This is the seventh installment in our series of essays written by veterans. We asked service members to share how their time in uniform shaped their perspectives on American life.
In July, I experienced a flash of panic that only one of America’s 28 million uninsured citizens can truly understand. Life—and my right ankle—took a tough turn. I had broken my leg running in a charity mud race in St. Petersburg, Florida, and for the first time since I’d left the Army the summer before, I didn’t know what to do when I needed to see a doctor. As a soldier, I had health-care providers available at all times to treat my every medical need, at no direct cost to me. As a civilian, I felt suddenly out in the cold.
As the pop of my fibula snapping was still fresh in my ears, my body still caked in mud, I sat in the grass under the event’s medical tent. Leg swollen, with an ice pack melting in the 92-degree heat, I furiously used my phone to consult Google about what to do next—and how much it would cost.
Query: “cost of ER visit”
Query: “cost of broken leg”
Google: “… typically costs up to $2,500 or more …”
And as my military training had conditioned me to do, I investigated the worst-case scenario.
Query: “cost of ankle surgery”
Google: “… between $9,719 and $17,634 …”
But one final search changed my prospects that day—and my perspective on the health-care debate in the United States.
Query: “cost of VA hospital visit”
I was taken aback: The results suggested I’d pay little to nothing. For me—an honorably discharged veteran of the war in Afghanistan with no disabilities—the total out-of-pocket cost for multiple X-rays, visits to orthopedic specialists, medications, and a knee scooter was just $8 through the Veterans Health Administration medical system.
Prior to that day, I had no idea how deeply my own government, and by extension my fellow Americans, cared for my well-being—that by virtue of my five years of military service, I was given the benefit of affordable health care even after I had stopped wearing a uniform. The vague, hour-long health-benefits briefing I sat through when I left the Army did little to explain how the system actually worked. My service had introduced me, unwittingly, to a lifetime of socialized medicine: care that is paid for with public money and provided by the government. According to the latest available data, 9.4 million people are covered by TRICARE, the membership-restricted, public health-care program for uniformed service members and their families. A further 6 million veterans use Veterans Health Administration services each year, with up to 15 million more eligible.
After my July revelation, I felt a deeper connection to my country. But I also felt very guilty. Before I learned the extent of the services available for most veterans at low or no cost, I was just another uninsured American anxious about a broken bone and the financial disaster that can come with it. While U.S. troops deserve compensation for their unique national service—for the long separations they endure; the long hours they work; and, sometimes, imminent threats to their lives—a thought has stayed with me: Do service members’ sacrifices mean they should be some of the only Americans to have guaranteed care?
There are teachers who work in dangerous neighborhoods to make sure disadvantaged children get an education. There are small-business owners who risk everything—including going without health insurance—to pursue the kind of entrepreneurial dreams that make the country an economic powerhouse. There are wage earners, artists, and single parents who may never get a job with health benefits, but who nonetheless work hard and contribute to the fabric of America.
It makes little sense to me, then, that my service should entitle me to any more or less medical care from my government than any other citizen receives.
In fact, as congressional Republicans have tried, and failed, to repeal and replace Obamacare, I’ve considered whether the alternative floated by Democrats like Bernie Sanders may be better for Americans—and America.
That plan—a single-payer, “Medicare for all” option in which taxpayers contribute to a national health-insurance program—remains something of a third rail in Washington, and it’s opposed by more than a third of the U.S. population. The opposition is, in part, rooted in the economy: It’d necessitate raising taxes or adding significantly to the deficit. And there’s philosophical opposition, too. Some Americans simply don’t think they should have to pay more to ensure coverage for their fellow citizens, while others are wary of how foreign the system would be. Before I enlisted, it never occurred to me that universal health care, let alone socialized medicine in any form, was a desirable option in the United States. Government health care in any form seemed oppressive to me, a limit on my freedom. But I found that, in many ways, the opposite was true. While any type of universal health-care system would have economic consequences, the associated gains—no longer worrying about coverage loss after a job change, for example, or feeling stressed about finding in-network doctors—for me outweigh that burden.
As a 2016 RAND Corporation study suggested, the U.S. government is capable of providing medical care that’s on par or better than many private alternatives. While it is something of a sport both within the military and among veterans to complain about the care they receive—and the system has seen its fair share of problems and failures—surveys show that in recent years, they are happier with their care than civilians with private providers.
Some critics argue that government-run health care is inefficient, pointing to long wait times at veterans’ hospitals. But, again, compared with the private sector, the waits may not be all that bad. If Anthem, Cigna, or another large U.S. health-insurance company were subject to the same level of congressional scrutiny as the military’s systems, I’m not sure they’d fare much better.
The VA is maligned for its failures because, in the eyes of many Americans, it should be held to a high standard as the care provider for men and women who have put their bodies on the line for their country. But the medical needs for which I’ve sought aid through the VA and military systems haven’t been extraordinary—only the cost and access to care have been.
During my Army service, I did my job, lived my life, and didn’t think twice about premiums, deductibles, or annual limits. Treatment was seamless, automatic, and focused on helping me perform my duties as a soldier.
When I broke my thumb while playing in my unit’s annual turkey bowl in South Korea—a decidedly non-mission-essential endeavor—X-rays, physical therapy, and an on-base orthopedic specialist were provided. So was my time off from work to make my appointments: To the Army, soldiers’ return to duty as quickly as possible is so important that they are often reprimanded by superiors if they miss scheduled appointments. A year later, after I’d changed stations to Joint Base Lewis-McChord in Washington state, I sliced open my leg in a hiking accident. After driving myself to the emergency room of Madigan Army Medical Center on base, I limped through the doors, got some stitches, and received easily accessible follow-up treatment. My unit’s embedded physician’s assistant worked out of an on-base clinic three blocks from my motor pool.
The rationale behind this type of care is clear: The Army understands that healthy soldiers are more effective soldiers. A national health-care system that treats all citizens this way may offer similar benefits. Chief among them is what I discovered earlier this year with the help of a Google search, when I realized I could get care when I needed it: a better quality of life.