Posted on Dec 1, 2016

Should troops buy their health care in CONUS?

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http://www.militarytimes.com/articles/cato-report-va-insurance-private

No-Show rates are one metric that destroy health care access and threaten our ability to provide care since congress wants to focus on costs. Many think that a nominal fee would help this. Nothing is free...

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Department of Veterans Affairs (VA)

Posted >1 y ago

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Responses: 17

SGM Erik Marquez

Posted >1 y ago

No show fees, or adverse action is a strong point...The issue with doing so in the Military is.... Most military members do not control thier own daily destiney.... And while the CofC and NCO support channel "SHOULD" know of and support them in medical appointments things go wrong, mission needs/times lines change and there are crappy leaders.... Now we have a SM being "punished" for a missed appointment he had no control over missing.

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1SG Al Brown

>1 y

I forget an appointment once. It was my fault, and the 1SG provided the obligatory butt chewing. We both got over it. If I would have been fined, I would have ETS'd.

SGM Erik Marquez

>1 y

1SG Al Brown - Ideally it would be a tiered deal...as always the desire is to modify behavior.The 1st time you're late for PT formation, is a one way discussion and more PT..next time no decision and LOTS more PT after that its clear your not trying so no more discussion and no more wasted leadership time on you. Check for accountability, note of missing, paperwork, UCMJ, repeat until packet is sufficient for seperation. Too many good Solider that deserve the leaders time to waste on a unwilling one. I was the same with missed appointments. ..Hey shit happens, dont let it happen again....but when it happens again and the reason is "But 1SG, it was a 4 day" ...well that is a differnt deal altogether

Capt Tom Brown

>1 y

I never had an incident of a Marine missing a medical appointment or sick-call if there was half a reason to go. No one tried to deny or prevent a man from going to sick bay or making a Drs. appointment no matter what our training involved. I made a point of telling every sick-bay commando that should we ever deploy into combat or any operational mission, for any reason, everyone without exception, would be going in. Sick bay would not be an option and all their light-duty, no-duty, shower-shoe, and no-shaving chits would not prevent them from going in. They would be landing in shower shoes.

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>1 y

SGM Erik Marquez SGM, I don't know if you read the new NDAA but the provision to have a fee to add your family members to Tricare and the fee for no show were removed. It was a serious push and I wonder how long it will be until it's added...

MSgt James Mullis

Posted >1 y ago

I've always wondered about the necessity for the VA to have it's own hospitals. I would like to see a cross the board cost comparison between Separate VA hospitals and the VA as an insurer that pays for veteran healthcare at civilian facilities/hospitals. This would certainly help folks in the rural communities where you may need to drive several hours to get to a VA hospital. Also, years ago the DoD did a similar cost analysis for Post/Base Hospitals versus civilian hospitals and we all know what happened, the majority of DoD Hospitals were closed or dramatically reduced in size.

As for No-show rates, the same thing happens at civilian facilities. My wife regularly has patients show up 45 minutes late for a 20 minute appointment, demanding to be seen. The typical policy is anything under 15 minutes late and you'll be seen, longer than that you get rescheduled. My wife actually likes to have one or two no shows a day, it gives her time to catch up on paperwork.

FYI: When I was on active duty a missed hospital appointment meant a trip to see the Commander or 1st Sgt. Isn't that still the case?

CPO Henry Enterline

>1 y

If I might suggest the VA hospitals are designed around specializing in shock trauma, combat wounds, rehabilitation and therapy and mental health where a local facility won't have the same degree of capability. I like your idea but I can't think of a government bureaucracy that completed overhauled itself like that. Perhaps a hybrid?