America's veterans are being asked to pay again — in cash, this time.
In a startling, unprecedented and shameful move on Monday, President Barack Obama enraged leaders of 11 of America's principal veterans service organizations (VSOs), at a meeting celebrating the 20th anniversary of the Department of Veterans Affairs' elevation to Cabinet status held at VA headquarters in Washington, D.C., telling them that a proposal to order the Department of Veterans Affairs (VA) to bill veterans' private insurance companies for treatment for service-connected injuries and illnesses is still under consideration.…
Article comments
26 - Clavos
The central point seems to be that the insurance companies are getting a free ride and, if that is the case, trying to find some equitable way of re-balancing that isn't shameful, it's good business practice.
Except that the proposal will ultimately shift the burden (thanks, Cindy) to the vets -- the insurance companies will make sure of that; their premiums will likely increase, and those who are severely wounded and/or disabled could conceivably reach their caps, endangering the health care of their families. Many of the service-connected vets don't even have private insurance for themselves -- they've not needed it. Now, they'll have to find it -- with pre-existing ailments.
Given that there is also a proposal to increase the overall budget for vets considerably, your outrage is possibly just a tad disproportionate.
So in your view it's logical that the Messiah giveth and the Messiah taketh away?
27 - Cindy
Besides what Clav mentioned, will they have copays? Problems with coverage? Hours on the phone arguing with insurance companies? (and etc. that I am too mad to think of at the moment) These in addition to the burden they already live with due to their military injuries?
28 - handyguy
1. It's only a proposal, and it isn't going to happen. Several Democrats in Congress have already called it 'dead on arrival.'
2. The policy was not aimed at vets, but at insurance companies. In many cases they are being paid premiums but are not providing any payouts for coverage. Direct a bit of your outrage at them.
3. The president himself met with leaders of veterans' groups to discuss this, immediately. Does this really sound like someone who is deliberately trying to disrespect or 'screw' veterans?
4. The increases proposed by the president for the VA are hardly minor: 11% in 2010 and $25 billion over 5 years. Again, does this sound like a proposal of someone trying to hurt veterans?
29 - Cindy
Obama backs off plan to alter vets' healthcare
By Roxana Tiron
Posted: 03/18/09 03:42 PM [ET]
The White House on Wednesday backed off a controversial plan that would have dramatically altered the way the Department of Veterans Affairs (VA) handles insurance claims, after veterans groups staged an all-out fight against such a proposal.
President Obama will not pursue a proposal that would have allowed the VA to charge private insurance companies for the treatment of veterans with service- and war-related injuries.
30 - Dr Dreadful
Democracy at work.
31 - bliffle
Maybe the intent is not to shift cost to Veterans but rather to their private insurance companies.
"...proposal to order the Department of Veterans Affairs (VA) to bill veterans' private insurance companies for treatment for service-connected injuries and illnesses..."
As stated, it would only result in increased cost to vets if the insCos shift burden thru increased premiums, which they could do.
Even so, sounds like a bad idea to me. Sounds like a continuation of the Bush cost-saving policies vis a vis Vets over the past 8 years.
32 - Cindy
Vets were also worried that it would interfere with their ability to get hired as businesses would be considering the increased costs to insure them.
33 - handyguy
Oh good, now we can all get back to the national pastime:
We must all boil with rage for at least a few more days about those AIG bonuses.
... until we forget about them and move on to the next instant outrage.
34 - Cindy
It doesn't bother you handy? It'll bother me very much for quite a long time. In fact, it will probably go into my permanent file.
35 - Baritone
Clav,
Well, first, given Cindy's #29 this may all be moot. As I noted above, such a move would be odious at best. However, given the turns this discussion has taken, it does appear that the issue itself is dead and that it was nowhere near becoming a reality.
I think Obama has run a number of things up the old flag pole, and will continue to do so in an effort to find a means to reduce spending and, in consequence, the deficit. No doubt he's going to continue to strike some nerves. About everyone is going to feel the pinch one way or the other.
BTW - I have no health insurance of any kind, nor does my wife. I use the VA exclusively for all of my medical needs excepting for dental care and glasses. I pay approximately $40 bucks everytime I set foot in the hospital - that includes any and all tests including 3 colonoscopies and 2 knee scopes.
I continue to get whatever medications I need, which thankfully aren't many, through the VA. Actually, I think I could get them cheaper from most pharmacies ever since WalMart began offering $4.00 prescriptions and most others have followed suit. But I feel it's best to keep it all under one roof as it were. They can pull up everything on their computer in seconds.
