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Raise Tricare co-pays? Give us something to pay for first

Submitted by on Sunday, 21 November 2010 One Comment

Everyone loves to look at the military’s health insurance with envy. It’s free! They don’t pay an arm and a leg like civilians do!

And when the budget recommendations come, implementing Tricare premiums, deductibles or co-pays always is on the table.

That would be understandable if “free” Tricare were at all comparable to any civilian program I’ve ever been under – and if it weren’t part of the military compensation package. But it’s not at all comparable to civilian land.

I can’t speak for every situation at every military base. I know at some larger installations there are at least urgent care facilities. Here, we have only the regular clinic and the emergency room. The clinic is down at least two doctors at the moment, making it impossible at times instead of merely difficult to get an appointment.

I tried last Monday when Big Guy began having asthma problems. I couldn’t get him in, so we wound up in the ER. It took four hours there for a doctor to diagnose him with a “cough.” Apparently the cough was serious enough for him to prescribe albuterol but not the other medication I use in his nebulizer when he starts getting in trouble.

“We’d rather you just bring him back here,” the doctor said.

“I bet I do within 24 hours,” I retorted.

The only thing that delayed our next visit was an exam on Tuesday with a PA who gave me a prescription for the medication that the doctor wouldn’t. Unfortunately, Big Guy was too far gone at that point. I tried calling Wednesday for an appointment. Nothing. I called again Thursday. Again, nothing, though they did promise someone would call within 24 hours. I tried Thursday night to book an appointment for Friday online. Nothing. Minutes later, he couldn’t move his peak air flow meter one smidge.

We went back to the ER, where the doctor diagnosed him with “asthmatic bronchitis.” He gave me the prescription I’d asked for on Monday, plus an oral steriod because Big Guy had deteriorated so much in the intervening three days.

That did the trick. By Saturday, he was nearly normal.

The call “within 24 hours” that I was promised Thursday? It never came.

It cracks me up when they say that military families should have to pay out of pocket because we “use” medical care more than the population in general. You bet your boots I do, when it takes three exams to resolve what should have been taken care of in one. Had this happened two years ago even the first ER trip would not have been necessary.

I would have called the guys’ pediatrician if they were sick and 9.9 times out of 10 I would have been able to get them seen that day. Yes, I would have had to leave a message for a triage nurse to call me, but that call always came in well under an hour.  In the civilian world, when you say “asthma,” people tend to react. If the pediatrician and her partners all had been booked, I would have had a choice of an after-hours clinic or an urgent care I could take them to.

Yes, I am well aware of what’s happened to medical costs in the civilian world. When I left civilian insurance, I was paying $700 a month to cover four people. But at least we had access to doctors the day we got sick. At least we didn’t have to go to the emergency rooms for clearly non-emergency care.

My experiences last week were a little unusual, but not extremely so. I know several parents who have been forced into the ER for ear infections. Out of curiosity, I checked online appointments tonight and among the three providers I can access, there were five open slots. I bet they’re gone by morning.

So when you call for Tricare copayments for activity duty, you better be sure you know what you’re asking for. Do you want the soldiers to pay so their kids can miss extra days of school when a slight problem with a chronic condition gets worse due to lack of access to care? While we’re at it lets double the co-pay for emergency care, just like in the civilian world. That’ll bring in a chunk of change, because that’s where we all have to go anyway.

Copyright 2010 Debra Legg. All rights reserved.

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