United States Department of Veterans Affairs
The United States Department of Veterans Affairs is a Cabinet-level executive branch department of the federal government charged with providing lifelong healthcare services to eligible military veterans at the 170 VA medical centers and outpatient clinics located throughout the country. Non-healthcare benefits include disability compensation, vocational rehabilitation, education assistance, home loans, and life insurance. The VA also provides burial and memorial benefits to eligible veterans and family members at 135 national cemeteries.
File:VA Medical Center NYC.jpg|thumb|VA Medical Center in Manhattan, New York City
While veterans' benefits have been provided by the federal government since the American Revolutionary War, a veteran-specific federal agency was not established until 1930, as the Veterans' Administration. In 1982, its mission was expanded to include caring for civilians and people who were not veterans in case of a national emergency. In 1989, the Veterans' Administration became a cabinet-level Department of Veterans Affairs. The president appoints the secretary of veterans affairs, who is also a cabinet member, to lead the agency.
the VA employed 412,892 people at hundreds of Veterans Affairs medical facilities, clinics, benefits offices, and cemeteries. In fiscal year 2016 net program costs for the department were $273 billion, which includes the VBA Actuarial Cost of $106.5 billion for compensation benefits. The long-term "actuarial accrued liability" is $2.491 trillion for compensation benefits; $59.6 billion for education benefits; and $4.6 billion for burial benefits.
History
The history and evolution of the U.S. Department of Veterans Affairs are inextricably intertwined and dependent on the history of America's wars, as wounded former soldiers and other U.S. military veterans are the population the VA cares for. The list of wars involving the United States from the American Revolutionary War to the present totals ninety-nine wars. The majority of the United States military casualties of war, however, occurred in the following eight wars: American Revolutionary War, American Civil War, World War I, World War II, Korean War, Vietnam War, Iraq War, and the War in Afghanistan. It is these wars that have primarily driven the mission and evolution of the VA. The VA maintains a detailed list of war wounded, as it is this population that comprises the VA care system.Origins
The Continental Congress of 1776 encouraged enlistments during the American Revolutionary War by providing pensions for soldiers who were disabled. Three weeks after passing the law compensating the injured, the Continental Congress in September 1776 also approved a resolution awarding grants of public land to all who served in the Continental Army for the duration of the conflict. Direct medical and hospital care given to veterans in the early days of the U.S. was provided by the individual states and communities. In 1811, the first domiciliary and medical facility for veterans was authorized by the federal government but not opened until 1834. In the 19th century, the nation's veterans assistance program was expanded to include benefits and pensions not only for veterans but also their widows and dependents.Prior to the end of the American Civil War in 1865, Delphine Baker, a volunteer nurse during the war, rallied support to petition the federal government to create a national home for Civil War veterans, based on the U.S. Soldiers Home in Washington, D.C., and the Naval Asylum in Philadelphia for U.S. active-duty veterans. The bill establishing the National Home for Disabled Volunteer Soldiers was passed on March 3, 1865. The very next day, President Abraham Lincoln vouched for the mission of the future facilities in his second inaugural address:
With malice toward none; with charity for all; with firmness in the right, as God gives us to see the right, let us strive on to finish the work we are in; to bind up the nation's wounds; to care for him who shall have borne the battle, and for his widow, and his orphan—to do all which may achieve and cherish a just and a lasting peace, among ourselves, and with all nations.The middle section of that quote would later form the guiding principle for the future Department of Veterans Affairs.
While domiciliary care for Civil War veterans was managed by the National Home system at 11 various campuses, the pension benefits was split amongst various agencies in the federal government. Throughout the mid-to-late 19th Century, the Bureau of Pensions managed financial benefits to veterans, widows and dependent children. With the completion of the Civil War and an expansion of eligibility in 1890, pension numbers soared, from 303,000 to 966,000 in 1893. Eventually the workforce had to be housed in a new purpose-built home, the , which housed the organization from 1885 to 1926.
Furthermore, many state veterans' homes were established. Since domiciliary care was available at all state veterans homes, incidental medical and hospital treatment was provided for all injuries and diseases, whether or not of service origin. Indigent and disabled veterans of the Civil War, Indian Wars, Spanish–American War, and Mexican Border periods, as well as discharged regular members of the Armed Forces, were cared for at these homes.