One other thought: Maybe, if people would drop the "messiah" and other such references there would be less ill will. That is more a response to the perceived responses of the Obama faithful than of Obama himself. I've seen nothing in anything he has said or done that even suggests that he has any such notion about himself or his administration.
Oh, and to anyone: I don't believe that Obama is any kind of socialist. But, if he is, I really don't give a rat's ass. If the balance of our economy and government moves more to the left in the ensuing years, it more than likely will be a good thing. So far, the so called free market hasn't turned out so well for the majority of us.
B
36 - handyguy
Cindy, the AIG thing? Of course it bothers me, but I think it's a distraction too. And cable news is beating it completely to death. And politicians of both parties are demagoguing it shamelessly. Those things bother me too.
Populist rage -- or canned media 'rage' -- is pretty cheap currency. It could also have unfortunate side effects, like preventing the government from taking further steps to fix the banking/credit system. And if that's not fixed, we'll really have something to rage about.
Wonkette sums up my attitude in a couple of their headlines from the last couple days:
Erupting Boils Of Rage And Pustules Of Righteousness, Coast To Coast
Special Tar-And-Feathers Liveblog: The AIG Guy’s Worst Wednesday Afternoon Ever
AIG CEO Will Testify, Then Go Immediately To Guantanamo
37 - Cindy
Well, it is more meaningful than that to me--conveniently reinforcing the protection of the wealthy as it does.
38 - Baritone
But, I must agree with handy. This is far more of a tempest/teapot issue than anything of real substance. It's maddening and an obvious embarrassment, but in the end it will be largely forgotten in a few days or weeks at most. There are a lot of bigger fish to fry as it were.
It appears that it will take a great deal more time for big corporate execs, wall streeters, bankers, etc. to wake up and smell the coffee. They see themselves as special - and talk about "entitlements!" They truly look upon themselves as "entitled" to millions - not because they're any smarter, or work any harder than the rest of us, but simply because they reside within the hallowed halls of corporate America - where they ply their trade.
On one level, they may be, or appear to be basically good, well meaning people, but there is a mindset which many such people possess that is obnoxious and condescending to everybody not of their ilk. It may ultimately serve them and perhaps the rest of us well if they get their legs knocked out from under them - if they have to - at least for a time - worry about making a mortgage payment or having money for their kids' braces or maybe having to let go their country club membership. (Oh, the horror!) Maybe a little coupon clipping?
Ultimately, I don't suppose the above will happen to many of them. But, perhaps, just the threat of such circumstances might serve to knock some of them off their fucking ivory towers.
Nah, probably not.
B
39 - zingzing
clavos: "false dichotomy, zing. it's not a case of either the vets or the kids, it's a case of either the vets or anything else."
that's the point, clavos. i'm not saying it's vets or kids, i'm saying there are loads of hard decisions we're going to have to make. this is just another one of those things. but the straight-up fact is that this thing with the vets probably won't happen (maybe, in part, because of articles like this), while the thing with the kids already has.
40 - Clavos
First, thanks to all who have commented, it's been a lively, yet civil discussion. Somewhat of a rarity on Politics threads.
Some thoughts/responses:
handy @# 28:,
The policy was not aimed at vets, but at insurance companies.
Perhaps. But Obama's people should have been smart enough to see how misguided the idea was, because there's no way the insurance companies would not have passed their increased costs on. Additionally, what would have happened to vets like Baritone, who don't have coverage? Try seeking new coverage with a host of pre-existing problems, such as a combat vet has.
In many cases they are being paid premiums but are not providing any payouts for coverage.
Would you have a citation for that? Even brain-addled, PTSD crazed, tripwire combat vets aren't stupid enough to buy insurance they'll not use. cf. Baritone, above, and comment #35.
The president himself met with leaders of veterans' groups to discuss this, immediately. Does this really sound like someone who is deliberately trying to disrespect or 'screw' veterans?
Actually, given the tenor of the meeting, as reported by the articles I cited, yes, it does. During the meeting he essentially told the VSO leaders he would do it, no matter what their concerns.
The increases proposed by the president for the VA are hardly minor: 11% in 2010 and $25 billion over 5 years. Again, does this sound like a proposal of someone trying to hurt veterans?
Not all of them, no. But regardless of how much the VA's overall budget is increased, the proposal would have hurt those of us who, at present do not have to pay for our service-connected injuries and illnesses.
