Public-sector health-care reforms that work?: a case study of the US Veterans Health Administration

The Veterans Health Administration (VHA) is the largest integrated health-care system in the USA, and provides public-sector care for honourably discharged veterans of the US armed forces. The panel sets out eligibility criteria for the VHA. The system is financed mostly from general taxation and can be characterised as a veteran-specific national health service. Since the 1970s, the quality of service provided by the VHA had been regarded as poor by almost all relevant stakeholders. However, in the past few years, the academic and popular press have reported a turnaround in the VHA's performance. This improvement can be attributed to a set of reforms that were gradually introduced from 1995. What could policy makers in other health-care systems learn from the VHA's story?