The film "Born on the Fourth of July" portrayed VA medical care as many saw it in the years after the Vietnam War.
VA surgeon Thomas Gauge remembers those times all too well.
"The system was overwhelmed," says Dr. Gauge. "It wasn't capable of dealing with the problems that it faced at that time."
But under a major restructuring that began during the Clinton administration, the VA has undergone an amazing transformation. It now offers what several surveys show to be the best medical care in the country.
"The VA health care system in the past few years has been rated exceptionally high in their quality of care," says Peter Gaytan with the American Legion. "And that rating comes from the patients themselves."
Patients like Frank Murino, who first entered the VA system after he was injured in Vietnam in 1968.
"You were a number," he remembers. "You were the last four digits of your Social Security number then."
Murino, like all patients, now has a personal physician who knows him well.
"You got respect today," he says.
And much of the care has shifted from hospital to outpatient services, with an emphasis on prevention — including checkups to prevent complications from diabetes and heart disease.
A big advantage for the VA is electronic medical records. The VA has the largest, and one of the most modern systems in the world. When a VA patient visits any facility in the country, the records are there. Indeed, after Hurricane Katrina, many VA patients received uninterrupted care even as they were forced to move.
"All of the information I need about any of my patients, including their X-rays and their tests, are always available, always accurate, always there in a legible form," says Gauge.
The electronic records also allow the VA to track its performance — to quickly learn what works and what doesn't — providing what many say could be a model for health care nationwide.