In any rational world, it would seem entirely sensible for the VA to create integrated healthcare records. Many observers might consider it odd that the department has not already done so. After all, America is a place of cutting-edge technology and digital entrepreneurial skills — just think of what Amazon, Facebook and Google have done. It is also a place where companies have been using digital technology for years; where the healthcare system accounts for a sixth of all economic activity; and where there are some 21 million veterans (equivalent to the entire populations of Norway, Sweden and Denmark combined).

在任何理性世界，退伍军人事务部创建完整统一的健康档案似乎都是完全合理的。许多观察人士可能感到奇怪——该部门居然还未完成这件事。毕竟，美国拥有大量尖端科技和数字创业技能——只需想想亚马逊(Amazon)、Facebook、谷歌(Google)取得的成就。美国企业多年前已开始利用数字技术；美国的医疗体系占全部经济活动的六分之一；美国有约2100万退伍军人（相当于挪威、瑞典和丹麦人口的总和）。

For the past two decades, however, the VA has repeatedly failed to implement an integrated record-keeping system (never mind that it has spent about $2bn on feasibility studies in recent years). While these delays can be blamed partly on mismanagement, the issues go well beyond that.

然而，过去20年，退伍军人事务部一直未能建立一个统一的健康档案保管系统（虽然近几年已在研究建立这一系统的可行性上花费了约20亿美元）。不断拖延部分可归咎于管理不善，但问题远不止于此。

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