tkhayes 348 #201 December 9, 2024 22 hours ago, BIGUN said: Hold on. It helps to actually read the article past the headline and not embrace the noise. Beginning around 2016, there was a shift from the backlog of trying to keep everything in-house at the VA. That's what was caused veterans to die. Congress opened the purse and gave the VA a directive to do "Care in the Community" to alleviate some of the issues. Your VA PCP recommends a specialst, the PCP sends it over to CinC, they coordinate with a local specialist, it gets done. It went well, kind of a FEMA model of approving funds for others to take care of the problem. After losing so many VA Doctors to higher pay in the community, the question became, why does the VA have its own healthcare system - why not "just" use CinC. There's an evaluation going on of cutting the budget and just doing CinC. No reason to be duplicitous. Fact is - this would be an even better model for the consideration of Universal Healthcare. that will cost substantially more money that has to come from somewhere, and the initial commentary was about the commitment of Musk (unappointed, unelected, unaccountable to anyone but trump) and Trump to cut 1/3 of the annual budget. So while your model might work at delivering better healthcare for veterans, it does not address the fact that they will likely slash the programs completely. or they will fail at saving the government any money. I am thinking the latter. Trump will once again balloon the deficit and debt and blame everyone else for his failures. His base will cheer him on and believe anything that he says. Musk and several other ultra billionaires will all quadruple their wealth and the average american will be no further ahead. The increase in debt and deficit will likely end up in the pockets of a few.... Quote Share this post Link to post Share on other sites
BIGUN 1,296 #202 December 9, 2024 1 hour ago, JoeWeber said: But with VA insurance, per your post, it's not the same. With VA there is a PCP requirement etc. Not so? Medicare doesn’t require a primary care physician and there are no referrals required to see a specialist - however the specialist usually requires one. Within the VA, the PCP is the pivot point. I hurt my foot, I see him, he refers me to an orthopod in the VA, if it's greater than 30 days out, it shifts to CinC. Quote Share this post Link to post Share on other sites
JoeWeber 2,720 #203 December 9, 2024 25 minutes ago, BIGUN said: Medicare doesn’t require a primary care physician and there are no referrals required to see a specialist - however the specialist usually requires one. Within the VA, the PCP is the pivot point. I hurt my foot, I see him, he refers me to an orthopod in the VA, if it's greater than 30 days out, it shifts to CinC. So standard insurance bullshit. There is no equivalency. And no, Medicare does not "usually" require a referral between specialists in my experience which is substantial. What is so important to you that you insist that VA bullshit is no different than Medicare? It is worse by your own examples. Quote Share this post Link to post Share on other sites
BIGUN 1,296 #204 December 9, 2024 2 hours ago, JoeWeber said: What is so important to you that you insist that VA bullshit is no different than Medicare? It is worse by your own examples. Well, I can tell you this. I have experience with both, you do not, so my bullshit trumps yours. Quote Share this post Link to post Share on other sites
JoeWeber 2,720 #205 December 9, 2024 (edited) 4 hours ago, BIGUN said: Well, I can tell you this. I have experience with both, you do not, so my bullshit trumps yours. Well, you wrote this: "Medicare doesn’t require a primary care physician and there are no referrals required to see a specialist - however the specialist usually requires one. Within the VA, the PCP is the pivot point. I hurt my foot, I see him, he refers me to an orthopod in the VA, if it's greater than 30 days out, it shifts to CinC". Wherein you artfully explain that with Medicare you don't need a PCP but in the VA system you do. So yes, that does sound like Trump bullshit. Also, the VA PCP chooses your specialist where in Medicare the choice is yours. And I have never yet had a specialist ask for a referral. But then I am always very studied up of the procedures, have read what the specialist has published, have a solid feel for their experience with the procedure and the devices, have my own preferences, and also precede my appointment request by providing recent imaging. Maybe you aren't as picky. Edited December 9, 2024 by JoeWeber Quote Share this post Link to post Share on other sites
BIGUN 1,296 #206 December 9, 2024 1 hour ago, JoeWeber said: And I have never yet had a specialist ask for a referral. But then I am always very studied up of the procedures, have read what the specialist has published, have a solid feel for their experience with the procedure and the devices, have my own preferences, and also precede my appointment request by providing recent imaging. Maybe you aren't as picky. Sounds like you got it all figured out. Quote Share this post Link to post Share on other sites
