Indian Health Service covers less services than the VA because of very limited mental health and substance abuse treatment. Still, according to the old numbers I found looking for a straight up comparison, the IHS spent $1,578 per patient per year while the VA spent $4,798. The numbers I found were only available because Congress asked the General Accounting Office to do a straight up comparison in 1967.

The numbers of veterans being treated for serious combat injuries might explain some of the differential. Medicare spends $5,450 but the entire service population is elderly, while the VA and the IHS only serve some elderly.

Under President Obama, VA health care funding has seen historic increases and, as important, he signed a law in 2009 that veterans’ groups had long sought requiring that VA health care be funded a year in advance. This became very important when Republicans took the House in 2010 and rendered Congress unable to pass gas.

On the other hand, the VA hospitals are dealing with the casualties of the longest war in US history as well as the two Iraq wars.

Given the challenges and my personal experience, why am I disinterested in taking Eric Shinseki’s hair? Both the VA and the IHS have too many patients for their resources. This is on Congress rather than Shinseki for the VA or Dr. Yvette Roubideaux for the IHS.