Nearly 1.7 million U.S. veterans under the age of 65 had no health care coverage in 2003 - no access to private insurance, to Medicare or Medicaid or to the Veterans Affairs health program - health care advocates said on Tuesday.

Many had seen combat in Vietnam or the Gulf Wars and most were employed, the Physicians for a National Health Program and Public Citizen said in a joint report.

“The number of uninsured veterans has increased by 235,159 since 2000, when 9.9 percent of non-elderly veterans were uninsured, a figure which rose to 11.9 percent in 2003,” the groups said.

They found that more than one in three veterans under the age of 25 lacked health coverage, and one in 10 of those aged 45 to 65.

“Like other uninsured Americans, most uninsured vets are working people. And uninsured veterans are denied the care they need - turned away because they can’t pay,” Dr. Steffie Woolhandler of Harvard Medical School, who helped found the PNHP, told a news conference.

The groups were especially critical of a January 2003 decision by the government to suspend eligibility for so-called Category 8 veterans, who include “middle-income” ex-servicemen and women making on average $25,000 a year or more.

“The armed services are aggressive in encouraging people to join the military to serve their country and to ‘be all you can be’,” said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group.

“But after leaving the service, almost 1.7 million veterans do not have the right to health care, in a way, being discarded by the government after serving their country. Without access to health care, no one can be all that they can be.”

The Department of Veterans Affairs said it was studying the report and preparing a comment.

GOVERNMENT SURVEYS

“These numbers should come as no surprise to the government because we used government data,” Woolhandler said.

The groups relied on the March 2004 Current Population Survey Annual Social and Economic Supplement, which includes information from 200,000 people, and the 2002 National Health Interview Survey of 93,000 people.

Those surveys have also been used as a basis for the widely quoted figure that 45 million Americans went without health insurance in 2003. People without health insurance are unlikely to get anything but emergency health care and often not even that.

Based on the data, 1.694 million American veterans had no insurance coverage last year, the researchers said.

That would include 680,000 Vietnam-era veterans and 900,000 from other times - mostly the 1991 Gulf War, because Korea and World War II veterans were covered by Medicare.

“An additional 3.9 million members of veterans’ households were also uninsured and ineligible for VHA (Veterans Health Administration) care,” the groups said in a statement.

Woolhandler said veterans who had any kind of coverage at all were filtered out.

“First, both surveys we analyzed asked respondents if they had ‘veterans or military health care’ and considered anyone answering ‘yes’ as insured,” reads the report, published on the Internet at http://www.pnhp.org/Veterans/veteranrep.doc

“The National Health Interview Survey was highly specific in this regard, identifying 1.43 million veterans with military/veterans’ medical care but with no other insurance. We considered all 1.43 million of these veterans to have coverage,” it added.

“The data suggest that the VHA currently cares for about 45 percent of the 3.15 million veterans without any other coverage.”