OT: National Popular Vote Interstate Compact

[Rick C]

On Friday, February 21, 2020 at 12:12:10 AM UTC-5, Michael Terrell wrote:

On Thursday, February 20, 2020 at 11:39:08 PM UTC-5, Rick C wrote:
On Thursday, February 20, 2020 at 10:46:41 PM UTC-5, Michael Terrell wrote:

I knew a woman who worked for Australasia's version of their VA. We discussed both systems for hours and hours. She agreed that we did a lot of things better than they did. She didn't like the scattered facilities, but that is changing as they move clinics from leased space, to custom medical facilities. A former president oped the system to a lot of previously ineligible Veterans, into a system that was already overloaded. My current clinic has 100 exam rooms. It has Xray and Ultrasound, ant to small Operating rooms. If it had rooms for patients, it would be a full hospital. It was built a few years ago as the prototype for new CBOCs.

The thing I don't get is why VA has separate medical facilities for retired Vets. Why isn't the standard medical care adequate? It seems redundant to have multiple medical systems for different classes of patients.

Sigh. The VA deals with more disabled patients than any other system. that is why they specialize in the needs for these patients. My VA Hospital is in Gainesville, and it is across a busy highway from the University of Florida's Shands teaching hospital. A lot of their students intern at the VA, to see first hand the damage done to people who served our Nation.

That's all great, but it really isn't a reason to have an entirely separate hospital system for vets. Having specialized care for vets is one thing, but that is not the same thing as having an entire healthcare system for vets. It's actually counter productive and expensive to have duplicate care. I seem to recall my friend had to make an appointment weeks in advance. I can get in to see a doctor in one or two weeks for most routine care issues.

Tricare For Life are mostly typical retirees, with very few problems that aren't related to aging. Treatment is usually provided at VA facilities, but the payments come from a different source.

I can see needing medical care for active duty personnel, but retirees would have to be near a VA facility to receive care from what you say. I know a WWII vet who used to drive 60 miles to a VA facility to receive the same care he could have gotten within 3 miles of his home in a civilian facility.

That was his choice.

Not sure what that means. We all have choices, but they are typically limited by others.


> They can refer you to civilian doctors for some treatments, but you have to request it.

That would have been great, but he did not seem to have that option or it was more expensive.


> Also, in many parts of the country, the DAV provides eight passenger vans to take people to appointments in another city.

WTF??? So rather than letting vets use the same health care system we all use they provide mass transportation to VA hospitals???


> Once again, you have to request this service. The DAV buys the vehicles, and turn them over to the GSA who pays for fuel and repairs. They are also covered in the same insurance as other Federal vehicles. Local Veterans volunteer to drive them. They give up one day a week, in exchange for a 'free' lunch while they wait for everyone to report in from their appointments. They can leave early, if everyone finishes early, but there is a sharp 2:00 PM cutoff for departure, so people are home before 4:00PM. You have to have an appointment to secure a ride. They verify it, and call you back. This service was already in use over 20 years ago, before I needed it.

Are you saying different drivers provide service every day or a community only gets service one day a week? While it serves a need, it seems a bit inefficient. How are potential users informed of this service???


> One of the VA's biggest problems is the shortage of good doctors and nurses, so they have to hire what they can get. I had one excellent VA doctor. he was so good that he was appointed director of the Ocala CBOC. Then they transferred him to the St. Petersburg VA hospital, as the director.

Yeah, I don't know what it takes to get a doctor to work for a group. Private practice is a different PITA for doctors.

--

Rick C.

+-+- Get 1,000 miles of free Supercharging
+-+- Tesla referral code - https://ts.la/richard11209

 

[Bill Sloman]

On Friday, February 21, 2020 at 2:46:41 PM UTC+11, Michael Terrell wrote:

On Thursday, February 20, 2020 at 8:30:23 PM UTC-5, Bill Sloman wrote:
On Friday, February 21, 2020 at 3:13:46 AM UTC+11, Michael Terrell wrote:
On Thursday, February 20, 2020 at 1:46:17 AM UTC-5, Bill Sloman wrote:

VA care isn't intended to be top notch for everyone. It is on the level of the Socialist's proposed 'Medicare For All'.

Top-notch means different things to different people. The UK national health service is a fairly spartan form of universal health care. You can buy private health care - where you get looked after as if you were in an expensive hotel.

If you have a real medical problem it isn't wise to put yourself into their hands. They don't get as much practice as the people in National Health Service hospitals, and if anything goes wrong they ship you to nearest one anyway.

<snip>

> You are a moron. Most officers retire after 20 years of service. They get 'Tricare For Life' instead of VA care.

Nice of you to confirm that my basic hypothesis was correct - no matter how ungraciously you went about doing it.

--
Bill Sloman, Sydney

 

[whit3rd]

On Thursday, February 20, 2020 at 10:07:53 PM UTC-8, Rick C wrote:

> That's all great, but it really isn't a reason to have an entirely separate hospital system for vets. Having specialized care for vets is one thing, but that is not the same thing as having an entire healthcare system for vets. It's actually counter productive and expensive...

