at ease when working with a provider who just “gets it.”

It takes a lot of persistence to find a health provider you can trust. Many veterans aren’t getting critical health care because they simply can’t find a provider they trust, or there are too many hurdles to jump.

What Veterans Are Saying

At RVP, our clients have experienced all kinds of barriers when looking for the health services they need.

In their own words, here are some reasons veterans have turned to RVP for support:

• “I would never have been able to afford the kind of health care I got through RVP. Having the financial roadblock removed by RVP allowed me to get support for as long as I needed.”

• “I wanted a provider who understood military service and trauma.”

• “I wanted a care plan that didn’t require medication.”

• “My psychologist in the military recommended a therapist in Portland for when I got home, but she wasn’t taking any more clients. She referred me to RVP.”

• “I couldn’t get to appointments.”

• “I didn’t want to have to explain military culture to my health provider.”

• “It was difficult to navigate our complex healthcare system.”

• “I didn’t feel like I belonged [at the VA], because at the time, we didn’t have a mass exodus of younger veterans [like me] getting out.”

• “There’s a mentality in the Marine Corps that women marines…you’re not veterans when you discharge. So don’t try to access services. And we heard that. We were told that.”