Incorporate VA medical into Medicare - Medicare Part V

Meetings
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In any industry, competition makes people strive to be the best. The medical field is no stranger to competition. Every medical industry has competitors running daily to be the best in their perspective fields. When medial facilities strive to excel and be better than their competitors, the patient’s yield the benefits with better services and quality of care. When there is no competition businesses do not strive to be the best and perform mediocre.
The VA has no competition and the veterans who put their lives on the line for our country suffer. Inside the VA it takes weeks or months for our soldiers to get the services they need. For weeks to get a prescription to months to wait for surgeries, our soldiers deserve better. My proposal is to incorporate the veterans into the civilian Medicare healthcare system.

Incorporation of VA into Civilian Medicare
Initiate:
• Medicare Part V (veterans/disabled military personal) OR
• Medicare Part V-D (veterans/disabled miliary personal/family dependents)
o Same benefits of Medicare A-B-C-D with no charges to veterans/military disabled/dependents
Medical, dental, vision, pharmacy benefits with no charge to veterans (as Medicaid patients are not charged)

Cut Government Costs:

  1. General building maintenance and rent/mortgage
  2. Electricity, water, phone, internet, payments
  3. Training medical staff
  4. Medical supplies
  5. Computers and IT support
  6. Management staff
  7. Government employees – move to civilian healthcare jobs
  8. Government spending on the veterans and family’s would remain the same with all the extras trimmed off such as building, supply, utilities, employee salaries, etc.

Other Benefits:

  1. Takes veteran’s health care out of the government’s control and places it into private competition driven civilian healthcare – services improve due to the competition
  2. Decreases wait time for veterans to get appointments for primary care and specialty visits through the VA from weeks/months/years to the same as in civilian medicine
  3. Decrease obtaining prescription time from weeks to hours
  4. Increase health care availability for veterans/dependence
  5. Adds more health care providers/staff to shortage currently in the civilian medical field
  6. Turn VA buildings into housing for veterans

Incorporate in phases over 3.5 years

  1. Grants funds to FQHC and other private civilian healthcare facilities for transition or to open a new clinic
  2. In each phase, move primary care VA providers/staff to FQHC/private healthcare facilities
  3. Transition by ages in phases:
    a. Move Ages 65 + to civilian Medicare provider
    b. Move 50 + to civilian Medicare providers
    c. Move 40 + to civilian Medicare providers
    d. Move all ages to civilian Medicare providers
  4. Or transition per geographic area
  5. VA hospitals close geographic locations over 3.5 years
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Here’s a detailed analysis of the potential methods, incorporating your suggestions, along with their pros and cons.

VA other benefits excluded

  1. VA disability program and payments
  2. VA travel cost for medical treatment

Proposed Methods VA medical coverage

  1. Incorporate Veterans into Civilian Medicare:

    • Establish Medicare Part V: Create a new Medicare part dedicated to veterans and disabled military personnel, ensuring comprehensive coverage without costs to them.
    • Phased Transition: Gradually transition veterans to civilian healthcare, sorted by age or geographic area.

  2. Establish a Board for Evaluation:

    • Ongoing Assessment of Bioenvironmental Conditions: Form a board tasked with studying and assessing military-related health issues, similar to the presumptive ratings established by the PACT Act for burn pits.
    • Research and Funding for Cures: Allocate funds for research aimed at finding effective treatments or cures for conditions prevalent among veterans, informed by the board’s evaluations.

Pros

Incorporation into Civilian Medicare

  1. Enhanced Competition:

    • Improved Quality of Care: Competition among healthcare providers can drive improvements in services and patient outcomes.
    • Faster Access to Care: Veterans could experience reduced wait times for appointments and prescriptions, aligning with civilian standards.

  2. Cost Savings:

    • Reduced Government Overhead: Eliminating the need for VA facility maintenance and staffing can lead to significant savings, allowing funds to be redirected toward direct healthcare services.
    • Streamlined Operations: Transitioning to a civilian model may only shift bureaucratic inefficiencies.

