Injured military veterans and private insurance

[alum]

Both Tricare and VA has always treated our family well...but we never had relatives who suffered combat-related injuries. I have been extremely happy with the care at NNMC and WRAMC for all our issues.

[Coramoor]

This was shot down within the last day or so.

I can't believe it didn't make a bigger stink. I mean, here BO is trying the royally screw over the men and women risking life and limb...and there is hardly a whisper from the MSM.

[Munchkin03]

Originally Posted by alum

Both Tricare and VA has always treated our family well...but we never had relatives who suffered combat-related injuries.

Honestly? That makes all the difference. If you've spent the better part of your post-military adult life dealing with private insurance, the shift to the VA--I can't speak for Tricare--is a jolt to say the least.

[alum]

Originally Posted by Munchkin03

Honestly? That makes all the difference. If you've spent the better part of your post-military adult life dealing with private insurance, the shift to the VA--I can't speak for Tricare--is a jolt to say the least.

I have only had military medical care for over 2 decades. There are some hassles but overall the care for our family has been quite good.

[AGDee]

I know Vietnam vets with combat related injuries who got awful care through the VA system. Not to mention, a lot of VA hospitals have closed so they have to travel pretty far for their care as well.

[KSigkid]

Originally Posted by alum

I have only had military medical care for over 2 decades. There are some hassles but overall the care for our family has been quite good.

And I believe Munchkin grew up in a military household (Munchkin: correct me if I'm wrong), so she probably also knows what she's talking about. Just because you've had good experiences with this doesn't mean that there aren't issues with the VA system.

[Munchkin03]

Originally Posted by alum

I have only had military medical care for over 2 decades. There are some hassles but overall the care for our family has been quite good.

Whoa, turn it down a notch. Note that I said I couldn't speak for Tricare, but that the VA is more problematic than most of your typical private insurers. You said yourself that you weren't familiar with how the VA works for those with service-related illnesses and injuries.

My father has combat-related injuries. He has private insurance from his civilian life, but since his illnesses are related to his service, he has access to the VA hospitals which are supposed to treat those specific injuries and illnesses. Sometimes he goes to the VA clinic, but for most of the big ones--including cancer--he has chosen to be treated by his own doctor and pay for it with private insurance, even though the VA would be free. VA clinics are woefully understaffed and often treat many, many people over a large geographic area. If you had the choice between going to a doctor in an office close to your home, and driving at least an hour to go to a crowded clinic to see a doctor (or more likely a physician's assistant) for 15 minutes, which would you pick?

It's not right that it's come to this. My dad can do this because he has private insurance. Many others in his siutation don't have that luxury.

[AKA_Monet]

From what the clinicians told me is there is just not enough trained and licensed staff at the VA to treat the array of combat-related injuries. There are more privately trained and licensed clinicians to treat the series of injuries.

This sounds like a case of HMO's trying to get into the game. But I am sorry, Kaiser does not have triage care that VA is accustomed to. Since you have to be military to be a part of the VA, then the number of people paying into the system is not as high as say an mass HMO system like Kaiser, Regence Blue Shield, etc.

While I do think ALL service personnel EARNED appropriate medical care and we should pay for it, the question is how? There just are not enough studies as to how this will work--the aftercare, etc. I do know there is a study are few years ago that was published in NEJM of how triage care improved in Iraq and how the clinicians trained for it from LA County Hospital, but, I have not seen the progression course of aftercare for combat-related injuries outside of intention to treat SOP's...

My guess, if the injury is not loss of limb, and starts with PTSD, if minimally treated like HMO's do, the stress becomes overwhelming to the point that something in the body actually does become afflicted early than later--assuming combat duty is an inexplicable, unexplainable overwhelming trauma...

I would like to see what the IAVA has to say about it.

[UGAalum94]

This issue is not who is treating the combat injured vets: it's who is paying for it. I agree that the VA system has problems, but I'm not that shifting the cost of care to the private insurers is the way to go.

Apparently, in some instances, the VA treats the vets and then bill the private insurers for say, flu shots or some other non combat related issue. (Quote from linked article: "Currently, veterans' private insurance is charged only when they receive health care from the VA for medical issues that are not related to service injuries, like getting the flu.")

The proposal, which now I'm pretty sure was dead, was that the VA was going to bill the private insurers for the cost of treating issues related to combat injuries as well.

So the Vets would get all the crappy care associated with the VA, but private insurers would pay for it. If we were talking about getting private care and private insurance paid for it, it might still create problems for vets with serious injuries seeking private insurance (pre-existing conditions and all that crap), but it makes some sort of sense. Getting VA treatment for combat injuries and billing a private insurer makes zero sense to me.

It seems to be a total lose-lose to me.

[AKA_Monet]

Originally Posted by UGAalum94

This issue is not who is treating the combat injured vets: it's who is paying for it. I agree that the VA system has problems, but I'm not that shifting the cost of care to the private insurers is the way to got.

When you don't have enough licensed trained clinicians, how many patients are treated per day? If less patients are treated, less pay is in returned. The way health insurance is done these days is by patient volume. However, the quality of care goes down precipitously...

The clinicians at the VA is are really good, there is just not enough of them to treat all the personnel that need to be seen in due course...

Private or civilian clinics are more abundant and could be reimbursed for treatment options. But, people have varying views. Sure, someone will get seen at the VA, but that may be awhile, opposed to a high volume location that sees a constant barrage of patients daily...

