Affordable Health Care for America: It’s Now the Law of the Land
Mar 23rd, 2010 | 27 responses
Plenty will be said an written by politicians, journalists and pundits about the historic event we just witnessed in the East Room of the White House: President Obama’s enactment of the most extensive health care legislation in decades—perhaps in our history.
As an American, I just want to express my thanks and my personal sentiments about this landmark legislation.
First, as I have said so often, I really have no dog in this fight.
Both as active duty and retired military I have always had the best health care in the world—health care provided and paid for by the U.S. government. Today I continue to enjoy this government sponsored health care, the best in the world, at minimal cost. And I know I will continue to do so.
I say this for several reasons.
First, because this is evidence—at least to me—that U.S. government provided, sponsored, paid for, or even “regulated” health care is not the socialist graveyard so many opponents of such legislation claim it to be.
Second, because in my opinion such legislation does not take away or diminish any of my freedoms, rights or patriotism by asking me to share some of my good fortunes with millions of other Americans who have not been as blessed.
Finally—and you can call me whatever you wish—because I do not object to paying a few more dollars in order for all Americans to begin to have a taste of the benefits I have enjoyed for so long.
And to those who view it differently, forgive me, but I don’t see this legislation as the end of “America as we know it now.” I see it as a new chance, new hope, a new beginning for so many Americans who have been left behind.
Legislation does not make or break a great nation. How such legislation is used to benefit or abuse its citizens does.
I firmly believe that the legislation that just became law will do the former—if we just give it a chance.
That is my personal opinion.
27 Responses to “Affordable Health Care for America: It’s Now the Law of the Land”
Both as active duty and retired military I have always had the best health care in the world—health care provided and paid for by the U.S. government. Today I continue to enjoy this government sponsored health care, the best in the world, at minimal cost.
Sorry to go off on a tangent but in my experience TriCare is awful. There is only one physician in a 40 mile radius that accepts it. There used to be two but one dropped it due to poor reimbursement and more hassles (mainly prior authorizations) than any private insurer he worked with. In my area TriCare reimburses worse than Medicaid which is saying a lot.
TriCare is an example of how badly the government can screw up health care. I don't know where you're from but if you are not in an area with a large military presence then TriCare can be a real problem.
DG:
I am sorry you have experienced problems with TRICARE physicians availability.
When I “only” had TRICARE, I did not experience such problems.
Now that I am under TRICARE For Life I can categorically state that I have the best medical care available anywhere in the world. I have had major surgery, every kind of preventative care, etc., etc. No problem.
Again, sorry about your experience.How was your medical care while on active duty?
DdW I never had to see a doctor in my 4 years except for my exit physical. I did get excellent dental care. Active duty generally had very good access to care because of sick call. Dependents and retirees had a much tougher time with access – the primary care clinics rarely had openings and most people resorted to the ER.
How does Tricare reimburse in your area? Is there a large military presence there? How do their reimbursements compare to Medicaid and Medicare in your state?
DdW,
For what it's worth, I think the cries of socialism are only so much noise, yet I still oppose the bill on the following grounds.
1. It creates a new entitlement, managed by politicians, that will almost assuredly cost more than is promised.
2. It's funding mechanisms are largely speculative, and, to the degree they exist, they remove the most effective levers from improving the fiscal position of two programs in fiscal difficulty, social security and Medicare.
3. The “cost” of the program has been managed dishonestly, with much of the costs unscored because they either (1) sit on state budgets, (2) come as a consequence of an individual mandate and therefore sit on the budgets of individual citizens, or (3) are the result of budget gimmickry (see CLASS, incremental SS taxes, and Medicaid reimbursements)
4. The provision of insurance is not a benefit in and of itself. In fact, insurance, by its very nature is designed to cost more than the underlying cost of services insured across the pool. If it doesn't, the insurer goes out of business. So providing insurance will raise the cost of health care in this country not lower it. That being said, I am entirely unclear on what the outcome-based benefits of the bill are and whether they are worth the $250 to $300 billion annual operating costs.
This of course is only my opinion as well ; )
Again, sorry to hear that even on active duty “dependents and retirees had a much tougher time with [medical] access.” My dependents did not experience such problems. And as a retiree, as I have already said, I could not ask for better care.
