Another Fine VA Mess

Long time readers already know I have Crohn’s Disease. I’ve dealt with the condition for almost 22 years, and for large chunks of that time I’ve relied on the Veteran’s Administration Health Care System for medical treatment. As such, I remember the bad ol’ days – when simply signing up for medical care was nearly impossible. The program has made great strides in the past decade and medical care has improved. This isn’t to say the available care is good everywhere; it simply means that fewer VA medical centers seem to have killing veterans as their top priority. I’m also more fortunate than most vets. Because of where I live, I can actually pick and choose from four medical centers. If I lived in Montana, that option wouldn’t exist – I would be stuck with whatever quacks the local VAMC could find to staff the place.

But beyond the quality of medical treatment, there is another problem that, quite frankly, I can’t see any way the VA can correct. The Veteran’s Administration is a government agency – and as such, a ridiculously bureaucratic nightmare to navigate. Just the simple process of checking in for an appointment is a time consuming mess (it means seeing three different clerks, in different offices, before actually getting into the clinic – where you then need to fight with another clerk in order to see a specific doctor).

But there’s another aspect to the bureaucracy that most people (especially those who defend government programs as both necessary and infallible) often forget about: that bureaucracy is staffed by people whose competence is often less important to keeping their position than a host of other factors. A perfect example is what I am now experiencing. Because I’ve been dealing with Crohn’s for so long and every other medication ceased working, I’m now undergoing chemotherapy treatments. It’s a “Hail Mary” attempt at getting this disease under control and it actually seemed to be working.

Enter the VA bureaucracy. As part of the treatment regimen, I stopped the infusion therapy and was supposed to switch over to pills. Great! Fewer trips to the local VAMC, no need to hit up friends for rides, fewer side effects. The pills were supposed to be mailed to me two weeks ago. When they hadn’t arrived by last Wednesday, I spent 45 minutes on the phone to ask where my medication was. Not to worry, I was assured. Because of the holiday weekend, it might take an extra day or two for them to arrive in my mailbox. The weekend came, the weekend went and still no pills. I called back today and after another 38 minutes (most spent on hold), I discovered that somebody, somewhere, placed a “Do Not Mail” flag on my VA pharmacy account. No reason, no rhyme, no excuse – and the faceless person on the other end of the phone assured me they were incapable of releasing the flag.

But wait! It gets even better. A week and a half ago (three days after the pills were supposedly mailed), I spent another hour at the VA pharmacy to get other prescriptions. The clerks (another bureaucratic mess, you need to see four clerks to get a prescription filled – and there isn’t even a paper form, it’s all in the computer) all had access to my account. All of them saw the prescription in question was ordered, one even asked me if I wanted to wait for that one, too. Not one mentioned the “Do Not Mail” flag or offered to remove it.

Is it incompetence? Bureaucratic overlap? A simple failure to communicate? Whatever the cause, the result is the same: another dissatisfied and confused customer. On the surface, an example of how the Veteran’s Administration can screw up a simple task. At a deeper level, it’s a perfect metaphor for why the less government does, the better.

For my friends wondering how I can simultaneously avail myself of a government program and decry government programs, you can find extensive arguments in my archives. But this is an earned benefit, through my prior service to our nation. And for myself and the millions of my fellow veterans, the VAHCS can be done away with by simply issuing us medical insurance that allows us to see private physicians. (Yep, it would cost the government less, too).