  3. Wider Provider Network:

    • Increased Choice: Veterans would have access to a broader range of healthcare providers and specialists, enhancing their healthcare experience.
    • Integration of Services: Comprehensive coverage across medical, dental, vision, and pharmacy services creates a more holistic healthcare approach.

Establishing a Health Evaluation Board

  1. Targeted Health Research:

    • Focus on Veteran-Specific Issues: A dedicated board can prioritize research on health issues prevalent among veterans, potentially leading to better treatment protocols and cures.
    • Presumptive Ratings: Similar to the PACT Act, this could facilitate quicker access to benefits for veterans suffering from conditions linked to their service.

  2. Enhanced Awareness and Advocacy:

    • Transparency and Accountability: Regular assessments and reports could hold the government accountable for veterans’ healthcare and highlight areas needing attention.
    • Collaboration with Civilian Providers: The board could foster partnerships between VA and civilian healthcare systems, encouraging shared knowledge and best practices.

Cons

Incorporation into Civilian Medicare

  1. Implementation Challenges:

    • Complex Transition: The phased approach may lead to gaps in care or confusion among veterans, particularly during the transition period.
    • Resistance to Change: Some veterans and healthcare providers may be resistant to the shift from a government-run system to a different government-run system with civilian healthcare personnel.

  2. Potential for Service Disparities:

    • Geographic Inequities: Some veterans, particularly in rural areas, may have limited access to civilian healthcare providers, potentially exacerbating health disparities.
    • Shortage of Providers: The existing shortage of healthcare providers in the civilian sector could limit the effectiveness of this model.

Establishing a Health Evaluation Board

  1. Funding and Resource Allocation:

    • Initial Funding Needs: Establishing and maintaining the board may require significant upfront investment, which could strain existing healthcare budgets.
    • Sustainability Concerns: Ensuring ongoing funding for research and evaluations could be challenging, especially in a fluctuating political environment.

  2. Effectiveness of Outcomes:

    • Potentially Slow Results: Research initiatives can take time to yield results, and immediate healthcare improvements may not be realized.
    • Competing Interests: There may be challenges in balancing the interests of various stakeholders, including veterans, healthcare providers, and government entities.

Conclusion

Incorporating veterans into the civilian Medicare system, along with establishing a board to evaluate military health issues, presents a multifaceted approach to addressing the chronic shortages in care and resources for veterans. While the potential benefits of increased competition and focused health research are significant, careful consideration of the implementation challenges and potential disparities is essential to achieving a successful outcome.

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Thank you!!

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Interesting idea!

Why is VA medical handled separately? Was it originally supposed to be far better?

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The Establishment of the Veterans Affairs Healthcare System: A Focus on Unique Military Needs

The United States Department of Veterans Affairs (VA) was established in 1930 to provide comprehensive healthcare and support to military veterans. Prior to its formation, veterans faced significant challenges in accessing medical care and support services, often left to navigate a fragmented and inadequate system. This article explores the reasons for the VA’s establishment, the specific healthcare needs it addresses, and the problems it aimed to solve.

Historical Context: A Need for Change

Before the establishment of the VA, veterans relied on a patchwork of local hospitals, charitable organizations, and the limited resources of the government. Many faced long wait times, inadequate care, and a lack of understanding of their unique needs. The aftermath of World War I highlighted these issues, as returning soldiers struggled with physical and psychological injuries without sufficient support.

Key Problems Before the VA

  1. Fragmented Care: Veterans had to seek care from various sources, often leading to inconsistent treatment and a lack of specialized services.

  2. Inadequate Resources: Many veterans lacked access to basic medical care, particularly for service-related injuries and conditions.

  3. Limited Mental Health Support: The psychological impact of war, including conditions like PTSD, was poorly understood and often ignored, leaving veterans without necessary mental health resources. Even today this area is insufficient to meet their needs as 22 veterans a day commit suicide.

  4. Lack of Prosthetic Services: Injured veterans faced significant challenges in obtaining prosthetics, which were often rudimentary and not tailored to their needs or were poor fit and resulted in members being wheelchair bound.

The Need for Specialized Care

The VA was created to address these issues and provide a centralized system for veterans’ healthcare. Its establishment marked a significant shift in how the nation cared for those who served in the military.

