Wednesday, March 18, 2009

And We All Want This?

UPDATE HERE, THANKS JANELLE (make sure to watch the video)

President Obama has floated a proposal that private insurers pay for the care of wounded veterans. It's a snake-like move which is more important in understanding the Obama administration's contempt for the military than anything I have seen to date. Living in a military town I come across wounded vets on a fairly frequent basis and I can only imagine what they think of their new Commander in Chief. It also is enlightening looking back on my college days.

I attended well known university and became friends with many of the 'best and brightest' of my generation. Many of these folks are now famous in their own right and many are wealthy beyond what I can hope to achieve.

It is curious to me though, that in the great group of friends that I had, exactly none of them chose to serve in the military in any capacity. Coming in on the heels of the Vietnam War I guess this is not so surprising, but there's more.

It took ME, in dire straits financially, a whole lot of gumption to sign on the dotted line with Uncle Sam. I had absorbed a base distrust for the military in college and didn't get too upset when the ROTC office on campus was vandalized or when a pro PLO march was held or when a woman (whom I now know was severely psychiatrically disabled) was picked up in a limo and given the stage at a campus-wide event to rail against men and corporate America in general. It's just the way it was.

The time I served in the military was easy time. I didn't do anything important in the service. I didn't even have to spend time overseas. But I met the most fantastic people. Men and women who chose to serve and had been shot at and who had lost friends in battle or in training accidents. The salt of the earth. I was amazed. I love those guys and gals. Love 'em. And you should too because whether or not you agree with why they were deployed they went when they were called with no question. Clinton or Bush, they went and saluted and protected your right to do whatever the hell you want to do.

And that brings me back to the culture in which Obama and his staff germinated. They have a deep distrust of the military and I would not be surprised if it rises to the level of hate with some of them. I believe that much of this comes from a knowledge that they wouldn't have been able to cut it in the service, and a fear that, faced with the possibility of combat, that they would have cut and run like little kids.

This decision to go back on a promise made to these fine folks is contemptible. Harvard still, I believe, will not allow the ROTC on their campus. Screw Harvard.

Used to be the highest calling was to serve one's country. Used to be. For me, it still is. For me, I stand with our vets and our active duty servicemen and women. Hard stand right? Bully for me right?

You would be surprised at how hard this stand is if you wander into the wrong community... the one with all the 'nuclear free zone' signs and the Priuses and the well manicured bicycle paths. The one with the super-high population of PhDs. You know, the university towns (and not that dreary Ag school darling) and beautiful places. The one's where the voters fight against school vouchers but send their kids to the best private schools.

Me, I'm right where I belong... in the sticks, with the medics and police and nurses that worked their way through school, and, in most cases, put in a few years in the Army or Navy or Marines. Hoorah. The salt of the earth. I am proud to be counted amongst them and honored that they have embraced me.

Obama has gone back on a promise here that cuts to the core of the health care issue. The VA is running out of money (big surprise with a non competitive enterprise), so he's sticking it to the patients; men and women who are battle-wounded in service of their country. Heroes. Why in the name of all that is holy do you think it will be any different when the government runs your health care?


  1. Right on, MDOD - Those bastards better not go through with this idiot idea. This is the dumbest damn thing they've yet proposed.

  2. From what I read, this was laid out by Rahm Emmanuel and Shinseki, not by the new darling.

    When, inevitably, this foolishness is tossed aside in embarrassment the Prez will undoubtedly denounce this idea with strong language, then claim to have fought for the rights of veterans. There's no doubt in my mind this will be abandoned, and no doubt in my mind that the gutless wonder will distance himself from this, blaming his staff.

  3. You know 911. I hope you are wrong. I agree with what you said. My relatives have fought in these wars. My friends have been in these wars. I was told as a child that freedom isn't free. I was taught to Thanks Service Men for their service.

    However, the whole damn healthcare system does not work for anyone involved. I don't know how to fix it. Do you have any ideas?

    I am gonna be hopeful. Not because I am naive just because it feels better to be hopeful. Also I am working per-diem now so I have kind of bailed out a bit. I am now spending some time teaching BSN students. They are very hopeful. I hate to think in a few years the healthcare system will chew them up and spit them out.

    I know you have thought about this at length. So what can we do?



