Prior to ObamaCare small businesses just gave no medical insurance for their employees and those employees went to Medicaid when they visited the ED, who legal cannot turn them down.... Medicaid comes from our tax dollars, the average joe, who does not have huge tax deductions of a corporation (unlike our famous business man who has an infinite tax deduction carry over from his virtual loss of income in a business).
With regards to the VA, all we see the negative stuff of the VA, we never see the positive aspect of the VA. As someone who worked for the VA for two years, I tell you the system didn't leave anyone without the basic medications or management. The higher specialties is where it fails and for that I'm sure the US will always have a second subtle tier... sorta like how it is done in France or the UK.... I.e. If you need an allergist now and not in a month from now, then go pay for one.