In the wake of the unfolding Veteran’s Affairs book-cooking scandal, several thoughts float to the top of my cranial soft tissue, riding pulsating waves of vanilla-flavored elevator music. You know, music that sounds like someone tried to recreate the tin-needle ecstasy of an old music box with an 80’s model Casio keyboard. See, I had a few experiences dealing with the VA a few years back. Most of my elevator music memories probably stem from waiting on hold with the education department, but that doesn’t mean the medical side of things was smooth. I just don’t remember which "sitting on hold" marathon came from what. Details.

So, my thoughts float on that elevator music, and two separate bunches of thoughts form two separate memories. And then there’s a third thought about healthcare in this country, in general.

The first memory that comes to mind is not from the VA but from my time on active duty. I spent my first two years in the Air Force wandering around southern Wyoming, western Nebraska and northern Colorado. Well, one day I was wandering around Ft. Collins, Colorado, enjoying my weekly day off by going downtown to listen to horrible music in dimly-lit rooms where sweaty co-eds from Colorado State University tried to inspire the primal urges of one another through ritualistic displays of inebriated kinesthetics. Anyway. Before I went inside such darkened rooms I usually chewed some form of mint-flavored gum, understanding that true vanity is a pretty comprehensive regimen. However, one night, the gum was exceptionally sticky, and as I was walking from my car to the bar, said gum somehow dislodged one of the fillings in a back molar. I only have two fillings in there. Never even had a cavity until I was 19. But that’s beside the point, I guess.

I called the base dentist the next day to schedule an appointment. It was a little disconcerting to walk my tongue across the back row of teeth and feel a gaping hole where that filling had once been. But the worst part was that the dentist couldn’t get me in to re-fill the hole for another month.

A whole damn month.

Then, I finally get in there and the captain who filled it in called me names and made jokes about how little tooth I had left. I mean, that’s cool, but usually I had to do something stupid to piss off an officer enough to earn a good peg-knocking. I guess my presence was enough for this lady. Hard to say if she was simply socially awkward or just downright malicious, but the effect was the same. She also seemed to revel in the fact that she could be as abusive as she wanted without fear of any recourse. After all, I was just a lowly airman, and if I called her by the name I had secretly given her in my head I would have found myself standing at attention before my supervisors. I’m sure she’s proud of all the teeth she saved now, though.

I also remember my experiences with the VA after separating. On my two deployments to Iraq I was extremely lucky. The worst of my injuries included nagging pains in muscles and joints – nothing combat related. I get tinnitus in both ears. A muscle in my back has been aching ever since 2005, after wearing the vest, plates, ammo, etc., etc., for 12 hours straight. And my wrist has never really been the same ever since something "popped" while loading .50 Cal ammo cans into the back of a Humvee. But I’ve never filed a claim for any of this stuff. None of it is that bad. However, the VA came into the picture when some other vets informed me that Iraq and Afghanistan veterans could get five years of free healthcare through the VA.

Sweet, right?

Well, I decided to take them up on the offer just in case I could fix my back or wrist problems with physical therapy. The initial appointment was a month out from when I called. No big deal. I go in to a local clinic and talk to a doc for five minutes. I think they drew blood and asked me if I had AIDS and all that. Then I was sent home and told to wait for a notification from the VA hospital in Augusta, Ga. About a week later a letter came: the appointment was two months out. Cool.

The day rolls around and I drive two hours to get to Augusta, sit around and wait a little while despite the fact I had an appointment, and then I finally get seen by the physical therapy folks. The lady was very nice and all that, but she made me squeeze things with both hands and then told me that something was wrong with my wrist. Yeah, like I said. So she sends me to radiology. I waited there for about 45 minutes before getting my wrist X-rayed. And that took less than five minutes.

By the way, there were only a few other people in the waiting room, and they never moved.

And that was it. The next appointment was scheduled four months out. Four months. In the meantime, I was supposed to do the cool stretches and exercises contained on a sheet they printed out for me with cartoon pictures of a guy standing in weird positions. I did the stretches but life is what it is and I forgot about the appointment. When I tried to reschedule, they made it another four months out. That wouldmake it10 months between the initial clinic visit and my first physical therapy session. Needless to say I didn’t go back to Augusta.

Granted, my situation was not life-threatening, but it brings me to my third thought:

Single. Payer. Health. Care.

If you want to know how this country would manage a single-payer system, then look no further than the VA or military systems. Everything is a macro-view, devoid of understanding. You are either a "1" or a "0" in some type of spreadsheet or matrix or whatever fancy tools some lowest-bidder contractor pulled out of his nethers and sold to a panel of numerophiles who’ve never worked a day in the medical world. (This is partly my imagination, perhaps?)The management ethos hinges on questions like, "what is most cost-effective?" or "which does the least amount of political harm?" Seriously, think about it. It really doesn’t matter what you or your doctor decide.

The way the system is set up begs for abuse and abusive personalities. I didn’t even tell you about the time I had walking pneumonia and the base clinicians said they couldn’t see me and diagnosed me with "a cold" over the phone.

"Take some Motrin. Drink orange juice."

Awesome. Never mind the part (and yeah, I told them this) about how I can’t sleep at night because I’m too busy coughing up blood. Sure, Motrin and O.J.

Anyone who wants single-payer healthcare needs to consider the reality of the human element. No system can be perfect, and when you create one that insulates the operators within it from liability (like the dentist who knew I had no choice but to sit there and take the abuse), and when it is managed from the perspective of business-suited actuaries who live miles away from the actual patients and doctors, you will end up with a healthcare system just as superficial as that music they make you listen to after asking you to "hold."

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