Our series on the Veterans Administration Health Care system three weeks ago prompted its share of negative reaction, primarily from people who felt we had papered over problems with VA care.

For example, Vietnam War veteran John Howard of Billings said you can't usually just drop in at the VA's health clinic in Billings for an emergency or if you're sick, as you might at a private doctor's office or clinic.

"You can't say it's a real clinic," he said. "If you have anything, like a sore throat, they don't want to see you."

Howard, who works part-time as a substitute teacher, said he has private insurance to augment his eligibility for VA health care. He sees the VA for annual check-ups and gets a prescription blood-thinning medicine, Cumadin, to help with circulation in legs he injured while on active duty during the Vietnam War.

Howard said he was accidentally dragged by a car while stationed at Fort Myer in Virginia, injuring his legs. He's been trying to get the VA to say problems with his legs are "service-connected," which would cover more of his care at the VA -- although he says he doesn't have confidence in the VA's health system. He doesn't like the waits and other experiences he's had at the local clinic.

Howard also said he once was unable to get an X-ray at the VA clinic in Billings and had to get it from a private hospital. The VA covered the amount, but Howard said it went to a bill collector before the billing was straightened out and paid.

Howard's experiences highlight several aspects of the VA that he feels don't speak highly of its health care system. We'll talk more about them in a minute.

One, however, has little to do with health care provided by the VA: The determining of veterans' disability and eligibility for care.

Like Howard, thousands of veterans apply to the VA for higher disability ratings, which involves deciding how much of an injury or sickness may be "service-connected." A higher rating means more care is covered for free at VA Health Care.

It's well-known that vets have been seeing long delays in processing of these claims and appeals. In fact, one veterans group last year filed a class-action lawsuit over the delays. A federal judge in San Francisco ruled this summer that delays are occurring and harming people, but that he couldn't force the VA to overhaul its operations. The ruling has been appealed.

U.S. Sen. Jon Tester's office says Congress has been trying to address the backlog, funding more processors and appeals judges.

Yet this issue is one of access to the system -- not the quality of its medical care.

As for the VA's Billings outpatient clinic, it is one of 11 statewide. They aren't open after-hours and, as described by Howard, they don't generally function as drop-in centers or urgent-care centers.

They're used often for check-ups or to see primary-care doctors about problems that may need referrals to a VA-employed specialist at Fort Harrison in Helena.

Covered vets who need emergency care or are sick and can't get into a clinic can go to a private hospital or doctor. The VA will cover some or all of those costs for veterans with higher disability ratings.

In 2007, VA Health Care paid about $20 million in Montana for this outside care, or 15 percent of its entire budget.

VA Health Care officials said in a state like Montana, where access to care within the system isn't as good as in more urban settings, the VA often contracts out care with the private sector.

They also freely acknowledged that a weakness of this socialized system in a large, rural state like Montana is that vets may not have the best access to care.

Still, groups that represent veterans say they hold in high regard the medical care now provided by the system.

"Overall, the VA (health care) is doing a wonderful job, especially in Montana," says Mike Clouse, state commander of the Disabled American Veterans. "We have a lot of veterans who are not seeing the big picture, and that's that we have had a night-and-day conversion in care provided (compared to years ago)."

There also can be no doubt that VA Health Care, like any health system, rations its care. It does so, in part, by classifying eligible veterans into priority groups, giving free care to the highest priority, and making lower-priority groups make co-payments. It also has a budget approved by Congress, and shapes or "manages" its care to stay within that budget.

Of course, care is rationed in our private-sector health system as well: Those without good health insurance or adequate money get less care; those with good coverage get more care.

Some readers also asked why our stories didn't mention the 2007 scandal of substandard conditions at Walter Reed Army Medical Center in Maryland, suggesting that we ignored it because it cast a negative light on VA health care and "socialized" or government-run medicine.

Not so. We didn't mention Walter Reed because it is not a VA hospital. It is owned and operated by the U.S. Army and the Department of Defense, separate from the VA.

The Walter Reed scandal also revealed that the Army medical center was managed by a private contractor, with ties to oil/construction giant Halliburton and the Bush administration.