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The Veterans Health Administration (VHA) provides health care for U.S. military veterans. By the early 1990s, the VHA had a reputation for delivering limited, poor-quality care, which led to health care reforms. By 2000, the VHA had substantially improved in terms of numerous indicators of process quality, and some evidence shows that its overall performance now exceeds that of the rest of U.S. health care. Recently, however, the VHA has started to become a victim of its own success, with increased demands on the system raising concerns from some that access is becoming overly restricted and from others that its annual budget appropriations are becoming excessive. Nonetheless, the apparent turnaround in the VHA’s performance offers encouragement that health care that is both financed and provided by the public sector can be an effective organizational form.
Author(s): Adam Oliver
Keywords: Veterans Health Administration; reform; quality; access
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Volume 85, Issue 1 (pages 5–35) DOI: 10.1111/j.1468-0009.2007.00475.x Published in 2007
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The Milbank Quarterly is an editorially independent multidisciplinary journal that offers in-depth assessments of the social, economic, political, historical, legal, and ethical dimensions of health and health care policy.