A challenge to raise the debate on health care infrastructure.

I hadn't anything to do on the Saturday evening before the recent American Association of Physicists in Medicine conference got under way in Minneapolis, so I took the advice of a hotel worker and walked to the banks of the Mississippi River to watch a fireworks display. For 30 minutes, the sky lit up and the thunder of exploding pyrotechnics echoed through the canyons of office towers. The display was launched from one of the many bridges that span Old Man River. A week to the day after I left Minneapolis, one of those bridges collapsed. As I write this, the death toll climbs, but is still miraculously small.

The investigation has begun, but more than that, a national review of bridges has commenced. More than a decade ago, I led a team of journalists in a review of bridges throughout Texas, which showed an alarming number of deficiencies. Little progress has been made since because maintaining bridges isn't something that garners politicians a lot of votes.

It's not just that the government is falling behind on the upkeep of bridges and roads, but other vital links as well. In their haste to cut waste, the feds have targeted $11 billion in cuts from Medicare and Medicaid. About one quarter of that will come out of imaging services. That's shortsighted any way you look at it, but it's not just hospitals and private clinics that are suffering—and let there be no doubt, they are.

Even the government's own medical facilities are being pinched. A year after auditors started looking into a Veterans Administration hospital in Florida, mammograms were still not being interpreted in a timely manner, radiological examinations were being ordered inappropriately, and managers were not adequately monitoring radiology productivity. What good is equipment if the staffing and training aren't there to support it?

Another audit released in July with the lyrical title "VA and DoD Are Making Progress in Sharing Medical Information, but Remain Far from Having Comprehensive Electronic Medical Records"—I'm not making that up—found that the government continues to dump hundreds of millions of dollars into data storage devices that can't communicate with each other.

The $1.4 billion Veterans Affairs and the Department of Defense have spent on their records systems is only a small part of the $40 billion in Deficit Reduction Act cuts, but it's those small cracks that ultimately lead to collapse.

We hear a lot in political debates—of which there seems to have already been 1,000 even before Labor Day, the traditional start of campaign season—about supporting our troops and homeland security. How about starting in the facilities that are supposed to care for them? How about making our homeland secure, not only for our wounded veterans but also for the old, who have already lived through wars? How about doing the same for the young? That would be a sound investment in our nation's infrastructure. I'd like my future leaders to be healthy.

Here's my call to the various medical associations reading this: Demand answers of our candidates. We have a little over a year until Election Day and in that time, push them to move beyond universal health care platitudes and medical savings accounts rhetoric and give some straight answers on how they're going to take care of our countrymen. To the individuals reading this: Raise those same questions when a presidential wannabe stumps in your town. Think these things aren't sexy? The questions relate directly to health care, homeland security, job security—in short, you—and there seems to be a great disconnect between some of those very real issues and the messages being delivered by politicians.

I challenge you to bridge the gap.

Dan Anderson
Editorial Director