Panel weighs closing all VA health care —

[Kirk W]

 

“The commission finds the current VA health care system is seriously broken, and because of the breadth and depth of the shortfalls, there is no efficient path to repair it,” Blom and other commission members wrote in the report, created as part of an overall effort to explore VA health reform options.

Under the proposal, veterans would be able to receive care at any provider that accepts VA payments or Medicare. Doctors would be reimbursed at rates 5 percent to 10 percent higher than Medicare rates to encourage them to participate.

 

Military Times, April 1, 2016

[skp51443]

That probably isn't a great plan as civilian doctors have little experience in treating a lot of problems the military have, far better to fix the VA so the veterans have experienced doctors providing them care, not some doctor (however good) that has never seen the issue before learning as they go.

 

Moving a lot of care outside the VA is probably not a bad idea but not for the stuff that isn't common in the general population.

[phillyg]

I'm a bit conflicted on this recommendation, and frankly, I don't see that congress would ever eliminate the VA healthcare program. I'm retired Navy but I don't use VA healthcare because I'm also retired federal civil service and I carried my very good BCBS health plan into retirement, so no need to go to the VA. I can't complain about my Medicare coverage, but most people need to buy a supplemental plan if they don't have other coverage. So, my question would be, is the VA-qualified participant also going to receive a supplement to cover his/her post-65 Medicare? If so, and the participant is not required to pay additional costs, then getting the same care I do sounds like a possible a winner.

 

OTOH, we have all heard that doctor shortages are in our future, and I can tell you with some authority that my family and I have had some difficulty getting to see doctors in a timely manner, especially as a new patient. Also, we have experienced changes in the various laws in my lifetime, for example (and not as a result of the ACA), in order to keep my military Tricare coverage into retirement and draw SS, (a right I was given prior to 1989) my wife and I have to pay $108/mo. each out of our SS payments just for the privilege of maintaining Tricare, so laws do change and it's usually not going to be to the recipients' advantage. It's interesting that Medicare is now my first payer, followed by BCBC (for which I pay more than $400 monthly out of my retirement annuity), followed by Tricare. I don't recall that Tricare has paid any benefits this year as my first and second payers have covered me in full.

 

Lastly, the above paragraph is my attempt to state the obvious, which is things can change, and who knows what the congress will do in the future. I'm not complaining about my health care, as I know there are many, many folks out there who are struggling to obtain any health care coverage at all.

[nana25k]

" we have experienced changes in the various laws in my lifetime, for example (and not as a result of the ACA), in order to keep my military Tricare coverage into retirement and draw SS, (a right I was given prior to 1989) my wife and I have to pay $108/mo. each out of our SS payments just for the privilege of maintaining Tricare, so laws do change and it's usually not going to be to the recipients' advantage. It's interesting that Medicare is now my first payer, followed by BCBC (for which I pay more than $400 monthly out of my retirement annuity), followed by Tricare. I don't recall that Tricare has paid any benefits this year as my first and second payers have covered me in full."

 

I Believe I'm confused. If you are retired military and over 65 then you are eligible for Tricare for Life. (Medicare pays first with tricare as secondary)It pays for everything (except dental and eye care).

You would have no need to pay for an additional health insurance.

Ron and I pay no medical bills or copays.

[Pieere]

That probably isn't a great plan as civilian doctors have little experience in treating a lot of problems the military have, far better to fix the VA so the veterans have experienced doctors providing them care, not some doctor (however good) that has never seen the issue before learning as they go.

 

Moving a lot of care outside the VA is probably not a bad idea but not for the stuff that isn't common in the general population.

 

Agreed Stan, I believe closing VA healthcare will cause more problems. I go to a Primary Care Doctor through CIGNA and he stated the same> That he will see me, but will not get in between my VA PCD and Cardiologist for treatments! I have been to outside specialists and they only spend about 10-15 mins with me. The VA doctors have spend up to 45-60 mins, if needed!

 

The other problem I see with this, just from personal experience The length of time it takes the VA to pay an outside provider caused undue stress as the private doctors billing departments kept sending the bills to me. The Va told me not to pay ( this would make me responsible for Payments); as they would pay it; but meanwhile I was put in arrears. Then had Collection Agencies calling and sending collection notices with threats to put it in an attorneys!