As to your other points/questions:
No I am not in an area with a a large military presence.
Under TRICARE For Life, MEDICARE pays for the first 80 percent of costs and TRICARE picks up the difference. Thus I pay zero.
Sorry I can't say anything negative about my government medical benefits. But eventually you may get some “horror stories.”
Contrary to a lot of the fear mongering and purely partisan attacks we see so often, those are valid and serious concerns, steveinch.
As to creating a new entitlement, if Social Security and Medicare are entitlements, then, yes, this is one, too. But the question then immediately begs, how many of us are willing to give up those first two “entitlements.” And yes, you are right, they are managed by the government (politicians), and we all know how inefficient the government is. Look at any government spending.
Perhaps one day we'll find a better way to manage these “entitlements.”
As to “funding” and “costs,” on SS and Medicare, yes we are in trouble on that. On the HCR, that partisan CBO scores it ok. We'll see
As to your # 4, again, we'll have to wait and see.Just like yours, these are opinions…and hopes
My only comment is on the CBO score.
Let me just point out a few things.
CBO was forced to score the medicare advisory board as lowering costs even though nobody knows how they are going to do it and Congress can override the board should they choose to do so. This is the bulk of the “savings” in the second decade. Remember when a blue ribbon commission recommended putting off mammograms until age 50, Washington erupted and the panel crept off into obscurity? There's no reason to believe that this won't happen again.
The incremental taxes from payroll taxes that are assumed as employers shift to cash compensation from health benefits because of the cadillac tax are credited to HCR, not to social security and Medicare. This means although the taxes will be collected “for” SS and Medicare, they will be used for HCR.
Congress had previously agreed to increase Medicaid reimbursement rates for doctors and hospitals. These increases are in the bill but only for 3 years. They are assumed to end at that point. Do we really believe this to be the case? Not so much in my opinion.
To be honest, I really hope you are right. It would be great if this would create some wonderful outcome and run within budget. I really wish I could bring myself to believe it but sadly I cannot. But thanks for staking out the point of view. The fact that reasonable people believe it could happen is a reason for hope
You seem to be quite a bit more knowledgeable in this area, and I appreciate that.
I am kind of “flying blind” here, relying on what CBO & others tell me, and hoping for the best.
I have learned from your comments and thank you for that.
Well we will see what happens, but based on past experiences with government healthcare cost overruns, I'm not optimistic. I'm also morally opposed to taking away the freedoms of Americans not to buy health insurance and the associated penalties, the same thing candidate Obama blasted candidate Clinton for supporting in the democratic primary before his 180 degreee flip-flop against this freedom.
Question for you then…
For those who make the “free” choice to not buy insurance, how do you propose that they are forced to pay for all of their own care so they don't take away my “freedom” of having to pay for them when they eventually need it? Or do you propose a la Bill Kristol (I think) that emergency rooms begin to turn those without insurance away? We already pay (quite substantially) for the people who have no insurance but need care in our premiums skyrocketing due to the hospitals passing on those costs. How else do you level the playing field other than an insurance mandate?
DdW,
My spouse is active duty military and we are happy with Tricare, but that is mainly because we've lived near a military hospital for most of our careers (I used to be on active duty and am now in the guard). In many areas, though, finding a doctor that takes Tricare is very difficult.
You should change that to minimal cost to YOU. Your care and my care under Tricare is not cheap and military health care costs have risen substantially since the 1990's despite all the force reductions and despite the fact that the military health system is partially nationalized. You may be old enough that you can assume you'll continue to receive great benefits for little cost to you for the remainder of your life, but those of us who are not retired cannot reasonably expect to receive the same level of retirement benefits. All you need to do is look at what health care costs are doing to the military personnel budget to see the unsustainability of the current system.
This is the one area I also have some concerns/questions about, albeit I would not classify it as a “moral” or “freedoms” issue.
Anna, above has addressed this also..
Rather than force people who don't want to have health insurance,to buy such or penalize them for it, we should use a similar method as most states—I believe—use when people refuse to buy automobile liability insurance, and still drive their cars: show proof of financial ability or some similar method to ensure that they will pay for their own medical care if and when necessary.
