Medicare patients 5.5 times more likely to get cataract surgery than VA patients.

"VA physicians and hospitals do not have the same financial incentives to perform cataract surgery as physicians and medical facilities outside the VA system.

"The results of our study raise important questions about the possible existence of a two-tier, federally funded health-care system that may not be equivalent in terms of quality of care," said Dr. French, who is also a research scientist with the Center of Excellence on Implementing Evidence Based Practice at the Richard A. Roudebush VA Medical Center."

More like the the possible existence of rationed care.