Effective July 1, 2008, all-ready low Medicare reimbursement rates to physicians will be cut by 10.6%. Lower reimbursement rates will result in physicians reducing the number of Medicare patients they see, decreasing access to health care for the elderly and the disabled.
Seniors and the disabled on Medicare are not the only populations affected. TRICARE, the Department of Defense’s health care program, serves active military, their families, and retired servicemembers. Its payment rates to physicans are based on Medicare reimbursement rates, thus the 10.6% cut will also affect their access to health care. Among these TRICARE members are soldiers returning from Iraq and Afganistan.
Currently, two proposed bills to halt the cut have been introduced by Republican Senator Chuck Grassley of Iowa and Democratic Senator Max Baucus of Montana. Senator Baucus would partly offset costs by redirecting funds from private Medicare Advantage plans. President Bush, however, has said he would veto any bill that would reduce payments to private Medicare Advantage plans. Senator Grassley has yet to release complete details of his bill.
We need to support our seniors, disabled and military personnel by contacting our representatives and urge them to halt the 10.6% Medicare reimbursement rate cut. Contact the White House and urge President Bush to sign legislation to halt the cut. July 1 is not far off, we need to speak out and act now.
Had to bump this up before it passed into oblivion -- page 2. And maybe I'll get some spillover viewers from the obama bashing thread. Hey! I look on page 2. Sometimes page 3 if I'm feeling daring! LOL
Isn't Grassley involved with the Harvard exposure with the 3.2 Million of undisclosed Pharma payoffs? Not bad for a Republican.
Karen~ this is regarding this thread and your comment about this thread on the Obama thread. Their has rarely, if ever, been a candidate on either side that I have agreed with or disagreed with on every point. That said, a decrease in Medicare is not something that I'd like to see happen. I'd have to see both sides of this before I could say one way or another. Thats because often times you find that you are hearing only one point of bill that is outrageous in it's totality. A candidate might be voting against a bill that might be good in one point but not so much in others. Then the media comes out with so and so wants to cut Medicare, when really it's not the Medicare he/she wants cut, but the rest of the bill is something they can't vote for. I don't know if that's true about this bill in particular, I don't know all the circumstances. Right now I have to go to sleep, but I'll check out your links tomorrow.
Karen? umm, this is Joie, actually Joy, and its my thread. I shamefully went a beggin to the obama thread to get some viewers.
I hope they can reach some type of agreement on how to come up with the money to offset the 10.6% cut, cuz it seems a shame to shortchange seniors, disabled and especially the soldiers that have fought in a war this Congress and President sent them to.
Pip,
Senator Chuck Grassley is the senior ranking Republican on the Senate Finance Cttee and Subcommittee on Health. He's powerful, and has been around for decades.
Joie2008-06-10 00:57:43Thanks for posting this!
I thought I'd add a bit more about Tricare... I think it's something people should know about.
My husband returned from Iraq in February and we are both insured under Tricare. Nightmare.
Joy....oops! For some reason I was thinking Karen posted that.
[QUOTE=habr0406]Thanks for posting this!
I thought I'd add a bit more about Tricare... I think it's something people should know about.
My husband returned from Iraq in February and we are both insured under Tricare. Nightmare.
[/QUOTE]
Can you find a local rheumatologist who will work out a payment plan until you get tricare squared away? Plaquenil is cheap, even without insurance. I live near a Navy base; many doctors around here will work with Navy patients to ensure they get the care they need despite Tricare. It's worth a try.
Pip
Joy - it is the same Rep on your post.
Pip
[QUOTE=Pip!]
Joy - it is the same Rep on your post.
Pip
[/QUOTE]
Senator Chuck Grassley is the senior ranking Republican on the Senate Finance Cttee (he was the chair when the Republicans were in the majority, so he's a powerful dude). The Subcommittee on Health is under the Finance Cttee, so these are issues/subjects that fall under its review and oversight.
Thanks Jas, that's a good idea and it may be what I have to end up doing...
Habr0406,
Sorrty to hear about all the difficullties you're having with your insurance TRICARE. I didn't know anything about TRICARE, the Dept of Defense health insurance program for active and retired military and their families, until I read about the July 2008 Medicare cuts -- a 10.6% reduction in physician payments that will also apply to docs that see TRICARE patients.
It makes me very angry that this President and Congress sends soldiers to fight in Iraq, sometimes several tours, and then cuts funding for TRICARE, jeopardizing post-war soldier's access to health care at a very critical time when they are most in need.
This still ongoing war costs us ,000 a second, 1/2 billion to billion a month. Economists say the ultimate cost could be trillions of dollars. So we cut health care funding to the soldiers that risk their lives in this war?
These cuts are not necessary, there is the billion needed to maintain current physician payment rates for the next 5 years if Congress redirects money from the private Medicare Advantage program, but our President, Mr. Privatization, doesn't want to cut into the profits for insurance companies, he'd rather cut TRICARE funding, our soldier's health care program.
I fear this is only just the beginning. Programs have to be cut, and its always the weakest links which go first. It's going to be very ugly. All those fine, patriotic speeches about honoring and paying tribute to our soldiers are empty words. We pay millions of dollars to private security contractors, like Blackwater, in Iraq, that pay their mercenaries many times over what our soldiers are paid and make the CEO of Blackwater a millionaire. And then our soldiers, our American men and women, sometimes after multiple tours, come back to the States to inadequately funded health care. Honoring our soldiers sacrifices and service takes more than just wearing a flag lapel pin, its ensuring their access to health care, by not cutting TRICARE funding.
Bumping to top as it relates to Support Troops-But Deny Care? thread.
