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My husband is in the NAVY and Tricare is managed by a private health insurer which has the same profit motive and shady claims practices as other private insurers. And yes, we've had significant problems with Tricare paying claims and getting access to care. As I said earlier in this thread, military service members and their families used to have ChampVA which was set up like Medicare with copays, deductibles and complete freedom of choice in physicians. Now we have an HMO style plan that can be extremely restrictive. Those who have access to care at military bases with hospitals have less hassles. Those of us not attached to a big base, as we are, are not so fortunate. We're just like anybody else. And yes, I have purchased private insurance from my own employers, when available, to help protect us from Tricare issues. With two wars on, our health care is stretched to its limits too. People tend to think we're all taken care of and get everything free which is just not so.
Last edited by Sneezyone; 07-28-2009 at 07:58 AM..
Reason: typo
Thank you, Sneezy, for sharing. Nita, I think your health insurance claims have been extraordinarily good. But I think you are in the minority. Most of us have had some struggles with insurance, and as healthcare costs have risen, have seen insurance become more and more difficult to obtain. Even when you do have insurance, it's not unusual to have claims denied, sometimes for no reason, and have to fight with insurance to pay. And when the doctor's office is at fault for not filling out the paperwork properly or in a timely manner, the doctor's office will turn your account over to a collection agency to get paid. I had that happen with a dentist. I had never been billed, was not aware that the insurance company had declined to pay, when a collection agency contacted me. My parents are on Medicare and have supplemental, and yet they pay at least twice what you are paying. So there is a lot of variance in the kinds of coverage people can get, the costs of coverage, and the quality of that coverage. And oftentimes it's the people who can least afford it who are paying the most out of pocket.
Wow.......I cannot imagine being in the military and not having full medical coverage. It's been a long time since I was in, andI know that some of the bennies have changed, like the GI bill for education, but I had no idea.
I'm adding that as the 176th entry why I don't want to be a lifer.
Wow.......I cannot imagine being in the military and not having full medical coverage. It's been a long time since I was in, andI know that some of the bennies have changed, like the GI bill for education, but I had no idea.
I'm adding that as the 176th entry why I don't want to be a lifer.
My step mom is retired Air force and my dad was retired Navy, they had no problems with health care benefits, she still doesn't. I will say, she lives in Ca so I am not sure what she has at this stage.
My husband is in the NAVY and Tricare is managed by a private health insurer which has the same profit motive and shady claims practices as other private insurers. And yes, we've had significant problems with Tricare paying claims and getting access to care. As I said earlier in this thread, military service members and their families used to have ChampVA which was set up like Medicare with copays, deductibles and complete freedom of choice in physicians. Now we have an HMO style plan that can be extremely restrictive. Those who have access to care at military bases with hospitals have less hassles. Those of us not attached to a big base, as we are, are not so fortunate. We're just like anybody else. And yes, I have purchased private insurance from my own employers, when available, to help protect us from Tricare issues. With two wars on, our health care is stretched to its limits too. People tend to think we're all taken care of and get everything free which is just not so.
I worked as a volunteer at AR Children's Hospital in the Admissions Department...I used to always look at the forms from Tricare and look at why they denied it. I saw LOTS of denials from them.
Wow.......I cannot imagine being in the military and not having full medical coverage. It's been a long time since I was in, andI know that some of the bennies have changed, like the GI bill for education, but I had no idea.
I'm adding that as the 176th entry why I don't want to be a lifer.
It's not that we don't have insurance, we do, it's just been contracted out to private insurers with all the usual results. I see people all over the Web touting the military's healthcare system as a model for single payer when they have no idea what Tricare is really all about. It doesn't function as a single payer system at all and it certainly isn't gov't run in the way people expect.
When DH joined in 1998, Tricare was still in it's infancy (it was enacted in 1993) there were four, no, I think it was six regional contractors and you had to transfer between regions when you moved. Now there are fewer regions and contractors, four I think, but you still have to transfer between them and care/billing is not seamless. That claim that we had go unpaid for two years was shuffled between two regions repeatedly; they couldn't decide which contractor should pay b/c our daughter was born in one state and we lived in another.
If I had a dollar for everyone who told me how good our medical care was I'd be rich. Often tho, those comments come from people who've had no contact with the active duty side since Tricare was instituted and/or are only familiar with the retiree plan, Tricare for Life (which essentially grandfathered in retirees and soon-to-be retirees with the CHAMPUS and CHAMPVA benefits they knew and loved). Tricare for Life is designed to work with Medicare but even that has issues. If you pick up any Military Times paper you'll find a regular column devoted to TFL issues. That's not a lib rag btw, the readership is old and conservative.
Honestly, unless you're stationed at a big base with a hospital or you transfer into Tricare Standard (which means paying a deductible and 20% copays for every service you receive) you're going to have problems getting care. There are very few active duty personnel who can afford that.
