The ceilings hung squat and low, traced by fluorescent lights dotted among recessed tiles. The hallway was dingy, scraped paint along bare walls and floors that wouldn’t shine no matter the scrubbing applied. Worn signs hung on the bathroom doors, faded now after too many handprints, only half the words now visible. Someone redrew the head on the men’s bathroom symbol, but they’d drawn it square. Inside, a black Magic Markered smiley face stared out.
It didn’t look like a hospital. Or it didn’t look like an American hospital, particularly not one in a major city. American hospitals are shiny and well-lit, with glass walls and artwork lining the corridors. They are regal, siblings to university buildings and museums and federal government offices.
But this wasn’t. What came to mind was Cuba — the dark hallways and simple plastic-upholstered seats lining the waiting room walls in the public clinics, the cement stairwells and overcrowding.
But even in Cuba the lines of patients move. People get seen promptly. Not here.
The emergency department was full. Some people stood along the walls. The woman behind the desk said it was a five-hour wait, maybe more.
“Busy day?” my friend asked.
“No,” the woman said looking apologetic. “This isn’t bad.”
We sat down beneath an overhead television. It was 1 p.m. The afternoon soaps were on.
Seven hours later, the evening news was coming to a close. Our wait also was ending.
Welcome to the VA system.
I’ve heard not every Veterans Affairs hospital is the same. Some, I’m told, don’t feel caught in the Soviet era. I don’t know; I’m not a veteran, and I’ve only ever been to one VA hospital. But that one visit was disturbing enough.
My friend and I were in San Diego. Our visits to California overlapped by a few days, so we decided to team up for some surfing, snorkeling and exploring the city.
But on day two she began complaining of lower back pain. An Air Force vet, she Googled the local VA services. There was a hospital on the outskirts of the city, just outside La Jolla Cove where we’d been snorkeling the day before.
She looked at me. “This should be fun,” she said.
Being a veteran, she knew. I did not. But within a few steps of walking in the door I understood viscerally. All the news stories I’d heard in recent years came flooding back, about long wait times and how the head of the VA had resigned and the system was again due an overhaul. It was akin to walking into an inner-city school — one look was enough to know the facility was under-resourced, that the job it was expected to do far exceeded its capacity. Long waits, substandard care, lost files and missed diagnoses seemed to ooze from every exam room. This was less a hospital than a holding pen. Prisons are better equipped.
And sitting there I had ample time to consider the string of ironies I was witnessing. Here I was in a VA hospital, and I kept having flashbacks to Cuba, a country where the population lives on a fraction of the American standard. But despite appearances, Cuban hospitals get better results. Their version of socialized medicine competes favorably with the profit-driven system employed by the United States, and it blows the VA system out of the water. I was looking at America’s finest — the soldiers, airmen, seamen and Marines of the U.S. military — as they were served up the worst of American health care. Some of them may have even served on Cuban shores, may have stood guard on Guantanamo Bay, Cold War warriors who fought the spread of communism.
What did they earn in return for their service? Socialized medicine.
It almost made me laugh: Fight in honor of American values and you earn guaranteed free government-run health care. “Oppose communism to secure your place in socialism.” I doubt that made it onto many recruiting posters.
But there is a tragedy hidden within the comedy: The modern American application of socialized medicine offers veterans few gifts. They give us their best, and we give them our worst. The VA system is known for wait times that sometimes outlast patients, for diagnoses that come too late. “Support our troops” seems to only hold until the fighting is over. After that we leave them to die on quieter battlefields.
The problem, of course, is not socialized medicine. Plenty of countries pull that off at a high standard — most of Europe, Canada, Costa Rica. But the United States has proven incapable at setting up its own system, even for soldiers. That U.S. soldier who was stationed at Guantanamo Bay may have done better to wander off base to see a doctor than visit the hospitals provided by their own government.
So, every day we rob veterans of what they have earned. We underfund and understaff and under-resource to the point of no return, to the point that servicemen and women die as a result.
It’s easy to blame the bureaucracy, to rest at the myth government can’t run anything well and move on. But that is a farce. Government-run health care works worldwide, just not here.
But the VA has to work. Not marginally, not sluggishly, but well. Efficiently. Smoothly, with dynamism and grace. We owe it to every American willing to pledge more than taxes and a vote every four years for his or her country. It may not have been on the recruiting poster, but it is the promise we made.
And we’ve failed. For a generation now we’ve failed. We’ve accepted the myth that government can’t work, that socialized medicine is doomed to fail, and our soldiers have paid the price for it. Sagging buildings and five-hour wait times are not the best we can do. Our veterans are worth more than that.