  4. One of my favorite things to do with my kids is to go to and choose a soldier to send packages to. I know I am like a broken record with this but maybe someone reading this didn't know about the program so I'm saying it again anyway. We just sent out a ton of girl scout cookies the other day and are planning to send more next week as soon as we choose another person to send them to (obviously in addition to whatever else the request).

    Your post hit on exactly why I am not crazy about our neighborhood. I had no idea when we moved in how little I would have in common with most of the people in the neighborhood. Our core beliefs are so different that it is hard to make real friends. I think the world thrives on differences but sometimes I would like to hang with people who think even remotely like I do where I don't have to explain every single thing I believe or just stay quiet.

  5. Thats what I like about Jaw-Jaw, 911, Military Service is still valued, even in the Big City. Sure, your neighbor might be a former Russian Speznatz Special Forces Assassin, but a Grunt's a Grunt when you get down to it.. Heck I would have paid the Navy to let me join, leather flight jacket, world travel, more women than you could shake a stick at...OK they might have shorted me on that last one...

  6. I have had the honor of taking care of some of the finest men
    and women this country has produced over the past twenty years. To do something like this to those wounded in war is plainly immoral.

    I posted about this yesterday in my blog, but it will get much more exposure in yours. Thank you for bringing it up and I hope everyone spreads the words about this travesty.

  7. 911, right now, I'm so furious I could put my foot through the door. As a mom of a former soldier, the idea that the boy king could say, "hey, dude, really sorry about that gaping wound you got from that Iraqi soldier. He's just misunderstood. But you, my boy, will have to pay to get your head closed up."

    Fuck me, where do I turn in my American passport? What will our country look like in four years?

  8. generalize much, 911?

  9. why yes, anonymous, i do tend to generalize, especially about anonymous posters who generalize! but i do know a few things about you specifically ;)

    1. your mother mollests collies
    2. you live with your parents
    3. you collect comic books and hustler magazine
    4. you switch to the left hand for a change once in a while

    'general' 911doc

  10. rahm emmanuel is an evil fucking asshole. anyone who thinks that this is a great idea should be shot. these guys and gals work hard as hell for our nation, and the last thing they need is to get dicked over by the feds.

    just google "The Rock Obama"!

  11. Hey...I WAS an ROTC girl!

    Anyways, my experience with the VA seems to be not so much a lack of money...but a lack of capacity. Great care...for great vets...if you can get it.

    It seems like the VA system would need to double it's capacity to meet the demand.
    It might not be economically feasible to built another 100 or so hospitals through out the country...especially when other hospitals are closing.

    It would seem to be fruitful if private and local health facilities are paid by the VA to provide care.

    Right now I have a patient ready to be discharge to the VA system for acute/subacute rehab. We have 15 beds available...their closest bed is 250 miles away.

    Seems like local and regional partnerships can be useful. Just a thought

    I am not commenting on the proposal talked about on this post (I don't know much about it) just my experience working in and out of the VA.

  12. This is masturbation.

    Our vets deserve the best care possible, but this "salt of the earth" and "heroes" talk is a bit dogmatic.

  13. More than a bit dogmatic and reactionary. But, such is 911.

  14. dear skeptic,
    i'm telling you about the vast majority of active servicemembers that i know. i'm telling you about the vast majority of medics, policemen, firemen, nurses, and doctors that i know. this is my blog, call it dogmatic if you like, but all i can write about is my experience. i do not think this rises to the level of 'dogmatic'.

  15. dog⋅mat⋅ic   /dɔgˈmætɪk, dɒg-/ Show Spelled Pronunciation [dawg-mat-ik, dog-] Show IPA
    –adjective 1. of, pertaining to, or of the nature of a dogma or dogmas; doctrinal.
    2. asserting opinions in a doctrinaire or arrogant manner; opinionated.

    re⋅ac⋅tion⋅ar⋅y   /riˈækʃəˌnɛri/ Show Spelled Pronunciation [ree-ak-shuh-ner-ee] Show IPA adjective, noun, plural -ar⋅ies.
    –adjective 1. of, pertaining to, marked by, or favoring reaction, esp. extreme conservatism or rightism in politics; opposing political or social change.

    i used to be a kennedy democrat, but the democrats 'change' amounts to fundamental changes in our country and a passive, incremental coup d'etat, so to the extent i oppose this, yes, i am a "reactionary" and i make no apologies.

    and here's an idea that has worked for countless web surfers and lurkers... you don't like the opinions here? then quit reading, go start your own blog (it's free and chock full of 'hope' and 'change'), or get a screenname and grow some balls.

