For tens of thousands of Union veterans, Patrick Kelly argues, the Civil War never ended. Many Federal soldiers returned to civilian life battling the lifelong effects of combat wounds or wartime disease. Looking to the federal government for shelter and medical assistance, war-disabled Union veterans found help at the National Home for Disabled Volunteer Soldiers. Established by Congress only weeks prior to the Confederate surrender, this network of federal institutions had assisted nearly 100,000 Union veterans by 1900. The National Home is the direct forebear of the Veterans Administration hospital system, today the largest provider of health care in the United States. Kelly places the origins of the National Home within the political culture of U.S. state formation. Creating a National Home examines Congress's decision to build a federal network of soldiers' homes. Kelly explores the efforts of the Home's managers to glean support for this institution by drawing upon the reassuring language of domesticity and "home." He also describes the manner in which the creators of the National Homes used building design, landscaping, and tourism to integrate each branch into the cultural and economic life of surrounding communities, and to promote a positive image of the U.S. state. Drawing upon several fields of American history--political, cultural, welfare, gender--Creating a National Home illustrates the lasting impact of war on U.S. state and society. The building of the National Home marks the permanent expansion of social benefits offered to citizen-veterans. The creation of the National Home at once defined an entitled group and prepared the way for the later expansion of both the welfare and the warfare states.

As the country sought healing and peace after the Civil War, Wisconsin citizens took up Pres. Abraham Lincoln's challenge "to care for him who shall have borne the battle." Their efforts paved the way for the establishment in Milwaukee of one of the original three branches of the National Asylum for Disabled Volunteer Soldiers. In May 1867, the first 60 veterans, including a musician from the War of 1812, moved to a single building on 400 rolling acres west of Milwaukee. By the end of the 19th century, the bustling campus boasted its own hospital, chapel, library, theater, and recreation hall, in addition to the grand main building. Subsequent wars and military conflicts created a need for additional buildings and services. Designated a National Historic Landmark in 2011, the campus continues to offer a healing environment for today's patients and stands as a testimony to advances in veteran health care.

In the World War I era, veterans fought for a unique right: access to government-sponsored health care. In the process, they built a pillar of American social policy. Burdens of War explores how the establishment of the veterans’ health system marked a reimagining of modern veterans’ benefits and signaled a pathbreaking validation of the power of professionalized institutional medical care. Adler reveals that a veterans’ health system came about incrementally, amid skepticism from legislators, doctors, and army officials concerned about the burden of long-term obligations, monetary or otherwise, to ex-service members. She shows how veterans’ welfare shifted from centering on pension and domicile care programs rooted in the nineteenth century to direct access to health services. She also traces the way that fluctuating ideals about hospitals and medical care influenced policy at the dusk of the Progressive Era; how race, class, and gender affected the health-related experiences of soldiers, veterans, and caregivers; and how interest groups capitalized on a tense political and social climate to bring about change. The book moves from the 1910s—when service members requested better treatment, Congress approved new facilities and increased funding, and elected officials expressed misgivings about who should have access to care—to the 1930s, when the economic crash prompted veterans to increasingly turn to hospitals for support while bureaucrats, politicians, and doctors attempted to rein in the system. By the eve of World War II, the roots of what would become the country’s largest integrated health care system were firmly planted and primed for growth. Drawing readers into a critical debate about the level of responsibility America bears for wounded service members, Burdens of War is a unique and moving case study. -- Jennifer D. Keene, Chapman University, author of Doughboys, the Great War, and the Remaking of America