Health Care

Discussion in 'Off Topic' started by Pima, Jul 4, 2009.

  1. Pima

    Pima Parent

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    Many senators are now saying they want to use tri-care or VA as the model for the NHS. Over on CC, people have truly bought into the idea that the military has the best system.

    What gets my goat is they say that it is free. None of them believe Bullet and I pay for it, have deductibles, limits and can't go to any doctor we chose, but are sent to pre-determined docs. My other thing I can't get, these same people who say the VA system (non-military members) is great were the same that 2 yrs ago calling out Bush and DOD because of Walter Reed.
     
  2. Capt MJ

    Capt MJ Member

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    Good post, Pima. We are watching the whole healthcare issue very closely, especially the discussion on taxing healthcare benefits!

    Husband just had finger joint surgery this month at VA in Baltimore; it was a 10 month wait after the original consult. Since it wasn't urgent, "just painful," he had to wait Space A for a slot on the surgical schedule. Good news, the bone surgeon and the plastic surgeon were both senior Johns Hopkins surgery residents on a VA rotation. Excellent quality of care. They both commented "this should have been taken care of months ago." Bad news, this is what single-payer healthcare could be -- months of waiting for non-urgent procedures, despite acute pain everytime the poor guy accidentally bumped the joint. He also has the USFHP Johns Hopkins plan, the TRICARE-funded program operating the same way as TRICARE Prime. The doc who looked at the problem initially was at the VA, so he went that way. He had no idea it would take so long, then he got annoyed enough to wait it out to see just how long it would take.

    I need to do a lot more reading on the issues and various proposals floating around.
     
  3. Just_A_Mom

    Just_A_Mom Member

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    It already is.
    I have one of the top medical insurance plans. We can go to nearly any doctor or hospital. One of my girls had had to wait months to get a consult with an orthopedic surgeon. She also waits 4-5 month wait for an appointment with her dermatologist.
    A couple of years ago her family dr referred her "urgently" to a GI dr. and for some "Urgent" medical testing. The wait was 3 weeks for the dr and another 2 weeks for the medical test.

    For the first 22 years of my life I was a product of military medicine. This was back in the day - before Tricare and when military hospitals were more abundant. It was also before flyers had concierge flight surgeons to take care of the family. We always got good prompt medical care.
    I have always thought the military medicine model was a good one. Military medicine has always been on the cutting edge - they gave us Physician Assistants and Nurse Practitioners. Two professions that met resistance (still do in some areas) in the civilian world. They basically have figured out how to deliver good care to lots of soldiers and their families.

    This is how the rest of the world lives.
    Even though you pay for your healthcare through Tricare - realize that you are set for life. You have freedoms that other working folks just don't have. You can switch jobs without fear of losing insurance or being in a position where paying for it is simply unaffordable. My employer pays $13,000/year for my family plan. If I quit my job or got laid off then Cobra is over $1000/month.
    I have a recent college grad who would have to pay over $400/month for Cobra.

    I am thankful that my parents had Tricare in retirement. My mom lived with a progressive, chronic disease for 15 years. She split her time between two states and was blessed with fabulous health care. Even when she went on Medicare, she still had tricare. She barely paid for anything even with mulitple medicince, medical equipment, specialists and ICU visits.
     
  4. Pima

    Pima Parent

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    I do understand that point JAM, and I would have no problem if people posed it that way, but they don't. Sorry to hear about your daughter and orthopaedics, I can relate to it.

    We only use tri-care as our 20% share when we have a co-pay, which with our Aetna plan is only for the pharmacy. With our Aetna plan, I called the doc on Monday and was in on Thursday for my knee with an ortho surgeon, for 8 sets of x-rays, the visit and my prescription, the bill was nothing. We pay (I think it is 138/mo for the ENTIRE FAMILY of 5), no co-pay, no deductible and no referral needed. For tri-care we pay 123/mo, with a co-pay and it does not cover vision or braces, Aetna does, including contacts and 2 yrly visits. I also would be placed into the referral system if I used them for my knee. As you can see a lot has to do with your plan, and where you live. DS went to the doc on Monday, found out he had acute tonsilitis, he had an appt with an ENT for Fri (until they realized they were closing early) he goes now on Weds. Again, I think it is where you live and how your plan is designed, to me that is something I think should be worked on. Sincerely I believe that because I can't get how we have this great plan and pay 15 a month more than Tri-Care, why can't it all be the same!