Perhaps Congress should cut their salaries instead of cutting TRICARE and Medicare -- after all, it was their decision to go into Iraq. Why should everyone else take a hit- a cut to services or programs that help them -- why not those who unquestioningly voted to go to war reduce their salaries and daily per diem?
I just don't understand what the problem with our government is. I understand it can't be perfect but it sure seems like it is just a bunch of a-holes up there in Washington. They are clueless. Make them live for a few months on minimum wage with a couple of kids in a house that is falling down around them, or make them live in a middle class suburb with no public transportation where they have to commute for an hour back and forth to work. Or give them the medical bills for a years worth of prescription meds and no insurance.
Its hard for me not to get emotional about this issue and criticize all of Congress, but I must point out that Republican Senator Chuck Grassley and Democratic Senator Baucus both are working on legislation that would halt this cut. Their biggest obstacle is shaping a bill that President Bush will sign -- he has stated he would veto a bill that would cut money to the private insurance run Medicare Advantage program, those funds would be used to offset the cut to doctor's payment rates and maintain them at current levels.
Wow, here I am being good and behaving myself for once and Link's out to get me!
Habr0406, first of all I want to say thank you to you and your husband, and your family for the sacrifices you have made for our country. I cannot imagine how hard it must have been for you when your husband was in Iraq. It takes a very strong, special person to endure that kind of stress, and I admire you and all the other spouses and parents of our brave soldiers.
I am so angry that our government is doing this to our soldiers and their families. This is a unacceptable and intolerable. And this is not something we can attribute to one party or the other. There is guilt to be shared by everyone. What has happened to us as a nation? I just don't get it.
Okay Link - go for it, LOL!
Karen
I'm just an average person out here, reading the news online, trying to better understand complex issues and government bureaucracy. With that said, I wanted to point out that Congress did not vote on this 10.6% cut to doc pay rates for Medicare and TRICARE. This cut was automatically set in play by the Sustainable Growth Rate (SGR) formula. The following is an excerpt about SGR from a response from a congressional office (I don't know who, if a DEM or REP) to a constituents protest about the cut. She posted it on another arthritis website, so its been copied and pasted a couple of times.
" The Medicare physician fee schedule assigns relative values to services that reflect physician work practice expenses, and malpractice costs. Medicare calculates physician fees based on a formula called the Sustainable Growth Rate (SGR) in order to control costs, while still providing a reimbursement. But over time, the medical system has changed dramatically while the formula has remained the same, and doctors are often being reimbursed at a rate less than their cost. Due to flaw in its methodology, the SGR mandated physician fee cuts in recent years, t he formula was set to result in a scheduled 10% cut in January of 2008. Last minute Congressional fixes have prevented these cuts. Absent long-term Congressional action, the SGR will mandate more fee cuts in the future.
Congress recently passed the Medicare, Medicaid, and SCHIP Extension Act (S. 2499). S. 2499 addresses your specific concerns with physician reimbursement and amends the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs. S. 2499 included several important provisions that support physicians and healthcare for children. The bill eliminates the reduction in Medicare physician payments scheduled for six months, providing a 0.5% increase through June 30, 2008. It also addresses numerous additional health related programs. The bill passed the U.S. House of Representatives with my support on December 19, 2007 by a vote of 411 to 3, and it was signed into law by President George W. Bush on December 29, 2007 (P.L. # 110-173).
I understand any severe reimbursement cuts to our physicians will cause some disincentive for physicians to treat Medicare patients, and this could leave many Medicare patients untreated. I see the need for reform of the SGR formula or replacement with an updated system that reflects increases in physicians' and other health professionals' practice costs. I am also working to find every way possible to bring down the costs of overhead for doctors, including malpractice insurance reform and curbing excessive regulations. Health care is too important for us to wait until we have a complete shutdown of the system before taking action. We are close enough to that point as it is, and cannot afford to continue to wait. "
So my understanding is that Congress hasn't dealt with fixing or replacing the SGR formula. In December 2007, Cognress voted to stop the cut in doc pay, and here we are again, with a cut set to go into effect July 1, 2008. This time however, Bush has said he veto a bill to halt the cut.
Not only do we need to support our military personnel, seniors and disabled, by protesting this cut, but we must also call for serious health care reform. Too many Americans are being left with inadequate or no access to affordable health care.
I've already wrote a letter to my congress person/senator/governor/and the president regarding the 2008 cuts.
Our active and retired military deserve so much more than this. The military health insurance has been whittled away over the years and is only a shadow of what was promised to the men and women who are serving and who have served. This isn't the first cut, but I sincerely hope it will be the last.
I've never had a problem with Tricare coverage. We have Tricare Prime vs. Tricare Standard which is offered to retired military. We chose to pay a higher premium for Prime with more extensive coverage and it's paid for itself many times over.
Please write to your representatives and let them know how you feel about the 2008 reimbursement cuts. Lindy
Joi,
It doesn't surprise me that you have turned this thread into your political agenda. A week or so ago you said something to the effect you don't know how you come across here on this forum. I meant to answer you at that time but time passed and I forgot about it. I remember now and I want to tell you how you come across. You come across crystal clear. 99.9 percent of your posts are negative. I would say 100 percent but surely you have posted something not negative, hopefully. Let me tell you a story. Some time ago, a member of this forum from Canada took every opportunity to post every negative thing she could find about the United States, our government and anything associated with the U.S. of A. I decided that I would search and post negative things against Canada/Canadiens. As I did my search, I found plenty of negatives against Canada, Canadiens and the government but, for every negative, I found 10, 20, 30 positives. Do you ever happen across any positives when you are looking for negatives? You disguise this topic and mix in the "neglected" troops just to take shots at the President. Yep, you come across crystal clear. Everyone knows you hate our President and he is all evil. We know that you believe that we are the satan of this world. We know that what you post by who knows who, is absolute and any other member that posts a different view is quickly debunked by you. The insurance industry has no say in debate because they are all corrupt criminals. You post a story by some nurse and one patient and it's not only gospel but shows just how garbage the United States and it's people are, excluding you and yours of course. I know of a nurse from this forum who has embellished her story just for the sake of her political agenda. Yep, crystal clear, Joi, crystal clear. You must be a joy to be around. I've noticed that you have attracted the other "negative" members. Remember, just keep yelling the sky is falling, the sky is falling.
