The Shape of Things to Come?

Whenever the subject of health care reform comes up, there is almost no mention of the "single payer" system that's already at work in the United States.

And no, we're not talking about the gold-plated program for our elected officials, or the premium plans available to most federal and state employees. Many Americans forget about another group of government workers who make do with limited choices and care that is sometimes awful.

The "employees" in this case are members of the U.S. armed forces. Their health care is largely provided by the military's network of doctors, hospitals and clinics. The system is based on the obvious need to create a system capable of caring for personnel injured in combat. It is also a long-standing "benefit" of military service, promising low-cost (or "no cost") care for service members and their dependents.

To be fair, many military doctors and treatment facilities have a well-deserved reputation for excellence. The Air Force mobile hospital at Balad AB near Baghdad has saved literally thousands of wounded troops; many go on to state-of-the-art rehabilitation centers in the U.S. that have produced their own share of miracles.

But talk to anyone who's served in the military for any length of time, and you'll hear horror stories about a system that is often inadequate. In some cases, base pharmacies don't stock the latest medicines due to cost. Advanced medical treatment is also difficult to obtain; the only transplants conducted at military hospitals are kidney transplants, a procedure that was only offered decades after their introduction at civilian facilities.

In other cases, military medicine can kill you, or leave a patient disabled for life.

Consider the plight of Airman First Class Colton Read, an intelligence specialist assigned to Beale AFB, California. On 9 July, Airman Read underwent surgery to have his gallbladder removed laparoscopically at Travis AFB near Sacramento.

Laparoscope surgeries to take out a gallbladder have become routine in recent years. Doctors across the U.S. perform the procedure hundreds of times every day. But something went terribly wrong during Airman Read's surgery. Somehow, the surgical team nicked or punctured his aorta, the large blood vessel that carries blood from the heart to other parts of the body. Doctors managed to repair the damage enough to save Read's life, but the tear began leaking, disrupting blood flow to the lower extremities.

Airman Read was airlifted to the UC Davis Medical Center, where surgeons were forced to amputate both legs. Over the past two weeks, he's undergone 10 additional surgeries to remove dead tissue from what's left of his lower limbs. Meanwhile, the diseased gallbladder is still in his body; complications from the original, botched surgery have prevented surgeons from removing it.

The Air Force has launched an investigation into what went wrong in the operating room. Airman Read's military career is likely over and his family cannot sue the doctors who almost killed him. Thanks to a federal law called the Feres Doctrine, members of the armed forces (and their families) can't sue military doctors who make catastrophic medical mistakes.

A bill now before Congress would end the prohibition. Normally, we're not friends of the tort bar, but this is one situation which cries out for legal remedy.

What happened to Colton Read is hardly isolated. An organization called Veterans Equal Rights Protection Advocacy (VERPA) claims that hundreds of military members have died or left permanently disabled by incompetent military doctors. From our own experience, we know of cases where members of the armed forces were misdiagnosed.

In one example, a retired NCO was told his severe chest pain was nothing but "indigestion," and sent home. He died hours later of a massive heart attack. At the same military hospital, a woman complaining of low back pain was given Motrin and told to "rest." Two weeks later, she was diagnosed with terminal liver cancer. The Air Force doctor who made the original, mistaken diagnosis was later reassigned to administrative duties, not as a result of the mistake, but because the service couldn't confirm that the man (who was born overseas) had actually graduated from medical school.

If you want a taste of nationalized health care, just take a look at the military medical system. Some of us have seen the future--or Barack Obama's version of our medical future--and it isn't pretty.