Monday, March 16, 2009

President Obama To Charge Wounded Vets For Health Care-Nice!

It appears that the Obama administration is going to proceed with a plan to charge the private insurance of wounded war veterans to pay for their cost of care in an attempt to save costs to the federal government.
In a word, DISGUSTING!
According to the head of the American Legion, Commander David K. Rehbein, the Obama administration will force private insurers to pay for some of the costs of treatment for veterans that have had war related injuries. One of the valid points that Commander Rehbein pointed out is that many private insurers have deductibles. And some are high. And that is an added cost on a veteran and or his or her family. And not to mention the real possibility that the said insurance premiums will more than likely rise as well. A double whammy to a veteran and his or her family.
Here is the thing.
The government recruits and asks these men and women to potentially make the ultimate sacrifice for their nation. Part of that compact should be that the federal government will incur the potential costs of a veterans injuries. Not pawn them off on a private insurance company. No city would do that to their police and or firemen and fire women. And we should expect no less from the federal government when it comes to the health and care of our wounded veterans.
The irony is that this administration is pushing for government funded national health care for all Americans. Would they push out some under a national health care scheme into private insurance when the cost would get too high for the government? Would there be any serious kind of private health insurance left if the Obama administration got their way?
The Obama administration must find a way to make sure that they stand by the federal government's commitment to its veterans and take care of their medical needs. There has to be other ways to make up these shortfalls. Nailing those financially for making the potential ultimate sacrifice is not the way to go for the Obama administration.

12 comments:

Rightwingsnarkle said...

There's more to this story than the headline, and certainly more to it than what's appearing on wingnut websites and passing for 'commentary.'

If a vet has non-service connected (SC) health care needs, and also carries other insurance, should the VA cover the cost of care, or should the other insurer?

As one vet recently posted elsewhere (scroll):

"The VA has been billing private insurance for years, if you have it. I'm 100% SC, Total and Perm. They still bill my Fed. Retired BlueCross/Blue Shield for visits, meds, etc. I have no problem with this as it eats up my deductable so when I see my private docs it's already paid. It's a way the VA can recoup some of it's money. Your deductable gets used up and you don't have to pay them the difference. If I use my private doctor, until the deductable is used up, I have to pay...so I always make sure I have appointments in January to eat it up. Years ago, when they first did this, it kinda pissed me off. Then I thought about it and said...hey, my deductables paid. If you don't have insurance and are SC, they take care of you. Non-SC, they take care of you for a very small co-pay. I don't have a problem with them billing insurance at all."

In other words, according to this poster, the VA has been billing private insurers all along. When the insurer assesses a deductible, the VA pays that (not the vet), but the insurer covers the rest. Then, when the vet sees their private physician for whom the private insurer is responsible, the deductible has already been met.

That seems to provide several benefits: the vet's deductible is covered, and the VA gets reimbursed. Win/win.

That is, unless you're a shill for the private insurance companies. Remember one simple fact - insurance companies only make money when they deny care. They don't make money paying for care. They don't want to pay for care. They want to make money. And they want to make lots of it. And they have been.

I'm very familiar with these players, having worked closely in the past with major payors around the country as the industry was consolidating in the early 90's (Wellmark, Anthem, United, and others).

I can't say for sure whether the recent news is about a policy announcement, a trial balloon for a policy (or range of policies), or one tactic within a larger policy/political strategy regarding healthcare.

And I can't assess whether the tactic will ultimately succeed in the context of a larger strategy.

It will be interesting to see how this plays out. I already know that the vets' group I have the most respect for has come out against this proposal.

But, if wingnuts are about anything at all, aren't they about the sanctity of the free markets? Isn't it totally cool with wingnuts that private companies have the chance to make money? Isn't it totally cool with wingnuts that 'the market' sort all of this out?

Anonymous said...

Yes this proposal is sick. It's betrayal of people who have given all they can give in many cases and they and their family are left with wrecked lives. Because of the nature of what combat wounds are there will always have to be government support of veterans' health care. Always. Government is the only entity that can pay for the care some wounded and disabled veterans require.

This cost-cutting by endangering the access to health care is sick. It targets people who have already served, already lived up to their part of the bargain, and have already lost something.

All I can keep coming up with to describe this Obama proposal is betrayal. And parasitic. I just can't think of anything else right now. Sick idea I hope fails.

Righty64 said...

