Posted on Mar 17, 2015
What are your thoughts on Tri-Care, and/or your concerns for the future of military health care?
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This is a topical and emotional discussion for all of us, in and out of the military. As service members I believe we get first class health care, but things will be changing due to things such as the affordable care act (ACA), and the fact that our elected officials say the current system is not fiscally sustainable.
I am recently retired, and aside from "Tricare for Life," I also have private employer provided health care insurance. By law, my employer provided health care is my primary insurance. This means they get billed first, and need to approve every procedure... And they are slower and less flexible than Tricare. It is frustrating, as everything is harder now.
I offer that, as I believe, as service members, we assume health care on the outside is wonderful, and ours is not much. I believe we have great health care, but no system is without issue.
A few closing points, so you can understand the costs, if you are not familiar.
1. As a retiree, we pay about 150.00 a quarter, as our cost-share/co-pay for "Tricare for Life" (Retirees); that starts upon retirement.
2. In my my job, free Health Care is provided (a benefit to consider when you transition), but if you want to include your family, it is around 465.00 per month extra. You also get vision, and dental, but can pay for higher level coverage, and include families, which I did as it was cheaper than Tricare Dental.
3. My son is college student, over 23, so is now insured under "Tricare Young Adult" (a benefit from ACA), which costs 205.00 per month.
4. When my daughter turned 23, before ACA, we paid about 150.00 a month for her insurance, until she landed a job after college. That was a private insurance thru USAA.
I am interested in your thoughts.
http://www.militarytimes.com/story/military/benefits/health-care/2015/03/16/commission-proposes-tricare-choice/24458697/
I am recently retired, and aside from "Tricare for Life," I also have private employer provided health care insurance. By law, my employer provided health care is my primary insurance. This means they get billed first, and need to approve every procedure... And they are slower and less flexible than Tricare. It is frustrating, as everything is harder now.
I offer that, as I believe, as service members, we assume health care on the outside is wonderful, and ours is not much. I believe we have great health care, but no system is without issue.
A few closing points, so you can understand the costs, if you are not familiar.
1. As a retiree, we pay about 150.00 a quarter, as our cost-share/co-pay for "Tricare for Life" (Retirees); that starts upon retirement.
2. In my my job, free Health Care is provided (a benefit to consider when you transition), but if you want to include your family, it is around 465.00 per month extra. You also get vision, and dental, but can pay for higher level coverage, and include families, which I did as it was cheaper than Tricare Dental.
3. My son is college student, over 23, so is now insured under "Tricare Young Adult" (a benefit from ACA), which costs 205.00 per month.
4. When my daughter turned 23, before ACA, we paid about 150.00 a month for her insurance, until she landed a job after college. That was a private insurance thru USAA.
I am interested in your thoughts.
http://www.militarytimes.com/story/military/benefits/health-care/2015/03/16/commission-proposes-tricare-choice/24458697/
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Col Williams, TRICARE already pays on average 8% less than Medicare; most providers can't even break even with what Medicare pays. So, here in Olympia WA, quite close to Joint Base Lewis McCord, fewer and fewer providers, even ex-military ones, participate in TRICARE.
We have to use the mail order pharmacy, for generics only (don't even think about a name brand drug, even when the generic is proven to be substandard). They only have a single source, and if they don't manage their inventory, they just cancel your prescription. If you're lucky, they will let you know, but most of the time they don't even do that.
The West region switched not too long ago from TRIWEST to UHC. Things are way worse for providers now. It takes four or more months for claims to clear, and things that never required authorization now require authorization.
They keep nickel and diming the program to death. It is already non-sustainable because providers lose so much money on it, and they've cheaped out in every way they can.
Because of mis-management in Congress and Pennsylvania Av, along with mis-management in the Puzzle Palace, the budget for DOD is a mess.
So, what do they want to do to fix it? Put it ALL on the backs of the troops. It is outrageous that active duty took a pay cut this year at the same time they raised the co-pay for generics, the kind you HAVE to get, a whopping 60%.
All these changes proposed by the modernization commission are ways to put more of the burden on people who go in harms way. These plans are decided by people who don't wear the uniform, and in most cases never did, and approved by a Washington DC that is at historically low levels of people who have served.
Military and veterans cannot unionize and we cannot strike. We rely on the help of MOAA, VSOs and other like organizations to lobby Congress, just to try to hold on to what we have.
None of these changes will benefit the service members or veterans, and all of them will ultimately result in reduced force readiness. But then, I guess that is what this President AND the GOP Congress want, isn't it? After all, even John McCain is for these changes.
And, no, PO2 William Allen Crowder these changes have nothing to do with Obamacare. They are being driven by a completely different color of money.
The future is very bleak for people who have served, unless SECDEF keeps his promise to grandfather those of us already retired. But even there, we're not protected from the gross mis-management I've already cited...
