VA healthcare integrated into Medicare network

[Buck2520]

I have VA healthcare which satisfies my ACA requirements, I find it adequate, but it sure could be better and more portable. It is quite challenging to get healthcare from the VA if you are traveling outside your home area. VA has some hoops to go through to get emergency care outside the VA and you might as well just forget non emergency healthcare while outside your home area. Add this to many veterans travel issues to get to a VA facility when there are lots of community healthcare resources available in your local community, and there just has to be a better system.

A recent proposal was floated by a political candidate to integrate VA healthcare into the existing Medicare network of healthcare. This sounds quite promising to me. What do others think about this? Is there a chance this could work? Seems like it could reduce cost and provide better healthcare for veterans. Anyone have thoughts on this? Please do not comment on the political candidate, just your thoughts on such a proposal.


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[Senator]

I think it should have been done a long time ago. I am a disabled Vet, so I have a biased opinion.

I should have the best healthcare the government can afford, certainly at least as good as others who get free healthcare.

I should be able to get a platinum policy, with a $0 deductible, and get a 100% tax credit for my monthly premium paid. Regardless of my income.

 

[M Paquette]

I'm not sure the Medicare network has the quantity of needed specialized resources available. There are a large number of folks with IED related injuries, ranging from brain injuries requiring rather specialized treatment, rehab, and long term care, to young, otherwise fit amputees, very different from the typical Medicare patient. Some of the regional VA centers have specialized clinics serving a number of these patients with problems very different from those of the general population.

I'm not comfortable with abandoning these veterans to the Medicare system.

 

[Buck2520]

I'm not sure the Medicare network has the quantity of needed specialized resources available. There are a large number of folks with IED related injuries, ranging from brain injuries requiring rather specialized treatment, rehab, and long term care, to young, otherwise fit amputees, very different from the typical Medicare patient. Some of the regional VA centers have specialized clinics serving a number of these patients with problems very different from those of the general population.

I'm not comfortable with abandoning these veterans to the Medicare system.

I see your point. Any integration would have to keep this in mind. We would probably still need specific VA hospitals and I am not advocating this not happen. But I do think 90% of VA care could be more effectively provided with some sort of hybrid system. What we have now is not working as evidenced by the problems we see it n the current VA system.


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[Senator]

I'm not sure the Medicare network has the quantity of needed specialized resources available. There are a large number of folks with IED related injuries, ranging from brain injuries requiring rather specialized treatment, rehab, and long term care, to young, otherwise fit amputees, very different from the typical Medicare patient. Some of the regional VA centers have specialized clinics serving a number of these patients with problems very different from those of the general population.

I'm not comfortable with abandoning these veterans to the Medicare system.

All true. Most Veterans healthcare is routine stuff. Not necessarily war related, but basic healthcare. The VA could handle the war stuff.

At least the Veterans would have the choice.

 

[DFA]

I am a Vet to and use the VA hospital as needed. I also have health care through DW Federal plan. I don't think that merging the VA with Medicare would provide any better care, but if the VA got out of the hospital business and acted like an healthcare insurance company that allowed the Vets to get care at any hospital and they just paid all the bill for service connected items and paid just like ACA plans do for the rest it would be a lot better. I live near Denver where the 1.7 billion dollar hospital is making news all the time and it won't be completed until 2018 now and could cost more and still is not big enough to support the future vets.

This I believe would support the vets better.

 

[ziggy29]

I am a Vet to and use the VA hospital as needed. I also have health care through DW Federal plan. I don't think that merging the VA with Medicare would provide any better care, but if the VA got out of the hospital business and acted like an healthcare insurance company that allowed the Vets to get care at any hospital and they just paid all the bill for service connected items and paid just like ACA plans do for the rest it would be a lot better.

The ACA does this for American Indians below 300% of the poverty line -- if you buy through the marketplace, there is no coinsurance, copayments or deductibles -- all care is 100% paid for. I believe this is how they decided to deal with treaty obligations for the federal government to furnish Indian health services, which is why the IHS already exists. (It also reduces the need to build out specific IHS facilities all over the country.)

There's no reason, IMO, they couldn't do this with veterans as well. It might even save money with the reduced need for standalone VA facilities (there would still be a few to meet the specific needs of vets but most could be handled in the "regular" system).

 

[DEC-1982]

I would ask why add only VA to medicare, why not medicare for all? Why do we need one ACA system and one Medicare system?

 

[ziggy29]

I would ask why add only VA to medicare, why not medicare for all? Why do we need one ACA system and one Medicare system?

Baby steps and political feasibility, I guess; many people fear sweeping, radical changes these days. Since vets can already get all their care at no cost through VA facilities, adding them to the Medicare rolls and scaling back the separate VA infrastructure isn't likely to be seen as a budget-buster. Also, veterans issues have a high level of bipartisan support, and it would be harder, IMO, for politicians who don't want "Medicare for all" to be opposed to this if it helps veterans and possibly doesn't cost a lot more money.

I'm not necessarily saying I would support doing this, but it could be worth considering and evaluating based on the specifics or a proposal. As far as approving of it, I'd probably defer to veterans on the matter.

 

[Buck2520]

It is a misconception that all VA care is at no cost to all veterans. There are cost to the veteran in most cases. I believe the current problems with access to healthcare for veterans could be solved with some sort of hybrid system that integrates community based healthcare assets into the mix. I am afraid the VA bureaucracy just will not allow it. Too much "protecting their turf". It is not only a veterans issue, it is a tax payers issue.


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[mickeyd]

I'm a recipient of VA care (excellent) as well as Medicare/Tricare at a local military facility (also excellent). My cost is whatever Medicare charges monthly ($105?). I do not think any change would affect my situation.

 

[Buck2520]

I'm a recipient of VA care (excellent) as well as Medicare/Tricare at a local military facility (also excellent). My cost is whatever Medicare charges monthly ($105?). I do not think any change would affect my situation.

Would most definitely affect your ability to get VA care if away from a VA facility but with your Medicare/tricare it would not matter, so net effect on you may not be issue.

However for thousands (more likely hundreds of thousands) of other veterans I can assure you access to VA medical care is a big issue. I recently needed emergency care in a location where there was no VA facility or hospital emergency room, so I went to a walk in clinic that was available. Now getting VA to pay for the service is proving to be quite an issue. I am priority 3 VA so all health issues are covered, but I am finding access to medical care to be very challenging.


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[braumeister]

I recently needed emergency care in a location where there was no VA facility or hospital emergency room, so I went to a walk in clinic that was available. Now getting VA to pay for the service is proving to be quite an issue. I am priority 3 VA so all health issues are covered, but I am finding access to medical care to be very challenging.

AFAIK, in that situation it might have been better to have called an ambulance. They would take you to the nearest emergency room, but if not, it would have been their call instead of yours, and probably have made your reimbursement claim easier. Just a thought.