[Kirk W]

Like seems to so often be the case with government issues, the question is whether the solution will solve a problem and not create worse problems in the place of what it was supposed to fix. Political solutions in other areas of health care do not seem to be good for everyone and made new problems for each one that was improved. Most of us have lost faith in our government and the political leaders, and so have I.

[phillyg]

"..........Believe I'm confused. If you are retired military and over 65 then you are eligible for Tricare for Life. (Medicare pays first with tricare as secondary)It pays for everything (except dental and eye care).

You would have no need to pay for an additional health insurance.

Ron and I pay no medical bills or copays."

 

Medicare doesn't cover services OCONUS; BCBS does and we do travel some. When you have both, Medicare is almost always the primary payer. Since we opted to keep BCBS, Tricare for Life doesn't seem to ever have to pay, but we haven't had really expensive bills since turning 65 so maybe at some point Tricare gets to pay. In order to have keep Tricare we have no choice but purchase Medicare Part B, which is the $108/mo I cited. We have discussed dropping our BCBS but haven't yet convinced ourselves it's to our advantage.

[DuffMan]

 

Military Times, April 1, 2016

 

Under the proposal, veterans would be able to receive care at any provider that accepts VA payments or Medicare. Doctors would be reimbursed at rates 5 percent to 10 percent higher than Medicare rates to encourage them to participate.

 

And so it starts - admission that the medical profession is being squeezed to make ACA / Medicare / Medicaid work. Then setting up a higher reimbursement rate for govt favored designated groups. So much for equality. Where will this go?

 

How long before the best and brightest decide the medical profession is not their best career path?

[nana25k]

"..........Believe I'm confused. If you are retired military and over 65 then you are eligible for Tricare for Life. (Medicare pays first with tricare as secondary)It pays for everything (except dental and eye care).

You would have no need to pay for an additional health insurance.

Ron and I pay no medical bills or copays."

 

Medicare doesn't cover services OCONUS; BCBS does and we do travel some. When you have both, Medicare is almost always the primary payer. Since we opted to keep BCBS, Tricare for Life doesn't seem to ever have to pay, but we haven't had really expensive bills since turning 65 so maybe at some point Tricare gets to pay. In order to have keep Tricare we have no choice but purchase Medicare Part B, which is the $108/mo I cited. We have discussed dropping our BCBS but haven't yet convinced ourselves it's to our advantage.

[/quote

 

So the only reason your keeping BCBS is for medical care outside the CONUS. As long as you have BCBS it will be secondary and it's doubtful Tricare will ever kick in.

Wouldn't a short term policy when you travel be a better investment?

Besides if you didn't qualify for TFL, would you not have enrolled in Medicare anyway?

[nana25k]

And so it starts - admission that the medical profession is being squeezed to make ACA / Medicare / Medicaid work. Then setting up a higher reimbursement rate for govt favored designated groups. So much for equality. Where will this go?

This is actually not a new proposal.

How long before the best and brightest decide the medical profession is not their best career path?

[Lavenders]

Going to the original article and reading it, I get the impression this was a suggestion made by people mostly from the civilian healthcare sector. (Guess they would love to get their hands on the veteran healthcare dollar, is my initial thought.) The article also states that veteran's groups are just about unanimous in denouncing the idea of privatizing veteran's healthcare, so I guess I'm not the only one that thinks it is one pretty stupid idea. I like the care I get from the VA and I've dealt with several different hospitals and clinics over the years.

[Kirk W]

So much depends upon the management side of things, just as is true with the current system. I recently had a colonoscopy done outside of the VA system but paid by them due to our location being near a VA outpatient clinic but far from any larger facility, as the recent changes allow. I had a good experience and the time lag to service was pretty normal, similar to the civilian world and the care was excellent. But not all care is equal even in the civilian system. With my wife in it and myself in the VA system, it is pretty easy to compare and each one has both good and bad points. With the recent intrusion of government into the civilian health care system, the bureaucracy side of things is not all that different today.

 

I'm not really thrilled with what I see happening in health care no matter where you get yours.....