ABSTRACT
The federal hospital system for veterans, established in the aftermath of World War I in a context of decentralization, privatization, and rejection of compulsory health insurance, seems an anomaly in health care policymaking. In the veterans' case, political judgments were transformed into scientific and bureaucratic decisions via the pragmatic use of experts. The system worked; the federal government governed. By the mid-1920s, too, there were shifts in the views of those who initially supported veterans' benefits. The coalitions of interest were breaking down. Most notably, the widening scope of medical benefits was troubling the medical establishment. The veterans hospital system was a feasible approach to the national medical care of veterans after World War I in a country without national health insurance. In contrast to the effective centralization of the medical profession, the federal government's role in health before the war was fragmented and weak; responsibility for public health resided largely in the states.
