It was a rare and urgent call to action as a critical threat looms over Veterans' healthcare. For the first time, 170 current and former Department of Veterans Affairs (VA) medical professionals have issued the 'Lincoln Declaration,' warning that Veterans’ care could collapse unless urgent action is taken.

The signatories—physicians, psychologists, researchers, and other healthcare professionals with experience in the VA—express profound concern about the future of Veterans' care. Many have chosen to remain anonymous due to fears of retaliation, but their message is unequivocal and urgent:

“We write to raise urgent concerns about proposed policies… [that] will undermine VA’s healthcare system and negatively affect the lives of all veterans.” — Lincoln Declaration

Lincoln Declaration: Impact on VA Healthcare

The Department of Veterans Affairs (VA) operates the largest integrated healthcare system in the United States, serving over nine million Veterans. Its specialized programs, including polytrauma centers, post-traumatic stress disorder (PTSD) and mental health treatment, prosthetics, and spinal cord injury units, are not easily replicated by private hospitals.

The letter’s central warning is that staffing reductions and outsourcing to community care providers now threaten the VA’s unique strengths. Privatization could close facilities, fragment care, and put Veterans with complex conditions at risk of losing critical services that only the VA provides.

This warning follows a 2025 report by the VA Office of Inspector General, which found 4,434 severe occupational shortages—a 50% increase from the previous year.

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VA Healthcare Performance: Empirical Evidence

Studies show VA healthcare outcomes are comparable to, or better than, those provided outside the system, especially for Veterans with complex needs.

• VA hospitals report better results for hospitalized Veterans compared to non-VA facilities.
• Reviews confirm VA care matches or exceeds non-VA quality across most specialties.
• Veterans treated at VA hospitals have lower 30-day mortality rates than those treated elsewhere.

Veterans Affairs healthcare often has better outcomes than private hospitals. Reducing VA services may increase Veteran mortality.

VA Staffing Shortages and Service Reduction Issues

The Office of Inspector General (OIG) audit revealed staffing shortages at 139 VA medical centers, impacting primary care physicians, mental health providers, and nursing staff.

Billions are being diverted to community care programs that pay outside providers to treat Veterans. Critics warn that this siphons vital resources from VA facilities, fails to guarantee consistent quality, and creates dire opportunity costs.

If current trends persist, specialized VA services—such as PTSD treatments, polytrauma care, and spinal cord injury units—face rapid reduction or closure. This may lead to dangerously long wait times, fragmented care, and increased risks of untreated health conditions for Veterans.

Sen. Richard Blumenthal of the Senate Veterans’ Affairs Committee acknowledged the letter and said, “Persistent staff losses and resource diversion are eroding the VA’s capacity. "

VA Healthcare Privatization Debate: Key Issues

VA leadership insists community care expands options and improves access, describing it as increased efficiency rather than privatization. However, critics warn that expanded reliance on outside providers risks undermining the VA’s core integrated care system by fragmenting services, creating gaps in communication, and eroding continuity of care for veterans who depend on complex, coordinated treatments.

However, the clinicians responsible for the Lincoln Declaration argue that Veterans with complex healthcare needs frequently do not receive equivalent treatment outside the VA system. They contend that reductions in staffing may leave these individuals without adequate care.

Veterans' Stakes in VA Healthcare System Changes

The looming changes in the VA healthcare system risk undermining the promise made to Veterans: that they will receive care for injuries and conditions sustained in service to their country.

Consider Robert, a decorated Veteran, who suffers from traumatic brain injury and PTSD. He relies on the specialized care provided at his local VA medical center, which has treated him for over a decade. Budget cuts and staffing shortages threaten this center's ability to continue offering the level of care that Robert and countless others like him have come to depend on.

This crisis is not simply about budgets; it is about whether Veterans with traumatic brain injury, amputations, PTSD, or spinal cord injuries will continue to urgently receive the critical care they were promised.

The Lincoln Declaration is regarded as a historic first, representing a large-scale public letter from VA clinicians warning of potential systemic collapse from within the organization.

“The VA is not just another hospital system. It’s a promise to veterans that their service won’t be forgotten in their most vulnerable hours.”

VA Policy Implications and Future Directions for 2025

The declaration has been delivered to VA leadership, the VA Inspector General, and congressional committees. Reports suggest more professionals may add their names. Calls are growing for hearings and oversight.

Will policymakers answer this urgent call to action and protect Veterans’ healthcare before it collapses? Immediate intervention is critical.

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