Well, no. US has a BIG armed service, with odd (temporary assignments, skipping off to foreign shores)
access-to-services requirements, and they have dependents, too. After 20 years or so,
at retirement, why not continue with the same care provider?

It's not like there's any strictly commercial service that takes marching orders and moves out with
the troops.

Every once in a while (Walter Reed fighting yellow fever in Panama is a notable example) having a
dedicated military medicine communty pays dividends.

 

[Rick C]

On Friday, February 21, 2020 at 3:01:25 AM UTC-5, whit3rd wrote:

On Thursday, February 20, 2020 at 10:07:53 PM UTC-8, Rick C wrote:

That's all great, but it really isn't a reason to have an entirely separate hospital system for vets. Having specialized care for vets is one thing, but that is not the same thing as having an entire healthcare system for vets. It's actually counter productive and expensive...

Well, no. US has a BIG armed service, with odd (temporary assignments, skipping off to foreign shores)
access-to-services requirements, and they have dependents, too. After 20 years or so,
at retirement, why not continue with the same care provider?

It's not like there's any strictly commercial service that takes marching orders and moves out with
the troops.

Every once in a while (Walter Reed fighting yellow fever in Panama is a notable example) having a
dedicated military medicine communty pays dividends.

That is the point. Once retired, the VA may or may not be convenient. Why bother at all with having to duplicate local healthcare when we already have the best healthcare in the world? At least that's what many here will say.

It seems very inefficient to try to have multiple healthcare systems for those in the US who are not in the active military. Let the VA specialize in what they really need to do and what they do well. Let the general healthcare system do what they do well and much more conveniently for everyone.

--

Rick C.

+-++ Get 1,000 miles of free Supercharging
+-++ Tesla referral code - https://ts.la/richard11209

 

[Tom Del Rosso]

Rick C wrote:

And that "huh" suggests you are very easily confused, since we were
discussing his point about things the government does like treaty
negotiations.

I must have missed something. This is the first I've seen anyone
mention "treaty negotiations" in this conversation. What is the
relevance???

On Tuesday, February 18, 2020 at 9:50:47 AM UTC-5,
dagmarg...@yahoo.com wrote:

Since you're for one-person one-vote, would you also argue that
China should have four times as many votes as the United States
in any negotiations between the two, since China has quadruple
our population?

If not, why not?

 

[Tom Del Rosso]

Tom Del Rosso wrote:

Rick C wrote:

And that "huh" suggests you are very easily confused, since we were
discussing his point about things the government does like treaty
negotiations.

I must have missed something. This is the first I've seen anyone
mention "treaty negotiations" in this conversation. What is the
relevance???



On Tuesday, February 18, 2020 at 9:50:47 AM UTC-5,
dagmarg...@yahoo.com wrote:

Since you're for one-person one-vote, would you also argue that
China should have four times as many votes as the United States
in any negotiations between the two, since China has quadruple
our population?

If not, why not?

I take that as a sign that you pay attention to what the other side says
here as much as the left usually does.

 

[Bill Sloman]

On Friday, February 21, 2020 at 11:48:51 PM UTC+11, Tom Del Rosso wrote:

Tom Del Rosso wrote:
Rick C wrote:

And that "huh" suggests you are very easily confused, since we were
discussing his point about things the government does like treaty
negotiations.

I must have missed something. This is the first I've seen anyone
mention "treaty negotiations" in this conversation. What is the
relevance???



On Tuesday, February 18, 2020 at 9:50:47 AM UTC-5,
dagmarg...@yahoo.com wrote:

Since you're for one-person one-vote, would you also argue that
China should have four times as many votes as the United States
in any negotiations between the two, since China has quadruple
our population?

If not, why not?

I take that as a sign that you pay attention to what the other side says
here as much as the left usually does.

When James Arthur is being pointlessly - and quite irrationally - provocative, he really doesn't deserve a lot of attention.

--
Bill Sloman, Sydney

 

[Michael Terrell]

On Friday, February 21, 2020 at 3:42:42 AM UTC-5, Rick C wrote:

On Friday, February 21, 2020 at 3:01:25 AM UTC-5, whit3rd wrote:
On Thursday, February 20, 2020 at 10:07:53 PM UTC-8, Rick C wrote:

That's all great, but it really isn't a reason to have an entirely separate hospital system for vets. Having specialized care for vets is one thing, but that is not the same thing as having an entire healthcare system for vets. It's actually counter productive and expensive...

You are as willingly stupid as Sloman.

Well, no. US has a BIG armed service, with odd (temporary assignments, skipping off to foreign shores)
access-to-services requirements, and they have dependents, too. After 20 years or so,
at retirement, why not continue with the same care provider?

It's not like there's any strictly commercial service that takes marching orders and moves out with
the troops.

Every once in a while (Walter Reed fighting yellow fever in Panama is a notable example) having a
dedicated military medicine communty pays dividends.

That is the point. Once retired, the VA may or may not be convenient. Why bother at all with having to duplicate local healthcare when we already have the best healthcare in the world? At least that's what many here will say.

Blame Obama. He created 'Veteran's Choice' but didn't fund it.