Doc @# 30:
Indeed. And one of the reasons why ours is still a better system than anything else that has come down the pike so far.
Bliffle @# 31:
As stated, it would only result in increased cost to vets if the insCos shift burden thru increased premiums, which they could do.
And they would have. As surely as the sun will rise tomorrow morning.
Cindy @# 32:
True. Also, vets who own their own small businesses were worried for the same reason.
Cindy @# 34:
Me too. I won't soon forget it, and it does give me another perspective on Mr. Obama.
B-Tone @# 35:
I think Obama has run a number of things up the old flag pole, and will continue to do so in an effort to find a means to reduce spending and, in consequence, the deficit. No doubt he's going to continue to strike some nerves. About everyone is going to feel the pinch one way or the other.
That's his job. Ours is to bird dog him along the way.
I have no health insurance of any kind, nor does my wife.
Lucky you. I do, and have to -- to cover the 20% of my wife's bills (+/- $80K annually) that Medicare doesn't cover, as well as her prescription bills ($5K monthly).
They can pull up everything on their computer in seconds.
So can you. Have you signed up for MyHealtheVet yet?
One other thought: Maybe, if people would drop the "messiah" and other such references there would be less ill will. That is more a response to the perceived responses of the Obama faithful than of Obama himself.
Perhaps. But the man has his share of hubris, as well. cf: His demeanor during the meetings with the VSO folks as reported by my links.
Handy @# 36:
AIG CEO Will Testify, Then Go Immediately To Guantanamo
Great idea, though I'd rather we shot them. I'll chip in on the air fare.
In conclusion:
It's been interesting (and eye-opening) to me that so many of you who are self-described liberals strongly in favor of the government paying for everyone's health care aren't more sympathetic to the vets' stance on this issue.
41 - handyguy
Or there was Sen. Grassley's delicate suggestion that the AIG execs should publicly apologize, then commit suicide.
That's just the kind of bracing rhetoric we need from our leaders during a crisis, by gum.
42 - handyguy
Just to clarify, my bit about premiums came from the CNN article:
"The vets are paying premiums to insurance companies, and that is a free ride that needs to stop," Gorman said in describing the president's message to the group.
There might be another idea floating too:
Both AMVETS and Disabled American Veterans believe that the VA could raise more revenue by being more aggressive about pursuing billings for non-service-connected treatments. Increasing third-party billing for non-service related injuries by 10 percent, suggested Agg, would free up more money to help service-related injuries.
43 - Clavos
Just to clarify, my bit about premiums came from the CNN article:
"The vets are paying premiums to insurance companies, and that is a free ride that needs to stop," Gorman said in describing the president's message to the group.
Yeah, well. Not the first time the President has gotten it wrong.
Both AMVETS and Disabled American Veterans believe that the VA could raise more revenue by being more aggressive about pursuing billings for non-service-connected treatments. Increasing third-party billing for non-service related injuries by 10 percent, suggested Agg, would free up more money to help service-related injuries.
A worthy idea. No reason why those being treated for non service-connected ailments shouldn't pay in the same way they would at another medical facility.
44 - Clavos
Or there was Sen. Grassley's delicate suggestion that the AIG execs should publicly apologize, then commit suicide.
Actually, he was suggesting they should emulate the Japanese and apologize OR commit suicide.
45 - Cindy
I think I liked it handy's way better.
"AIG execs should publicly apologize, then commit suicide."
I don't really mean it rhetorically though.
46 - Baritone
Clav,
Well, it is great - for me. However, as I imagine you can relate to, not so good for my wife. She's pretty much hanging out there. She's had 2 abdominal surgeries owing to diverticulitis and a resultant perforation of her colon which damn near killed her. In each case the hospital read the handwriting on the wall and chose to write off their portion which was around $50000., but we still had to pay the surgeon, the anesthetist, labs, imaging (X-Ray, MRI,) pharmacy, etc. to the tune of around $30000. (We're down to about the last $3500.)
What president didn't have his share of hubris? It pretty much goes with the territory. I think a lot of people who became inured to the Bush - uh - style just can't wrap their minds around a president who actually has a command of the language and an air of personal dignity. Obama is not condescending, he is simply confident.
Did you happen to see his town hall in Cal earlier this evening? He took questions and comfortably answered - and with NO teleprompter.
B
47 - Lumpy
I can understand why Obama might cinsider this measure , but bringing it up at an appearance before veterans groups seems remarkably stupid and insensitive.