LEV
Lindy -
I'm so glad you posted about writing to your representatives. That's the only way this travesty is going to be averted.
Lev -
You putz!
Pip
[QUOTE=Joie]
Perhaps Congress should cut their salaries instead of cutting TRICARE and Medicare -- after all, it was their decision to go into Iraq. Why should everyone else take a hit- a cut to services or programs that help them -- why not those who unquestioningly voted to go to war reduce their salaries and daily per diem?
[/QUOTE]
Blasphemy! Off with her head!!!
Seriously, whether you agree with the war or not, you have to agree that cutting the medical services to our military and their families (who also suffer) is so wrong I can't even think of a word to describe how I feel about it. It just stinks, royally.
That isn't to say that these cuts are acceptable for the elderly or disabled either. Something has to be done.
Jesse882008-06-12 18:50:23Jesse,
They haven't. Until the rate cut takes effect you can't say whether it will affect the soldiers benifits. If it was voted 140 to 3 there is a good reason for it, a good reason for it. The sky isn't falling. Where does it say they are cutting the medical services? After it takes affect and benifits are affected negatively, then you can say a negative. Right now you can't. I strongly suggest you visit the tricare websight. Most people in this world would love to have a insurance service like tricare. Now, look up, is the sky really falling?
LEV
One more thing, they are posting blogs, blogs. Call your senators office and ask for the real scoop, not some blogged story from a person that can't smile unless it's for the sake of negativity. Our country and our leaders are for our servicemen, even those that call them murderers and rapists, I think.
LEV
"Democracy demands dialogue, and dialogue flows from disagreement. But we can, and maybe must, be relentlessly partisan without being actively uncivil. Indeed, the more passionate our certainty that we are right, the more urgent our need to practice the art of civility – otherwise, we make dialogue impossible, and the possibility of dialogue is the reason democracy values disagreement in the first place. For those who believe in dialogue, then, hypocrisy lies in the pretense that we can discuss our differences seriously without the aid of civility."
Civility: Manners, Morals and Etiquette of Democracy, Stephen L. Carter
QUOTE FROM LEVLARRY
"Everyone knows you hate our President and he is all evil. We know that you believe that we are the satan of this world."
LL,
Everyone? We? LL, have you organized a hate committee against me for expressing viewpoints and opinions contrary to yours?
I do not hate President Bush. He had the misfortune of having 9/11 occur on his watch, and, well, history will judge these eight years. I do not believe he is an evil man, just not a highly intelligent man, who was misguided and ill-served by his advisers.
I do not believe you are the satan of this world, I believe you are a very rude, mean-spirited man whose vitrolic personal attacks have been directed at not only me but others -- Stephen (Bodak), janie, Pip, Lorster -- and for reasons having nothing to do with differing political viewpoints but simply a vent for your anger..
QUOTE FROM LL:
" We know that what you post by who knows who, is absolute and any other member that posts a different view is quickly debunked by you."
My posts are almost always footnoted with the link to the source of the information or article. Often my posts are simply articles that appear in newpapers or on PBS, posted with no or little commentary by me..
If I have "debunked" comments by others, then that is because they were not accurate. I question information that is passed off as fact that is not consistent with other information I have read or heard from a variety of sources.
QUOTE FROM LL:
"You post a story by some nurse and one patient and it's not only gospel but shows just how garbage the United States and it's people are, excluding you and yours of course."
The story you are referencing was about a retired veteran of 27 years who had difficulty obtaining cancer treatment from TRICARE. It was relevent as Congress now deliberates over legislation to halt a 10.6% cut in doctor payments to go into effect July 1,2008.
You accuse me of being a "negative" person. The following are excerpts of posts I have made:
June 7: "I would really like to have an ongoing discussion about health care reform, though I know its a controversial and complex issue and its difficult having a dialogue in this format. We're not likely to come up with a solution, all I hope is to increase awareness and consideration of possibilities and not have them hastily dismissed as not workable. We're the richest, strongest country in the world, surely we can do better. "
June 12: "the heart of the problem is our health care system is unraveling. How can we allow ourselves to be "polarized" on this issue when we all have RA and will be dependent upon our health care system for the rest of our lives? We need to do better, we can do better, but we better start. "
QUOTE FROM LEVLARRY:
"You must be a joy to be around."
Well, finally, something we can agree upon.
Joi,
There was no reason whatsoever to even mention our president in this thread except to take a cheap shot at him. He's not here so to defend himself against your cheap shot opinion. If our president, that uninteligent man, were debating you on almost any subject, he would show what an ignorant person you are. It's that simple. There was no reason to bring in the iraq war or the third tour soldiers to try to make a political point in a healthcare thread. A thread based on opinion, not fact.
