The History of the Veterans Health Administration

By Lisa Roner

The Veterans Health Administration, the largest integrated health system in the United States, has a rich history which can be traced back to the earliest settlers of our nation. Since the pilgrims of the Plymouth Colony passed a law that provided support for disabled soldiers of its war with the Pequot Indians, the U.S. has made caring for its military veterans a national priority.

From pensions for disabled veterans of the Revolutionary War and veterans homes and hospitals for soldiers of the Civil War to disability benefits, health insurance and vocational rehabilitation for veterans of World War I, the U.S. has continuously expanded and refined its veterans programs. But with an increase in the veteran population after World War I, the system grew more complex and cumbersome with oversight of veterans' affairs the responsibility of a number of federal agencies, including the Veterans Bureau, the Bureau of Pension of the Interior Department and the National Home for Disabled Volunteer Soldiers.

In 1930, the U.S. Congress authorized the President to "consolidate and coordinate activities affecting war veterans" and established the Veterans Administration (VA). The need for services grew rapidly following World War II as more than 1 million returning troops were guaranteed specialized assistance with rehabilitative physical and emotional care under the Servicemen's Readjustment Act of 1944, also known as the GI Bill of Rights. According to the House of Representatives Committee on Veteran's Affairs, in 1946, the Department of Medicine and Surgery was established (this department later became known as the Veterans Health Services and Research Administration).

In 1989, the VA was elevated to Cabinet level status, and health care services were consolidated in the Veterans Health Administration (VHA). The Veterans Administration is overseen by the Secretary of Veterans Affairs, while the Under Secretary for Health serves as the chief executive officer of the VHA.

"There is only one place for the veterans of America, in the Cabinet Room, at the table with the President of the United States of America," said President Bush as he marked the occasion.

According to a November 2004 examination by Perlin, Kolodner and Roswell in "The American Journal of Managed Care," the VA transitioned from a hospital system made of independent and sometimes even competing facilities, to a true health care system in the mid-1990s. In 1995, 22 geographically defined Veterans Integrated Service Networks were established to more effectively administer resources and reflect the geographically shifting veteran population.

According to the Veteran's Administration, the VA health care system has grown from 54 hospitals in 1930, to 171 medical centers, more than 350 outpatient and community clinics, 126 nursing home care units and 35 domiciliary facilities today. In 2009, more than 8 million veterans and their family members were enrolled in the VA health care system.

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