    Finally, people need to realize that ret. families are being forced into tri-care and paying deductibles, because the system is overburdened. In No VA they are not accepting any new retirees, that covers, Bethesda, Andrews, Walter Reed, Fairfax family and Prince William family (satellite offices opened 7 days a week, and 2 nights), Ft. Belvoir, and Quantico, Bolling. I am sure I missed some, but even if you say the system is great it does not help one bit, when you can't get into a doc. I am allowed using tri-care to visit certain docs, and even in tri-care their 1st question is prime or standard, because some don't take standard.

    I am not trying to bad mouth the VA and tri-care, but I think people have a utopian belief that the VA system is the magic pill, when in fact it is over burdened and actually needs to be re-addressed. The VA system will now have a lot more soldiers to care for because of Iraq and Afghanistan on top of longer life expectancy. From 1974-1990, they weren't facing as many vets being covered as they do now. Our cousin went to Iraq and was medically dq from the Army b/c he got heat stroke (big shocker there, August, Kevlar and in a tank), he now has lifetime coverage. He was discharged from the Army as a 1st Lt.
     
    Last edited: Jul 5, 2009
  5. Just_A_Mom

    Just_A_Mom Member

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    Allow me to further clarify - the Model is a good one. The system itself has some problems - true retirees have a hard time getting care at military hospitals but there are far fewer now.
    My dad retired close to a military hospital that closed in the 90's. All my mother's care was at civilian hospitals. My dad was convinced over several ICU visits that her good care was a direct result of Tri-care. She was never once rushed out.
    The situation with Walter Reed was an unplanned for survival rate for seriously injured soldiers from the war. Similar with the VA system.
     
  6. Capt MJ

    Capt MJ Member

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    Let me stipulate I am truly grateful for the care my husband and I receive through TRICARE Prime, the USFHP Johns Hopkins and the VA. First priority should be the care of active duty and combat wounded. We're happy to wait and realize minor surgery on a finger is w-a-a-y down the priority list from those who are grievously wounded or ill.
     
  7. Pima

    Pima Parent

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    I think Capt we all would give up our spot for any ad member, IMHO, they are serving and pay the dues today, luckily Bullet was never injured and we have our sep. insurance. It was never my intention to go to the base, but under our tri-care, we first must be shut out before they will allow us to go off base, otherwise tri-care would not cover us. What was scary to me was that I had to register with 7 hospitals, and all 7 were not accepting, thus even the Tri-Care system is over burdened.

    Our friends of 15 yrs were over for dinner tonight, he retired in 01 and never took SW airline insurance for the family b/c they are close to a base and are in the system. They received a letter asking them to disenroll if they had a 2nd ins. company because of the burden. Also she has medical issues(allergies), and the base did not have the prescription so she had to fill off base, her bill was $44.00 co-pay for 32 pills. The reason why is that the pharmicists stated tri-care rules are 1 presc is for 30 days, thus $22 co-pay, she had 32 pills, so the 2 extra, even prescribed by the doc was deemed a 2nd prescription. The base never charged her 2 co-pays, but once she went off base (forced to since the base didn't have it), they lived by the beauracratic policies...tri-care states this, so we will do this. Things like that happening frightens me when tri-care and the VA are being used as a model for every American.
     
  8. kp2001

    kp2001 USMMA Alumnus

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    Please tell them to use 'The Mail Order Pharmacy' (aka TMOP) option with Tricare for your friend's prescription. Through this program they will be able to get three months of the prescription for the copay of one month. It is a program that not enough people take advantage of. And if they decide to not do that make sure their physician only writes for 30 pills at a time so they don't get charged like that again as some of the Tricare pharmacy rules are quite arcane.
     
  9. Just_A_Mom

    Just_A_Mom Member

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    Pima - those tri-care rules for prescriptions are pretty standard for all insurance companies. My BC policy has the same rules, we can only get a 30 day supply at a time.

    KP2001 - good point about the mail order. My Mom went through express scripts and they are wonderful. My BC policy uses them too. I think my mom paid < $5 for her prescriptions and got a 3 month supply. The medicine arrives promptly and efficiently.
     
  10. Pima

    Pima Parent

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    We have no copay for our prescriptions, thus it wouldn't matter for us. Our friend went home and looked at her previous scripts written by the same base doc. All of them were for 32 or more. The only difference is this time the script was filled off base due to the fact that the base did not have it.

