FWIW, it sounds like veteran's health care in the us is more top down than most "government" health programs in other countries. All the staff are VA employees,

FWIW, it sounds like veteran's health care in the us is more top down than most "government" health programs in other countries. All the staff are VA employees, right? In Canada, by contrast, the doctors and hospitals tend to be private. The government pays, and sets price schedules, but they don't directly control care. It's obviously a bit more complicated than that, but the public system sounds much less centralized than your VA health system.