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'If You Have a Choice Between Going to a Dumpster or to a VA Hospital, Head for the Dumpster Every Time'

'If You Have a Choice Between Going to a Dumpster or to a VA Hospital, Head for the Dumpster Every Time'

Brutally honest and politically incorrect, this unofficial advice was given just before I retired from the US Army. My 30-year career was challenging but consisted mostly of garrison assignments typical of the Cold War. My retirement health challenges were smoothly handled by Tricare, the public-private health-care partnership used by most military retirees.

All that changed after 9/11, when the military pivoted to the new normal of a permanently deployed expeditionary force. According to a recent RAND Study, nearly 75% of all American soldiers are now on their third or fourth combat deployment. 

Whether their wounds involved lost limbs, traumatic brain injuries, or post-traumatic stress disorder, the Veterans Administration was – and still is – unprepared for the new generation of combat veterans.

No one should have been surprised that the VA – a classic traditional, top-down hierarchy – reacted with typical bureaucratic subterfuge, including lying, lost records and phantom waiting lists. Here’s why:

Rule #1In government organizations, everything always rolls downhill. You carry out Washington’s orders even when they no longer make sense, even if that means doctoring the patient waiting lists. The vets wait forever for an appointment but executive bonuses still get paid, because of…

Rule #2Don’t rock the boat. VA is a bureaucracy which takes care of itself first and the vet second – but only if no one makes waves. Its procedures and organizations are eternal and time-tested, meaning that nothing much has changed since Vietnam. So if whistle-blowing begins just because some malcontents had the nerve to die, the VA instinctively circles the wagons and promises to get to the bottom of things. But mostly they just mumble until the threat of accountability dies too. 

Rule #3No one ever gets fired. Although some dedicated public servants work for the VA, its bureaucracy is the medical equivalent of academic tenure. If you are a supervisor conscientious enough to set and enforce standards, you can expect to be accused of sexism, racism, or worse. Don’t be surprised if your superiors won’t back you up either (see Rule #2). The whole system resembles the Soviet economy where foot-soldiers in the worker’s paradise grumbled, “We pretend to work and they pretend to pay us.” Same idea at VA, except we pay them a lot more.

Rule 4: Who they gonna’ call? Any bureaucratic crisis inevitably has three phases: They ignore you, then dispute your findings, and finally attack you personally. But stonewalling at VA makes sense because today’s vets represent just one-half of one percent of the American people. Since more than 99% of us don’t serve anyone except ourselves, just how long do you expect public outrage to endure? That’s a tough question, but every VA bureaucrat is betting that his department, his supervisors, and their internal agendas will endure a lot longer.

They might be wrong, because the White House just appointed a top aide to spend time over at VA finding already well-known facts. Maybe they’re worried that Breitbart or Fox News will start pointing out that the current debacle shows what can happen with socialized medicine, including Obamacare. The alternative, at least for the veteran, is the Tricare system mentioned above.

I live in San Antonio, now rivaling Houston as a center of medical excellence. After my third stroke, Tricare allowed me to be treated at a leading civilian hospital, where I met Dr. David Friedman. “Colonel, I’ve done some genetic testing. Your clotting factors are 80 times higher than average, which is why you’re having these strokes.” That was five years ago, all of them stroke-free because Tricare allows Dr. Friedman to check my blood thinners every six weeks. Hey, you like your doctor, Tricare allows you to keep your doctor, right?

Even had I been lucky enough to get an appointment, would the VA have been that good? Nope, I don’t think so either. So why not kill a dysfunctional bureaucracy before it kills another veteran – while gobbling up our tax dollars? After fighting in Iraq and Afghanistan, haven’t those kids suffered enough?

Colonel (Ret.) Kenneth Allard is a former draftee, Dean of the National War College and military analyst for NBC News.

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