The Department of Veterans Affairs has been wracked with scandal over shredding benefit claims from injured soldiers in an effort to cover up the inordinately long waiting lists to see a doctor or get a procedure that VA officials have acknowledged contributed to dozens of deaths.
Now we learn from National Public Radio that there is a vast disparity in how much the VA spends on veteran benefits and medical treatment, depending on where they live. As it turns out, geography is destiny for veterans when it comes to tapping into VA benefits, including health care, monthly disability checks, home loans, life insurance and education through the GI bill.
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Based on a review of data from 3,000 counties throughout the country, NPR and several affiliate radio stations found extraordinary variations in coverage from state to state – and even within states – on how much the VA spends per veteran.
Among the states, West Virginia and Arkansas were the highest per veteran spending in 2013 – or just over $7,600 -- while Indiana, New Jersey, Delaware and Pennsylvania had the lowest – or less than $5,000 a year. Other states near the top include New Mexico, South Dakota and Oklahoma, while others near the bottom include Michigan, Ohio, Iowa and Illinois.
Nationally, the average is just over $6,000, according to NPR, and that figure was calculated after filtering out factors such as the cost of building and operating VA facilities.
But those are just average expenditures based on the overall population of veterans. When NPR examined how much the VA spends on health services “per patient," those costs also varied widely. For instance, spending is nearly $30,000 per patient in San Francisco, but less than $7,000 per patient in Lubbock, TX. Nationally, the average expenditure per patient is just below $10,000.
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“Places like Boston, that have special VA services for elderly, homeless and low-income vets, tend to have sicker patients and higher VA health care spending,” according to the NPR report. “That may help explain why the VA spends $25,000 on medical services per veteran patient every year in Boston and just $6,500 per patient on Cape Cod.”
Some of the variation is due to benefits costing more in different places. It stands to reason that it costs more to treat veterans in cities where doctors and nurses are paid more. Other discrepancies are because many veterans aren’t using all the services they’re due.
But exactly why there is such diversity of costs throughout the country remains something of a mystery – both to NPR and VA officials. According to the report, “there’s no obvious pattern” and there’s “no strong association between spending per veteran and the size or age of the veteran population, or the affluence of a particular area.”
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Yet some say that it might come down to a matter of management skills – with some facilities doing well and others doing quite poorly.
Ashish Jha, who studies VA health care at the Harvard School of Public Health, told NPR that management differences and spending tax dollars responsibly could account for the difference.
Here’s a link to the NPR report and a state-by-state chart of VA spending per veteran.
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