    I know that she is upset because her lag time for seeing a doc is getting longer. I told her last night, I have no pity, b/c they opted to only use tri-care, he has insurance at SW airlines, but did not take it,

    For retirees there are 2 theories, although she has been my best friend in the world for 15 yrs, we part here. She has the belief that her husband paid his dues, they promised it and should fulfill that promise. She feels she should not have to pay for private insurance. I feel that my husband paid his dues and lived, and since we have the option not to burden the system(w/Aetna), we will not use it, giving AD members the ability to have more availability/access to the docs. The AD members are under enough stress (pay and deployments being the top 2), adding medical could cause more stress.

    By the time we were in for about 6 yrs, I quickly saw a trend that caused resentment in me towards retiees, and swore I would never be one of them. If you go to the base on the 1st, 2nd or 3rd of the month, you will not be able to get into see a doc (unless you are fortunate like we were to be flight med) and forget about finding any of the following in the commissary:
    1. Milk
    2. Bacon
    3. DIAPERS
    4. Formula
    5. Carons of cigarettes

    Also expect long lines at the BX/PX. Why because that is the reiree pay day and they make their doc appts. go to the BX/PX and then to the commissary. It is an all day affair for them since base hospitals are closing, the ones that have remained open are seeinga higher influx of retirees. After their day is done, than they hit the class six and gas station on the way out!

    Out of consideration for young soldiers living pay check to pay check, I never go on base for my grocery run on the 1st or the 15th. They deserve the right to get the diapers for their own children, not like the retirees who take the last pack for their grandchildren.

    Done my venting about retirees from a retiree!:unhappy:

    Back on topic

    The real point of this thread is to state don't use the VA or Tri-care as a model, b/c many AD members have their own horrific referral stories, where it took months or yrs to finally get their issues resolved and this includes AD members. 15 yrs ago Bullet asked for an elective surgery, he had to fulfill 2 requirements before they would even refer him(this had nothing at all to do with medical issues or flying whatsoever) he did, we were AF stationed at Ft. Bragg, he could either wait 9 mos after the referral was complete and do it at Bragg or drive 70 miles to SJAFB and have it done in 6 mos. We opted SJ, but the point is even AD members face wait times for simple procedures that never needed referrals in the "real world"

    Our DS waited 36 hrs for his arm to be cast, because ortho couldn't take him, so they sent him home in a splint and a sling with meds and said we'll see you in 2 days. He was 13, and the son of an AD member.

    Tri-Care works great for young single AD members because they use it 1x a yr for their planned physical, and if they do get sick, there is sick call every day M-F 2x a day that they can go to without an appt. It is when they get married, start having kids and needing appts for Ob/GYN, allergies, flues, sport physicals, etc. that people start seeing the big pic. Of course we were fortunate to have the "concierge" service of flight med, so when he was flying we called that morning and were in an hour later. When we weren't (Leavenworth and Pentagon) I got the real taste of Tri-Care and dealing with calling them(the 800 number) to get an appt. for the same day. If I was lucky enough to get one, Ihad to wait an hr at the docs for my appt, b/c they were always running late.

    People need to also see an underlying statement that even the military acknowledges the problem, which is why does Flight Surgeons exist and take family members. They do this so the the flyer is not stressed out that their loved one is caught in the system when they are up in the air. In other words they acknowledge that family practice, OB/GYN/ peds are overburdened. I will defend flt surgeons for the rest of my life. These guys work harder than the FP or Pediatrician, no offense to them. Whenever we had a medical issue they have done house calls(even dropping off the scripts when Bullet was deployed), gone to the off base hospital to check on the family member, and called the flyer to make sure they have no questions. They work 24/7, and are dedicated to the flyer and his family. The relationship and trust is so close, you get to a point that you call them at their home on their off hours before running to the ER for a phone consult of whether you should go and spend the night waiting in an ER. The job is not 8-4. Not only have they done all of those things for us personally, they have even been kind enough to take the time to personall meet an AFA cadet (Hornet) druing his lunch break to mentor which route he should do in obtaining his dream of being a flt surgeon. He also gave him his personal email for direct access. This doc never had to do this, but a flyer came and asked for the favor, and he was kind enough to agree(that whole brethren thing only found in the military).

    Again I am not saying the other docs are horrible and uncaring, I am just trying to highlight how much extra work they put in for the flyers and their families to give the "concierge" service. They should all be applauded. JUST like MullenLE and retnavy, because they go far beyond the requirements of the job since they do it for the love of the service.
     
