Columbia International Affairs Online: Policy Briefs

CIAO DATE: 05/2010

Failure to Provide: Healthcare at the Veterans Administration

Robert Hamowy

March 2010

Independent Institute


Prior to World War I, the federal government effectively provided no hospital or medical care to veterans other than extending domiciliary care to a few veterans disabled while in service. With American entry into World War I, however, it was decided to extend the treatment accorded members of the armed forces who were receiving hospital care after they had been mustered out. As a consequence the Veterans Bureau was created in 1921. In 1930 a new agency, the Veterans Administration (VA), took over responsibility for all veterans' affairs. Following World War II and the passage of a comprehensive GI Bill that included generous medical and hospital care for returning soldiers, the VA rapidly expanded to the point whereby it established itself as the largest supplier of health care in the nation. For most of the period since the end of World War II these medical facilities were plagued by waste, poor management, and negligence. While it is true that conditions at VA facilities have improved since the late 1980s, they still lag behind those that obtain at the nation's voluntary hospitals. The shift from inpatient to ambulatory care, an increase in chronic care needs in an aging population, and increases in the demand for medical services as a result of the most recent Middle Eastern conflicts clearly undermines the reason originally put forward to operate a direct health care system. However, given the pressures put upon Congress by the American Legion and other veterans groups, it is unlikely that the United States will follow the lead of the governments of Australia, Canada, and the United Kingdom and close or convert their hospitals to other uses and integrate the treatment of veterans into the general heath-care system.