Complementing Public Care with Private: Evidence from Veterans Choice Act

Abstract

We study the effect of complementing public health care with private care. Leveraging a policy at the Veterans Health Administration that generates discontinuity in private care access, we find that expanding coverage to private care increases private outpatient care by $53 (SE: 5) and decreases VA outpatient care by $20 (SE: 7), with no impact on inpatient care. The policy led to a marginally significant 0.1 p.p. (2.8%, SE: 0.04) decrease in one-year mortality, possibly because of decreased wait times and increased access to certain specialty care. Given our estimates, the benefit of access expansion significantly outweighs the increased costs.

Keywords: Veterans, Healthcare Access, Public Health Care, Public Policy, regression discontinuity