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The Department of Veterans Affairs (VA) is an executive branch department of the federal government responsible for providing care, benefits and support to eligible veterans of the United States armed forces. The provision of benefits to members of the armed forces date as far back as to the U.S. colonies. Today, the VA is comprised of three (3) distinct bureaus: the Veterans Heath Administration (VHA), Veterans Benefits Administration, (VBA) and the National Cemetery Administration (NCA). The VHA is the nation's largest integrated healthcare delivery system.

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The 1776 Continental Congress first provided pensions to disabled soldiers, with individual states initially providing direct medical care. In the 19th century, the federal government authorized the first facility for Veterans and benefits were expanded to widows and dependents for the first time. It was in his 2nd inaugural address that President Lincoln uttered the phrase that would go on to be the VA's motto and indicate the government's commitment to care for those injured in the Civil War and provide for the families of those who had died.

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The 20th century saw significant changes to care and benefits for Veterans. In 1917, Congress established a new system of benefits, such as vocational rehabilitation for the disabled, and by 1920, there were 3 federal agencies charged with administering these benefits. Consolidation of the 3 agencies took place shortly after, in 1921, with the creation of the Veterans Bureau. Already existing Veterans hospitals were transferred to the Bureau and a program of additional hospital construction was undertaken. Another consolidation took place in 1930 when President Hoover elevated the Veterans Bureau to a federal administration and created the Veterans Administration.

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The Veteran population increased dramatically after World War II and Congress enacted many new benefits for them, such as the GI Bill. The VA was then elevated to a cabinet-level executive department, led by a Secretary, under President Reagan in 1988 and became the Department of Veterans Affairs.

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In the face of a reputation for providing substandard care, the VHA has undertaken ambitious programs since the mid-1990s to improve the care provided to Veterans. Studies and evaluations over the years, including a 2009 Congressional Budget Office report, have shown VHA care to be comparable to or better than private sector care, especially in terms of compliance with evidence-based treatment guidelines.

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The controversy centered on facilities not meeting a set goal of patients getting a primary or specialty care appointment within 14 days and staff at some hospitals falsifying records to meet that goal. A number of veterans died as a result of waiting for care to begin.

Many performance management experts, however, cite the goal as unrealistic, vague and difficult and contributed to the creation of a system that drove bad behavior. Safeguard systems such as checks and balances were also missing that would hopefully have caught such gaming behavior. Several policy changes have been made since then, including Veterans being able to see non-VA providers if an appointment is not available within a certain timeframe or if the Veteran lives a certain distance from a VA facility.

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GI Bill: "It is said the GI Bill had more impact on the American way of life than any law since the Homestead Act of 1862." (VA, n.d.). The VA Home Loan Guaranty Program is the only provision of the original GI Bill that is still in force.

1959: President Lincoln's words were adopted as the department's official motto.

Premiums and Copayments: Veterans do not pay insurance premiums. No copayment is required for a military- or "service"-related medical condition.

VHA locations: 146 VA Medical Centers (VAMC) with integrated outpatient clinics, 772 Community Based Outpatient Clinics (CBOC), and 134 VA Community Living Centers (VA Nursing Home) Programs.

Healthcare Training: 70% of all U.S. physicians have studied at VAMCs; 113,000 health care trainees learn at VAMCs each year.

Employees: In 2020, the VA employed 412,892 people.

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1. Geppert C. M. A. (2016). What is the VA? The Largest Educator of Health Care Professionals in the U.S. Federal practitioner: for the health care professionals of the VA, DoD, and PHS, 33(7), 6–7.

2.  Department of Veterans Affairs. n.d. History Overview. https://department.va.gov/history/history-overview/

3.  Brunker, M. (2014, Jun 25). https://www.nbcnews.com/storyline/va-hospital-scandal/performance-mismanagement-how-unrealistic-goal-fueled-va-scandal-n139906

4.  MIRECC/CoE. (n.d.) The Origin of the VA Motto. https://www.mirecc.va.gov/visn20/Newsflash/Origin-of-the-VA-Motto.asp#:~:text=What%20was%20that%20credo%3F,side%20of%20the%20main%20entrance.%E2%80%9D

5.  Congressional Budget Office. (2009, Aug 13). Quality Initiatives Undertaken by the Veterans Health Administration. https://www.cbo.gov/publication/24955