Archive for February 17, 2024

Treating military members as health care expenses

Posted: February 17, 2024 by navygrade36bureaucrat in News/opinion
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Not a week goes by without someone remarking that I must be lucky to have military medical insurance. A few years ago I would agree that military health care, despite the ups and downs, was actually not too bad. I’ve had surgery, preventative and acute care, and almost all the time it was decent.

The Military Sealift Command hospital ship USNS Comfort (T-AH 20) makes her way through the Panama Canal to cross into the Pacific Ocean on June 3, 2009. The Comfort is participating in Continuing Promise 2009, a four-month humanitarian and civic assistance mission providing medical and other services in seven countries throughout Latin America. DoD photo by the U.S. Navy. (Released)

That’s not true anymore. It’s now taking months to schedule an appointment. I called in January and was given first availability in April. The visits I have had recently are rushed, and I notice more doctors being borrowed between facilities to make appointments happen. Increasingly, I have to seek care at facilities more than an hour’s drive from my home.

What happened? Well, to put it bluntly, the military decided that health care is an expense, not an investment. Last year the services combined all military health records and scheduling into one system called MHS Genesis. This in itself is a good thing, since it means if I seek care at an Air Force hospital, they can get my records electronically without me having to bring physical records along from a Navy hospital

But someone used the merger to lay off thousands of employees. From the perspective of a twidget sitting behind a desk, heath care is an expense. You do everything in your power to minimize expenses, including firing people, shuttering facilities and offering less services in the pursuit of “finding efficiencies.” I’m sure it padded someone’s pockets, but it’s now resulting in less and less health care.

I’ll use myself as an example. I need a routine surgery. Normally it takes 2-4 weeks to schedule. Right now I’m looking at summer time at the earliest, because the USNS COMFORT is deploying, and when she deploys, they empty the nearby Naval hospitals of doctors to go underway. Great for Central America, terrible for our own military members.

Gee, the US government caring more about foreign citizens than their own people? Where have I seen that before?

If you need mental health appointments, better schedule a month out. While there are lots of suicide resources available on the spot, they are almost all over the phone and haven’t made a dent in suicide rates:

“Active Component suicide rates have gradually increased since 2011.  While the 2022 Active Component rate is slightly higher (3%) than 2021, both years remain lower than 2020.” -Department of Defense Releases Annual Report on Suicide in the Military: Calendar Year 2022

Surprising no one, the military’s solution to lack of care is…bring more dependents into military health care?

Seriously, I’m not joking, read about it here.

Hicks laid out a plan to grow the number of patients who receive care in a military treatment facility by 7% by the end of 2026, compared to the number of beneficiaries in December 2022. That would mean 3.3 million people would be using the MTFs in three years, according to Military Times calculations.

So let me get this straight. You can’t see patients in a timely fashion now. You “right sized” health care so that it barely gets by. You prioritized treating foreign citizens over your own. You did one thing right, which was move dependents out into civilian care so they can get treated and not suffer. And instead of hiring more people, or changing how you man the USNS COMFORT, or any number of ways to address the inability to provide health care, you want to bring on MORE patients into an already stressed system?

This makes no sense except in one case: financial. In the FY2024 request for funding, there is this section:

Controlling Health Care Costs
DOD’s budget request noted that private sector care accounted for 65% of the total care delivered to
beneficiaries and that it “will continue to represent an important part of the overall health system in [FY2024] and beyond.” DOD did not state a long-term strategy to control these health care costs while sustaining military medical readiness requirements and other health-related program investments.

So well over half of military health care is delivered by the private sector. Literally, the military couldn’t make it work if it tried. But that’s expensive, and in typical fashion, the military thinks it can do it cheaper, despite not having a great track record in doing so.

Treating health care as an expense, rather than a mission enabler, means we’ll never get the surge capacity needed to deal with wartime injuries and never get appointment scheduling to a reasonable level. This limits the use of Tricare as a recruiting and retention tool, and will exacerbate an already difficult recruiting problem. It’ll force more people, including myself, to pay out of pocket for care we were promised when we first signed up. And for some reason, the military wants to shoot itself in the foot over this.

I don’t recommend it…I heard gunshot wounds take 4-6 weeks to schedule an initial appointment.

This post represents the views of the author and not those of the Department of Defense, Department of the Navy, or any other government agency.

The Smell of Pot in Fitchburg and Days of Yore

Posted: February 17, 2024 by datechguy in culture

As some of you might know my wife because of a back/hip issue has to sleep on a recliner in the den as we don’t have a hospital bed which is why I sleep on the couch in the den because I didn’t get married to sleep apart from my wife.

Today I woke up to the overwhelming smell of pot in the house. This is a very strange thing because nobody who lives here or has lived here uses and all the doors and windows are closed with it being 30 degrees outside.

It is the nature of things to change and also the nature of people who are 60+ to note how much better the “old days” were.

I’m sure if it was 150 years ago Fitchburg would have smelt of horses and if it was 100 years ago Fitchburg would have smelt of factory smoke and burning coal and 40 years ago depending on which way the wind blew Fitchburg smelt of the waste water treatment plant.

But right now there are parts of Fitchburg that smell like pot and this morning anyways the smell was so bad it got into my house.

I plan to die here in the city I was born in and that my parents were born and died in. This is my home. I understand that in hundreds of ways my life is much easier than it was for my folks and even than the me of 30 years ago.

But at the risk of sounding like a sixty year old man, let me say this: I miss normal, normal was good, I miss sanity, sanity was good and I miss the post world war 2 years of my youth when America was great and was not shy about it’s greatness.

And the only reason why some of you reading this do not is because you didn’t have the joy of living through those years made possible by folks like my dad.

And it’s not because my parents generation who fought world war two were the greatest generation, they would point to their own folks as better than them. It’s just that the generations that have followed have sucked royally.

Decline is a choice and we’ve chosen it, and the more fool us.