Summary: With a budget of $16.6 billion and a network of hundreds of hospitals, outpatient clinics, and nursing homes, the Department of Veterans Affairs' (VA) health care system provides medical services to more than 26 million veterans. VA is seeking to fundamentally change the way in which it runs its health care delivery and financing systems. It is also seeking authority to significantly expand eligibility for health care benefits and to both buy health care services from and sell health services to the private sector. This testimony discusses (1) changes in the veterans population and the demand for VA health care services; (2) how well the existing VA system, and other public and private health benefits programs, meet the health care needs of veterans; (3) steps that could be taken using existing resources and legislative authority to address veterans' unmet health care needs and increase equity of access; (4) how other countries have addressed the needs of an aging and declining veteran population; and (5) approaches for preserving VA's direct delivery system, alternatives to preserving the direct delivery system, and combinations of both. both.
