It’s no surprise that the U.S. veteran population is shifting, in fact it’s estimated that by 2045, the number of women veterans will be double of that now. As shifts in veteran demographics occur, so do the needs VA centers in different geographic areas. In this blog we’ll explore some of the trends of veteran demographics, and the associated growing-pains that going along with it.

It probably doesn’t come as a surprise to our readers that the VA is currently going through a downsizing phase. In 2017 VA Secretary Dr. David J. Shulkin announced at the State of the VA Address that the VA would be demolishing or re-purposing 430 vacant or mostly vacant buildings within the next 24 months.

Additionally, it was announced that the VA would review the function of some 784 non-vacant, underutilized VA buildings. So what’s the cause for these shifts, and what are the possible solutions?

Population Shift

Americans have been moving from rural areas to urban and suburban areas since the industrial revolution. Prior to the industrial revolution (1760), the majority of Americans lived rural, agrarian lives. That changed abruptly, and the population of cities in the US has only increased as populations in rural areas has decreased.

The US population natural rate of increase (average births – average deaths) is currently at 3.1 per 1,000 people, down from 14.5 per 1,000 in 1950. The population of cities, however, is growing at a much faster rate, with cities like New York and Los Angeles growing at rates in the high double digits since 1950 (30.6% and 90.6% respectively)!

Not only are Americans moving out of rural areas, but the population of veterans across the US has been dropping for decades. In 1980, 18% of US adults were veterans, in 2014 that number was down to 8%.

This significant drop in the veterans population occurred directly after a period of large-scale VA infrastructure investment. In fact, on average VA buildings are 60 years old (constructed in 1959)!

Growing Costs

As discussed in almost every blog I’ve ever written, the ballooning costs of medical care in the US also contributes to the closure of VA facilities. Adjusted for inflation, Americans paid an average of $10,739 in medical expenses in 2017 compared to $1,797 in 1970 (in 2017 dollars)! That’s more than a four times increase. This directly increases the costs of running a VA facility, as the costs of care translates into expense of the facility regardless of who’s running it.

Finally, upkeep and maintenance on empty and underutilized buildings isn’t cheap either. It’s not economical to hold onto unused property, you still have to pay property tax, landscaping upkeep, plumbing/electrical maintenance, etc. An underutilized building can sometimes be even more expensive, especially in older buildings that do not have isolated sections for climate control.

So now what?

Current solutions up for debate are: demolition unused buildings, selling unused buildings, allowing rural veterans to receive private care close to home via the Mission Act, and multi-purposing underutilized facilities.

Although the demographic picture of veterans as a whole is decreasing, many inter-city facilities are going through growth periods as patient traffic increases. One example among many is a $10million construction of a new outpatient clinic at the Ralph H. Johnson VA Medical Center in North Charleston, South Carolina.

As with any form of downsizing, layoffs are necessary. Unfortunately this means many professionals will need to transition to other jobs. Fortunately for those in the medical field, the US currently has a shortage of doctors, so finding a job should be somewhat easier!

What’s your opinion on the VA closing or re-purposing hundreds of facilities? Drop and comment and keep the conversation going!