There was a time, not long ago, when the VA health care system was thought of as the epitome of socialized medicine - our own equivalent to the British National Health Service (NHS).

Then the VA computerized and modernized.  A RAND study found VA care superior to the care at most other hospitals, on the average; although RAND noted that the VA did better on criteria it chose to measure itself by.

Now, on the eve of Walter Reed revelations, a Miami Herald investigation (using the Freedom of Information Act) brings back images of the NHS, at least with respect to mental health care:

• Despite a decade-long effort to treat veterans at all VA locations, nearly 100 local VA clinics provided virtually no mental health care in 2005; the average veteran with psychiatric troubles gets almost one-third fewer visits with specialists than he would have received a decade ago.
• Mental health care is wildly inconsistent from state to state; in some places, veterans get individual psychotherapy sessions while in others, they meet mostly for group therapy.
• In some of its medical centers, the VA spends as much as $2,000 for outpatient psychiatric treatment for each veteran; in others, the outlay is only $500.

The uneven mental health treatment of veterans across the country is attributed to the VA's health system reorganization, which gave a lot of leeway to local managers.

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