48 - Pleiku 69-71
If you want to save money, quit fighting wars we don't need to be fighting, the money could be used to bail out anouther coruped Gov.agencie
49 - Baritone
Stupid and insensitive? No. A miscalculation, perhaps. Again, his goal was to involve the insurance companies. The miscalculation comes with not thinking down the road as to how, as Clav suggests, the costs could be passed on to the vets via higher premiums and/or co-pays.
The error as I see it is that the private sector should be kept as far away from the VA as possible. The VA works. It is SOCIALIZED
medicine! It's not perfect. It's run by humans after all. But it works. No other system in this country offers such a wide range of care under one roof. Don't mess.
B
50 - jamminsue
On the Rachel Maddow show onMSNBC this evening, it appears Obama has backed offfrom this idea.
Cool!
51 - Cannonshop
#45: Agreed. There's tall buildings, with windows, so they don't even have to run afoul of New York's handgun laws to do so, and it would provide some make-work to stimulate the economy.
The only problem, of course, is that they would need the NYPD to clear the streets for the jump so that innocent folks who were screwed over don't get insult added to injury.
Notably: VA doesn't work well, but it DOES work-a rare thing in any government agency not directly designed to kill people and break their stuff. It doesn't hold up to Civilian standards, but it does provide better care than relying on poverty-ER medicine or other "Public Health" systems in this country.
52 - Baritone
It doesn't hold up to Civilian standards...
I disagree. While you can't go to the VA to get a face lift or a tummy tuck, there is little that one can't get if needed from the VA. No doubt some facilities are better than others, but that's just as true in the private sector.
Clavos indicated that the VA hospital in Miami is exemplary and I believe the facility here in Indy is as well.
In the ten or so years I have been going to the VA, I have rarely had to wait more than 15 or 20 minutes for an appointment. I see my primary physician at least twice a year who facilitates getting me into the various clinics - ortho, heart, etc. I always receive appointment reminders in the mail, and often a phone call the day prior.
I am claustrophobic. I had a conventional MRI for my knee which turned out to be 35 minutes of relative terror. While they don't have an open sided MRI at the hospital, they had no problem outsourcing me to a private facility for my next MRI for my other knee. Both of my knee scopes have been outsourced, so that I wouldn't have a long wait to get them done.
The clientele at the VA is somewhat specialized. There are no kids. The great majority of patients are men, although owing to the rise in women serving in the military and coming into harm's way, there is a growing contingent of women patients as well.
Many of the patients are an older, cantankerous lot. Many are poor. Of course a large number of them are disabled in some manner. It ain't no suburban spa.
But, regardless, the quality of the care and the facility is, IMO, first rate.
B
53 - Mark Schannon
Clavos,
Agree completely with your sentiments. Thankfully, someone with more brains & sensitivity alerted the higher ups to this nonsense & the White House today withdrew the idea.
I've said elsewhere that, in a crisis, your primary job is to minimize the screwups as you try to figure your way out. This was a perfect example.
In Jameson Veritas
54 - roger nowosielski
Mark Schannon,
You should get on Aetius's thread. I touches on things you might like to address. Besides, I'd be interested to hear your views regarding Aetius's article.
Remember, we still have an issue or two to settle. Consequently, I need more material (from you) to better understand where you're coming from and the position you're espousing.
Roger
55 - Heloise
Good article Clav. I too was wondering about the cash part even before I read the article. It sounds like an after thought. I read your explain and you still don't explain it. Okay.
But all one has to do is to visit a VA hospital. There is a real one in Chicago. And the physical structure is old and decrepit. I think I tried to get a job there once and that's why I went in there. Didn't work there nor get hired.
Don't know any Vets either and never heard them complain. Glad someone is bringing up the obvious not enough has been done for them. What about the crazies coming back from Iraq? We have to worry about the PTSD from all these people returning. America cares not for those who get damanged in war after they send them off.
Heloise
56 - roger nowosielski
Clavos,
To the best of my knowledge, VA has always been underfunded. And given the size of the budget and the stimulus package, the amount of money to be saved is indeed a pittance.
Do you know, Clavos, what would the reaction from the private insurance companies be if this proposal went through?
On the face of it, at least, it appears analogous to a similar move when those on Social Security and Medicare would be/are (?) required to pay for some of the benefits if either their total income is above certain level and if they have other medical insurance besides
57 - Clavos
The thing is, Roger, that all honorably discharged veterans are entitled to treatment at a VA facility.
Among those veterans, however, are two kinds of patients: those who come for treatment for conditions that occurred as a result of their service, and those who seek treatment of conditions that have no connection to their service.