Mr. Snarkie, your last paragraph is interesting. I think you can not differentiate between a libertarian economic policy and conservative. I actually believe that those who serve our nation in the armed forces deserve the best care. If that is done by the government through the VA, I am for that. I am not a pure libertarian. We ask them to serve and that is the ulitimate potential sacrifice. I think that we may be in agreement on this. Hope and Change, Snarkie!

skeneogden said...

I think the bigger issue here is the continued tone deafness of current administration. Although their plan may have merit it wasn't properly articulated in the announcement.

What many people see is a $500 million cut to our vets, and that stings when people also see a proposal to give the miscreants in Gaza $900 million.

This administration is looking more and more like "The Gang That Couldn't Shoot Straight". It's these amateurish blunders that concern me more than anything.

I believe it's only a matter of time before we are seriously challenged by someone on the international stage and I am not sanguine about the outcome.

Rightwingsnarkle said...

I think you can not differentiate between a libertarian economic policy and conservative.

Those labels are as meaningless to me as the names for any of the various flavors of flying magic jesus worship.

Give me a well-articulated position, like "I support doing x for y because of z," and I know where a person stands.

Best of all, actions speak louder than words.

As for veterans' care, history tells a sad tale.

People (wingnuts in particular) loves them some warriors, but only if they keep their pain and wounds hidden.

My opinion? Sure, vets deserve the best care available, in all respects - acute care for physical and mental injuries, long-term rehab, the works.

It should be timely, it should be high quality.

And the cost of that care should not put the vets in a tough financial situation. Ever.

But then again, I think everybody deserves such care, under those very same terms.

skeneogden said...

Does RWS ever post any thing without an ad hominem? I'd take him more seriously if he did.

There is a difference between snark and incivility.

Anonymous said...

Snark: Your first reply was very informative (regardless of the "I can't help myself" namecalling at the end).

So is this new policy going to try to include service-related injury or not?

"According to the head of the American Legion, Commander David K. Rehbein, the Obama administration will force private insurers to pay for some of the costs of treatment for veterans that have had war related injuries."

That says yes. Snark either ignores or denies the point (can't really tell which).

I don't see how the government can demand private insurance to cover such injuries as insurers have, I'm sure, excluded such injury from coverage.

Is this a covert attempt to nationalize health insurance?

Rightwingsnarkle said...

I don't see how the government can demand private insurance to cover such injuries

In the insurance world, it's called 'coordination of benefits.'

Have you ever had a situation, say with kids' dental bills, where both spouses have some degree of dental coverage - in effect, two insurance plans?

Coordination of benefits is the process whereby both insurers work together to each pick up a part of the tab. Neither insurer gets off the hook, but neither is left holding the complete bag.

So, again, the policy may be a win/win, insofar as the poster I originally cited has described. The vet gets covered services, and also gets their commercial insurance deductible met by the VA. The VA gets the commercial insurer to kick in some money to supplement theirs (ours).

Health care financing in our existing system is needlessly complicated, because there are so many administrative players who add nothing of value. And the name of the game for the insurance companies is to avoid paying out anything, or to pay the absolute minimum. Why let them off the hook?

If I understand the other commenters here correctly, and they appear to be very uninformed, they want Uncle Sam to pay the full freight, no questions asked, even when there's another payor standing in the wings, a payor who's collected premiums from the insured vet and/or spouse, and who has the resources to pony up to help pay for the vet's care.

I'm surprised that they'd leave that money on the table, though maybe they're just insurance company shills.

Like I said before, I don't think that anybody's care should be up for debate. It doesn't matter to me if somebody's a wounded vet, a sick single head of household, a kid who needs a physical exam and some vaccinations, or an injured illegal immigrant - a person who needs care should be able to get it, period.

The care should be thorough, high quality, and readily available.

And nobody should ever be tipped into bankruptcy or financial hardship because they need care.

skeneogden said...

If the program was to work as RWS explains it would, then how come the administration couldn't articulate it a concisely as he did?

How are they going to tackle the economy, Iran, the Middle East, etc. when they can't even come up with a coherent policy for something as mundane as this?

Maybe Obama should spend more time in policy meetings and less time on Leno.

Anonymous said...

Snark: "In the insurance world, it's called 'coordination of benefits.'"

Couple questions (if you come back to this older post):

What private insurance? How many veterans also have private insurance anyway? Many are retired, many are unemployed, or underemployed, many don't have private health insurance for the same hundreds of reasons that "millions" of Americans don't have private health insurance.