It seems very inefficient to try to have multiple healthcare systems for those in the US who are not in the active military. Let the VA specialize in what they really need to do and what they do well. Let the general healthcare system do what they do well and much more conveniently for everyone.

Tell me how many Hospitals and CBOCs the VA operates. I have three CBOCs within 20 miles from my home.

 

[Michael Terrell]

On Friday, February 21, 2020 at 1:07:53 AM UTC-5, Rick C wrote:

On Friday, February 21, 2020 at 12:12:10 AM UTC-5, Michael Terrell wrote:
On Thursday, February 20, 2020 at 11:39:08 PM UTC-5, Rick C wrote:
On Thursday, February 20, 2020 at 10:46:41 PM UTC-5, Michael Terrell wrote:

I knew a woman who worked for Australasia's version of their VA. We discussed both systems for hours and hours. She agreed that we did a lot of things better than they did. She didn't like the scattered facilities, but that is changing as they move clinics from leased space, to custom medical facilities. A former president oped the system to a lot of previously ineligible Veterans, into a system that was already overloaded. My current clinic has 100 exam rooms. It has Xray and Ultrasound, ant to small Operating rooms. If it had rooms for patients, it would be a full hospital. It was built a few years ago as the prototype for new CBOCs.

The thing I don't get is why VA has separate medical facilities for retired Vets. Why isn't the standard medical care adequate? It seems redundant to have multiple medical systems for different classes of patients.

Sigh. The VA deals with more disabled patients than any other system.. that is why they specialize in the needs for these patients. My VA Hospital is in Gainesville, and it is across a busy highway from the University of Florida's Shands teaching hospital. A lot of their students intern at the VA, to see first hand the damage done to people who served our Nation.

That's all great, but it really isn't a reason to have an entirely separate hospital system for vets. Having specialized care for vets is one thing, but that is not the same thing as having an entire healthcare system for vets. It's actually counter productive and expensive to have duplicate care. I seem to recall my friend had to make an appointment weeks in advance. I can get in to see a doctor in one or two weeks for most routine care issues.

The VA has the Military equivalent of Sick call. If you have a legitimate need to be in a hospital, the VA pays for you to be stabilized, and if needed, transferred to their nearest hospital.

Tricare For Life are mostly typical retirees, with very few problems that aren't related to aging. Treatment is usually provided at VA facilities, but the payments come from a different source.

I can see needing medical care for active duty personnel, but retirees would have to be near a VA facility to receive care from what you say. I know a WWII vet who used to drive 60 miles to a VA facility to receive the same care he could have gotten within 3 miles of his home in a civilian facility.

That was his choice.

Not sure what that means. We all have choices, but they are typically limited by others.

It means just what I said, unless this was 30 years ago.

They can refer you to civilian doctors for some treatments, but you have to request it.

That would have been great, but he did not seem to have that option or it was more expensive.

More stupidity. If the VA refers you to an outside provider, they pay the bill. Like my annual visit to a Prosthetic company for Diabetic shoes.

Also, in many parts of the country, the DAV provides eight passenger vans to take people to appointments in another city.

WTF??? So rather than letting vets use the same health care system we all use they provide mass transportation to VA hospitals???

More willing stupidity. Some services are only available at a hospital. CBOcs are slowing being updated as their patient base grows and older leased buildings are being replaced by owned properties.

Once again, you have to request this service. The DAV buys the vehicles, and turn them over to the GSA who pays for fuel and repairs. They are also covered in the same insurance as other Federal vehicles. Local Veterans volunteer to drive them. They give up one day a week, in exchange for a 'free' lunch while they wait for everyone to report in from their appointments. They can leave early, if everyone finishes early, but there is a sharp 2:00 PM cutoff for departure, so people are home before 4:00PM. You have to have an appointment to secure a ride. They verify it, and call you back. This service was already in use over 20 years ago, before I needed it.

Are you saying different drivers provide service every day or a community only gets service one day a week? While it serves a need, it seems a bit inefficient. How are potential users informed of this service???

The number of days depends on the requirements. Most locations ry to keep it to four days a week, but the will make a Friday run if it's needed.

One of the VA's biggest problems is the shortage of good doctors and nurses, so they have to hire what they can get. I had one excellent VA doctor.. he was so good that he was appointed director of the Ocala CBOC. Then they transferred him to the St. Petersburg VA hospital, as the director.

Yeah, I don't know what it takes to get a doctor to work for a group. Private practice is a different PITA for doctors.

A lot of those 'Private Doctors' are denied hospital privileges because of too many malpractice claims against them. A lot of hospitals have trouble hiring in the public sector, as well. Since you never served, it's really none of your business.

