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.
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