Do we have any numbers for how many people, how many insurance companies, this would affect? (Other than the financial estimate given that shares no other data with the public so far.)

I haven't looked at my policy in years, are you SURE war-related injuries are covered at all? Why would they co-pay for medical care that they don't cover in the first place?

I guess the government could cooerce them into breaking those contracts after-the-fact, they don't seem to be having any difficulty doing this regarding executive pay, but if they do, I would infer that this IS a socialized medicine power play.

As for having the government pay 100% of veterans health care bills, other countries do this without a problem (Australia, for example). I guess you could call it socialized medicine for a sub-set of the population. Doesn't this proposal indicate they can't, or are unwilling to, pay for medical care, even for a relatively small number of citizens? And arguably, citizens that DESERVE to have their medical bills covered by the very government they served?

Rightwingsnarkle said...

Snark: "In the insurance world, it's called 'coordination of benefits.'"

Couple questions (if you come back to this older post):


I was able to check 'follow by email' at some point in this thread, so was notified of your questions. There's so much stupid in what you've written, it's hard to know where to start. Let's just try taking it piece by confused piece.

What private insurance? How many veterans also have private insurance anyway? Many are retired, many are unemployed, or underemployed, many don't have private health insurance for the same hundreds of reasons that "millions" of Americans don't have private health insurance.

I don't completely understand your first question. I guess if you're wondering what for-profit insurance policies are affected, the answer might be - any of 'em, and all of 'em. But it's not clear to me what you're asking.

As for how many vets have for-profit insurance, that's a worthwhile question. I wonder if the VA could answer it for you, or if you could get some data via Google.

There should also be data somewhere that breaks down the total number of vets, the number/percentage of vets who are of retirement age, unemployed, completely disabled, have additional for-profit insurance from other sources, etc.

I guess if you really wanted answers you could actually, you know, spend some time looking for them. Or, am I being quizzed here?

As for your quote marks around the word 'millions,' is that because you're outraged over the fact that a huge number of people in the richest country on earth, ever, have no health insurance coverage? Or are you disputing the figure?

And there really aren't hundreds of reasons for the lack of coverage. It really boils down to just a few, having to do with employer benefits, or lack of them; guidelines for qualification for public programs; the practice by for-profit insurance companies of denying applicants' coverage for their own reasons; and the political difficulty, going back to Harry Truman's presidency, in getting this issue addressed in the same way that other industrialized countries have addressed it.

Do we have any numbers for how many people, how many insurance companies, this would affect? (Other than the financial estimate given that shares no other data with the public so far.)

Again, if you wanted to know, you could start digging.

BTW, what do you mean "we," white man?

I haven't looked at my policy in years, are you SURE war-related injuries are covered at all? Why would they co-pay for medical care that they don't cover in the first place?

I'm not SURE of much, other than the reliable ridiculousness of engaging in productive discussions on wingnut blogs.

You do raise an interesting question regarding cause (war-related). Sometimes the line is clear (Tammy Duckworth lost both of her legs in a combat-related accident, for example), but sometimes the line is blurred. And for-profit insurers love to dispute cause as a way to avoid covering the cost of treatment.

Remember, for-profit insurance companies make money by denying care, not by paying for it.

I guess the government could cooerce (sic) them into breaking those contracts after-the-fact, they don't seem to be having any difficulty doing this regarding executive pay, but if they do, I would infer that this IS a socialized medicine power play.

Ah, the latest wingnut talking point - government as coercive contract-breaker; coupled with the scary term socialized medicine.

As for having the government pay 100% of veterans health care bills, other countries do this without a problem (Australia, for example). I guess you could call it socialized medicine for a sub-set of the population. Doesn't this proposal indicate they can't, or are unwilling to, pay for medical care, even for a relatively small number of citizens? And arguably, citizens that DESERVE to have their medical bills covered by the very government they served?

You took a while to introduce a straw man, but eventually came around.

Fact is, other countries pay %100 of everybody's (or almost everybody's, or almost %100) care.

If you think that this kind of coverage is good enough for vets, why isn't it good enough for everybody else?

OK, that's 4 minutes of my life that I won't get back.

kthxbai

DoorHold said...

"There's so much stupid in what you've written"

I appreciate the effort but will not read past the comment quoted above. I know that's just your personality, but ... whatever. Thanks for trying though.