Yeah the VA sends my stuff in the mail where ever I tell them to. It is a pretty good system but it can still improve. A couple of years ago in San Diego I went to the ER at the VA hospital on La Jolla Village in the hopes of safely passing a stone and I was already alternating between writhing in pain and feeling fine, anyone who has experienced renal colic doesn't need an explanation. It was about 1AM. I was between attacks and I calmly explained my emergency, was told I would have to wait about 7 hours and "here, take this paperwork and wait over there". By the time I got back to my dad's van I was in agony again.
My dad suggested we go to Mexico and within half an hour I was across the border headed to a privately owned urgent care clinic with public options. When I arrived there, I was not asked how I could pay for it. I was asked by a doctor (who offered to speak with me in English) what my symptoms were, how long I had been experiencing them, etc. I was in the middle of an attack at that particular moment. Within two minutes of my arrival, I was on a bed and being prepared for the insertion of a catheter. Another nurse was already giving me injections and had an iv bag set up before they even knew my name.
By dawn, I was ready to have the catheter removed as the stone was too big to enter it, so simply by removing it I could finish passing the stone. Within an hour I was paying less than $800 US for the whole thing and walking out with prescriptions filled. That was a 7mm calcium stone. It took four hours to get back to the US side of the line.