Before you fire bomb my house, back away and read this using
your critical thinking skills, ok?
I have an
acquaintance who, as I am, is a military
retiree. Like me, he has one of the best double barreled medical insurance plans
available to anyone, anywhere. As a retiree, I am required to have Medicare part B deducted from my Social Security each month. Unlike non-retirees, my wife and I are covered by both Medicare,
having paid into it, and Tri-care, which was our military health care provider
and now serves as a Medicare supplement for her and for me for the rest of our lives. Is this a good
plan? Hell yes, it is! It is of no financial benefit for me (or him) to use any
Veteran's Administration facility or service, as Tricare covers everything that
Medicare doesn't. My friend however, frequently sees VA doctors and uses VA
facilities instead of using private resources, even though it makes no monetary
difference. I would estimate that Tricare has a realistic value to us of probably
$12,000 annually. If we need more rigorous care, it will be worth even more.
Many believe
that the military is alone in providing this kind of extended medical coverage
to retirees, but I assure you this isn't the case. Some public sector retirees
are able to retire on as few as 20 years service with 20 to 25 more working
years ahead of them, but only if they so choose, since in many cases their
retirement will be sufficient and their health care is essentially free if they
so decide. A teacher in Albany, NY for example might retire at age 59 (for example) with a cash in
hand annual retirement pension of about $68,000, they may also elect to
continue to keep their same health care coverage until Medicare kicks in, at
which time, it converts to a "Cadillac" Medicare supplement program.
This healthcare additional coverage has an estimated value of $14,000 annually
for a 25 year NYPD retiree.
I know, "Good
for you, so what?" - well here's what. We hear today a lot of concern over
the log jams at Veteran's Administration hospitals. Hospitals in Arizona are
backed up to the point that we are outraged that veterans aren't able to get
treatment immediately. Unfortunately, we rarely hear anyone question why that
is and even less frequently does anyone suggest any action other than "build
more facilities."
There is,
however plenty of room to discuss this issue in a factual, rather than
emotional, manner. First of all, the VA
as we know it was established in 1930. For WWI vets, the government's
obligation once discharged was as follows: Congress established a new system of
veterans benefits when the United States entered World War I in 1917. Included
were programs for disability compensation, insurance for servicepersons and
veterans, and vocational rehabilitation for the disabled. By the 1920s, the
various benefits were administered by three different federal agencies: the
Veterans Bureau, the Bureau of Pensions of the Interior Department, and the
National Home for Disabled Volunteer Soldiers. Note that this includes absolutely
no provision for lifetime medical treatment for non-service related health
problems.
Following, actually
still during, WWII, Veterans benefits were greatly expanded for active duty
servicemen, while in the years since 1930, the increasing number of older WWI
vets was already becoming an issue. Remember
one critical factor here, all (or the vast majority of) these vets were draftees. They had
involuntarily been taken from whatever civilian occupation they may have been pursuing
and forced into military service. The GI Bill of Rights greatly expanded veterans
benefits again, this time as a means of avoiding the usual post war economic
doldrums as former soldiers were cashiered out and became gluts on the job
market. The GI Bill college, job training and zero down mortgage guarantee benefits were aimed specifically at this
issue. Meanwhile, the VA became a "go
to" source of health care for all veterans, even if they had absolutely no
service connected disability. And why not? We were one of the few industrialize
nations not bombed or fought in/on/or over. we could afford it.
At this point I must come clean and admit
that my brother, a two year draftee, received medical care for his several
cancers at the VA in Washington. He had been out of the military for well over
40 years, but because the United States, unlike most developed nations, has no
universal healthcare and he was a self employed musician, what insurance he
could afford would have been inadequate in any case. Am I glad Steve had access
to the VA? Of course I am, but I remain unconvinced that he should have. The
fact remains, however, that he was a draftee and not a volunteer.
All this still
begs the question, "Why do we provide perpetual healthcare for any person who serves two years,
statistically has a <10% chance of ever seeing combat, and leaves the military in good physical condition with no service
connected health issues? Why do we
continue to house and treat a man who leaves the service and works 45 years at a civilian job with
medical benefits, and, after he develops a heart condition , treat him as if he
is different from, say, a retired 40 year mechanic who has to pay for his own healthcare?"
Of course no
one in Government will address this issue because it's a political hot potato.
There is a simple solution in the near and long term.
First of all, a military retiree with Tricare
for Life, has zero need for VA medical
facilities, unless they were separated with a service connected disability.
Stop retirees from using the VA hospital system. Period. Stop it! Even an underachiever who retires at 20 years
as an E-6 will have about $25,000 annually for life in actual compensation,
plus medical coverage worth at a bare minimum, $10,000 more per year!
Additionally, and
obviously, current non-retiree users of
the system have to be grandfathered in even if their health issues are not
service connected.
We are now an
all volunteer military and have been since 1973, so persons entering the
military are doing so because they want to, not because they have to. If these persons are careerists with no service connected disability they will have Tricare upon retirement and should use civilian medical providers.
Many (most) will work after separation and, like I was, may be covered under an employer's
plan until they retire again.
Persons enlisting
or being commissioned who leave the service before retirement with no service
connected medical issues should receive a pat on the back, a job reference and,
perhaps as much as 2 years' health care coverage extension, just not at the VA.
Upon becoming employed they should
receive coverage under their employer's health plan. At 65 they will become Medicare
eligible and can buy a supplement if they wish. Since they left the military
voluntarily and in good health, they should not be VA eligible for medical care
unless it can be shown that there is an underlying service-connected reason to
the contrary. Of course exceptions could be made for proven indigence.
The
retiree previously referred to who uses the VA, vice civilian medicine, is
retired from the military on 24 years, retired from another government job on another 20 plus, has Medicare and
Tricare and, with Social Security, has a household income in the $120,000 per year
range.
This should (would) free up a slew of
beds and appointment times for veterans with real issues, mental and/or
physical which are now lumped in with
persons who should have other insurance.
The large
scandal which rocked the VA hospital system in 2014 was far worse in Phoenix
that elsewhere. Why do we think that is? Well, take 37,000 retirees in Sun City alone of the
roughly 200,000 retirees in the area, many of whom are draft era short service people
, and it becomes obvious. People retiring to Arizona are, as a group, not poor,
not homeless and have worked for a living. many of them use the VA because they
can, not because they need to. Unless specifically diagnosed with a service
connected disability they should use Medicare and a supplement like non-vets.
This may sound
harsh, especially from a long time military member, but when we don't have beds for soldiers with traumatic brain injury
or PTSD, or missing limbs, or other line of duty issues because a 75 year old who
left the military in good health at 24 has lung cancer from smoking for 50 years after he
left the service, our priorities are
skewed. In most states a cop or firefighter who isn't a retiree gets no follow on
health care unless disabled, yet they are exposed to severe hazards on the job, too.