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Originally Posted by Wardendresden
But Robyn, you consistently speak of controlling costs. Controlling costs will involve controlling costs of drugs also. In some cases not accepting them if they are priced too high...
'Socialized' or Not, We Can Learn from the VA | RAND
Now if your main concern is that you just don't want to rub shoulders with all those poor, disadvantaged folks, then keeping your high cost health care in glorified surroundings is important to you.
But it has NOTHING to do with controlling costs.
If, as a Viet Vet, I could get accepted into the VA system, I'd go in a heartbeat. But with massive numbers of injured returning from the longest idiotic war we've ever fought (thank God we got those Weapons of Mass Destruction), and very little budgetary help by a Congress that praises our "heroes," the VA has found it necessary to begin limiting its services which used to be wide open to any veteran. But, fortunately, I did not receive a service related injury or wound, and even on social security my income will remain above what the VA will now accept.
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I'm not sure where you get a lot of this. I am mostly interested in a combination of controlling my family medical costs as much as I can - while getting the best possible health care. It's a juggling act to be sure. Especially since my husband has MS. And because excellent PCPs who will accept new Medicare patients are hard to come by (at least where I live). But I've juggled for a long time - and will continue to juggle.
As for other people's personal health care costs - I don't think they should necessarily come down. What I am saying is - for some people (perhaps a lot of people) - they will in probability be forced down as a result of government rationing/restricting access/etc. The only thing a sane somewhat financially healthy person can do when facing this reality is to save money. So when the day comes that the health care system you're a part of says you can't have X, Y or Z - or you can have it - but 6 months down the road (when you need it now) - you have some chance of paying for it yourself.
Note that this doesn't necessarily mean that people will wind up paying less for the health care system (as some people are finding out now as they shop for 2014 policies). It's just that the landscape in terms of who gets what and who pays for what is changing.
With regard to your personal situation - if you like the VA system - and you can't access the facility where you live (for whatever reason) - you should consider moving to a place with a good VA system you can use when your wife retires from her work. E.g., to the best of my knowledge - our VA facilities here are pretty good (they were overhauled/modernized at some point with the help of a prominent "retired" local physician). My father had no problems in terms of using the local facility when he first moved here (and he's far from low income). IOW - it might be a good fit for you (and we do in fact have a fair number of vets who retire in this area in part because of the VA facilities). Now I can't say all of this is 100% accurate today with regard to our local facility (I don't follow the situation day by day) - but you get my point. I'm all about people trying to solve their personal problems first if they can. Even if it means moving (we would have left Florida had the state high risk pool shut its doors before we went on Medicare - proposals to close it were floated perhaps every 2-3 years - but - luckily - never got off the ground).
IOW - the days of living in a "set it and forget it" world are long past. Robyn