Yep, I've attacked people especially those that make
statements as fact when in fact they are opinion. Does that strike a nerve with you? You say to me that you have debunked others debates or arguments because they weren't accurate? Is your
opinion considered
accurate? Hello, anything home in there? Just because you post links to the bloggers and reporters that type their
opinions does not make anything printed fact. Can you maybe understand what I'm saying? Even George Duhbya could figure that out, the hayseed that he is, can you? This thread that you authored and titled,
Medicare Cuts Impact Elderly, Disabled & Military
Sure seems like to me that you were making a statement of fact when in fact you were giving opinions of fact, right? You then give us links to two newspaper reporters opinions, a lobby group, and a blogger. Any rocket scientists somewhere? Any fact to back up your statement? People that depend on reporter opinions, bloggers opinions and lobbiest for their information aren't highly intelegent creatures, know what I mean jelly bean?
Here in Michigan, many workers have taken close to a fifty percent paycut. Here in Michigan, if you have Medicare or medicade, you have the largest group of medical providers and practically every medical facility advertises "Medicare, Medicade Welcome". If you have another insurance provider you are given a booklet with some doctors and hospitals and you are very limited to who cares for you. Let the doctors take a 10% pay cut, I gaurentee you, they certainly won't give up the best paying, no questioning, insuance company, the "government insurance agency". Oh, they may cut patient times by 15% but they aren't giving up those easy uncle sam dollars that many live off of. Let's wait and see how the cut really affects the elderly, the disabled and the military.
And again you defend posting one nurses negative story, out of one million stories and you have the audacity to call the one bad one relavent. What are the good stories, irrelavent? Is that how your parents raised you, by making only the bad relavent? Again, do you ever happen across any good stories while searching for the negative story? I know you do you just find no joy in them. There is always a bad in a bunch of good. The problem is that you bruise all the good looking for the negative. Shame on you. Got any good nurses story you'de like to share? Of course not.
Here is the real Joi, this is the statement you wanted to make on this healthcare thread, your quote:
All those fine, patriotic speeches about honoring and paying tribute to our soldiers are empty words. We pay millions of dollars to private security contractors, like Blackwater, in Iraq, that pay their mercenaries many times over what our soldiers are paid and make the CEO of Blackwater a millionaire. And then our soldiers, our American men and women, sometimes after multiple tours, come back to the States to inadequately funded health care. Honoring our soldiers sacrifices and service takes more than just wearing a flag lapel pin, its ensuring their access to health care, by not cutting TRICARE funding.
So in short, Joi, I wouldn't have a problem with you if you didn't camaflauge your political agendas in a forest of healthcare posts and if you would not make opinions in the guise of fact as you did with this thread, there is no fact. That's not honest and it's not nice.
LEV
Just keep drinking the Koolaid and everything will seem fine!
QUOTE FROM LEVLARRY:
"There was no reason whatsoever to even mention our president in this thread except to take a cheap shot at him."
President Bush's approval and signature on legislation being worked on by Senators Baucus and Grassley will be needed in order to halt the Medicare and TRICARE 10.6% reduction in physican payments effective June 30, 2008 and to continue current payment rates with a slight increase until December 31, 2008. President Bush has indicated he would veto that legislation if it decreased funding to private Medicare Advantage program.
Most likely there will be a bipartisan bill that the President will sign extending current pay rates six more months. If they don't meet the deadline in two weeks, they can always make it retroactive.
Lev makes some really good points. Did you know that now that their are much fewer American deaths in Iraq since the surge, now that life is getting back to normal there, Nancy Pelosi wants to ban Military press conferences? She didn't seem to mind them when the news was grim, but now that it's getting better and better she wants to shut it down. Why? I think it's because the liberal media and liberals in general thrive on bad news because they WANT us to be the bad guy. The Nancy Pelosi's and the Herry Reid's want to keep the masses hating the US in order to insure their liberal agenda. I think their is kool aid on the menu, but it isn't conservatives that are drinking up.I do not like Kool Aid....I think joie has tried several times to promote what " she thinks " is fact. Lev did make some good points. It's pretty clear what side of the isle joie is on and what her agendas are. That said I sure do not mind her posting stuff. Just be prepared for the ????? to follow...
"promote what I think is fact?" Medicare is not to set for a reduction? Grassley and Baucus are not working on a bill? Bush has not threatened a veto if it cuts funding to Medicare Advantage? Its all in print.
You take issue with my "opinion" that the cost of this war now impacts spending on domestic programs, is that a wild fabrication on my part? that is a consequence.
I've been accused of having a "political agenda." My "agenda" is a a better health care system -- its a real problem, one that not much action has been taken to correct it, so its worsening -- so "we", especially those of us w/ "pre existing condtions need to speak out for change. And it is not solely political, it is economic -- health care costs are going up, it is social -- working families are having a hard time buying insurance, and it is moral -- people are getting sicker and die without health care.
You may disagree with what I have posted, but I have NEVER been as mean, or as hateful, or personally attacked ANY OF YOU!!!!!!!!!!!.
Joi,
You are now trying to dance us around the room. What you stated as fact is that the cut will impact the elderly, the disabled and the military. It more than likely wont. Be honest, what's so hard about it. You stated your opinion in a way to make it seem as fact in order to get members to write and call their lawmakers in order to try to affect the lawmakers votes or opinions. That's not just dishonest, it's immoral. Now you want to try and dance around it? You did not say, "in my opinion, bla bla bla.....", did you? No, you stated it as fact and pasted an opinion as if it were a fact. That's dishonest and immoral. I don't have a problem with you being a democrat or a supporter of Senator Obama but, I will always take issue with a post that is not honest, whether it be on topic or off topic, whether it be you or anyone else. Whether JasmineRain likes it or not. She is not anythinjg to me or someone I look up to or someone whose morals I value. JasmineRain thinks that your way of promoting your agendas is a good way. She will probably teach her children that to get ahead, dishonesty is a good way to win, good for her. It's her children and she thinks that your ways are good and good for her. Probably her parents taught her that dishonesty is an honest way of winning or getting ahead. Probably both of you are democrats and Obama supporters and good for yous, what a coincidence. I sure do not mind you or anyone posting. Most of your posts are ignored. you complained that Levlarry and DONN get all the views, are you happy now? Post away, Joi.
