Combat patches: Are they for show or do they really mean something??

It's called the Combat Service Identification Badge, or CSIB.

Combat patches serve as a source of Esprit de corps. They identify those that were in the same units you served in combat, and gives an opening for meeting new friends and sharing experiences.
I am authorized to wear combat patches from the following five units:
US Military Assistance Command, Vietnam --
First Aviation Brigade --
23rd Infantry Division (Americal) --
196th Light Infantry Brigade --
5th Special Forces Group --
I wear the 5th Group patch but can identify with personnel I see and meet from the other units. That magic first question "Where did you serve in the 1st AVN / 5th Group / 23rd Div / 196th LIB / MACV?" is the ice breaker for many great conversations and finding new and lasting friendships.
I wear lapel pins showing service with MACVSOG-CCS and Project 404 for the same reason. I identify with individuals who served in those Special Ops programs.

RP is heavy with people worried about their pins, badges, patches, medals and distinctive headgear.
What they are for no longer matters

These patches symbolize what we have earned going to war to defend our country and stop terror in this world. We take pride in our patches . Would you rather we stop being the world police? Or going back to retire what we have damaged? We have floating hospitals for God sake! There is a lot that we do in this world .

It means something. It means that in some capacity you were present for the great show, or as the British used to say ... "You saw the elephant".
That being said, it is not "the end all and be all" that some would make it out.

In other branches patches mean something. The Marine Corp has patches but we don't wear them because the Eagle Globe and Anchor is our badge We are all warriors from the Commandant down to the Pvt. So we are all equal in that respect. Their have been many times in our history when Cooks, clerks and every MOS were used as infantry. Korea Chosin Reservoir Thanksgiving 1950 is a good example of that. I was 18 when I got out Bootcamp and ITR. I was just as Proud of that uniform as the commandant. Civilians respected us. especially the girls. Our uniforms were tailored to fit we didn't look like a sack of s---. The boots in the army should be trying to bring themselves up to the veterans level in the unit instead of dragging them down to the boots level so they don't feel bad.

I have one MACV patch I earned in the Navy as a Machinist on a River Patrol Boat Mobile Base 1. When discharged I continued my military career in the National Guard in Maryland first then Washington State. When I first entered the Guard the Company 1st SGT. said upon review of my records I'm allowed to wear the Military Assistance Command Vietnam Patch as it was a multi-service command (Air Force, Marine,Army and Navy). that patch means a hell of lot to me as I was 19 and scared out of my wits during my first rocket attack and from then on I was and still am hyper vigilant. Not many of my peers went and many protested the war I endured many sneers and outright disgusting remarks when I returned so now I wear my Vietnam Veteran hat and appreciate the welcome from strangers and other Vets too. The simple answer is yes, SGT, it means an American answered the call of Duty, Honor and Country. Fair Winds my friend.

This is something that was not part of the Army for the 14 years I was in, from the withdrawal from Vietnam to right before Gulf I. During my time, soldiers wore their current unit patch (TRADOC, FORSCOM, or a Division or separate Brigade/Battalion (I had 7th ID twice, 2nd ID, and TRADOC)) on one shoulder and if you were in a combat area (Vietnam, Panama as part of the Noriega arrest, or Grenada during the medical student rescue) you wore the unit patch from that action on the other. What exactly is the combat badge and wear is it worn?

I have a list of illnesses, including PTSD, and the memories of SCUDS and chemicals to convince me that yes, it means a whole lot to me.

I was proud to wear my combat patch from Vietnam and I stood out from the others when In was stationed in Germany that hadnt been there yet.