In the past few decades, the role of the Department of Veteran's Affairs (VA) as a health care delivery system has raised awareness among health care administrators, veterans, and policy makers alike. The core mission of the VA delivery system is to provide primary care, specialized care, and related medical and social support services to veterans (Wilson & Kizer, 1997). Some of the most common medical benefits awarded under the VA are to veterans who have become disabled by illness or injury in the line of duty during military service. As a result, the VA health care delivery system serves as a safety net because many of the veterans served are psychologically and economically disadvantaged and have a high disease burden (Wilson & Kizer, 1997). In addition, veterans who use the VA health care system have a higher level of illness than the average population, and 60 percent have no private or Medigap insurance. The VA health care delivery system provides many services for veterans, and also contributes greatly in managing health care resources.
Research indicates that the availability of federal, state and local government funds to subsidize the care of persons left without services varies by state and community and may not match community need (Wilson & Kizer, 1997). In this way, the VA health care delivery system contributes in managing health care resources because it takes on the strains of existing alternatives. Within this patchwork, the VA health delivery system stands out as a significant, coordinated, nationwide safety net for veterans (Wilson & Kizer, 1997). The VA also cares for small vulnerable populations for whom care is expensive but generally unprofitable in the private sector (Wilson & Kizer, 1997). In addition to veterans with service connected injuries, illness and exposures and former prisoners of war, the VA is legislated to treat veterans with special disabilities of spinal cord dysfunction, blindness, amputation, traumatic brain injury, substance abuse and homelessness resulting from mental illness (Wilson & Kizer, 1997).