I did make good points. So many are being asked to sacrifice salary and so much more. I don't feel sorry for doctors if they must take a rate cut, boo hoo hoo. Life is tough for many many americans. I noticed that the groups against the cuts were ama, doctors associations physicians associations and etcs. What a surprise. Government needs to continue cutting in more places than doctors fees but they don't seem to understand that way of thinking, why should they?
In Michigan our lawmakers worked 98 days last year and were paid , 000 plus benifits and expenses. If they can stick around for 6 years, they have their health insurance paid for the rest of their lives and recieve a large pension. Fortunately, now we will be able to vote for part time Michigan lawmakers.
Joi, one more thing. You posted this:
You may disagree with what I have posted, but I have NEVER been as mean, or as hateful, or personally attacked ANY OF YOU!!!!!!!!!!!.
You were mean to your ownself. You attacked your ownself. You were hateful to your ownself. You are the one that was dishonest and misleading and you knew you were. You damaged your ownself, I just called you on it. And now you want to blame me for your dishonesty and misleading posts. I'll say it one more time, what you did is dishonest and immoral. Doesn't that bother you? So go ahead, get mad at me, not yourself, what a surprise.
LEV
Only uninformed people can defend Bush/Cheney. They should be impeached. Three cheers for Joie.Roxy. That's a ridiculous statement.Roxy,
I have to ask, just because I need some humor. Reading your political posts are like listening to Gomer Pyle explain the facts of life. Anyway, why should uninformed people be impeached?
LEV
Joie-
Please don't let these rude threads hurt your feelings. For almost everything you post, someone is going to have a negative thing to say about it. They will sit there and type five paragraphs about how negative you are and they will highlight in red everything they disagree with. I find it ironic that they will sit there for so long and type all this negative stuff about everything you say, and then they will call you the negative one. You ever hear the phrase "you sure talk a lot of crap for not saying anything at all"?
People like these will always have a comeback and will always find a few supporters. It's ok. If people want to slam you for expressing your concerns about the country on a forum, they can. I would say just laugh it off.
Lev says he is sure many Americans would love to have Tricare. I would like to invite Lev to join the military, go to Iraq for our country, and then return home to a wife with RA who is being refused medical care. It's not that easy is it Lev? It's much easier to sit at your computer in your safe home and talk crap. And I'm sure you'll have a five paragraph rude response to me, but that's ok. Talk it up Lev, tell me how lucky I am to have Tricare. And you can sit there and say I'm just once exception, but I'm quite certain I know many more military personnel than you do and I know I'm not the only one who has experienced such difficulties with Tricare.
Joie, once again, thank you for posting all that you do. And no, I don't agree with everything you say. And I'm sure you don't agree with everything I say all the time. We are all different people from across the world. It would be quite scary if we all had the exact same opinions. It would be nice if we could all express our opinions without being criticized.
It really does mean a lot that you posted this thread and I hope that it's raised some awareness.
Lev- Respond away... tell me how wrong I am.
Why are you being refused medical care???? My son's wife gets medical care through Tricare.She probably has the version of Tricare that in fact does suck. Every time I for treatment they ask which one I have, and it's obvious that the majority of offices don't take one Tricare. I took my children and myself out of the military system years ago because we did have some inferior healthcare.
Depending on where you live, the more extensive tricare is great. Once you find a doctor who takes your insurance, you don't have to get a referral, no co-pays at the time of service...I basically go anywhere and get all the treatment I need. I have had enough x-rays, mri's, ct scans to light up the east coast! In fact this year has been so rough I have met my deductable already. I'm not paying anything for my meds now etc.
The long and the short of it, she should look into switching or at least speak with an advisor about all the ins and outs of the two versions.
I have Tricare Prime, which is supposed to be the best kind.
I'm being told that I can't see my rheumatologist back in Minnesota in July, which is when my next appointment is supposed to be. I've been on plaquenil for about a month now and I need to get some blood work done and get another prescription so I can stay on it.
Tricare has told me that I can't go see that rheumatologist. And, to see a rheumatologist around here (North Carolina) I must first go see my PCM (primary care manager) at the Naval Base, and my PCM must write me a referral to see a rheumatologist.
My PCM is booking out about a month, they then have 2 days to send out the referral and Tricare decides whether or not it's approved. Tricare then has 10 days to let me know who I can see.
After much arguing, I was accepted to go into the Naval Base and see an alternative PCM two weeks ago. That PCM told me he would write a referral to see my rheumatologist in MN, which he did. But Tricare denied that. So they said I needed to go back to the Naval Hospital to see the PCM again and get a new referral. Once again, they were booking about a month out. And once again, after much arguing on the phone, I got a PCM to write me a referral without me going in.
I finally, finally have gotten approval to go to a rheumatologist. There is only one doctor I'm allowed to go to within 55 miles. Considering this rheumatologist deals with a lot of Tricare patients, he knows that he may bill Tricare 0 and only get 0 of that. So this doctor isn't too concerned about getting me in. He is booking a month out right now but won't put me in his appointment books?? He said he'll call me when he decides that he'll put me in the apt book. The only reason I can figure he's acting like that is because I have Tricare.
