Another new story about government healthcare as it currently exists.

 

Philadelphia Inquirer
August 26, 2009

VA Apologizing For Mistaken Notices

 

CHARLESTON, W. Va. -- The U.S. Veterans Affairs Department will apologize personally to veterans who received erroneous letters saying they had been diagnosed with Lou Gehrig's disease, agency spokeswoman Katie Roberts said yesterday.

VA employees were still trying to determine exactly how many veterans mistakenly received letters intended to inform people with ALS, or Lou Gehrig's disease, of benefits available to them or surviving spouses and children.

Roberts said the VA mailed more than 1,800 letters last week and had been notified by fewer than 10 veterans who received them in error. But the National Gulf War Resource Center, a veterans group, said at least 1,200 veterans received the letters by mistake. Roberts did not say whether the VA determined how the error occurred. -- AP

It shocks me how little the media is paying attention to the track record of current government healthcare programs, most notably the VA and military healthcare networks.  In both cases, the government has a track records: 1) Make promises 2) underestimate the cost of those promises 3) make cuts to promised programs 4) break promises 5)

 

Here's a story in today's  Tacoma (WA) News Tribune where the government military healthcare program is actually telling people where they can or can't live, which is about as "Big Brother" as one can get:

TRICARE Proximity Rule Enforcement Displaces Families

By Tom Philpott

Retired Navy corpsman Lloyd Tilch Sr., his wife, Debbie, and their chronically ill son, Cody, pulled up roots last month in Blythe, Calif., and moved into a rented house 110 miles away, near to the Marine Corps base hospital at Twentynine Palms, Calif.

The Tilch family had to move – and had only 11 days to do so after opening a letter from their TRICARE support contractor – to remain eligible for TRICARE Prime, the military’s managed care network, Debbie Tilch said.

As many as 190,000 TRICARE Prime enrollees across the United States have received similar letters. They advise that TRICARE is enforcing a rule requiring beneficiaries enrolled in Prime at a military treatment facility to seek a waiver, either from the MTF commander or TRICARE Regional Office, if they live more than a 30-minute drive, or 40 miles, from the base.

Debbie sought a waiver for her family but was turned down. Suddenly she faced a difficult choice: move her family within 30 minutes of Twentynine Palms by July 20 or see Prime coverage end effective Oct. 1. Without Prime, the family would have to rely on TRICARE Standard, the military’s more costly fee-for-service insurance option.

Given that her youngest, Cody, has been hospitalized 19 times in the past year alone, and that husband Lloyd, 50, can’t work because of his own fragile health, Debbie worried that staying in Blythe under TRICARE Standard would be both unaffordable and dangerous.

With TRICARE Standard, her family’s out-of-pocket costs every year quickly would hit the $3,000 catastrophic cap that protects retirees. But more worrisome was the prospect that 11-year-old Cody, coping with “three life-threatening health issues,” might lose access to Prime specialists who have been treating his epilepsy, diabetes and weakened heart for years.

No TRICARE policy official was available to discuss the wholesale enforcement this year of the 30-minute rule across the TRICARE system. Austin Camacho, spokesman for the TRICARE Management Activity in Falls Church, Va., did explain in an e-mail that the decision, which was made in January, flowed out of a concern for assuring quality care to beneficiaries.

“The change was made after research confirmed a direct correlation between proximity of medical care and quality of medical care,” Camacho wrote. “We determined that to optimize their health care, our beneficiaries need to have a primary care physician near their homes.”

The TRICARE support office on base told Tilch she would have to get a new address within 40 miles of the base by July 20 or access to Prime would end Oct. 1. Debbie said she offered a nearby Post Office Box address but TRICARE insisted on an actual residence.

Scott K. Celley, vice president of external affairs at TriWest, said enforcement of the waiver rule for commutes longer than 30 minutes are occurring across all TRICARE regions. The purpose, as TRICARE policy officials explained, “is to ensure that beneficiaries are accessing care within a reasonable distance of where they live so they are getting good quality care and can reach their providers in a reasonable period of time,” Celley said.

In Tilch’s view, TRICARE is enforcing its 30-minute commute rule now to save money by forcing more retirees to use Standard. She noted that under TRICARE Standard, if Cody or Lloyd have to be hospitalized in a civilian facility, her family’s cost would be $535 per day or 25 percent for institutional services, whichever is less, plus 25 percent for separately billed professional charges. Under Prime, retiree families pay only $11 a day.

It’s just not fair now for TRICARE to force long-settled retirees to move nearer to base or lose access to promised benefits, Debbie said.

She said Cody is having three seizures a day, related in part to stress of moving to a new community. Their rent in Twentynine Palms is double what it was in Blythe, she said. Moving expenses totaled $5,000 last month. Yet she still has to drive Cody to specialists more than 200 miles away.

“When they pass the Obama health care plan,” Debbie asked, “are they going to tell those people where to live?”

Military beneficiaries, she said, deserve better than this