But, I grant you, there are many loopholes, problems with this.
I also, do not feel that this issue alone should be used to deny millions of Americans adequate health care/insurance.
Andy:
Glad that you and your wife are happy with Tricare.
As I mentioned, we have been happy with it, too, whether we lived near a military hospital or not. As I also mentioned to steveninch, there are probably those who have not had such good experiences.
On my remark
you mention that ” that I should change that to minimal cost to me.
Well, that is exactly what I said—no need to change I expanded on that on one of my comments:
I don’t know how much more “minimal” that can get, and it is the same coverage for everyone on TRICARE For Life.
I agree with you, TRICARE is not cheap, and military health care costs continue to rise. That is one reason I am so extremely grateful for such benefits.
However, the purpose of my post was not to minimize the cost of such coverage to you and to the taxpayers, or to claim that I should continue to “receive great benefits for little cost to [me] for the remainder of [my] life” while “those of us who are not retired cannot reasonably expect to receive the same level of retirement benefits.”
The purpose was to say that if I can enjoy such benefits, then why not other Americans who need such coverage much more than I do and who can afford such the least, and that I would be willing to sacrifice a little myself in order for “ all Americans to begin to have a taste of the benefits I have enjoyed for so long.”
If the current system is “unsustainable,” let’s see where we can cut costs and benefits to make it more sustainable. I am not adverse to that.
Thanks for your comments.
Thanks for your comments. My principle concern with our health care system is sustainability – actually the lack of sustainability. Obviously that's not the only problem and while it's admirable this new legislation covers many uninsured, it means little if promises made today can't be kept over the long term. And my worry is that they can't, nor can the government keep the great benefits offered to military people like us and military retirees. Our politicians don't show much interest in addressing those fundamental problems and I doubt there will be political capital to do major health reforms until a decade or two passes. So I'm sorry if I came across as testy, but my cynicism about the future is running strong today.
I've been married to an Active Duty Soldier for almost 20 years. We have three sons, two with special needs. Tricare has been amazing, but the number of doctors who will accept coverage can vary from each location, even around areas with large military facilities. In one area (on the East Coast), docs were dropping Tricare coverage left and right. In another area (in the South), it took us over a year to get medical equipment. Tricare approved it, but the hospital fought accepting the “allowable amount”, even though they already agreed to accept Tricare (where they got most of their money, anyway). I'm a very experienced consumer of Tricare services, and I can honestly say that I fear that more doctors will drop Tricare patients and go toward private practice under the new pressures they will face. Hopefully I'm wrong, but I'm very concerned. I heard a rumor today that we would be taxed on our medical benefits, as if it were income? Gosh, I really hope that rumor is wrong.
I understand your concerns, Andy. A lot of military people (active and retired) have them and we can only hope that “our politicians” will keep remembering their promises and our sacrifices.
And I think there are good signs.
For example (and I address your concerns too, chaoticmom) there were many concerns that HCR would negatively affect Tricare.
At least one legislator (a Democrat) is addressing this, at least for the short term
This was a few days ago.
Since then, I believe some legislative action has been taken on this. Will research it and post it.
Finally, chaoticmom, be careful with rumors trying to shed a negatiove light on the Obama administration and/or the HCR legislation.
Courage!
DdW: You have stolen my thunder on this. But, you have saved me a significant amount of typing. I just found this site today and am greatful for having done so. It is such a pleasure to see and read people who may not agree, but are civil to each other.
As a Disabled Vietnam Combat Veteran, if it were not for the VA I would have no healtcare coverage at all due to “pre-existing conditions” attibutable to my service to this great country. I am a small business owner and, all things remaining equal, I will now be able to provide healthcare coverage available to my wife, myself and my employees. The money paid out by that plan for me will be paid directly to the Southern Nevada Veterans Healthcare System to help cover other Veterans. I never left a brother in the jungle or in the river and it has pained me to not be able to contribute more to my fellow Veterans.
Robert:
First, thank you for your service and especially for your combat duty.
Second, glad you found this site, TMV, and thank you for commenting.
Thirdly, thank you for your positive comments on our nation's health care for veterans and, I believe, on the newly enacted HCR legislation.
Delighted to hear about how, as a small business owner, you'll be able to provide better coverage to your employees and, of course, for your family.
