One difference is that the VA is a complete system, with it's own hospitals and staff. Medicare is that half-way solution, a public insurance system which buys

One difference is that the VA is a complete system, with it's own hospitals and staff. Medicare is that half-way solution, a public insurance system which buys medical services for the members from the private sector. As for the VA system's woes, I would say: yeah, it's definitely possible to build a system that doesn't work well. But that doesn't mean we shouldn't be trying.