Yeah, they call it VA Choice.Often they will allow a case or direct a case to private doctors. I know that is the case with prostate cancer and reading from other vets on blogs many other medical conditions
Your hero Trump constantly claimed he started it. Obama signed a bill to give it a trial, and Trump signed it into law after the trial period ended.
When I was in the US in 2018, I went to the VA hospital in town. They assign you a regular primary care provider and since it was my first visit there in many years, my primary care provider was a nurse practitioner that talked to me for almost an hour taking a complete history. I told her about my neuro muscular problem, and a few days later she called and said she had gotten an appointment at neurology for me at the world renowned Cleveland clinic about 100 miles away. I really didn't want to extend my trip any longer to spend some days there for testing, probably to be told there was nothing they could do which is what the neurologists told me in Ger5many after extensive testing. So I thanked her and declined.
When I lived in San Antonio the VA medical center there is quite large and provides very good care. It is also connected, literally by a pedestrian bridge over a street and by agreement that any complicated cases will be dealt with University Medical Center, a large teaching hospital in town. The interns and residents spend time rotating between both hospitals.
VA hospitals vary greatly in quality and services offered depending where they are. Obviously a VA hospital in a small town won't be as good as one like in San Antonio, a large city with a very large veteran population because of the mild climate, low cost of living, amenities and activities, and 2 large military hospitals, Brooke Army Medical Center (BAMC) at FT Sam Houston and Wilford Hall at Lackland Air Force Base. Wilford hall recently downgraded to mostly outpatient clinics due to the smaller number of active duty military nowadays. Wilford Hall used to be 1 of the 3 level 1 trauma centers in San Antonio, now BAMC and University Hospital are the remaining 2. I worked in the ER at both BAMC and University as an EMT.