 

[Rick C]

On Friday, February 21, 2020 at 11:47:08 AM UTC-5, Michael Terrell wrote:

On Friday, February 21, 2020 at 1:07:53 AM UTC-5, Rick C wrote:
On Friday, February 21, 2020 at 12:12:10 AM UTC-5, Michael Terrell wrote:
On Thursday, February 20, 2020 at 11:39:08 PM UTC-5, Rick C wrote:
On Thursday, February 20, 2020 at 10:46:41 PM UTC-5, Michael Terrell wrote:

I knew a woman who worked for Australasia's version of their VA. We discussed both systems for hours and hours. She agreed that we did a lot of things better than they did. She didn't like the scattered facilities, but that is changing as they move clinics from leased space, to custom medical facilities. A former president oped the system to a lot of previously ineligible Veterans, into a system that was already overloaded. My current clinic has 100 exam rooms. It has Xray and Ultrasound, ant to small Operating rooms. If it had rooms for patients, it would be a full hospital. It was built a few years ago as the prototype for new CBOCs.

The thing I don't get is why VA has separate medical facilities for retired Vets. Why isn't the standard medical care adequate? It seems redundant to have multiple medical systems for different classes of patients.

Sigh. The VA deals with more disabled patients than any other system. that is why they specialize in the needs for these patients. My VA Hospital is in Gainesville, and it is across a busy highway from the University of Florida's Shands teaching hospital. A lot of their students intern at the VA, to see first hand the damage done to people who served our Nation.

That's all great, but it really isn't a reason to have an entirely separate hospital system for vets. Having specialized care for vets is one thing, but that is not the same thing as having an entire healthcare system for vets. It's actually counter productive and expensive to have duplicate care. I seem to recall my friend had to make an appointment weeks in advance. I can get in to see a doctor in one or two weeks for most routine care issues.


The VA has the Military equivalent of Sick call. If you have a legitimate need to be in a hospital, the VA pays for you to be stabilized, and if needed, transferred to their nearest hospital.


Tricare For Life are mostly typical retirees, with very few problems that aren't related to aging. Treatment is usually provided at VA facilities, but the payments come from a different source.

I can see needing medical care for active duty personnel, but retirees would have to be near a VA facility to receive care from what you say. I know a WWII vet who used to drive 60 miles to a VA facility to receive the same care he could have gotten within 3 miles of his home in a civilian facility.

That was his choice.

Not sure what that means. We all have choices, but they are typically limited by others.


It means just what I said, unless this was 30 years ago.


They can refer you to civilian doctors for some treatments, but you have to request it.

That would have been great, but he did not seem to have that option or it was more expensive.


More stupidity. If the VA refers you to an outside provider, they pay the bill. Like my annual visit to a Prosthetic company for Diabetic shoes.


Also, in many parts of the country, the DAV provides eight passenger vans to take people to appointments in another city.

WTF??? So rather than letting vets use the same health care system we all use they provide mass transportation to VA hospitals???


More willing stupidity. Some services are only available at a hospital.. CBOcs are slowing being updated as their patient base grows and older leased buildings are being replaced by owned properties.


Once again, you have to request this service. The DAV buys the vehicles, and turn them over to the GSA who pays for fuel and repairs. They are also covered in the same insurance as other Federal vehicles. Local Veterans volunteer to drive them. They give up one day a week, in exchange for a 'free' lunch while they wait for everyone to report in from their appointments. They can leave early, if everyone finishes early, but there is a sharp 2:00 PM cutoff for departure, so people are home before 4:00PM. You have to have an appointment to secure a ride. They verify it, and call you back. This service was already in use over 20 years ago, before I needed it.

Are you saying different drivers provide service every day or a community only gets service one day a week? While it serves a need, it seems a bit inefficient. How are potential users informed of this service???


The number of days depends on the requirements. Most locations ry to keep it to four days a week, but the will make a Friday run if it's needed.


One of the VA's biggest problems is the shortage of good doctors and nurses, so they have to hire what they can get. I had one excellent VA doctor. he was so good that he was appointed director of the Ocala CBOC. Then they transferred him to the St. Petersburg VA hospital, as the director.

Yeah, I don't know what it takes to get a doctor to work for a group. Private practice is a different PITA for doctors.


A lot of those 'Private Doctors' are denied hospital privileges because of too many malpractice claims against them. A lot of hospitals have trouble hiring in the public sector, as well. Since you never served, it's really none of your business.

Actually it is my business. I'm paying for it. In this country you get the same rights to vote as everyone else and have no more say in healthcare decisions than anyone else. That's how our government works. Equality regardless of what you think of other people. That's why we have protections built in for minorities no matter what sort of minority they are.

--

Rick C.

++-+ Get 1,000 miles of free Supercharging
++-+ Tesla referral code - https://ts.la/richard11209

 

[Rick C]

On Friday, February 21, 2020 at 11:30:11 AM UTC-5, Michael Terrell wrote:

On Friday, February 21, 2020 at 3:42:42 AM UTC-5, Rick C wrote:
On Friday, February 21, 2020 at 3:01:25 AM UTC-5, whit3rd wrote:
On Thursday, February 20, 2020 at 10:07:53 PM UTC-8, Rick C wrote:

That's all great, but it really isn't a reason to have an entirely separate hospital system for vets. Having specialized care for vets is one thing, but that is not the same thing as having an entire healthcare system for vets. It's actually counter productive and expensive...

You are as willingly stupid as Sloman.

Well, no. US has a BIG armed service, with odd (temporary assignments, skipping off to foreign shores)
access-to-services requirements, and they have dependents, too. After 20 years or so,
at retirement, why not continue with the same care provider?