We have to use the mail order pharmacy, for generics only (don't even think about a name brand drug, even when the generic is proven to be substandard). They only have a single source, and if they don't manage their inventory, they just cancel your prescription. If you're lucky, they will let you know, but most of the time they don't even do that.
The West region switched not too long ago from TRIWEST to UHC. Things are way worse for providers now. It takes four or more months for claims to clear, and things that never required authorization now require authorization.
They keep nickel and diming the program to death. It is already non-sustainable because providers lose so much money on it, and they've cheaped out in every way they can.
Because of mis-management in Congress and Pennsylvania Av, along with mis-management in the Puzzle Palace, the budget for DOD is a mess.
So, what do they want to do to fix it? Put it ALL on the backs of the troops. It is outrageous that active duty took a pay cut this year at the same time they raised the co-pay for generics, the kind you HAVE to get, a whopping 60%.
All these changes proposed by the modernization commission are ways to put more of the burden on people who go in harms way. These plans are decided by people who don't wear the uniform, and in most cases never did, and approved by a Washington DC that is at historically low levels of people who have served.
Military and veterans cannot unionize and we cannot strike. We rely on the help of MOAA, VSOs and other like organizations to lobby Congress, just to try to hold on to what we have.
None of these changes will benefit the service members or veterans, and all of them will ultimately result in reduced force readiness. But then, I guess that is what this President AND the GOP Congress want, isn't it? After all, even John McCain is for these changes.
And, no, PO2 William Allen Crowder these changes have nothing to do with Obamacare. They are being driven by a completely different color of money.
The future is very bleak for people who have served, unless SECDEF keeps his promise to grandfather those of us already retired. But even there, we're not protected from the gross mis-management I've already cited...
COL Charles Williams
LCDR Jaron Matlow Thanks for you comments! You must have been out there/here longer than I. I am just getting used it. I guess it is good, I have employer provided health care. AUSA is another group, that helps a lot... I suspect Navy, Air Force, Marines have similar groups.
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TSgt Tim (lj) Littlejohn
Our pay and benefits have pretty much been on a down slide since Reagan left office.
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Col Williams, I retired January 2001. I also worked VA benefits at DAV for 4 years, so I'm kind of tuned in to these things...
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Sir, my biggest concern is that the US Government, although it is good at a great many things, it is not good at "social programs." Any program where there is just raw accounting, we're amazing at. Any program that requires you to treat "one bean different from another bean" we're horrible at.
Bean counters count beans, they don't sort beans, and if they do sort beans, any singular bean will end up in a pile with other beans that are "similar"
Health care is about people. That means no two beans are alike. Health care insurance is about bean counting. And there is the crux. Can you put a fiscal cost on people? Or Health? Or do you just write a blank check, and balance the budget around it.
When it really boils down to it, you can't budget Health Care (or Health Care insurance). It doesn't work. This as a concept are going to fail, just like trying to budget "foreign aid." As an example, imagine we budget $1,000,000,000,000 for foreign aid. We do a great job at sticking to that budget. And then 3 tsunamis hit, and we have to go over budget, because we're a civilized society, and taking care of people is what civilized people do. We'll figure out the budget later. The budget is irrelevant. Taking care of people is what is important.
Unfortunately, people forget the point. They focus in on cost, not capability.
When it boils down to it, does the US Government have the Capability to support Tricare/VA/etc as long as needed? Yes, not just yes, but hell yes. Not only that, it has an obligation to. But, people are now focused on cost, and more specifically cost of sustainability.
What the government should be looking at is which programs we do NOT have the capability to support, and then remove those. That frees up cost, reducing the concern. Until then, cut the check.
Bean counters count beans, they don't sort beans, and if they do sort beans, any singular bean will end up in a pile with other beans that are "similar"
Health care is about people. That means no two beans are alike. Health care insurance is about bean counting. And there is the crux. Can you put a fiscal cost on people? Or Health? Or do you just write a blank check, and balance the budget around it.
When it really boils down to it, you can't budget Health Care (or Health Care insurance). It doesn't work. This as a concept are going to fail, just like trying to budget "foreign aid." As an example, imagine we budget $1,000,000,000,000 for foreign aid. We do a great job at sticking to that budget. And then 3 tsunamis hit, and we have to go over budget, because we're a civilized society, and taking care of people is what civilized people do. We'll figure out the budget later. The budget is irrelevant. Taking care of people is what is important.
Unfortunately, people forget the point. They focus in on cost, not capability.
When it boils down to it, does the US Government have the Capability to support Tricare/VA/etc as long as needed? Yes, not just yes, but hell yes. Not only that, it has an obligation to. But, people are now focused on cost, and more specifically cost of sustainability.
What the government should be looking at is which programs we do NOT have the capability to support, and then remove those. That frees up cost, reducing the concern. Until then, cut the check.
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I really do not know. TRICARE is a mess at times and has been great at other times for me. It can be useful having a third party health insurance in that family members can receive special treatments or surgery's. Personally, I am happy the way things are now, but I have a feeling that it will change soon due to contionous slow moving storm of change.
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