Meanwhile, I'm trying to figure out a way to stay on Plaquenil and hoping and praying that it's not hurting me in anyway, considering I can't get the bloodwork done right now to make sure I'm ok.
My husband is thinking of just flying me home to MN to see my old rheumy and we'll just pay out of pocket for the costs. I haven't been feeling the best lately and our patience is wearing thin.
Anyways, I don't mean to complain and have people feel sorry for me. And yes, Tricare does have it's pros at times. Trust me, before I got married, I was pretty sure I was marrying into the best insurance ever! It has been such a nightmare though. And I kept on telling my husband, "Someone should know about this! Military personnel are getting denied healthcare and nobody knows."
And then I saw this thread and I wanted to thank Joie for sharing, because I do think it's important that people know what some of our military personnel are going through.
TheLa, what kind of Tricare do you have? I think standard is the one where you pay a bit more but you don't need referrals? I think prime is cheaper, but you need referrals to go anywhere other than the ER. And the referrals can take months and possibly be denied. And then when you get the referrals, they only approve an x amount of visits. Does that sound right?
We've talked to so many Tricare reps and as soon as we think we have it figured out, a different rep tells us something completely different.
So this is how the government runs healthcare and people are practically jumping through hoops to get our whole nation under their thumb? That doesn't make any sense.
Linncn2008-06-17 06:44:36It's because people don't know. Like my mom said... "If I'm experiencing problems and need to see a doctor, I want to be able to call a doctor and book an appointment. I don't want to have to wait 8 months and get 4 approvals first. I'd rather pay a bit more for insurance and have the freedom to actually find a good doctor that I like within a reasonable amount of time."
How scared would I be right now if say... I had a lump in my breast? We all know how important it is to get something like that looked at right away! Early diagnosis could save your life. But I would have to wait to see my PCM at least a month, get a referral that will take up to two weeks, and then if approved, try to book an appointment with the ONE doctor I'm allowed to see... which I'm sure would be booking a ways out as well.
I can only pray that not many people have to deal with something like that.
Based on past history, the thought of the government taking over our healthcare system scares me silly. Granted, there have to be changes made, big time, but getting the government involved is not the answer.
I've been reading good arguments on both sides and at this point I couldn't tell you who was right even if I had to. What's clear is that we have to protect the healthcare of the military, disabled and elderly, at the very least, but everyone needs comprehensive healthcare.
Joie's first post did come across as being fact, as she wrote it, but I'd like to give her the benefit of the doubt that she was just trying to give us information based on what she read and believes, rather than printing out the whole article. Links are always a good way to get that information across and she did provide some at the end of the post.
Quoted by Lev:
The sky isn't falling. Where does it say they are cutting the medical services? After it takes affect and benifits are affected negatively, then you can say a negative.
Lev, isn't it too late then?
I think it's safe to say that no one wants benefits cut to any of the deserving people who need it. The argument seems to be whether or not that is really going to happen. At this point, I'm confused. Guess I need to go back and do some more reading.
Linncn -
This is sounding like the government is allowing only one provider (ie the government). If we had a national plan then they'd get all the choices we do. Which has got to be better than this.
Hugs,
Pip
Hi Habr, I had Tricare Prime and now have Tricare for Life and I just read your post. If you're active military your health care is provided to you by the military. It's covered like Tricare Prime coverage. Tricare Prime is retired military coverage. It sounds like you might be having a problem because you're seeking healthcare outside your geographical area. If that's the case then all you need to do is fill out a form, submit it and you can change your PCP to one locally. There are waits to see doctors everywhere, it's not inherent to the military system, Tricare Prime, or Standard. Right now I'm waiting to see a dermatologist and the wait is 2 months, with or without Tricare for Life.
The system has worked very well for myself and my husband. Even with traveling as much as we do it's worked. Waiting and being patient is part of the process that we have to develop when we have this disease. Waiting for appointments, having to have referrals, authorizations, and paperwork is the same for most insurances.
In 14 years I've never been denied care, prescriptions, surgery, or any other type of treatment. In fact I've been quite surprised that many of the treatments have been authorized. There's a system set up and you have to know how to work it.
When we travel to Mexico I'm able to get an extension on my prescriptions for 3 months. It's called a vacation override. Instead of the usual 3 months of RXs I can get 6 months. This is one of the little extras that Tricare offers. There are a lot of advantages to Tricare Insurance and for the most part it's a well run organization.
On another note I wanted to point out that VA health treatment has nothing to do with Tricare (government military run health insurance) and is a completely seperate entity.
I'm defending Tricare because it has always been there for me and not once has it not authorized treatment or services or denied medications. Believe me, I've utilized the services to the max and all over the world. I'm wondering now if it will remain as is or morph into something less. Lindy
Pip...what makes you think that a National Plan will add choices?
Military dependent care has ALWAYS been a mess. The complaints Habr have are nothing new. Getting to see a civilian doctor was never easy and the internal system gives priority to the military person so it can take forever for a dependent to get an appt with a military doctor. It is even worse if you are in a remote or secondary base.
Habr...the best I can suggest is that you appeal the Tricare decisions. Involve your base dependent support office if you need to. You've got to learn to work the system. And when open enrollment time comes you might consider Tricare Standard and Extra which has higher out of pocket expenses but allows you the choice to see your own doctors. Tricare Prime is a typical HMO and dealing with gatekeepers when you have a chronic illness is a pain
buckeye2008-06-17 08:40:03Thanks buckeye. If this rheumatologist in NC refuses to see me I'm going to have to appeal Tricare's decision so I can fly back to MN and at least get the blood work done to make sure the plaquenil isn't affecting me in any negative ways. I've definitely am learning that you need to work the system, argue until you're blue, and yes, have patience patience patience.
