I had 2/3 of a very eloquent, detailed post completed (with links!) when my computer went AWOL.  Notice the AOL in there?  Yeah, my internet decided it didn’t like my router and it refused to recognize the connection, so after fighting my computer for several hours, and losing a kick-ass post, I was pretty upset.  For now, you get the second rate, less eloquent, less coherent version of my thoughts.  You know, sort of like a 4th grader’s essay.

          Why Universal Health Care Sucks, by Mental Mommy.

         

          When I think of universal health care, I think of TriCare – the insurance that covers the men and women in the military and their dependents.  Now, I have said before that some of us love this system and some of us hate it.  As a hater, it is no wonder the equation "Universal Health Care = TriCare care" scares the shit out of me.

          First, TriCare is not free.  We pay into it every month.  We also pay a seperate fee for life insurance, which I believe is optional, though highly recommended.  While it is not the several hundred dollars many people pay through their jobs, it also does not come with the options that many others enjoy. 

          There are two levels: Prime and Standard.  Prime is what you start at by default.  Prime means you have to go to a military hospital for everything unless it is a serious emergency, and even then, your ER claim has to be justified before they pay it.  If you go to a civilian provider, your claim will not be paid.  On standard, you have to find a doctor who accepts TriCare and then you can see them all you want, but you have a 20% cost share.  There is an annual cap, which I believe is based on the rank and pay grade of your enlisted family member.  It is a very fair cap, I assure you.

          So what’s the big deal? 

          I PAY for standard.  I pay for standard because I like being able to have a good doctor-patient relationship with my physicians.  I like knowing that there are 4-5 doctors in a practice, not 15-20.  I like knowing that I can get to know them all and even request appointments with specific doctors without being viewed as a pain in the ass.  I like not having to fill out 20 pages of questions only to have the doctor come in and ask the very same questions.  I also like not having to wait an hour or more for a scheduled appointment.  I like that if I want to get in that week, I most likely can.  I like that there are after-hours options that don’t involved the ER or their wait times. 

          My sons receive Prime.  When Skeeter was born, the military hospital’s pediatric unit was full.  I was able to get him in where I go and I loved the care he received.  Again, we see the same 1-2 doctors, they know us by name, we rarely wait for anything, and they never rush us out the door or make us feel silly for asking questions.  Later, I found out that when one child is out-sourced  for care from the MTF (military treatment facility), the other has the right to follow to make life easier.  Mind you, no one from our insurance company told us this because that would cost them more money.  I had to go to our health benefits advisor (who does not work for them, but the military) after having numerous difficulties getting an appointment for Mega.  Now both boys are seen at the same office by the same physician and it’s not only convenient, it’s very comforting. 

          Do you know what your insurance company pays on your claims?  TriCare pays about 25% of what is billed, depending on what is billed.  How many doctors do you think want to work for that kind of money?  How many lab techs, nurses, and other medical staff will want to invest 8-12 years of medical school to turn around and work for 40 years to pay off their student loans?  How much do you think universal health care will be able to pay for every claim?

          Every time I look at an LES (leave and earnings statement – pay stub!), I flinch when I see what is taken out in taxes.  If we were pushed to a higher bracket, there is no way my family would survive.  But where else would the money come from to fund universal health care? 

          Would universal health care mean the end of programs like SCHIP, FAMIS, medicare, and medicaid?  That would free up some funding, but again, who is going to actually care for all these people?  Would private insurance still be available?  At what costs and with what benefits and drawbacks? 

          While the insurance we recieve is not my favorite, it does meet our needs.  Through Standard, I can still choose my physicians (though the list of those who accept TriCare is rapidly dwindling due to the low payments and the amount of time it takes to process claims), I can get care at the same place every time, and I have the option of name brand drugs if I want to pay for them.  If I had to remain on Prime, have all my decisions made for me, and only go to a huge medical complex where no one knows a thing about you, I think I’d be very sick for a very long time before I went anywhere near that treatment center.

          Perhaps it wouldn’t be that bad, but without concrete plans and long-term projections better laid out and explained by the politicians, it is the vision my mind forms and I don’t like it.   

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