    Last edited: Jul 6, 2009
  11. justawife

    justawife Founding Member

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    Tricare cobra is 900 for three months. Just FYI.

    PIMA is right about the Tricare, here many doctors will not accept it. Next door neighbors son as "issues" no one will take him they have to go to walter reed it takes several tries to get on the book, she starts about 3 months out for tourette's. Peds clinic is under staffed, the care there is wonderful.

    Woodbridge family is the worst, a contract doctor, who I swear got his medical degree from a cereal box, told me my 17 yo son has scoliosis. He didn't. I was told that it was my imagination that I had side pain. Months later I was in the ER, with my stomach touching my heart. The surgery took place 11 months after that ER visit. Took 6 weeks to get a CT scan.

    Fast forward 3 years need another CT scan, took a week with BC, Tricare paid the co-pay.

    Things were alot better 10 years ago. They have closed too many hospitals and clinics. The Dr.s are paying the price with being deployed more often and are being sent 6 months on then back home. Neighbor would prefer 1 year instead of the yoyoing. With this last deployment, he drop his papers, it is driving many out. Same problems that the regular troops have.
     
  12. Pima

    Pima Parent

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    That's okay Woodbridge DOC told us that they thought DS had bone cancer because of the break in his foot, we kept telling them he is a national Tae Kwon DO champ and that is how he broke it, this is after it was set at Bolling. They sawed off the cast to take an x-ray, the doc said you're right it's not cancer, now go to the front desk and make a new appointment to have it recasted at Belvoir, because we can't cast here, for those who are not in the area it is a 20 mile ride and Belvoir is the same place that sent us home with his broken arm from ER, luckily for him it was in the morning, so he only waited about 6 hours to get recasted!
     
  13. indexer

    indexer Banned

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    Sorry, PIMA your original post was flawed.

    The Walter Reed fiasco had to do with parts of the hospital that were privatized and ended up screwing things up for soldiers.

    Replace soldiers with America, and you've summed up the Bush legacy.

    Elections have consequences.:shake:
     
  14. Pima

    Pima Parent

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    Actually many of the soldiers were replaced under Clinton. Clinton was the start of contracting out people. Hospitals started closing in 93. The first time I saw a contracted doc was at Ft. Bragg in 93, long before Bush. Base housing, self help, O'Club, and MWR all moved from military managers to contracted employees in the early 90's. This was also when the dentists were started to be contracted.

    Even if the flaw of privatization exists the fact is the system is flawed. The VA should not be used as the fix for NHS. If it is overburdened now, can you imagine the nation being forced to enroll in a plan like this?

    Indexer, quick question are you a cadet, parent of a cadet, ret. military or active military? I am getting a sneaky feeling that you are none of these and are here to have political fights.
     
  15. indexer

    indexer Banned

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    removed by the moderating staff
     
    Last edited by a moderator: Jul 7, 2009
  16. J Collins

    J Collins Founding Member

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    PIMA, a burden ???

    nah I see it this way.. if our family goes on base or on post for military care they then bill my primary insurance (Regence) and Tricare (our secondary) does nothing.. BUT the military benefits from us two ways..

    1) we pay for Tricare prime
    2) The Gov. bills our insurance for everything we get seen for, so the military WANTS us kind of retirees.. cause they earn some $$.
     
  17. LineInTheSand

    LineInTheSand USCGA 2006

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    Ha, the troll is back.
     
  18. Pima

    Pima Parent

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    J

    I see your point, and do agree that the govt does make money from the retirees. What I meant as a burden is that the hospitals are undermanned, thus by going to the base, I feel like I am taking an appt away from the AD family member, esp. since I am still young enough that I don't use the specialists, I would be assigned to FP, which is the same practice that non-flying families utilize.

    The point is moot for me anyway, because no base/post in NoVA is taking new retirees. I also know that this is true for SJAFB, since our friends who rertired at the same time were also told there is no room at the inn!

    LITS I saw that too, but it said it was edited by the mod, so I took it as they wrote that.
     
  19. Just_A_Mom

    Just_A_Mom Member

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    PIMA -
    when will the new hospital at Fort Belvoir be finished? Will this allow them to start taking retirees again?

    I think you are right the military hospitals are all undermanned and overwhelmed by the war. You just can't build new hospitals and clinics overnight and between the increase in the numbers of the military and dependents and the need for medical professionals overseas they have been caught in a bind.
     
  20. mombee

    mombee Banned

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    Is TRICARE standard not an option when the DoD facilities are no longer accepting retirees??
     

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