  16. good news.. it got dropped. maybe democracy stilll works if people take a stand and are vocal enough

  17. Wait, isn't this blog all "universal health care will destroy America"?

    Why is "socialized" health care such a great thing for vets? Won't they get much better care with their private insurance?

    If it's a good thing for vets, why isn't it good enough for our children? If it's not good enough for all of our citizens, how can we sleep at night knowing that we're forcing our vets into such a bad system?

    Could someone explain this to me?

    Wife of a disabled American veteran.

  18. Anna - No not that one.12:52 PM, March 19, 2009

    Though I haven't served, my family and friends have. Grandfather (career Navy), four great uncles all fought and survived WWII, father was Navy, Husband is Navy, two step-sons, Navy and Army (Ranger, ex-Pres. Honor Guard) and frankly, they all used their private insurance after discharge as opposed to going to the VA for treatment.

    My husband thought the floated proposal (which has been shot down) was a good idea. There were NO particulars written down, but if the Administration could have managed it so that the private insurers would act as primary and the VA as secondary insurers (covering deductibles so that there would be no out of pocket expense for the vets), then that would have freed up monies for improving VA care for things that are really needed for vets, such as better and more widely available treatments for brain injuries, amputees and psychiatric services.

    I think it's too bad that people screamed and shot it down rather than discussed options. There are some great VA hospitals in this nation and some really shitty ones. That money could have gone to good use had it been correctly handled.

  19. "or get a screenname and grow some balls."

    Hey that's my line...

  20. I am interested in your response to Anna#1 911. She does pose an interesting question...

  21. Anna,

    We do not give our veterans health care, they earn it. To ask them to pay for the treatment of injuries received while serving our nation would be unacceptable. Shifting the burden to private insurers would lead to increased health care premiums for veteran's families and could discourage employers from hiring veterans.

  22. dear anna,

    the va is what it is. i do not like it. i get my health care there. the doctors that have taken care of me there have been great though my procedures and studies have been scheduled at their convenience, not mine (what i mean is that i get a letter in the mail telling me when my next study/procedure is and no one bothers to ask me what days i have available), and they are scheduled months in advance.

    for instance, an MRI i had recently would have been done in the private world within a week but in the VA it took three months. no worries, my particular problem is not too time dependent. then, another procedure was scheduled on a day i was working and i tried for three days to cancel it. one problem, i started trying on friday, the procedure was tuesday, and monday was a federal holiday. even though i left over three messages that i would not be able to make the apointment i got a threatening letter about cancellation of benefits if i missed two more scheduled procedures. i cleared this up retroactively but it took another few phone calls an a few hours navigating phone trees.

    but anna, there are plenty of posts on this blog detailing the failings of both military medicine and the VA when compared to private medicine.

    for instance, about a year ago on a weekend i had to transfer a patient to the va and the phone rang 530 times before it was answered. it was not the wrong number, i had to hand the phone to my clerk to hold while i took care of patients and she paged me when they answered 15 minutes later.

    since i have friends who work there (and i have also worked there and in military hospitals) i also know that getting something as simple as an EKG or an XRay is not possible after hours or on weekends unless you do it yourself. the VA hospitals would fail right now if it weren't for the indentured servitude of medical students, nursing students, interns, and residents.

    but anna, you miss the point entirely, the question is not what would be better for the vets, in the particular area of prosthestics and rehab from traumatic injuries the VA and the military hospitals are fantastic. the issue is one of honesty. the issue is respect for our servicemen and women who have chosen to give up so much to serve and were promised as part of their service that they would be cared for no matter what. if you haven't seen obama wax poetic about this duty click the link at top.

    obama's idea of service is to be a 'community organizer', my idea of service is a bit different. as the commander in chief, and one who has already sent thousands into battle to kill and destroy for this country, he has just spit on those that have no choice but to obey his orders. it's flat out pathetic.

  23. I agree with most everyone (who actually addresses the issue) that the idea, which had a shelf life of about 2 hours, was a bad one. I don't think, however, that taking a look at the care offered by the VA to its veterans, and considering new ways to administer that care, is an unreasonable thing to do.

    I've never heard such praise for the care proffered by the VA before. If our vets deserve the best, and they do, is the current standard of care at the VA facilities in this country really something to huzzah about?