The latter group already are means tested and pay copays (as Baritone explained he does, above), either themselves (as in B-tone's case) or, if they have private insurance, the VA bills their insurance carrier, just as any other medical provider would.
The group who are suffering conditions incurred as a result of their service, and/or are deemed disabled as a result of their service, are NOT required to pay, not even copays. It was the insurance carriers of this group that Obama was proposing to start billing for services.
Not only would this have been a revocation of the VA's primary and most important mission, it would have inevitably resulted in those veterans having to pay out of pocket expenses in the form of copayments and/or increased premiums on their insurance.
In addition, as Cindy mentioned above, many (if not most) of this group are seriously wounded and/or sick; their treatment is complex, long lasting (often for life) and very expensive, greatly increasing the likelihood of such veterans "topping out" on their insurance, and winding up uninsured altogether, which also would hurt their families.
It was a very bad idea, which would not have resulted in much savings (relatively speaking), but definitely would have cost the president (and by extension, the Democratic party) a lot of good will, not only with the millions of veterans and their families, but with the voters in general.
58 - The Obnoxious American
Clavos,
Fantastic article. Terrible thing we are discussing here. I just can't believe Obama would actually do this.
Forget about bailing out corporations. What about the 8 billion for the monorail between cali and las vegas? Or any of the other pork projects or handouts in the several trillion in spending over these first two months? Obama clearly has his priorities totally wrong.
One good note however, Obama did do his NCAA brackets, so we are covered in that regard.
59 - Clavos
Roger,
...those on Social Security and Medicare would be/are (?) required to pay for some of the benefits if either their total income is above certain level and if they have other medical insurance besides...
Actually, Medicare only pays 80% for ALL patients, regardless of income, and doesn't pay for medications (with a few very specialized exceptions), so everyone on Medicare has to have so-called "Medigap" insurance to cover the 20%, as well as insurance for medications.
60 - Clavos
Thanks OA.
I'm sure it wasn't Bam's own idea, but I do fault him for not stepping on it AND the insect who proposed it; at the very least, his own political self-interest alarms should have gone off when they presented the idea to him.
61 - The Obnoxious American
Clavos,
As the left has reminded us many times over the last eight years, he is the president and it all falls under his responsibility. See Katrina for more details.
But don't worry, Obama will always do what is expidient, so now that everyone is in a huff, Obama will likely give another prime time teleprompter speech talking about his new proposal to help all the vetrans. He will sound pious doing it, and the average joe will walk away thinking, wow, I am really glad we got that Obama guy in office.
Given Obama's proclivity to do what is perceived as expedient, as opposed to having a principled center, I wonder if foreign countries are scheming ways to control Obama via drummed up outrage over this or that policy. It really wouldn't be hard. A little propaganda, some foreign owned press outlets, and you could effectively guide the president's actions via expediency. It happens all the time in the business world, it's known as managing up.
62 - Baritone
Clav,
RE your #40: "Have you signed up for MyHealtheVet yet?"
Yes. I haven't quite figured it out yet, though.
B
63 - Cindy
Jobless rate hits 11.2% for Vets. USA Today. 3-20-09.
Having a military record is apparently seen almost in the same way as having a felony conviction one Vet said. Employers apparently think Vets must have some kind of mental aberration from having been in a war.
64 - roger nowosielski
Pretty soon it will be 20 percent and rising for the country at large.
65 - leighann
The VA hospitals that I know about are terrible! (Biloxi)My dad is a disabled vet (with service related injuries) who is also mentally ill. He is in liver failure and the VA has him seeing a nurse practitioner. Not a liver specialist, not even a doctor. When my dad's amonia levels go up, his eyes get very matted. When he asked her about this she told him that she did not deal with eyes, he would have to go somewhere else. He can't walk, take his pills independently, or even hold a spoon to feed himself but each time he has been just about ready to get on a transplant list, they tell him that he failed the drug test for THC. We finally got tired of it and took him the next day for another test from a civilan doctor and he passed. When VA ran it again, he passed but they would not even listen to his wife before that when she told him that there was no way he has been smoking marijuana. I go to a support group on line for families of liver patients and I have heard a few of the people from VA say that they have dealt with the same thing. If you complian it just makes it worse, and if you have no other insurance then you do not have any other choice but to take the crap tht they give.
Thankfully, my father does and now sees a civilian doctor, a real doctor at that.
So much for socialized medicine, where my family is concerned anyway.