In 2005, Phillip Longman, a senior fellow at the New America Foundation, published an article entitled "Best Care Anywhere" in the Washington Monthly. The article, which later became a book (which I blurbed), made an unexpected argument: the Veterans' Administration's health-care system had quietly become one of the best — if not the best — health systems anywhere.
Longman's evidence was expansive. A 2003 New England Journal of Medicine compared the VA with Medicare on 11 measures of quality. "On all 11 measures, the quality of care in veterans facilities proved to be ‘significantly better.'" The Annals of Internal Medicine published a study that compared VA facilities with private managed-care systems in their treatment of diabetes patients. "In seven out of seven measures of quality, the VA provided better care." The National Committee for Quality Assurance ranks health-care plans on 17 different performance measures. "In every single category," Longman wrote, "the VHA system outperforms the highest rated non-VHA hospitals."
Then there was the testimony of the veterans themselves. "The quality of care is outstanding," Peter Gayton, deputy director for veterans affairs and rehabilitation at the American Legion, told Longman. A survey found that 81 percent of VA hospital patients were satisfied with the care they received compared to 77 percent of Medicare and Medicaid patients.
The VA's reputation isn't nearly as good right now. Secret waiting lists in Phoenix are alleged to have contributed to the deaths of 40 veterans. VA hospitals across the country are under investigation for similar malpractice. Some are calling for Department of Veterans' Affairs Secretary Eric Shinseki's resignation. (Read Vox's explainer on the VA scandals here.) So I asked Longman: was he wrong about the VA then? Or are we getting the story wrong now? A lightly edited transcript of our interview follows.