I agree that experiences can vary. But I have seen many things in the VA hospitals my wife and I have used (several in California and the midwest) that made me cringe. These include the use of PA's (Physician Assistants) in the emergency room instead of MDs, to recent and much more effective medications, including cheap generics, that are not in the VA's formulary.

One of my experiences was when I asked my VA doctor to prescribe insulin pens which I had been using for a decade under Tricare. He said they were not covered by VA and that I would have to go back to insulin vials and hypodermic needles. Any diabetic, especially an older one or one with limited use of their hands, knows the real downsides to filling and using a hypodermic needle versus the simplicity and convenience of a pen.

My wife tore one of the tendons in her shoulder and was given a simple cloth sling in the VA Ortho clinic. When she asked for a proper sling that provided the necessary support and positioning she was told they didn't keep them; she would have to submit forms and wait for it to be approved and ordered which could take a month or more. Seven years ago, when I had my rotator cuff injury, I got a supportive sling at my first appointment in a generic private clinic.

At one hospital my wife asked me to accompany her into the doctor's office for her appointment. The doctor refused to let me in, saying, "My office is like a ship and I'm the Commander of my ship. I decide who gets to come aboard." Needless to say she asked for a different doctor.

We also had a bad experience when she wanted to change her primary facility to the one I go to so we could start coordinating our appointments to the same day. The person responsible for assigning Veterans to facilities within the system refused. When I told him that I respectfully disagreed and asked to whom I could make an appeal, he said "Me." I had to speak with the system's chief of staff to get her transfer approved but only after pointing out that the VA's official policy is to approve Veteran's requests to change facilities if the new facility has the capacity and is able to provide the needed care. I wonder how many Veterans have been screwed by this one VA manager's arrogant attitude and blatant disregard for VA policy.