It's not like there's any strictly commercial service that takes marching orders and moves out with
the troops.

Every once in a while (Walter Reed fighting yellow fever in Panama is a notable example) having a
dedicated military medicine communty pays dividends.

That is the point. Once retired, the VA may or may not be convenient. Why bother at all with having to duplicate local healthcare when we already have the best healthcare in the world? At least that's what many here will say.


Blame Obama. He created 'Veteran's Choice' but didn't fund it.


It seems very inefficient to try to have multiple healthcare systems for those in the US who are not in the active military. Let the VA specialize in what they really need to do and what they do well. Let the general healthcare system do what they do well and much more conveniently for everyone.


Tell me how many Hospitals and CBOCs the VA operates. I have three CBOCs within 20 miles from my home.

There are over 100 doctors withing 5 miles of my address in Maryland and around 1000 doctors within some 20-25 miles. There are 200 within 30 miles of my Virginia home and some as close as 15 miles (it's in the middle of nowhere). I'm not sure what that has to do with anything. My point is the VA network of doctors duplicates the rest of the US medical system for no purpose. The VA handles the special needs of Vets that other facilities might not do as well. But they don't need to duplicate the 99% of medical needs the rest of healthcare is perfectly capable of providing.

Do you get what I'm saying? It would be easier for all and cost less to let Vets get their standard care from the same nationwide medical system everyone else gets. It's the 1% that need special care that the VA can specialize in.

I'm trying to communicate with you, but you seem to not want to hear what I'm saying.

--

Rick C.

++-- Get 1,000 miles of free Supercharging
++-- Tesla referral code - https://ts.la/richard11209

 

[whit3rd]

On Friday, February 21, 2020 at 11:37:17 AM UTC-8, Rick C wrote:

> There are over 100 doctors withing 5 miles of my address in Maryland and around 1000 doctors within some 20-25 miles. ... The VA handles the special needs of Vets that other facilities might not do as well. But they don't need to duplicate the 99% of medical needs the rest of healthcare is perfectly capable of providing.

The VA has its own health maintenance organization, and EVERY HMO
'doesn't need to duplicate' a national health establishment. But, that's not what
it effectively does; rather, it becomes a part of the nation's health institutions.

You make it sound like there's some virtue in the private ownership of other HMO
institutions, and... there isn't. In fact, historically, some health care has been religiious, some
private, some governmental... and the mass-production schemes that effect health
care in urban communities accomodate well into any of those.

> Do you get what I'm saying? It would be easier for all and cost less...

Sounds like content-free sales-speak: infomercials on the Rick C. channel.

 

[Rick C]

On Friday, February 21, 2020 at 3:26:41 PM UTC-5, whit3rd wrote:

On Friday, February 21, 2020 at 11:37:17 AM UTC-8, Rick C wrote:

There are over 100 doctors withing 5 miles of my address in Maryland and around 1000 doctors within some 20-25 miles. ... The VA handles the special needs of Vets that other facilities might not do as well. But they don't need to duplicate the 99% of medical needs the rest of healthcare is perfectly capable of providing.

The VA has its own health maintenance organization, and EVERY HMO
'doesn't need to duplicate' a national health establishment. But, that's not what
it effectively does; rather, it becomes a part of the nation's health institutions.

HMOs are regional and private, for profit organizations. They LIMIT customer's choices in order to provide healthcare at lower costs. Kaiser-Permanente is a common HMO, but they don't serve every area. Why? Because it is too expensive to duplicate healthcare services over the whole country. That's my point.

Kaiser-Permanente makes it work by having adequate facilities in densely populated areas where they recruit lots of customers. In the rest of the country they have no facilities.

The VA appears to be using a model where they provide limited access over much of the country requiring their customers to van-pool to their appointments. Clearly not a model based on financial factors. Terrell says in some cases they will pay for out of network care which may end up being rather expensive compared to just providing Medicare or a more standard insurance scheme since they may have to pay full price if there is no price agreement.. Obviously I don't know all the details, but I can't see how providing general medical care through a special network of providers is of advantage to Vets unless they have special needs from injuries.

In this case, the customer, the Vets, aren't paying, so they won't worry so much about the costs. Most of us pay at least some portion of our insurance premium and so want to have quality care that is cost effective. We also wish for Vets to have the same sort of medical care. Don't we all deserve equal protection and medical care? Are some more equal than others.

You make it sound like there's some virtue in the private ownership of other HMO
institutions, and... there isn't.

Not sure what you are responding to. I don't think I've even mentioned HMOs.

In fact, historically, some health care has been religiious, some
private, some governmental... and the mass-production schemes that effect health
care in urban communities accomodate well into any of those.

I think you are confusing how it is paid for with how it is rendered. Are there religious organizations that only treat members of their churches???

Do you get what I'm saying? It would be easier for all and cost less....

Sounds like content-free sales-speak: infomercials on the Rick C. channel..

Ok, but you have stopped discussion and are replying with absurdities. So I assume you have nothing further to discuss.

--

Rick C.