I just want insurance that works, just like everyone else.
ETA: This article just appeared this week in AF Times:http://www.airforcetimes.com/news/20..._help_072409w/
By the time it reaches the Military Times papers, you know people have been complaining a long time...it's old news.
Last edited by Sneezyone; 07-28-2009 at 08:06 PM..
The primary reason that our healthcare system is in its current condition is that our gov't traded our freedom for safety. This consisted of regulating nearly everything. There are now laws concerning the number of yearly med students, med schools, requirements for doctors, nurses, and everything in between. As the medical consumer is required to use an "approved" doctor, hospital, medicine, etc. a key component of market systems was removed. The idea of competition. The quality of treatment therefore became very high and for the most part, the same. Unfortunately, the cost rose along with it and as more regulations are put in place for every new medical development, the cost continues to rise.
Now, the reason that countries that have universal HC have lower costs is this: They traded safety for economy. They keep the regulations, but they lower the standard on all of them. All of the hospitals use the bare minimum in order to keep costs low. Shortcuts that would not be allowed by most consumers are encouraged. This, however, has its drawbacks. The number of secondary infections soared because dressings are not changed as often. Floors are not mopped regularly. Medical equipment is not cleaned. Just a few months ago over 120 women were given gonorrhea because a spatula was not washed in between patients. The reason: that would have taken too much time (you have to pay someone for that time)
In these countries you get "free" HC, but there is no competition, and all of the care is mediocre.
I would suggest removing many of these regulations. Encourage more people to be doctors, instead of limiting their number. Allow doctors trained in other countries in. Heck, even let nurses give out scrips. Ultimately, those who want the best care will pay what they are willing to get it. Those who would be willing to receive lesser care for a lower cost, should be allowed to do so as well. I hate it when people way that the Free-Market system has failed. What we have now is not even close to Free-Market. Prices and wages are greatly influence by the government.
As for everyone who thinks that our system is not as good as the universal systems(quality wise):
The problem with comparing systems, is that there are far too many factors that must be reconciled. Its like doing an experiment without a control. I realize that our HC does not always receive good marks, usually in regards to life expectancy and infant survival rates. Take away these issues and the US shoots to the top. Now, I can explain the descrepancies in these rates.
1. Life Expectancy.
The US leads the modern world in accidental deaths. This includes falls, gunshots, car accidents, etc. There are very few countries that even come close to our numbers. This is really not a reflection of our HC system, but of our culture. Not really a good thing, but not related to HC.
2. Infant Survival Rates
Another thing that antagonists of out current HC system point out, is that the US has a terrible rating in survival rates of live births, at least in comparison to other modern countries. The problem is that there is a huge discrepancy between what we and the rest of the world consider to be live births. The US pretty much considers every child that is born alive to be a live birth. (seems natural, right) However, we are the only country to do so. Every other country consider babies that are pre-mature, have heart, heart, lung, or brain defects, are shorter than 30 centimeters, or weight less than 6 lbs as still-borns. If they survive, they are considered miracles and are then added to the rankings. If not, then they were never expected to live in the first place. Another example of comparing apple and oranges.
Sorry for the insanely long post. I just believe Gerald Ford's words "A government big enough to give you everything you want, is strong enough to take everything you have."
Last edited by akafish77; 07-28-2009 at 10:53 PM..
Reason: Grammar
The primary reason that our healthcare system is in its current condition is that our gov't traded our freedom for safety. This consisted of regulating nearly everything. There are now laws concerning the number of yearly med students, med schools, requirements for doctors, nurses, and everything in between. As the medical consumer is required to use an "approved" doctor, hospital, medicine, etc. a key component of market systems was removed. The idea of competition. The quality of treatment therefore became very high and for the most part, the same. Unfortunately, the cost rose along with it and as more regulations are put in place for every new medical development, the cost continues to rise.
Now, the reason that countries that have universal HC have lower costs is this: They traded safety for economy. They keep the regulations, but they lower the standard on all of them. All of the hospitals use the bare minimum in order to keep costs low. Shortcuts that would not be allowed by most consumers are encouraged. This, however, has its drawbacks. The number of secondary infections soared because dressings are not changed as often. Floors are not mopped regularly. Medical equipment is not cleaned. Just a few months ago over 120 women were given gonorrhea because a spatula was not washed in between patients. The reason: that would have taken too much time (you have to pay someone for that time)
In these countries you get "free" HC, but there is no competition, and all of the care is mediocre.
I would suggest removing many of these regulations. Encourage more people to be doctors, instead of limiting their number. Allow doctors trained in other countries in. Heck, even let nurses give out scrips. Ultimately, those who want the best care will pay what they are willing to get it. Those who would be willing to receive lesser care for a lower cost, should be allowed to do so as well. I hate it when people way that the Free-Market system has failed. What we have now is not even close to Free-Market. Prices and wages are greatly influence by the government.