JoeWeber 2,720 #207 December 9, 2024 1 hour ago, BIGUN said: Sounds like you got it all figured out. Not really, when you're short on smarts you simply need to put in extra effort. My practice is that when I sit with my finalist specialists it's an interview. I would never take a specialist solely on a PCP referral. Quote Share this post Link to post Share on other sites
BIGUN 1,296 #208 December 10, 2024 (edited) 14 hours ago, JoeWeber said: My practice is that when I sit with my finalist specialists it's an interview. I would never take a specialist solely on a PCP referral. I'm glad your process works for you, Joe. Edited December 10, 2024 by BIGUN Quote Share this post Link to post Share on other sites
TriGirl 318 #209 December 10, 2024 (edited) On 12/9/2024 at 5:55 AM, tkhayes said: that will cost substantially more money that has to come from somewhere, and the initial commentary was about the commitment of Musk (unappointed, unelected, unaccountable to anyone but trump) and Trump to cut 1/3 of the annual budget. So while your model might work at delivering better healthcare for veterans, it does not address the fact that they will likely slash the programs completely. or they will fail at saving the government any money. My concern about Hegseth's idea is that he says the "choose your own" healthcare provider, funded by the VA, for only service-related injuries/health problems. There is your hidden issue: what gets determined to be "service-related." A friend of mine has what his VA doctor described as "paratrooper knees" after many years jumping round canopies while carrying radio equipment (active duty). However, he has never been able to get his broken-down knees categorized as "service-related" for his disability claim. The doc claims they can't prove it was caused by his airborne time in the service. [smh] It's this kind of nonsense that we'll hear about incessantly if the VA goes to the type of medical care option Hegseth is proposing, and we'll be back to veterans suffering. Edited December 10, 2024 by TriGirl 3 Quote Share this post Link to post Share on other sites
JerryBaumchen 1,354 #210 December 10, 2024 52 minutes ago, TriGirl said: My concern about Hegseth's idea is that he says the "choose your own" healthcare provider, funded by the VA, for only service-related injuries/health problems. There is your hidden issue: what gets determined to be "service-related." A friend of mine has what his VA doctor described as "paratrooper knees" after many years jumping round canopies while carrying radio equipment (active duty). However, he has never been able to get his broken-down knees categorized as "service-related" for his disability claim. The doc claims they can't prove it was caused by his airborne time in the service. [smh] It's this kind of nonsense that we'll hear about incessantly if the VA goes to the type of medical care option Hegseth is proposing, and we'll be back to veterans suffering. Hi Tanya, And, I have an old friend who spent about 1 1/2 yrs on the 7th Army Parachute Team in Europe in the late 60's - early 70's. He tweeked his knee on a landing. When he separated from active duty, the Army told him to see a local specialist. The doctor almost went ballistic, said he was seriously injured & might to have the knee replaced. He continued sport jumping for about another 5 yrs. He, in his early 80's, still gets a disability check every month from DoD. Some fairness, Jerry Baumchen Quote Share this post Link to post Share on other sites
billvon 2,989 #211 December 10, 2024 1 hour ago, TriGirl said: The doc claims they can't prove it was caused by his airborne time in the service. [smh] And if he ever does manage to prove that, it will quickly become a "pre-existing condition." Quote Share this post Link to post Share on other sites
JoeWeber 2,720 #212 December 11, 2024 6 hours ago, billvon said: And if he ever does manage to prove that, it will quickly become a "pre-existing condition." Maybe, and I’m hanging it out here, health care for all conditions and from any cause shouldn’t be a benefit. Maybe dividing us into different groups for different reasons and offering a wide variety of different benefits at different costs is just too unwieldy and inefficient. Quote Share this post Link to post Share on other sites
BIGUN 1,296 #213 December 11, 2024 20 hours ago, billvon said: it will quickly become a "pre-existing condition." That could actually work more in his favor. Under 38 CFR § 3.306, “a preexisting injury or disease will be considered to have been aggravated by active military, naval, or air service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease.” Quote Share this post Link to post Share on other sites
billvon 2,989 #214 December 11, 2024 2 hours ago, BIGUN said: Under 38 CFR § 3.306, “a preexisting injury or disease will be considered to have been aggravated by active military, naval, or air service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease.” That sounds like it would work against them. Arthritis, for example, progresses naturally with time, and is very often kicked off by minor injuries earlier in life. So a severe case of arthritis that started with a minor injury in the military would not be covered due to the last part of that rule. Quote Share this post Link to post Share on other sites
