Veterans care comes of age - the Civil War

The Civil War was the first experience in the history of the United States that was truly national in the involvement of its citizens and in the impact on daily life in communities in both the north and the south. The Civil War was a war of volunteers, both military and civilian. Very early in the war, it became dear to social leaders in the North that new programs were required to deliver medical care to the wounded beyond what was available through the official military structure.

The leading civilian organization was the United States Sanitary Commission, which had secured permission from President Lincoln in the summer of 1861 to deliver medical supplies to the battlefront, to build adequate field hospitals staffed with volunteer nurses (mostly women), and to raise funds to support the commission’s programs (6).

As the war continued, civilian leaders began to address the issue of caring for the large number of veterans who would require assistance once the war ended. The Sanitary Commission favored the pension system rather than permanent institutional care for the disabled veteran, fearing that a permanent institution would be nothing more than a poorhouse for veterans (7). Other groups were as strongly in favor of the establishment of a soldiers’ asylum as the Sanitary Commission was opposed to the concept.

Both groups gathered information on European military asylums, particularly the Invalides in Paris, to use in either opposing or supporting the creation of a disabled volunteer soldiers’ asylum (8).

Post-War reshuffling of administration models

The victory of the Union was seen as the triumph of the nation, and the creation of a national institution to serve the defenders of the Union was an affirmation of that national victory. At the time of its creation, the supporters of the National Asylum probably had only limited awareness of the number of veterans who could potentially become members of the National Asylum. The number of troops, which fought for the Union would have indicated the potential membership: over 2,000,000 men, a third of the white men of military age (13 to 43 years old in 1860), served in the Union army (9).

If the number of men who were disabled in service through loss of limb, wounds, or disease equaled the sixth that died in the war, the number eligible for admission to the National Asylum would have been over 300,000 (10).

Even with the establishment of the National Asylum by law in 1865, the institution experienced difficulties in being realized. The original corporation charged with its organization could not secure a quorum after a year in existence.

In March 1866, new legislation replaced the 100-member corporation with a twelve-member board of managers. This group had to select sites, commission construction projects, and designate local officials while serving as unpaid volunteers of an independent Federal agency. The managers of the Asylum looked to past models and local efforts to guide the creation of the new institution.