Would love to hear more details about how the new legislation will affetc you and your business.
Again, welcome and thank you
Dorian de Wind
As y'all can see here, it's not any kind of magic “affordable health care for all, now, forever, instantly.”
Now the incrementalist ratchet toward a universal federal entitlement has been made, though.
In the meantime, we have messy “reform” that retains the insurance model with employee benefits. Ugh.
Tricareforlife the coverage for retired Military 65 and over is connected to medicare. In theory it works good except that in many cases there are few DRs who accept new Medicare patients and thus no tricarefor life patients. We have had trouble in Oregon finding Drs who would accept us, this is due to the crazy way the Government pays Drs in different states.
I have no experience with the VA as I am not disabled nor have any other qualification for VA coverage. I am just a retiree.
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MOAA came out today with the information that should assist all Tricare and Tricare For Life (TFL) beneficiaries who have questions about said benefits and the new “Obamacare” law. TFL has been “too good to be true”, Tricare and Champus for us were difficult. None of us can know for sure what will happen, but we hope and pray for the best for all career military veterans and their families who have sacrificed so much. I for one, as a military spouse, rarely used Army medical facilities (by cloice) while my husband was on active duty unless we were overseas. Most of our assignments stateside did not mean living on post, so we paid for and appreciated private health care that was reasonable in the 50;s and 60's. Organizations like MOAA have been of great assistance to all veterans of any rank, keeping us apprized of just what is going on in Congress and the Department of Defense. We hope you find this source of information useful.
Armywife:
Thanks for your husband's service and for your comments.
Actually, I just published a piece here at The Moderate Voice, citing the excellent information being provided by MOAA that should lay to rest all the rumors and concerns that the new health care legislation will negatively affect our military and veterans' health benefits.
Please read irt here:
http://themoderatevoice.com/67257/renewed-fear-…
Dorian
chaoticmom:
As I just mentioned to another reader, I just published a piece here at The Moderate Voice, citing the excellent information being provided by MOAA that should lay to rest all the rumors and concerns that the new health care legislation will negatively affect our military and veterans' health benefits.:
http://themoderatevoice.com/67257/renewed-fear-…
DdW and others: You can say what you want about military health care coverage. It looks good on paper, I'm sure. The coverage can be excellent for the Military Soldiers and Families, but that absolutely does not mean there will be the number of doctors needed who actually accept that coverage. I think you're missing the point. At this point my concern is not the lack of coverage, but rather lack of providers who will accept Tricare payments. This is a very real concern now, and I sadly believe it may be a greater concern in the future. I am an educated and experienced user of the Champus/Tricare system, and do not say this lightly or with any fear mongering.
So, how to entice more doctors into the system, or to keep them accepting the coverage? That might be the real concern for those covered by Champus/Tricare.
Our benefits are only as good as those who are willing to honor them. I've been w/several practices who have dropped all Tricare patients, and fought one hospital for over a year to order the TRICARE covered medical equipment that my sons needed. That hospital accepted Tricare, but did not want to buy the equipment at the agreed upon Tricare reimbursement amounts. They had to in the end, of course, but I believe did so at a loss for the hospital. I can see their frustration.
chaoticmom:
Thanks again for your comments.
I can only speak for myself and for what I hear from friends about military health care.
As I have mentioned repeatedly, my family and I have always received what I firmly believe is the best, very available, and timely health care in the world at no or minimal cost.
But, I am sure there are exceptions, and I am sorry to hear that your family is one of them.
The purpose of my post was to express my personal gratitude for having been the recipient of such health care and hoping that finally all Americans will receive some semblance of good health care.
If there are problems with Tricare, let us try to get them fixed.
However, any such problems did not start with the Obama adminsitration nor are they the consequence of the newly enacted health care reform.
Finally, regardless of some of the doctors availabilty problems some of us may have with Tricare, I hope that you will agree what a blessing, what a peace of mind it is, if you, or I or our loved ones have a serious accident, a serious illness and need major surgery or extended medical care, thast we will certainly get such without having to sell our home, declare bankrupcy, etc., etc. as so many millions of Americans without adequate health insurance would have to do.
Thanks again, and sorry for rambling on