+++- Get 1,000 miles of free Supercharging
+++- Tesla referral code - https://ts.la/richard11209

 

[whit3rd]

On Friday, February 21, 2020 at 2:38:28 PM UTC-8, Rick C wrote:

On Friday, February 21, 2020 at 3:26:41 PM UTC-5, whit3rd wrote:

The VA has its own health maintenance organization, and EVERY HMO
'doesn't need to duplicate' a national health establishment. But, that's not what
it effectively does; rather, it becomes a part of the nation's health institutions.

HMOs are regional and private, for profit organizations. They LIMIT customer's choices in order to provide healthcare at lower costs. Kaiser-Permanente is a common HMO, but they don't serve every area. Why? Because it is too expensive to duplicate healthcare services over the whole country. That's my point.

Utter nonsense. Claims of Inefficiency mean expense/cost ratio goes up, not that expense alone
(for the organization) goes up. You don't make a 'too expensive' decision on veterans'
benefits AFTER they serve, unless the retirement plan goes bankrupt.

> Kaiser-Permanente makes it work by having adequate facilities in densely populated areas where they recruit lots of customers. In the rest of the country they have no facilities.

Not much good for a retirement community drawn from all states, posessions, and a few
foreign nations. They retire to EVERYWHERE.

Do you get what I'm saying? It would be easier for all and cost less....

Sounds like content-free sales-speak: infomercials on the Rick C. channel.

Ok, but you have stopped discussion and are replying with absurdities. So I assume you have nothing further to discuss.

How do you serve the veteran population 'easier'? The content-free comment stands
unchallenged. It was never absurd, it was something else: dismissive. I can't tell
what you're talking about, or why anyone should enthuse over an alternative..

 

[Rick C]

On Friday, February 21, 2020 at 8:24:57 PM UTC-5, whit3rd wrote:

On Friday, February 21, 2020 at 2:38:28 PM UTC-8, Rick C wrote:
On Friday, February 21, 2020 at 3:26:41 PM UTC-5, whit3rd wrote:

The VA has its own health maintenance organization, and EVERY HMO
'doesn't need to duplicate' a national health establishment. But, that's not what
it effectively does; rather, it becomes a part of the nation's health institutions.

HMOs are regional and private, for profit organizations. They LIMIT customer's choices in order to provide healthcare at lower costs. Kaiser-Permanente is a common HMO, but they don't serve every area. Why? Because it is too expensive to duplicate healthcare services over the whole country. That's my point.

Utter nonsense. Claims of Inefficiency mean expense/cost ratio goes up, not that expense alone
(for the organization) goes up. You don't make a 'too expensive' decision on veterans'
benefits AFTER they serve, unless the retirement plan goes bankrupt.

You aren't reading what I write. I never said anything about efficiency. I'm talking about giving patients lesser care for the dollars spent. They can get better care for the same cost at civilian hospitals. Why make them travel further to get the care they need and then pay more for it?

Kaiser-Permanente makes it work by having adequate facilities in densely populated areas where they recruit lots of customers. In the rest of the country they have no facilities.

Not much good for a retirement community drawn from all states, posessions, and a few
foreign nations. They retire to EVERYWHERE.

Not sure what you are talking about here. Are you saying there isn't healthcare in places where people retire unless the VA provides it???

Do you get what I'm saying? It would be easier for all and cost less...

Sounds like content-free sales-speak: infomercials on the Rick C. channel.

Ok, but you have stopped discussion and are replying with absurdities. So I assume you have nothing further to discuss.

How do you serve the veteran population 'easier'? The content-free comment stands
unchallenged. It was never absurd, it was something else: dismissive. I can't tell
what you're talking about, or why anyone should enthuse over an alternative.

I have said many times that aside from the special care that wounded Vets require, civilian healthcare is perfectly qualified to provide health benefits to Vets. Other than the specialized care at a small number of facilities, there is no reason to have a special network of VA healthcare facilities that duplicate existing healthcare.

It's like having a special car designed for Vets. They need transportation, right? So why not Vet cars? We have VA hospitals because of the special needs of wounded Vets. That has grown into a government bureaucracy of VA healthcare that is redundant with civilian healthcare. Just like any bureaucracy that becomes self justifying.

--

Rick C.

++++ Get 1,000 miles of free Supercharging
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[Michael Terrell]

On Friday, February 21, 2020 at 2:37:17 PM UTC-5, Rick C wrote:

On Friday, February 21, 2020 at 11:30:11 AM UTC-5, Michael Terrell wrote:
On Friday, February 21, 2020 at 3:42:42 AM UTC-5, Rick C wrote:
On Friday, February 21, 2020 at 3:01:25 AM UTC-5, whit3rd wrote:
On Thursday, February 20, 2020 at 10:07:53 PM UTC-8, Rick C wrote:

That's all great, but it really isn't a reason to have an entirely separate hospital system for vets. Having specialized care for vets is one thing, but that is not the same thing as having an entire healthcare system for vets. It's actually counter productive and expensive...

You are as willingly stupid as Sloman.