BIGUN 1,296 #215 December 12, 2024 (edited) 17 hours ago, billvon said: That sounds like it would work against them. Arthritis, for example, progresses naturally with time, and is very often kicked off by minor injuries earlier in life. So a severe case of arthritis that started with a minor injury in the military would not be covered due to the last part of that rule. You brought up knees. If one went thru MEPS, and took an Airborne physical, where a high school sport torn ACL was noted, but they let him go anyway and their knee got progressively worse - later in life, he would have a paper trail to point at. WRT Arthritis - in this example they would probably assess a secondary or tertiary claim for ankle/knee/hip arthritis. Edited December 12, 2024 by BIGUN Quote Share this post Link to post Share on other sites
kallend 2,026 #216 December 23, 2024 House ethics report on Matt Gaetz https://www.telegraph.co.uk/us/news/2024/12/23/matt-gaetz-paid-underage-girl-400-for-sex-us-ethics-report/ Looks like he would have fit right in with the Trump administration. Quote Share this post Link to post Share on other sites
tkhayes 348 #217 December 23, 2024 45 minutes ago, kallend said: House ethics report on Matt Gaetz https://www.telegraph.co.uk/us/news/2024/12/23/matt-gaetz-paid-underage-girl-400-for-sex-us-ethics-report/ Looks like he would have fit right in with the Trump administration. The GOP is ok with rapists and rape but draw the line at child rape I guess that is a plus? Quote Share this post Link to post Share on other sites
jakee 1,489 #218 December 23, 2024 1 hour ago, tkhayes said: The GOP is ok with rapists and rape but draw the line at child rape MAGA didn't. Quote Share this post Link to post Share on other sites
wmw999 2,439 #219 December 23, 2024 2 hours ago, tkhayes said: The GOP is ok with rapists and rape but draw the line at child rape I guess that is a plus? Well, they put Roy Moore up for election to replace Jeff Sessions. But enough people were grossed out that Alabama actually elected a Democratic senator Wendy P. Quote Share this post Link to post Share on other sites
wolfriverjoe 1,523 #220 December 23, 2024 2 hours ago, tkhayes said: The GOP is ok with rapists and rape but draw the line at child rape I guess that is a plus? 1 hour ago, jakee said: MAGA didn't. 21 minutes ago, wmw999 said: Well, they put Roy Moore up for election to replace Jeff Sessions. But enough people were grossed out that Alabama actually elected a Democratic senator Wendy P. It's abundantly clear that the GOP & MAGA have no concerns about what their candidates have actually done. They only care about what they can and will do when in office. Their nominees for various positions are exactly the same. You know, like for the Supreme Court. 2 Quote Share this post Link to post Share on other sites
kallend 2,026 #221 December 23, 2024 So Scumbag Gaetz, (R, and a favorite of Trump) sought a restraining order today against the House Ethics Committee in an effort to halt the panel's release of its final report summarizing his gross moral turpitude. Appears to be moot. 3 Quote Share this post Link to post Share on other sites
kallend 2,026 #222 December 24, 2024 Gaetz is the man that Trump wanted to be the attorney general of the United States, the highest-ranking law enforcement official in the land, the leader of the Department of Justice. Trump wanted to give that position to a man who paid at least half a dozen women for sex, according to the House report. And the violation of Florida’s prostitution law isn’t even the real depravity; the committee took pains to detail the underlying implication of his actions: “Representative Gaetz took advantage of the economic vulnerability of young women to lure them into sexual activity for which they received an average of a few hundred dollars after each encounter.” Trump wanted to give our Justice Department to a man the committee says committed the statutory rape of a 17-year-old girl. A man who is accused of setting up a phony email account at his office in the House to buy illegal drugs and who then used the drugs to facilitate sexual misconduct. Says as much about Trump as it does about Gaetz. Maybe more. Quote Share this post Link to post Share on other sites
jakee 1,489 #223 December 24, 2024 And apart from the finer details, there's nothing in the report that wasn't already widely known. Trump knew Gaetz was a regular John when he nominated him. Trump knew he was a junkie. Trump knew he preyed on high school girls. Trump knew he bragged about it in the workplace. Quote Share this post Link to post Share on other sites
SkyDekker 1,465 #224 December 24, 2024 3 hours ago, jakee said: And apart from the finer details, there's nothing in the report that wasn't already widely known. Trump knew Gaetz was a regular John when he nominated him. Trump knew he was a junkie. Trump knew he preyed on high school girls. Trump knew he bragged about it in the workplace. This! And the Republicans here are silent. All that talk about protecting children, all that talk about protecting the oppressed. And yet, when it happens in their ranks, they support it. Quote Share this post Link to post Share on other sites
kallend 2,026 #225 December 24, 2024 8 minutes ago, SkyDekker said: This! And the Republicans here are silent. All that talk about protecting children, all that talk about protecting the oppressed. And yet, when it happens in their ranks, they support it. Silence implies assent. Quote Share this post Link to post Share on other sites