Here's the key feature of the VA system: doctors get to be doctors, not gate-keepers or profit-skimmers. Doctors don't own the labs that do the tests they order, and when somebody sues them, the doctors are backed up by a regiment of government lawyers. Doctors don't have to lay awake at night worrying about getting sued or making their malpractice payment. A big local scandal is a VA dentist who didn't bother cleaning his instruments between patients. Right now they are trying to track down all of his patients and see how many have contracted hepatitis or even worse diseases because this dentist ignored over a hundred years of standard medical practice. Should he be immune to malpractice suits?