After a frightening ER visit made clear the limits of for-profit care, one veteran makes the case that the VA isn’t “socialized medicine”
If you live long enough with a spinal cord injury or disorder (SCI/D), you learn to recognize trouble early. Your body teaches you when something is wrong and when delays can be dangerous.
So, when I recently became seriously ill and went to my local emergency room, I expected urgency. Instead, almost as soon as I arrived, I sensed I might not get the care I needed.
After my vitals were taken and it was determined I wasn’t going to die in the next five minutes, a clerk asked for my driver’s license, proof of insurance and a credit card. Only after providing that information was I offered a bed.
A paramedic slid a tube up my nose, down my throat and into my stomach. My condition worsened, and within hours, my skin began to break down. When I told a nurse I felt the onset of autonomic dysreflexia, she asked, “What’s that?”
That’s when I requested a transfer to the Department of Veterans Affairs (VA) SCI/D center.
Veterans with SCI/D live in what many Americans dismiss as “socialized medicine.” To me, it’s simply the VA, a government-run, publicly funded health care system designed for long-term, coordinated care rather than for profit. For people with complex disabilities, that design isn’t ideological; it’s lifesaving.
That’s why I don’t flinch when people warn about “socialized medicine.”
Once that phrase enters the debate, the conversation changes. We stop talking about whether people can afford an emergency room visit or insulin and start hearing about government takeovers, endless wait times and doctors fleeing the country. “Socialized medicine” becomes a scare tactic. For me, and millions of other veterans, it’s simply health care.
The VA is the largest integrated health care system in the United States, with 170 medical centers and more than 1,190 outpatient clinics. I know it’s not perfect, but it’s built to care for people, not to maximize profits.
The VA isn’t an abstract policy idea. It’s where my doctors coordinate my care. It’s where my equipment gets ordered. It’s where decisions are made based on my medical need rather than my insurance coverage.
When people rail against “socialized medicine,” they’re effectively defending a for-profit health care system designed to extract as much money as possible while delivering the least amount of care.
The National Health Expenditure Accounts (NHEA) found that U.S. health care spending was $15,474 per person in 2024, more than any other wealthy nation. Comparable countries spend far less, yet their citizens live longer and die from preventable causes less often. This for-profit model is so indefensible that lobbyists spend more than $500 million a year protecting it.
Even being “insured” no longer guarantees access to care. Millions of Americans technically have coverage but can’t afford to use it. High deductibles, surprise bills and narrow networks force people to delay or skip treatment. The NHEA says health care consumed 18% of our economy in 2024, yet millions remain one diagnosis away from financial ruin.
Inside the VA, much of that chaos disappears.
I don’t shop for plans or worry about what’s “in network.” I don’t open the mail and find a surprise bill. Most care decisions are between me and my doctor, not buried in approvals or billing rules. When my doctor says I need something, I usually get it. When you’re already sick or injured, not having to fight the system isn’t just convenient, it’s a relief.
That doesn’t mean the VA is flawless. There have been serious failures, and veterans have every right to demand better. But the VA is scrutinized in ways private health care rarely is.
When something goes wrong at the VA, it becomes national news. Similar failures happen every day in private hospitals but remain largely invisible. Fewer headlines don’t mean fewer problems; they mean less transparency.
I’ve seen this double standard firsthand. While I was testifying before Congress on behalf of Paralyzed Veterans of America, a lawmaker suggested dismantling the VA over wait-time concerns, an action that would push millions of veterans into private systems that were never designed to care for us.
Trying to underscore the absurdity, I replied, “If we shut down the VA every time it falls short, then by that measure, we should probably shut down Congress, too.”
No health care system, public or private, is flawless. The difference is accountability. Public systems like the VA operate in the open. Private systems often resolve failures through nondisclosure agreements and confidential settlements, limiting public scrutiny and systemic improvement.
Nowhere is the VA’s value clearer than in its SCI/D system of care. The VA understands that caring for someone with SCI/D isn’t a one-time event — it’s lifelong. Its hub-and-spoke model links specialized centers with regional clinics, so patients don’t fall through the cracks.
Care is coordinated. I don’t spend my life fighting insurance companies for approvals. My doctors, nurses, therapists, psychologists and social workers work within the same system. In private health care, patients are often left to manage complex care on their own, while insurers profit from delays and denials.
Preventive care matters, too. Pressure sores or bladder infections can quickly become life-threatening if missed. Early intervention saves lives and money. But prevention doesn’t generate quick profits, so it’s often neglected in for-profit systems.
At its core, the VA works because it isn’t built around profit. Private insurers exist to maximize shareholder returns. The VA exists to take care of people. That difference matters.
Every developed nation has figured out how to spend less, cover everyone and avoid bankrupting people when they get sick —except the United States.
We don’t need to copy another country. We already have an American model that works. We should build on the VA as a foundation for universal health care that guarantees basic care for everyone, while allowing private care as supplemental coverage.
I’ve lived in both the private and public health care systems. I’ve watched my wife navigate the endless games of private insurance while seeking care at for-profit hospitals. It’s exhausting and infuriating. For me, the VA has worked, and it makes me wish there was something in the public system she could rely on, too.
Maybe it’s time we stop fearing the term “socialized medicine” and start listening to the people who actually live inside these systems. Health care works best when it puts people first.
As always, I’d love to hear your thoughts at al@pvamag.com.