As for everyone who thinks that our system is not as good as the universal systems(quality wise):
The problem with comparing systems, is that there are far too many factors that must be reconciled. Its like doing an experiment without a control. I realize that our HC does not always receive good marks, usually in regards to life expectancy and infant survival rates. Take away these issues and the US shoots to the top. Now, I can explain the descrepancies in these rates.
1. Life Expectancy.
The US leads the modern world in accidental deaths. This includes falls, gunshots, car accidents, etc. There are very few countries that even come close to our numbers. This is really not a reflection of our HC system, but of our culture. Not really a good thing, but not related to HC.
2. Infant Survival Rates
Another thing that antagonists of out current HC system point out, is that the US has a terrible rating in survival rates of live births, at least in comparison to other modern countries. The problem is that there is a huge discrepancy between what we and the rest of the world consider to be live births. The US pretty much considers every child that is born alive to be a live birth. (seems natural, right) However, we are the only country to do so. Every other country consider babies that are pre-mature, have heart, heart, lung, or brain defects, are shorter than 30 centimeters, or weight less than 6 lbs as still-borns. If they survive, they are considered miracles and are then added to the rankings. If not, then they were never expected to live in the first place. Another example of comparing apple and oranges.
Sorry for the insanely long post. I just believe Gerald Ford's words "A government big enough to give you everything you want, is strong enough to take everything you have."
In these countries you get "free" HC, but there is no competition, and all of the care is mediocre.
That's a misinformed line straight out of Faux News, and it's BS. But don't believe me, go the the Canada and UK forums and see what folks in those countries have to say about their health care.
The primary reason that our healthcare system is in its current condition is that our gov't traded our freedom for safety. This consisted of regulating nearly everything. There are now laws concerning the number of yearly med students, med schools, requirements for doctors, nurses, and everything in between. As the medical consumer is required to use an "approved" doctor, hospital, medicine, etc. a key component of market systems was removed. The idea of competition. The quality of treatment therefore became very high and for the most part, the same. Unfortunately, the cost rose along with it and as more regulations are put in place for every new medical development, the cost continues to rise.
Now, the reason that countries that have universal HC have lower costs is this: They traded safety for economy. They keep the regulations, but they lower the standard on all of them. All of the hospitals use the bare minimum in order to keep costs low. Shortcuts that would not be allowed by most consumers are encouraged. This, however, has its drawbacks. The number of secondary infections soared because dressings are not changed as often. Floors are not mopped regularly. Medical equipment is not cleaned. Just a few months ago over 120 women were given gonorrhea because a spatula was not washed in between patients. The reason: that would have taken too much time (you have to pay someone for that time)
In these countries you get "free" HC, but there is no competition, and all of the care is mediocre.
I would suggest removing many of these regulations. Encourage more people to be doctors, instead of limiting their number. Allow doctors trained in other countries in. Heck, even let nurses give out scrips. Ultimately, those who want the best care will pay what they are willing to get it. Those who would be willing to receive lesser care for a lower cost, should be allowed to do so as well. I hate it when people way that the Free-Market system has failed. What we have now is not even close to Free-Market. Prices and wages are greatly influence by the government.
As for everyone who thinks that our system is not as good as the universal systems(quality wise):
The problem with comparing systems, is that there are far too many factors that must be reconciled. Its like doing an experiment without a control. I realize that our HC does not always receive good marks, usually in regards to life expectancy and infant survival rates. Take away these issues and the US shoots to the top. Now, I can explain the descrepancies in these rates.
1. Life Expectancy.
The US leads the modern world in accidental deaths. This includes falls, gunshots, car accidents, etc. There are very few countries that even come close to our numbers. This is really not a reflection of our HC system, but of our culture. Not really a good thing, but not related to HC.
2. Infant Survival Rates
Another thing that antagonists of out current HC system point out, is that the US has a terrible rating in survival rates of live births, at least in comparison to other modern countries. The problem is that there is a huge discrepancy between what we and the rest of the world consider to be live births. The US pretty much considers every child that is born alive to be a live birth. (seems natural, right) However, we are the only country to do so. Every other country consider babies that are pre-mature, have heart, heart, lung, or brain defects, are shorter than 30 centimeters, or weight less than 6 lbs as still-borns. If they survive, they are considered miracles and are then added to the rankings. If not, then they were never expected to live in the first place. Another example of comparing apple and oranges.
Sorry for the insanely long post. I just believe Gerald Ford's words "A government big enough to give you everything you want, is strong enough to take everything you have."
Are you saying the problem is mostly in our heads and all we really need is more deregulation?
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