Well, no. US has a BIG armed service, with odd (temporary assignments, skipping off to foreign shores)
access-to-services requirements, and they have dependents, too. After 20 years or so,
at retirement, why not continue with the same care provider?

It's not like there's any strictly commercial service that takes marching orders and moves out with
the troops.

Every once in a while (Walter Reed fighting yellow fever in Panama is a notable example) having a
dedicated military medicine communty pays dividends.

That is the point. Once retired, the VA may or may not be convenient.. Why bother at all with having to duplicate local healthcare when we already have the best healthcare in the world? At least that's what many here will say.


Blame Obama. He created 'Veteran's Choice' but didn't fund it.


It seems very inefficient to try to have multiple healthcare systems for those in the US who are not in the active military. Let the VA specialize in what they really need to do and what they do well. Let the general healthcare system do what they do well and much more conveniently for everyone.


Tell me how many Hospitals and CBOCs the VA operates. I have three CBOCs within 20 miles from my home.

There are over 100 doctors withing 5 miles of my address in Maryland and around 1000 doctors within some 20-25 miles. There are 200 within 30 miles of my Virginia home and some as close as 15 miles (it's in the middle of nowhere). I'm not sure what that has to do with anything. My point is the VA network of doctors duplicates the rest of the US medical system for no purpose. The VA handles the special needs of Vets that other facilities might not do as well. But they don't need to duplicate the 99% of medical needs the rest of healthcare is perfectly capable of providing.

Ask them how many want to deal with not only the VA, but the high number of disabled patients. Ask how long they are willing to wait for payments to be processed, or to get approval to perform surgery and report it for all to see.

Do you get what I'm saying? It would be easier for all and cost less to let Vets get their standard care from the same nationwide medical system everyone else gets. It's the 1% that need special care that the VA can specialize in.

I'm trying to communicate with you, but you seem to not want to hear what I'm saying.

No, you're trying to cram your narrow view down my throat.

 

[Michael Terrell]

On Friday, February 21, 2020 at 2:40:54 PM UTC-5, Rick C wrote:

On Friday, February 21, 2020 at 11:47:08 AM UTC-5, Michael Terrell wrote:


A lot of those 'Private Doctors' are denied hospital privileges because of too many malpractice claims against them. A lot of hospitals have trouble hiring in the public sector, as well. Since you never served, it's really none of your business.

Actually it is my business. I'm paying for it. In this country you get the same rights to vote as everyone else and have no more say in healthcare decisions than anyone else. That's how our government works. Equality regardless of what you think of other people. That's why we have protections built in for minorities no matter what sort of minority they are.

Actually, you aren't paying for it. The Veterans prepaid it, while on Active duty. This was done in that we received less pay then the same job paid a Civilian in the same job. Not only that, by signing on the line, we offered up to, and including our lives. If Active duty were paid the same as Civilians, then you would be paying it.

 

[Michael Terrell]

On Friday, February 21, 2020 at 5:38:28 PM UTC-5, Rick C wrote:

On Friday, February 21, 2020 at 3:26:41 PM UTC-5, whit3rd wrote:
On Friday, February 21, 2020 at 11:37:17 AM UTC-8, Rick C wrote:

There are over 100 doctors withing 5 miles of my address in Maryland and around 1000 doctors within some 20-25 miles. ... The VA handles the special needs of Vets that other facilities might not do as well. But they don't need to duplicate the 99% of medical needs the rest of healthcare is perfectly capable of providing.

The VA has its own health maintenance organization, and EVERY HMO
'doesn't need to duplicate' a national health establishment. But, that's not what
it effectively does; rather, it becomes a part of the nation's health institutions.

HMOs are regional and private, for profit organizations. They LIMIT customer's choices in order to provide healthcare at lower costs. Kaiser-Permanente is a common HMO, but they don't serve every area. Why? Because it is too expensive to duplicate healthcare services over the whole country. That's my point.

Kaiser-Permanente makes it work by having adequate facilities in densely populated areas where they recruit lots of customers. In the rest of the country they have no facilities.

The VA appears to be using a model where they provide limited access over much of the country requiring their customers to van-pool to their appointments.

It is not required, it is a courtesy service for those who can't drive. Get your lies straight. The vast amount of appointments are at local CBOCs.

From the VA Website:

The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,255 health care facilities, including 170 VA Medical Centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA ...

https://www.va.gov/

So, by your logic they should close down all other hospitals and clinics..

Clearly not a model based on financial factors. Terrell says in some cases they will pay for out of network care which may end up being rather expensive compared to just providing Medicare or a more standard insurance scheme since they may have to pay full price if there is no price agreement. Obviously I don't know all the details, but I can't see how providing general medical care through a special network of providers is of advantage to Vets unless they have special needs from injuries.

Clearly, you are lying.

In this case, the customer, the Vets, aren't paying, so they won't worry so much about the costs. Most of us pay at least some portion of our insurance premium and so want to have quality care that is cost effective. We also wish for Vets to have the same sort of medical care. Don't we all deserve equal protection and medical care? Are some more equal than others.

