Caring for Veterans

…to care for him who shall have borne the battle and for his widow and his orphan

Lincoln’s Second Inaugural Address

In recent years news of long waits, mismanagement, and even incompetence in Veteran’s Administration (VA) hospitals has saddened the country. Reports were sometimes exaggerated and not always fair, but with the constant flow of veterans of wars in the Middle East, the VA Health System struggles to keep up; clearly the situation was and is unacceptable. Those who go to battle on behalf of the country expect us to deliver on our promises to them.  It seems reasonable to review the long and frequently sad history of our care for veterans as Veteran’s Day approaches.

The Grave of a Revolutionary War Veteran

These aren’t a new problems. In 1636 Plymouth Colony, at war with the Pequot Indians, passed a law assuring disabled veterans care. In 1776 the Continental Congress promised pensions for disabled veterans in order to encourage enlistments. Unfortunately, the Continental Congress had neither the authority nor the money to actually do that—it was left to the states.

After the ratification of the Constitution, the newly formed government took some responsibility, but the situation was cloudy. Compensation to veterans often took the form of land grants in lieu of cash, though some individual states provided medical care. It wasn’t until 1818 that the War Pensions Act formally addressed Congress’s obligations toward veterans of the Revolution.

Thomas Doughty, the Navy Asylum

The first medical facility for veterans—The Navy Asylum—was built in 1811 in Philadelphia using money (20 cents per month) collected from the pay of those serving in the Navy and Marines. It wasn’t until 1853 that the Army got a similar facility.

The onslaught of the Civil War brought an explosion of need. It is estimated that before the war the U.S. had about 80,000 war veterans. After it there were 1.9 million, twenty-four times as many, 60,000 of which were amputees. Before the war even ended, by 1862, the General Pension Act, the National Cemetery System, and the Homestead Act all aimed at addressing issues. Hospitals were overrun, and medical care in tents was common.

Wounded of the Civil War (The Civil War Through the Camera; the Internet Archives)

After the war veterans in organizations such as the Grand Army of the Republic lobbied for improved benefits. A number of hospitals were built, often by the states. A series of pension acts and reforms were passed but until 1890 Civil War pensions were only available for servicemen discharged because of illness or disability attributable to military service. Applications for benefits frequently included family letters, doctors’ notes, and affidavits meant to prove that injuries date to battles or at least to service. That year the criteria was expanded to include men incapable of manual labor for any reason. The rolls doubled.

Up to that point the laws were war-specific, but an effort was made to generalize them—just in time to cover the Spanish American War. In 1890 the Sherman Act entitled all veterans, regardless of war and regardless of disability to a pension when they turned 62.

Joseph Ambrose, World War I veteran, holding the flag that covered the casket of his son, who was killed in the Korean War.

A mixed bag of measures were passed during and in the immediate aftermath of the World War I, including, for the first time, education benefits to help soldiers reintegrate into the economy. In an effort to consolidate benefits, the Veteran’s Bureau was established in 1921 and various programs were folded together. In addition veteran’s hospitals were transferred to it from the Public Health Service, and an ambitions project of building hospitals ensued.

A second round of compensation took place in 1930 when the Veterans’ Administration as we now know it was established, pulling together three component agencies under a cabinet level umbrella. Things didn’t go smoothly then either. The Great Depression exacerbated dissatisfaction with bureaucratic complexity and delayed pensions. When veterans marched on Washington to demand payment in 1932 estimates are that 15-40,000 men participated.

Chairman of the Joint Chiefs of Staff Adm. Mike Mullen, a wounded veteran

Further changes after World War II expansion of benefits under the G.I. Bill resulted in the VA more or less as we know it now. The most recent reorganization appears to be 1953.

The wars of the ensuing 75 years have only stretched resources further and further, while bureaucratic inefficiency appears to have become more knotty, not less. Longer life spans, better battlefield medicine resulting in lower mortality, growing understanding of PTSD and closed head injuries, and growing numbers of female veterans—to name a few—require change and add to the challenges. As we continue to deploy troops in Afghanistan and Korea, and move them from Syria to Iraq to Saudi Arabia and other hot spots, the challenges grow. Medical benefits, education, pensions all are complex and expensive. Issues such as variations in length of service, service-related injuries (or not), and location of service (battle zone or not) complicate decisions. The question isn’t whether we should continue to fulfill Lincoln’s call to care “for him who will have borne the battle,” but to what extent and how. As we honor our veterans this month, let these things not be forgotten.

For more information see:

“About VA: History,” The Veteran’s Administration official site,

Blakemore, Erin. “Pensions for Veterans Were Once Viewed as Government Handouts,” The History Channel website, April 25, 2018.

Urbi, Jaden. “The VA’s History of Setbacks and Missteps,” CNBC, May 18, 1918. (Includes video of the history of the VA)

U.S. Department of Veterans Affairs: A History, VCU Libraries Social Welfare History Project, Virginia Commonwealth University,

VA History in Brief, Department of Veteran Affairs.

“Women Veterans,” on Benefit Programs, 2019.

Caroline Warfield, who grew up as an army brat, has a particular interest in veterans affairs. She writes historical romance and family sagas. Her latest novel, Christmas Hope takes place in and around Amiens and northern France 1916-1919. Some wars must be fought, some loves must live on hope alone, and some stories must be told. This is one of them.

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