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October 11, 1995

The Future of the Department of Veterans Affairs

Author Affiliations

St Louis VA Medical Center St Louis, Mo

JAMA. 1995;274(14):1130. doi:10.1001/jama.1995.03530140042017

To the Editor.  —The recent article by Drs Fisher and Welsh1 and the Editorial by Dr Pittman2 illustrate that the future of the Department of Veterans Affairs (VA) is no less than the future of academic medicine. The future of both relies on solving the health care crisis, which itself is due to the following three main problems: escalating costs, lack of preventive health care for 40 million uninsured Americans, and the impending bankruptcy of academic medical centers.3The VA's future is grim because of both demographic and financial considerations. The VA will soon lose its major patient base for the past 50 years—World War II and Korean War veterans now in their 60s and older. Even if the VA could lure more veterans and their families away from the private health care sector, it still faces the impossible task of competing with private health maintenance organizations

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