Unique Health Challenges

Traumatic Brain Injury (TBI)

TBI has emerged as a significant concern among veterans, particularly those who have served in combat zones. The nature of modern warfare, including exposure to explosive devices, has led to an increase in TBIs. Symptoms can range from mild concussions to severe brain damage, affecting cognitive function, emotional regulation, and overall quality of life. The VA has developed specialized programs to diagnose, treat, and rehabilitate veterans suffering from TBI.

Prosthetics

Many veterans return from service with limb injuries that require prosthetic devices. The VA provides comprehensive care for veterans needing prosthetics, including advanced technologies and rehabilitation services. This includes not only the fitting of prosthetic limbs but also ongoing support to help veterans adapt to their new circumstances. The VA’s commitment to developing cutting-edge prosthetic technology is vital for enhancing the quality of life for these individuals. New prosthetic research has even incorporated robotics and ai to improve functionality.

Post-Traumatic Stress Disorder (PTSD)

PTSD is another prevalent issue among veterans, affecting those who have experienced combat or other traumatic events during their service. Symptoms may include flashbacks, anxiety, depression, and difficulty in social situations. The VA offers specialized mental health services, including counseling, therapy, and medication management, tailored to the needs of veterans grappling with PTSD. The understanding of military culture within the VA system helps create a supportive environment for healing.

Addressing Other Common Military Ailments

In addition to TBI and PTSD, veterans face a range of other health issues that are less common in the civilian population. These include:

  • Chronic Pain: Many veterans suffer from long-term pain due to injuries sustained in service, requiring ongoing management and treatment. Civilians populations historically see more addiction issues and civilian healthcare personnel often assume veterans are simply overmedicated.
  • Substance Abuse: Some veterans may turn to alcohol or drugs as a way to cope with the stresses of service-related injuries or PTSD.
  • Sexual Trauma: Military sexual trauma (MST) is a significant issue that affects many veterans and requires specialized treatment approaches.

The VA has established dedicated programs to address these conditions, ensuring that veterans receive the comprehensive care they need.

Conclusion

The establishment of the Veterans Affairs healthcare system in 1930 was essential to address the unique health challenges faced by military veterans. By creating a centralized and specialized system of care, the VA has been able to solve many of the problems veterans encountered before its formation, including fragmented services, inadequate mental health support, and limited access to necessary medical resources. With specialized services for TBI, prosthetics, PTSD, and other military-specific ailments, the VA plays a crucial role in supporting veterans’ health and well-being. By providing tailored care that recognizes the complexities of military service, the VA ensures that those who have served the nation receive the comprehensive healthcare they deserve.

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How about helping veterans who live hours away from the va to be able to go to Walmart or any pharmacy and get their prescriptions at no cost, instead of waiting for the community care doctor calling your prescription into the va then they mail it to you a week later. If the veteran is 100% then make it no cost like you’re at the va. Basically make the copay of whatever the va charges you on your disability percentage available at pharmacies close to you. I live 2.5 hours away from a VA hospital. I get community care, but the VA has mail me my prescriptions. So when I’ve been real sick and couldn’t wait, I’ve had to pay out of pocket. Doesn’t seem right, I served my country, got seriously injured, and since I’m 100% rated, shouldn’t have to wait for my meds.

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Good idea. I hope that DOGE, by cutting regulations and eliminating administrative staff, can simply the bureaucracy. Institutions love to make things complicated and the bigger the institution and tougher it is to terminate its employees, the more complicated (and absurd) the service.

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You are completely right!!!
Once the veterans were placed on Medicare, the veterans would see a local doctor and go to a local pharmacy - there would be no sending a prescription to the VA. The VA clinics - primary care would be gone. The veteran would see any provider that takes Medicare and get their prescriptions filled at any pharmacy that takes Medicare insurance. There would be no copays.
I completely agree - it isn’t fair for you! You have risked your life for this country. That is why I have proposed placing all veterans on Medicare to see any Medicare provider and receive at no cost to you medical services/prescriptions/supplies.