The interesting thing, of course, is that you cannot find a single person eligible for VA care who wants healthcare outside of the VA system. Look around at the "whaling and gnashing of teeth" when a VA hospital/clinic is slated for closure and the veterans are told that they have to go to a "civilian hospital" for healthcare. Decades ago, we discussed cutting back on services at our AF hospitals in areas where there was a large civilian healthcare presence (e.g., Omaha with two medical schools) and spread out the military physicians to the isolated locations so there wasn't one OBGYN on single coverage 24/7/365 at a place like Loring AFB (long since closed.) The blowback from every rank from O-10 to E-3 was tremendous. They absolutely refused to go anywhere near the civilian healthcare system. Even today, if you gave a retiree the option to either a) have healthcare at their local civilian hospital, or b) be treated at a military hospital, I guarantee you that 99 out of 100 would chose option (b). If you don't believe me, go camp out at your local American Legion for a week or so.
The bolded is categorically false. As a private, non-VA Pain Physician, I have VA patients that come to me all the time. In fact, the exact reason they come to me, is because for years and years, their pain care has languished so badly in the VA system. Finally, through a program called HealthNet, they're allowed to see a non-VA physician, outside of the VA system, for specialty care. Invariably what I hear from them, when we discuss getting an MRI of the spine and discuss what interventional options are appropriate, is, "Wow. I didn't know any of this existed. They act like it doesn't in the VA. They just let me deal with my pain for the past ten years on the same medicine which isn't working."
It's actually worked out great, because they're sending patients to me simply to do any interventional treatments that might help and they go back to their VA PCP for their meds.
The patients only end up seeing me, specifically, because they were offered the choice of either taking a 2 hour drive to the nearest VA Pain MD, or seeing me, who's 3 miles away, and they chose me.
When the do finally get in to see me, they're blown away at how fast we get an MRI and get them whatever injection they need (if any) compared to how it is in the VA system, which according to them, is exactly "never," at least in the past 10 or so years, they've been suffering with their painful condition.
