Money, so they say, is the root of all evil today.

In the continuing furor over care at Walter Reed, it seems even more bizarre that the VA system is considered to be the best healthcare system in America according to any number of recent surveys...until you realize that the two statements I just made have no relation to each other at all. Walter Reed, like many of the problematic medical facilities out there, is a military hospital run by the Department of Defense, in this case by the Army. Bethesda Naval hospital, as the name implies, is run by that service branch. The VA system, on the contrary, is run by the Department of Veterans' Affairs, a completely different branch of the government. The latter has been hurt lately by an influx of new wounded veterans without a corresponding increase in its budget and the fact that it's current head, Jim Nicholson, is a Republican toady:

He has been accused by some veterans and the organizations that represent them of being primarily a mouthpiece for the Bush administration and of being slow to respond to increasing strains on his agency as returning soldiers move from facilities like Walter Reed, which is run by the Defense Department, into the veterans affairs system.

Critics say he has under-emphasized his agency’s budget needs to Congress, has not responded to calls for more mental health workers and brain trauma specialists and has failed to overhaul disability claims procedures. Some leaders of veterans groups say Mr. Nicholson is less communicative than his predecessors.

Still, VA care is among the best in the country, as this Washington Monthly story demonstrates:

And so it goes today. If the debate is over health-care reform, it won't be long before some free-market conservative will jump up and say that the sorry shape of the nation's veterans hospitals just proves what happens when government gets into the health-care business. And if he's a true believer, he'll then probably go on to suggest, quoting William Safire and other free marketers, that the government should just shut down the whole miserable system and provide veterans with health-care vouchers.

Yet here's a curious fact that few conservatives or liberals know. Who do you think receives higher-quality health care. Medicare patients who are free to pick their own doctors and specialists? Or aging veterans stuck in those presumably filthy VA hospitals with their antiquated equipment, uncaring administrators, and incompetent staff? An answer came in 2003, when the prestigious New England Journal of Medicine published a study that compared veterans health facilities on 11 measures of quality with fee-for-service Medicare. On all 11 measures, the quality of care in veterans facilities proved to be "significantly better."

Here's another curious fact. The Annals of Internal Medicine recently published a study that compared veterans health facilities with commercial managed-care systems in their treatment of diabetes patients. In seven out of seven measures of quality, the VA provided better care.

It gets stranger. Pushed by large employers who are eager to know what they are buying when they purchase health care for their employees, an outfit called the National Committee for Quality Assurance today ranks health-care plans on 17 different performance measures. These include how well the plans manage high blood pressure or how precisely they adhere to standard protocols of evidence-based medicine such as prescribing beta blockers for patients recovering from a heart attack. Winning NCQA's seal of approval is the gold standard in the health-care industry. And who do you suppose this year's winner is: Johns Hopkins? Mayo Clinic? Massachusetts General? Nope. In every single category, the VHA system outperforms the highest rated non-VHA hospitals.

Not convinced? Consider what vets themselves think. Sure, it's not hard to find vets who complain about difficulties in establishing eligibility. Many are outraged that the Bush administration has decided to deny previously promised health-care benefits to veterans who don't have service-related illnesses or who can't meet a strict means test. Yet these grievances are about access to the system, not about the quality of care received by those who get in. Veterans groups tenaciously defend the VHA and applaud its turnaround. "The quality of care is outstanding," says Peter Gayton, deputy director for veterans affairs and rehabilitation at the American Legion. In the latest independent survey, 81 percent of VHA hospital patients express satisfaction with the care they receive, compared to 77 percent of Medicare and Medicaid patients.

No, the current problem lies with Walter Reed and the military's hospital management. In many ways, they are suffering from the same problem as a number of government agencies do: complete hubris and incompetence in the face of a Congress and media that basically spent six years ignoring their roles as guardians of the public interest. Just like the Justice Department decided that it could can a bunch of US Attorneys and no one would notice, just like the administration decided to put cronies in charge of FEMA and no one would notice, just like they decided to make up the reasons to fight a war, and are trying to do it again, hoping no one will notice...it's just the way that they operate.

If I told you that Halliburton is ultimately at fault, would you be shocked? At this point, you shouldn't, because Halliburton's fingerprints are all over the scandal:

In a letter from the committee to Weightman, the members said the Garibaldi memo “describes how the Army’s decision to privatize support services at Walter Reed Army Medical Center was causing an exodus of ‘highly skilled and experienced personnel.’ ... According to multiple sources, the decision to privatize support services at Walter Reed led to a precipitous drop in support personnel at Walter Reed.”

The committee’s letter also noted that Walter Reed awarded a five-year, $120 million contract to IAP Worldwide Services, which is run by Al Neffgen, a former senior Halliburton official.

The committee also noted that more than 300 federal employees providing facilities management services at Walter Reed dropped to fewer than 60 by Feb. 3, the day before IAP took over facilities management. IAP replaced the remaining 60 employees with 50 private workers.

“The conditions that have been described at Walter Reed are disgraceful,” the committee statement said.

“Part of our mission on the oversight committee is to investigate what led to the breakdown in services. It would be reprehensible if the deplorable conditions were caused or aggravated by an ideological commitment to privatize government services regardless of the costs to taxpayers and the consequences for wounded soldiers.”

The committee letter said the Defense Department “systemically” tried to replace federal workers at Walter Reed with private companies for facilities management, patient care and guard duty — a process that began in 2000.

“But the push to privatize support services there accelerated under President Bush’s ‘competitive sourcing’ initiative, which was launched in 2002,” the committee letter states.

During the year between awarding the contract to IAP and when the company started, “skilled government workers apparently began leaving Walter Reed in droves,” the letter states.

“The memorandum also indicates that officials at the highest levels of Walter Reed and the U.S. Army Medical Command were informed about the dangers of privatization, but appeared to do little to prevent them.”

The memo signed by Garibaldi requests more federal employees because the hospital mission has grown “significantly” during the wars in Iraq and Afghanistan. It states that medical command did not concur with their request for more people.

“Without favorable consideration of these requests,” Garibaldi wrote, “[Walter Reed Army Medical Center] Base Operations and patient care services are at risk of mission failure.”

Seriously, it's not a new scandal each time, it's the same scandal being created by the same folks, whose effect always seems to be to poison this country. It's not that all of them are evil, though some may be, it's just that they don't really give a shit, and that's a bad thing for the people running the country to think.