While Iraq has loomed large in foreign policy in the last
two years, America’s ongoing military operations carry an important lesson for
domestic policy, as well. In a bitter twist of fate, the stateside treatment of
wounded veterans illustrates the dangers of government-run health care.
The most dramatic example of depending on government comes
from the shocking plight of a group of World War II vets. As detailed by a
recent account in the Detroit Free Press, roughly 70,000 U.S. military
personnel were Pentagon guinea pigs in tests of chemical weapons agents.
Though the men suffered skin cancers, blistered genitals
and other ill effects from the poison, the federal government first denied that
such tests even took place. It was not until 1991, under pressure from Congress,
that it relented. The Department of Veterans Affairs promised to take care of
the affected veterans.
The VA is best known for its extensive system of hospitals,
but the Free Press found that the agency has done little to help those who
suffered from the tests. Veterans who file claims have received perfunctory form
letters denying treatment.
Unfortunately, the VA is also failing the veterans of more
recent conflicts, such as the Gulf War. As
The Detroit News has reported,
Michigan veterans face unacceptable delays in getting adequate medical
Marine Cpl. Chuck McCall of Dearborn, for example, paid two
different visits to a VA office in Detroit, waiting a total of 14 hours before
being able to talk with anyone. He told The News that medical benefits were then
denied on grounds, apparently mistaken, that "he earned too much money fighting
in Iraq to qualify."
McCall is not alone. The News reports that during the 12
months prior to October 2004, the number of cases of veterans waiting more than
180 days for benefits approval rose 25 percent, to more than 71,000. In
metropolitan Detroit, 1,400 new cases are added each month, and the backlog of
claims is already near 7,000.
Phil Budahn, a VA spokesman, told The News that the
department should be able to handle the load. He points out that there are still
only 30,000 to 35,000 veterans of the war on terrorism. This is a small portion
of the 5 million veterans that the VA is theoretically prepared to handle.
But there is little reason to think that the problem of
insufficient facilities — a de facto rationing system — will go away anytime
soon. Extensive waits exist around the country, especially in the South, where
construction of new facilities has not kept up with the migration of veterans to
Sunbelt states. Meanwhile, veterans in the Northeast live in fear of the closure
of VA hospitals.
To see how the capacity problem lingers over time, consider
the Bay Pines Veterans Medical Center, near St. Petersburg, Fla. In 1994, Robert
E. Bauman, a former VA official, estimated in a
study for the Cato Institute that
waiting times for nonemergency surgery at the facility ranged anywhere from two
to 18 months. In 2002, the nonprofit Heartland Institute’s
Health Care News reported that 4,400 veterans seeking care at the Center
would wait more than three years before their first appointment.
The U.S. government, through the VA, runs the most
extensive health care system in the country. If there was ever a government-run
health care system that should work right, it would be the one charged with
upholding the moral promise of supporting veterans who have served and suffered
for their country. Yet even this promise, and the extensive political power of
veterans, is not enough to deliver timely, adequate care.
The VA, despite its money and many dedicated medical personnel, shares the problem of all government-run health systems: top-down bureaucracy that is shielded from meaningful competition for the customers it is supposed to serve. As a result, it promises far more than it delivers and effectively discourages many patients from seeking proper care.
"Free" health care isn’t so free, it turns out. Sadly, the
plight of America’s veterans serves to illustrate that point yet again.
John R. LaPlante is an adjunct scholar for the Mackinac
Center for Public Policy, a research and educational institute headquartered in
Midland, Mich. Permission to reprint in whole or in part is hereby granted,
provided that the author and the Center are properly cited.
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Copyright © 2004 Mackinac Center for Public Policy