LinB, I'm so happy to hear that Tricare has worked well for you. I understand patience is important, and I had to wait for appointments when I had civilian health care as well... but I'm just starting plaquenil and it's important to keep on it so it can start working. I would hate to think I'm tearing my stomach apart just to have to stop it because I don't have a doctor. I hope Tricare continues to be so wonderful for you and hopefully soon I'll be allowed to see a rheumatologist!
Buckeye -
What she describes sounded to me like early HMO experiences. You remember, when there were few docs that would take it - before it went to almost totally HMO. A few years ago. LOL
It still worries me that they're going to vote on cutting the funding when we're in the middle of a war. Where's that 10.6% going to come from?
Pip
Harbr, you can have your blood work done irregardless of where you are. You PCP in Mn. can fax a lab request to a lab in N.C. and you can have labs done. If you're seen at the military clinic you can have labs done there at the request of your PCP. You then can have a phone consult with your PCP. I've done this in the past and it's worked. I then forwarded the labs to the specialist.
I know it's a little different when you're using the military clinics and hospitals. I've been lucky in that respect because the military clinics have been too busy to take military retirees and we've been referred out to civilian doctors. One of the problems with military clinics presently is the war. Many of the doctors and medical staff have been sent to Iran and Afghanistan and that's left the military clinics at a loss. There aren't enough medical people left to staff the military clinics and hospitals. That's one of the reasons for the wait and probably the primary reason. Military personnel is seen first, followed by dependents, and if there is time retirees can be seen at the military clinics. I haven't found a military clinic in any area that we've been in that takes on patients that are retirees. It's just a fact of life. I don't mind being referred out to civilian doctors because it makes the experience a little easier.
I'm sorry you're having such a hard time getting treated. See if you can have your labs done with a request from your other PCP. It might work. Lindy
Lev says he is sure many Americans would love to have Tricare. I would like to invite Lev to join the military, go to Iraq for our country, and then return home to a wife with RA who is being refused medical care. It's not that easy is it Lev? It's much easier to sit at your computer in your safe home and talk crap. And I'm sure you'll have a five paragraph rude response to me, but that's ok. Talk it up Lev, tell me how lucky I am to have Tricare. And you can sit there and say I'm just once exception, but I'm quite certain I know many more military personnel than you do and I know I'm not the only one who has experienced such difficulties with Tricare.
Lev- Respond away... tell me how wrong I am.
Habr,
First, let me assure you that I am an old soldier. I didn't sign up for the military but was drafted. I didn't try to avoid it. I accepted fact that there was a good possibility that I would be killed. Many that I was drafted with were killed. I didn't fight in the iraq war, but did fight in another war. If needed and allowed, I would fight in the iraq war even with my disease and ask nothing more of my country. Not a big deal. Todays soldiers sign a contract. They will do x in return for the government doing z. You and your husband signed a contract with the military. Both of you should have known that if callled upon, the soldier is contracted to go to war. You both should have known what the military would give you in return, right? I don't like cry babies. Did the contract that you and your husband signed with the military offer something that they are not fulfilling? Habr, there are two types of people in this world. The one type bitches and bitches about all the negative. The other type finds a way to change the negatives into positives. Which are you? If you are not being treated fairly, certainly there is the chain of command to get the results needed. You could have started a thread about tricare and asked for help from fellow members. You certainly have gotten some very good suggestions here, right? All of your fellow tricare friends haven't been able to give you a good path to take to put you and your familiy in a better position? Which type of people are they? There are only two types. Boo-hooing will get you nowhere except on a path of tears and negatives. Everything can be changed into good. Certainly not by sitting around bitching and then bitching at everybody as if your problems that you allowed are their faults, right? You don't seem like a doer, you seem more like a bitcher and a boo-hooer, if I'm wrong then I'm wrong. Do you listen to the members here that talk about the good things of tricare? Why do you think that is? They educated themselves and made good decisions and that's why they aren't in your room crying and bitching. Follow their leads. Take advise from them. They are good positive role models. You need to learn more of those strong positive women, not the negative ones. The negatives will take you on a path that leads to bumpy roads filled with potholes of negatives. Oh, and by the way, I still receive and am very thankful for the benifits from my wonderful government in appreciation for the sacrifices that I made with my military services.
Quoted by Lev:
The sky isn't falling. Where does it say they are cutting the medical services? After it takes affect and benifits are affected negatively, then you can say a negative.
Lev, isn't it too late then?
Jesse88,
Nowhere does it say that "they" are cutting medical services for the elderly, the disabled or the military. Well what if it does? Then ask for my help and you will get it. If you put the disabled vote with the military vote and add in the very powerful elderly vote, it can and will be fixed. Hey, what if you are in a car accident today? It's possible. What if your car fender is all smashed up? What you going to do? Fix it? Orrrrrrrrrrrrrr, maybe you shouldn't drive anymore just to eliminate all the ifs associated with driving, not very logical is it?
LEV
Lev -
Have you thought about pursuing all the help the government gave the Nam and Korean vets and maybe getting some mental health benefits? Maybe some nice antidepressents so you won't be such a pisher?
Pip
Hey Lev, I guess you didn't get to hear it much when you got back home, but thank you for your service.
