As a third-year medical student in the 1990s, my wife did her surgical rotation at a Veterans Health Administration (VHA) facility. "The guys were great," she says, referring to the patients. "But the place was a dump."
She keeps remembering the flies that circled over a patient in an operating room during an open heart procedure.
A friend of mine, a Vietnam vet, experienced the VHA from the other side, as a patient. He couldn't get in to see a specialist during one of his bouts of health trouble so a nurse got on Skype and described his heart beat to a physician a hundred miles away.
There is such a thing as telemedicine, which brings far-flung patients closer to medical care through the miracle of electronic connections. Saying "thump-a-thump-a-thump-a…" into an old Dell laptop ain't it.
The VHA's problems go far beyond secret waiting lists and canceled appointments. Yes, it's bad that facilities delay the delivery of care to veterans into a future sometimes so distant that the would-be patients are more of a concern for morticians than for physicians by the time they make it to the front of the line. But the sad fact is that the care they finally receive often sucks.
In 2010, well before the current scandal, the Los Angeles Times reported, "Many veterans wounded in Iraq and Afghanistan are being buffeted by a VA disability system clogged by delays, lost paperwork, redundant exams, denials of claims and inconsistent diagnoses."
Three years earlier, Newsweek found "a grim portrait of an overloaded bureaucracy cluttered with red tape; veterans having to wait weeks or months for mental health care and other appointments, families sliding into debt as VA case managers study disability claims over many months, and the seriously wounded requiring help from outside experts just to understand the VA's arcane system of rights and benefits."
In 2008, the Department of Veterans Affairs' own Inspector General found lethal "pre-operative, intra-operative, and post-operative quality of care issues" at its Marion, Illinois, facility that resulted in "a mortality rate that was over four times the expected rate." It even discovered unqualified doctors performing procedures, and others practicing despite disqualifying disciplinary records.
The report conceded that the VHA has no real way to check its physicians' past for discipline issues.
I wrote the other day that the care provided to veterans by the United States government, in its facilities, on the taxpayer dime, is an all-too-typical example of what to expect from single-payer, government-run health systems. That's true.
The real threat to veterans in need of medical care isn't a passing scandal about bureaucratic delays and cover-ups; it's a history of shitty care provided by a system that's not really capable of offering better.