To the Editor Massarweh et al1 studied temporal changes in morbidity and mortality following noncardiac surgery in Veterans Affairs (VA) institutions. In an accompanying Invited Commentary, Johanning and Arya2 state that the Original Investigation “serves notice that the quality and safety of surgical care in the VA system are on par with if not better than other large integrated health care systems,” a comment reiterated by Johanning in popular news outlets, such as Reuters.