It's not like I am for this bill, I just question the feasibility of one plan over another.

[alum]

Originally Posted by Munchkin03

Whoa, turn it down a notch. Note that I said I couldn't speak for Tricare, but that the VA is more problematic than most of your typical private insurers. You said yourself that you weren't familiar with how the VA works for those with service-related illnesses and injuries.

My father has combat-related injuries. He has private insurance from his civilian life, but since his illnesses are related to his service, he has access to the VA hospitals which are supposed to treat those specific injuries and illnesses. Sometimes he goes to the VA clinic, but for most of the big ones--including cancer--he has chosen to be treated by his own doctor and pay for it with private insurance, even though the VA would be free. VA clinics are woefully understaffed and often treat many, many people over a large geographic area. If you had the choice between going to a doctor in an office close to your home, and driving at least an hour to go to a crowded clinic to see a doctor (or more likely a physician's assistant) for 15 minutes, which would you pick?

It's not right that it's come to this. My dad can do this because he has private insurance. Many others in his siutation don't have that luxury.

I was only speaking from personal experience so that's why I qualified my statements both times by writing "our family" in my posts.

We do choose to use an MTF that is about 45-90 minutes away depending on traffic. Recently I had to go there on a daily basis during rush hour for about 6 weeks. We could go on the economy to our various doctors and specialists but having all our medical needs addressed at one facility where the specialists work together AND not having to deal with insurance paperwork.co-payments, etc was and is the ideal decision for our family.

That all being said, I do not believe that all VA Hospitals are of equal caliber and I absolutely do believe that not all servicemembers are receiving the care they deserve ie the WRAMC expose.

[epchick]

Originally Posted by Munchkin03

My father has combat-related injuries. He has private insurance from his civilian life, but since his illnesses are related to his service, he has access to the VA hospitals which are supposed to treat those specific injuries and illnesses. Sometimes he goes to the VA clinic, but for most of the big ones--including cancer--he has chosen to be treated by his own doctor and pay for it with private insurance, even though the VA would be free. VA clinics are woefully understaffed and often treat many, many people over a large geographic area. If you had the choice between going to a doctor in an office close to your home, and driving at least an hour to go to a crowded clinic to see a doctor (or more likely a physician's assistant) for 15 minutes, which would you pick?

Your dad and mine sound like they are in a very similar position. My dad was in Vietnam and has had combat-related injuries since. He's been pushed around the VA system for years, and still hasn't gotten the treatment he needs for Agent Orange. A few years ago he FINALLY was able to get his back & neck surgery he desperately needed (he was a paratrooper and suffered severe nerve and bone damage). Now he's suffering complications from those surgeries, but everytime he gets an appointment at VA, it either gets cancelled or postponed (and it's always scheduled 6 months or longer away).

My dad does get private insurance from his job, but he doesn't want to use just when he gets "VA benefits" and now he's finally starting to realize that VA is crap.

IDK if this is VA or just veteran's benefits in general, but anyone who has family that are recently retired (or about to be retired) need to make sure that the gov't/VA (i'll have to ask my dad which one it is) acknowledges your marriage, and acknowledges your children (and whether or not they are in college). My mom & dad got married when I was 5....and not until this year has VA acknowledged their marriage. Not only that, but they never acknowledged that I was in college, thus my dad never got the benefits he gets for having children in college. My dad had been hounding them EVERY year I was in college and it wasn't until I graduated that they decided "oh yeah, your daughter was in college, sorry" but they'll only give him 1 year worth of back $ that he deserves.

[Munchkin03]

Originally Posted by epchick

Now he's suffering complications from those surgeries, but everytime he gets an appointment at VA, it either gets cancelled or postponed (and it's always scheduled 6 months or longer away).

IDK if this is VA or just veteran's benefits in general, but anyone who has family that are recently retired (or about to be retired) need to make sure that the gov't/VA (i'll have to ask my dad which one it is) acknowledges your marriage, and acknowledges your children (and whether or not they are in college).

The cancellations/postponements are a serious problem, and are based more on facilities, but it's a widespread issue. Like I said, I can't imagine how annoying it would be if that was your only source of healthcare.

As far as the marriage/children thing, that is a VA-specific problem, since the DOD keeps pretty good records of marriage and children stuff--they have to for a lot of reasons. I don't think the VA knows or cares about my existence; my father isn't in that bad a condition where they could have gotten financial assistance with college.

[AGDee]

I should have added that I also know people whose HMOs denied them certain treatments saying that they were things the VA should cover.

[epchick]

Originally Posted by Munchkin03

As far as the marriage/children thing, that is a VA-specific problem, since the DOD keeps pretty good records of marriage and children stuff--they have to for a lot of reasons. I don't think the VA knows or cares about my existence; my father isn't in that bad a condition where they could have gotten financial assistance with college.

Ahh thanks for the clarification. Yeah, my dad should be (because of all the combat related issues) almost 100% disabled--in the eyes of VA. But they WILL NOT raise his disability. He has to throw a fit w/ his back & neck surgeon just so his disability could be raised to 40%. He just came back to the VA today and they are thinking of raising it to 60%.

I don't think my dad's condition is that bad, but then again, i'm not in his body. I know that he can't sleep for more than 3 hours w/o getting pains, so he's constantly tired, his hands & feet are completely numb and he can't feel them, and something is constantly hurting him.