Why VA Health Care Is Different

Is VA health care really “all that different” from what veterans would find in the private sector? As someone who spent more than 25 years managing private sector health care organizations and recently joined VA as its under secretary for health, I’ve had the unique opportunity to compare the health care systems. Over the past several months, I’ve met with veterans and their families, veterans service organizations, VA clinicians, facility staff, and veteran employees at all levels. Through these meetings and travel to dozens of facilities, I’ve come to realize that many of the essential services provided by the VA cannot be found in or even replicated in the private sector.

Over time and in partnership with successive generations of veterans, the VA has evolved into an interconnected, institutionalized system of care and services. And while many of these services aren’t unique to the VA, ours is the only health care organization that combines these services “under one roof” and integrates them in a way that is veteran-centric. Further, as our country continues to struggle with improving health outcomes and unsustainable increases in health care costs, the VA can play a crucial role. As a long-standing, highly integrated, and patient-focused provider of care, the VA can lead the way in advancing the nation’s health care. This is the appropriate role for government: Do what the private sector cannot or will not do, given the nature of its enterprise.

The VA has 3 core strengths that distinguish its services from those of the private sector in caring for veterans: (1) systemwide clinical expertise regarding service-connected conditions and disorders; (2) a team approach to primary care that is veteran-centric; and (3) a holistic view of the veteran that includes physical, psychosocial, and economic determinants of health, as well as critical support services for family members and caregivers. First, the VA brings together comprehensive expertise on service-connected health issues in a single health care system. Our clinicians are trained to identify, assess, and treat a wide spectrum of health issues, such as spinal cord injury and limb loss, conditions arising from environmentalexposures, and traumatic brain injury...