Hi Joie, well said, your opinion on health care or any O/T subject is just as important as everyone elses on this board. I find your posts very informative and thought provoking. There is one person on this forum though, that thinks he is mightier than thou, (in his own mind), its very sad really, take no notice, only listen to the opinions of those you know are not mentally ill. Keep up your great efforts, hugs Janie.
Lev, are you saying we should just wait until this bill goes through and then "fix" it later? You're kidding, right? Or am I not understanding your point?
As for it not saying anywhere that there will be cuts, I can tell you from the many posters I've seen in my doctors' offices, there is indeed a threat to Medicare. I admit I'm not informed enough about the other cuts to comment on them. But I do know this much. It makes no sense to wait and see if a bill will negatively impact any segment of our society and then go back and try to "fix" it. I won't stop driving my car on the off-chance I'll have an accident, but if I know my brakes are bad, I'm going to repair them now, and not wait. I may or may not get the chance to fix those brakes (and my broken or dead body) after the accident.
Habr,
I reposted your first quote to me in an attempt to show how you attacked me. Telling me what I should do. Telling me how much harder your life is and how much more knowledgable than me you are. It's surprising how you suggested that I go to Iraq as if you yourself had gone to Iraq. Hello? When I came back, we weren't offered any healthcare. Hello? You see, I did my part to insure that not just myself but every american is free and safe in their homes and can sit at their computer and talk crap, even you. I paid my dues, mine and yours. You are a very rude and disrespectful person. Why say I won't get you down? I attempted to get you up. You were already down. You got you and your family down by not even sending in the papers that you knew had to be sent in. You either didn't have the knowledge, intelegence, or will, to get yourself up. You could only cry and bitch and blame every one and thing for your own predicament that could and can be very easily fixed. I'm the one that told you it can be fixed.
Thank you Lev for your service. Try to not hate the world so much, we're not all that bad. And we all really just want to be your friends.
Habr, I don't hate the world, I love this world. I just believe that you baby babies and you treat adults like adults and you let adults that act like babies know that they aren't babies and that they need to act accordingly. Habr, I have plenty of real friends and loved ones. Most of my friends are old tried and true friends. I really have no need for new friends, especially cyber friends, what's next, a robot dog?
Jesse,
If you are having trouble with your brakes and you tell your hairdresser and your hairdresser tells you that you need to change the brake pads and the rotors and so you buy the pads and rotors and change them. You jump in your car and head for the store and realize that you still have the same problem, the pedal goes almost to the floor. While standing in line you tell the story to the cashier and she tells you that you should have changed the brake calipers. So you go and buy the brake calipers and change them. You get in your car and drive down the street and realize that you still have the same problem. Finally, you decide to go to an expert and the expert says, well it's not your brakes, you need a master cylinder. He replaces the master cylinder and problem solved. Experts are called experts for a good reason. Opinions can be considered. If you read any of the links you would see that doctors associations and etcs are against the cut, of course. Keep in mind Jesse that the doctor groups and lobbyist for them are very powerful. More than likely the pay cut will never take effect. Just keep in mind that medicaid and medicare is the largest medical insurance agency and it's pretty much a no question asked payer. Doctors are not about to give up that golden goose, not over 10%. If you have medicaid or medicare you have the largest network of doctors and hospitals at your disposal. Do you have medicaid or medicare? Do your parents? When a medicaid or medicare patient goes to the doctor, the doctor already knows what medicaid/medicare will pay, with-out question, there is no grey areas or questions as with other insurance agencies that must be absolutely convinced that the work is needed beyond a shadow of a doubt. And even then they may deny the payment. Who ever is telling you that the cut will effect any government insured is certainly with the medical family.
LEV
[QUOTE=levlarry]
First, let me assure you that I am an old soldier. I didn't sign up for the military but was drafted. I didn't try to avoid it. I accepted fact that there was a good possibility that I would be killed. Many that I was drafted with were killed. I didn't fight in the iraq war, but did fight in another war. If needed and allowed, I would fight in the iraq war even with my disease and ask nothing more of my country. Not a big deal. Todays soldiers sign a contract. They will do x in return for the government doing z. You and your husband signed a contract with the military. Both of you should have known that if callled upon, the soldier is contracted to go to war. You both should have known what the military would give you in return, right? I don't like cry babies. Did the contract that you and your husband signed with the military offer something that they are not fulfilling? Habr, there are two types of people in this world. The one type bitches and bitches about all the negative. The other type finds a way to change the negatives into positives. Which are you? If you are not being treated fairly, certainly there is the chain of command to get the results needed. You could have started a thread about tricare and asked for help from fellow members. You certainly have gotten some very good suggestions here, right? All of your fellow tricare friends haven't been able to give you a good path to take to put you and your familiy in a better position? Which type of people are they? There are only two types. Boo-hooing will get you nowhere except on a path of tears and negatives. Everything can be changed into good. Certainly not by sitting around bitching and then bitching at everybody as if your problems that you allowed are their faults, right? You don't seem like a doer, you seem more like a bitcher and a boo-hooer, if I'm wrong then I'm wrong. Do you listen to the members here that talk about the good things of tricare? Why do you think that is? They educated themselves and made good decisions and that's why they aren't in your room crying and bitching. Follow their leads. Take advise from them. They are good positive role models. You need to learn more of those strong positive women, not the negative ones. The negatives will take you on a path that leads to bumpy roads filled with potholes of negatives. Oh, and by the way, I still receive and am very thankful for the benifits from my wonderful government in appreciation for the sacrifices that I made with my military services.
[/QUOTE]
Lev, I too thank you for your service to our country. Were you in Nam or Korea? Can you tell us what your job was there? Were you in the rear with the gear?Lorste