Veterans' Adminstration Health Clinics, open them to all instead of closing them down. The Single Provider Public Option (update:h/t Bwak)
Since it appears impossible to extend Medicare to all (largely because 3/4 of the cost is charged to the fisc), why not a fallback public option.
Simply calculate the actuarial algorithms needed to render VA care self-sufficiently accessible via premium payment by non-vets. The facilities are in place—the economies of scale are already formidable and would become more so; the information technology is already cutting edge. You are way less likely to be the victim of Medical Murder at a VA hospital.
Open door, stand back, and get out of the way of the *stampede…
Best of all, per late arriving info, the influx of eager public patrons seeking single provider services will enable existing VA facilities to avoid redundancy.
*Those in the know rate VA care best in the country.based on outcomes.
Yes, I agree there is much to be admired in care administered through the Vet Admin. I have had several opportunities to witness this through visits to friends at these hospitals. What I wouldn't give to be able to receive care there if I should need it.
Actually, I should be qualified to receive this care. I served in the U.S. Marine Corps and served TWO tours of duty in Vietnam. But there turned out to be one little problem in my case. Toward the very end of my enlistment, it was revealed I was Gay. This earned me a "Undesirable" discharge. A reduction in rank to Private. Confiscation of anything ever issued to me by the government and a Military Police escort to the outside of the base main gate at Camp Pendelton, where I was told to get out and walk to town to catch a bus. With the only thing I was allowed for my service, a 32 dollar bus ticket home.
September 20, 2009 1:12 AM | Reply | Permalink
This earned me a "Undesirable" discharge.
Gee. If only my gay brothers had banded together behind some candidate who promised to end DADT, wouldn't that be someth....oh wait, never mind.
I had a real cold shot when I bought a friend of min who was an Air Force vet a copy of a book called "My Country, My Right To Serve"--then Clinton was elected, and I tossed it! because I figured it had just been rendered irrelevant!
September 20, 2009 1:46 AM | Reply | Permalink
There is something VERY wrong with that picture. Have you appealed this? I don't think there's a statute of limitations on that sort of thing.
The climate might be right now for redress. Don't give up on it.
September 20, 2009 2:11 PM | Reply | Permalink
Thanks for sharing. I am not gay, though I too served in Vietnam.
I have spent some time at the VA hospital and they are excellent doctors.
September 20, 2009 9:05 PM | Reply | Permalink
I tried to use my VA medical bene's in 2003 when I became unemployed-10 years active duty, honorable discharge,but serve in europe; no Vietnam experience. Got turned down because a few weeks earlier Bu$h had signed an Executive Order requiring no less than a Purple Heart as the entry fee for getting an application approved. I've heard Obama is suppose to being correcting that, but there's been no action from what I've read things have changed.
September 20, 2009 12:23 PM | Reply | Permalink
Color me coonfused--I thought the one thing you were always guaranteed was medical care for any condition, whether service related or not.
Not so?
September 20, 2009 2:06 PM | Reply | Permalink
No, that is not true. The medical need has to be service related, usually, or you have to have very low income.
It is getting easier to get in, though. The rules signed by the previous president have been relaxed.
September 20, 2009 9:10 PM | Reply | Permalink
OKAY
September 20, 2009 12:24 PM | Reply | Permalink
A related idea--make a year or two of military or public service after high school mandatory (the way many european countries do) and then make the VA care available to the "Veterans" at some sort of reasonable premium.
We'd still be left with trying to figure out what to do with people between 20 and 65 for the interim, but all kids would be covered via private ins or Schip, and everyone else by VA moving forward.
September 20, 2009 4:29 PM | Reply | Permalink
VA care
What I find ironic is the juxtaposition of our stated scorn for the Brit NHS, and our widespread envy of those who are able to avail themselves of the closest thing to it here, our own "single-provider" service, the VA.
September 20, 2009 5:20 PM | Reply | Permalink
Excellent idea. Actually, a lot of VAs are in danger of closing because the vet have moved elsewhere.
Keep 'em open.
September 20, 2009 6:33 PM | Reply | Permalink
VAs are in danger of closing
I had no idea, altho in view of b-juice's above it makes sense, since the number of vets must be shrinking exponentially with the draftee sized army receding into the past.
Well, hell, for sure open up the VA as a competitor to Kaiser...I'll bet they can beat Kaiser by 10% and Kaiser beats Aetna by 30%...
September 20, 2009 11:24 PM | Reply | Permalink
It's not just that they are shrinking, it's that they are moving.
I should run down links for you, I get this on the authority of me dear old mum who is a retired VA nurse and keeps up on this stuff.
I'm just too tired and watching a stoopid football game right now. Maybe tomorrow night....
September 20, 2009 11:28 PM | Reply | Permalink
.
As near as I can glean from this site, at most a vet who is treated at a VA facility pays the following co-pays:
"Four Basic Types of Co-payments
Medication – Prescription copayment charges were established by Congress. The charge is $8 for each 30 day or less supply of medications provided on an outpatient basis for nonservice-connected conditions.
Outpatient – The copayments will be based on primary care visits ($15) and specialty care visits ($50).
Inpatient – Congress determined the appropriate inpatient copayment should be the current inpatient Medicare Deductible Rate ($840 in 2003) for the first 90 days that you remain in the hospital plus a $10 per diem charge.
Long Term Care – VA charges for Long Term Care Services vary by type of service provided and the individual veterans ability to pay."
September 20, 2009 11:35 PM | Reply | Permalink
As near as I can glean
apparently, I only gleaned half the story, because, (just as faroff said) you have to be enrolleed first, and that's where the screen is. details here
September 20, 2009 11:49 PM | Reply | Permalink
erica commented: VA care available to the "Veterans" at some sort of reasonable premium.
For Christ's sake erica, how much of a premium do you think the vets need to pay. I think the 58,000 who paid the ultimate price in Vietnam would disagree. Then let's not for get the hundred of thousands left wounded and disabled. I bet the vets from WWII and Korea would also think that is a grand ideas as well.
Now the vets are returning from Iraq and Afghanistan, busted up, screwed, and many living on the streets of this country because some asshole bureaucrat at the VA just can't be bothered because they are so busy. I mean it's not like they are asking for a handout like a bank, only some help adjusting and healing.
It raises more than a few hackles on my neck erica. I didn't get the opportunity to have a yes or no say in the matter. I was drafted. I could serve or go to jail, so it's even better to get drafted, shot to shit, and fucked by your fellow Americans when you return.
I suppose I fail to understand the progressive logic you offer, but then I can't afford to extend a liberal bias to any great extent.
I would like to hear your opinion on this matter in say ten years after you receive that "Greetings You friends and neighbors have selected you to serve your country." If you manage to make it back alive, I have to ask. How much is that worth?
September 21, 2009 11:20 PM | Reply | Permalink
how much of a premium
I'm somewhat nonplussed. Admitedly, not being a vet, I had no reason to parse the matter closely, but i have always thought that lifetime health care (albeit with deductibles and copays--bullshit!--was part of the deal when you risked your life.
Apparently not.
That said, assuming that the "premium" per vet were paid by the general revenue fund, there would also be a number which would actually reflect the marginal cost of each new citizen who signed up willing to pay for the access--certainly cheaper and better health care than anywhere else.
September 22, 2009 4:17 AM | Reply | Permalink