Veterans' Bureau
The United States' entrance into World War I in 1917 caused a massive increase in veterans, overwhelming the federal system. When the Republican nominee for president, Warren G. Harding, accepted his party's nomination to the 1920 presidential election, he issued a promise to the more than four million Americans who served in the war:It is not only a duty, it is a privilege to see that the sacrifices made shall be requited, and that those still suffering from casualties and disabilities shall be abundantly aided and restored to the highest capabilities of citizenship and enjoyment.At the time of the election, dissatisfaction with the benefits programs for World War I veterans ran rampant throughout the country. To receive benefits, veterans had to navigate through three different federal agencies: the Bureau of War Risk Insurance for insurance and compensation, the U.S. Public Health Service for medical and hospital care, and the Federal Board for Vocational Education for rehabilitation, education, and job training. Veterans from previous conflicts continued to rely on the Bureau of Pensions and National Homes for Disabled Volunteer Service for their compensation and medical care respectively.
After winning the election, President Harding appointed a committee in April 1921 to identify a solution. On August 8, 1921, Harding signed Public Law 67-47, popularly known as the Sweet Act, which established the , which absorbed the War Risk Bureau and the Rehabilitation Division of the Federal Board for Vocational Education. In 1922, it gained a large number of veterans' hospital facilities from the Public Health Service, most of which had been recently established on former U.S. Army bases.
One of the landmark measures included in the new law was removing the burden of proof for two disabilities that veterans claimed - tuberculosis and neuropsychiatric disorders. While the legislation only applied to those two categories, it was groundbreaking in establishing presumptive conditions for future claims.
Charles Forbes led the fledgling agency through its initial two years, before resigning in 1923. His replacement, former brigadier general Frank T. Hines took on director of the Veterans' Bureau. By the 1920s, the various benefits were administered by three different federal agencies: the Veterans' Bureau, the Bureau of Pensions, and the National Home for Disabled Volunteer Soldiers.
The United States final federal consolidation of veteran government entities came on July 21, 1930, when President Herbert Hoover signed Executive Order 5398, merging all three agencies into the Veterans' Administration. Hines, who had remained in charge of the Veterans' Bureau for seven years, was named the first administrator of Veterans Affairs, a job he held until 1945 when he was replaced by General Omar Bradley.
World War II
In 1940, with war already raging in Europe and Asia, VA began preparing for potential American involvement in the conflict. Hines informed Congress that the agency was coordinating with the War Department to assist in the event of a national emergency with both hospital bed space and highly trained medical staff.Following the Japanese attack on Pearl Harbor and America's entry into World War II, the U.S. Army's need for physicians and other healthcare professionals was acute. As the surgeon general of the Army, Maj. Gen. Norman T. Kirk, bluntly reported, "It was difficult during the past year to secure the additional Medical Corps officers needed to meet the requirements of the increasing Army since there are not sufficient physicians available to meet both military and civilian medical needs."
The military's demand for healthcare professionals drained staff from the civilian medical community and VA alike. Between 1942 and mid-1944, 16 percent of VA employees were furloughed for military service. A December 1943 agreement between Secretary of War Henry L. Stimson and the VA's administrator paved the way for a collaborative use of limited medical personnel. Their solution included inducting select VA doctors and dentists into the Army but allowing them to remain at VA facilities. While detailed to VA, Army personnel wore a distinctive shoulder sleeve insignia designed by the Heraldic Section of the Army's Office of the Quartermaster General. One of the most notable to wear this patch was Gen. Omar N. Bradley.
The close of World War II resulted in not only a vast increase in the veteran population but also a large number of new benefits enacted by Congress for veterans of the war. In addition, during the late 1940s, the VA had to contend with aging World War I veterans. During that time, "the clientele of the VA increased almost fivefold with an addition of nearly 16,000,000 World War II veterans and approximately 4,000,000 World War I veterans." Prior to World War II, in response to scandals at the Veterans Bureau, programs that cared for veterans were centralized in Washington, D.C. This centralization caused delays and bottlenecks as the agency tried to serve World War II veterans. As a result, the VA went through a decentralization process, giving more authority to the field offices.
The Servicemen's Readjustment Act, commonly known as the GI Bill, was signed into law on June 22, 1944, by President Franklin D. Roosevelt. "The United States government began serious consolidated services to veterans in 1930. The GI Bill of Rights, which was passed in 1944, had more effect on the American way of life than any other legislation—with the possible exception of the Homestead Act."
Unlike previous legislation, the GI Bill stipulated that all benefits were to be managed by the VA. Further educational assistance acts were passed for the benefit of veterans of the Korean War.