(Editor's note: This is an edited version of a commentary that was originally published Dec. 3, 2004.)
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 U.S. government, through the Department of Veterans Affairs, 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 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 treatment.
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 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.