You're right We don't pay, because we have already paid for it while on Active Duty. Not that a Snowflake like you has any clue about the size of the VA system


I was required to apply for Social Security at 62, and enrolled automatically into Medicare and Medicaid. Yet another lie from rick. It is difficult to find a good doctor who will accept them, in this area because ere are so many retirees.

You are the one who thinks he is more than equal.

 

[Jasen Betts]

On 2020-02-22, Michael Terrell <terrell.michael.a@gmail.com> wrote:

On Friday, February 21, 2020 at 2:40:54 PM UTC-5, Rick C wrote:
On Friday, February 21, 2020 at 11:47:08 AM UTC-5, Michael Terrell wrote:


A lot of those 'Private Doctors' are denied hospital privileges because of too many malpractice claims against them. A lot of hospitals have trouble hiring in the public sector, as well. Since you never served, it's really none of your business.

Actually it is my business. I'm paying for it. In this country you get the same rights to vote as everyone else and have no more say in healthcare decisions than anyone else. That's how our government works. Equality regardless of what you think of other people. That's why we have protections built in for minorities no matter what sort of minority they are.

Actually, you aren't paying for it. The Veterans prepaid it, while on Active duty. This was done in that we received less pay then the same job paid a Civilian in the same job. Not only that, by signing on the line, we offered up to, and including our lives. If Active duty were paid the same as Civilians, then you would be paying it.

That's a fine sentiment, but it's not infact where the money comes from.
There is certanly a debt owed to the veterans, but it is being repaid from taxes.

--
Jasen.

 

[Rick C]

On Saturday, February 22, 2020 at 1:13:37 AM UTC-5, Michael Terrell wrote:

On Friday, February 21, 2020 at 5:38:28 PM UTC-5, Rick C wrote:
On Friday, February 21, 2020 at 3:26:41 PM UTC-5, whit3rd wrote:
On Friday, February 21, 2020 at 11:37:17 AM UTC-8, Rick C wrote:

There are over 100 doctors withing 5 miles of my address in Maryland and around 1000 doctors within some 20-25 miles. ... The VA handles the special needs of Vets that other facilities might not do as well. But they don't need to duplicate the 99% of medical needs the rest of healthcare is perfectly capable of providing.

The VA has its own health maintenance organization, and EVERY HMO
'doesn't need to duplicate' a national health establishment. But, that's not what
it effectively does; rather, it becomes a part of the nation's health institutions.

HMOs are regional and private, for profit organizations. They LIMIT customer's choices in order to provide healthcare at lower costs. Kaiser-Permanente is a common HMO, but they don't serve every area. Why? Because it is too expensive to duplicate healthcare services over the whole country. That's my point.

Kaiser-Permanente makes it work by having adequate facilities in densely populated areas where they recruit lots of customers. In the rest of the country they have no facilities.

The VA appears to be using a model where they provide limited access over much of the country requiring their customers to van-pool to their appointments.


It is not required, it is a courtesy service for those who can't drive.. Get your lies straight. The vast amount of appointments are at local CBOCs.

From the VA Website:

The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,255 health care facilities, including 170 VA Medical Centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA ...

https://www.va.gov/

So, by your logic they should close down all other hospitals and clinics.

Let me explain. The VA is the largest single healthcare provider because the provide care across the entire country. That does not mean they are larger than the aggregate of the civilian medical network which is comprised of many organizations.

Try to listen to what I am saying. The civilian sector provides care to the entire country of 300,000,000+ people. The VA takes care of a small fraction of that number. In the process of doing that they essentially duplicate the existing civilian network and provide less access to care.

Clearly not a model based on financial factors. Terrell says in some cases they will pay for out of network care which may end up being rather expensive compared to just providing Medicare or a more standard insurance scheme since they may have to pay full price if there is no price agreement. Obviously I don't know all the details, but I can't see how providing general medical care through a special network of providers is of advantage to Vets unless they have special needs from injuries.


Clearly, you are lying.

I'm asking you to explain what you are talking about and you say I am lying.. Facts are facts. One healthcare system is better than two. With all the bad press the VA has had over the decades continuing today, it would seem they have more work to do simply to try to match the civilian network's level of care.

In this case, the customer, the Vets, aren't paying, so they won't worry so much about the costs. Most of us pay at least some portion of our insurance premium and so want to have quality care that is cost effective. We also wish for Vets to have the same sort of medical care. Don't we all deserve equal protection and medical care? Are some more equal than others.


You're right We don't pay, because we have already paid for it while on Active Duty. Not that a Snowflake like you has any clue about the size of the VA system


I was required to apply for Social Security at 62, and enrolled automatically into Medicare and Medicaid. Yet another lie from rick. It is difficult to find a good doctor who will accept them, in this area because ere are so many retirees.

You are the one who thinks he is more than equal.

Ok, if you are going to rant I guess the conversation is over.

Why were you required to apply for SS at age 62? I'm 66 and still not collecting.

Yes, there are doctors who don't accept Medicare. With the coming changes that won't continue much longer. It will ultimately be that they either take Medicare or find a new job like in many advanced countries like the UK.

--

Rick C.

----- Get 1,000 miles of free Supercharging
----- Tesla referral code - https://ts.la/richard11209