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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2006.106302v1 97/12/2199    most recent Submit a response View responses View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Himmelstein, D. U. Articles by Woolhandler, S. Search for Related Content PubMed PubMed Citation Articles by Himmelstein, D. U. Articles by Woolhandler, S. Related Collections Insurance Other Health Financing Health Policy Access to Care Other Health Service Delivery

David U. Himmelstein, MD, FACP, Karen E. Lasser, MD, MPH, Danny McCormick, MD, MPH, David H. Bor, MD, J. Wesley Boyd, MD, PhD and Steffie Woolhandler, MD, MPH, FACP

David U. Himmelstein, Karen E. Lasser, Danny McCormick, David H. Bor, and Steffie Woolhandler are with the Department of Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, Mass. J. Wesley Boyd is with the Department of Psychiatry, Cambridge Health Alliance/ Harvard Medical School, Cambridge.

Correspondence: Requests for reprints should be sent to David U. Himmelstein, MD, Department of Medicine, Cambridge Hospital/ Harvard Medical School, 1493 Cambridge St, Cambridge, MA 02139 (e-mail: david_himmelstein{at}hms.harvard.edu).

Objectives. 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.

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