    Mostly, I have heard complaint after complaint about the VA denying the existence of disease (from Agent Orange to Gulf Syndrome), making people wait ridiculous amounts of time for appointments which often end up being with unsupervised residents. Not to mention reusing equipment meant for one-use only, various degrees of filth, vermin -- let's just say "facility shortcomings" and call it a day.

    I think most of us will be asked to consider new ways that initially appear nothing but unfair, even odious. But *everything* has to be put on the table, sacred cows and all, for this country to truly change for the better. I even briefly wondered whether putting private health insurance in an administrative role for vets might not actually improve the quality of their care, and save money, too.

    But that would be... wrong.

  24. dear bianca,
    i think i agree with you, i would only ask for you to tell me what this 'change' is, exactly, and what constitutes 'better', for i too, truly want this country to change for the better, but i have an idea that it is on the specifics that we might disagree.

  25. Anna - No not that one9:42 AM, March 20, 2009

    Gonna assume the Anna you are referring to is ME ME ME, and respond to the two posts.

    First off, to DocV, military/veteran is a protected class in this nation. Not hiring them solely for that would be actionable. Additionally, when insurance companies write their policies for businesses, they do not ask what types of employees these companies have. Asking, "do you employ any current or past members of the military" would be akin to asking "so, how many blacks do you have working for you?"

    To 911Doc: "but anna, you miss the point entirely, the question is not what would be better for the vets, in the particular area of prosthestics and rehab from traumatic injuries the VA and the military hospitals are fantastic. the issue is one of honesty. the issue is respect for our servicemen and women who have chosen to give up so much to serve and were promised as part of their service that they would be cared for no matter what."

    No, I didn't miss the point. There was nothing in writing in this floated proposal so every argument (both pro and con) is merely conjecture. But IF the idea was to use private insurers to cover vet treatment costs (acting, in effect, as a primary insurance with the VA as secondary) and IF the vet had to pay nothing out of pocket, then I saw it as generating revenue for much needed improvements in the VA system. Not a bad thing.

    Nowhere did I read that Vets would be required to carry private health insurance or that VA benefits were to be pulled or cut back in any way. So I don't see how this is a lack of respect or dismissal of rightly earned benefits.

    I know from experience that there are VA hospitals where fabulous care is available - the unfortunate thing it is not true for every VA facility.

    One would have hoped that money gained from private insurance companies could have helped reduce this disparity. No matter though, it's all moot now.

  26. anna,
    respectfully, the way you paint it this is merely a tempest in a teapot, yet the head of the American Legion came away from a meeting with the President furious. the administration got caught with its hand in a big cookie jar trying to dump it's contractual and honorable responsibilities onto insurers who, for as long as there has been a VA or private insurance, have been operating under the federal government's promise to take care of their veterans in all ways, especially in the area of medical care. it was, at best, a cheesy attempt to dodge a financial obligation for, in comparison to the ridiculous numbers being tossed around washington these days, a pittance, and, at worst, just what i said it was. if the former the administration is not merely dishonest, but stupid.

  27. Regarding the accusation of dogmatism: It is not wrong to be dogmatic about truth. There are things that are true, and other things that are false. I know, you are rolling your eyes and thinking, "there is no such thing as `truth.' It is all relative." Well, there ARE such things as truth and falsehood, good and bad, and the professors who made you think that you would look very sophisticated and erudite by saying otherwise are not good role models. Guaranteeing care for wounded veterans is a duty and a moral good. We should be dogmatic about that truth.

  28. Well said CountryRat. *applause*

    You too 911...

  29. Anna - No not that one12:06 PM, March 20, 2009

    To 911 Doc in re: "...yet the head of the American Legion came away from a meeting with the President furious."

    Absent any specifics, I'm not going to jump off a bridge because someone else did. :)

    My husband (Naval Officer) thought that the uproar is postulated on the mention of change and not actual substance.

    If our vets are taken care of and there is no out of pocket expense to them, AND it generates revenue for better facilities/treatment, then the outrage seems to be unwarranted.

    I think they (the Administration) fell down on how this was presented and if you want to call that stupidity, then yes, it was. But I see no treachery in trying to improve care for vets in a time of global financial craptasticness and getting money from wherever possible (as always with the caveat that there is NO burden to the vets).

    The Dept. of VA is getting a big boost in funding over the next five years so I don't think it's a case of libruhls shafting those who have served. Merely a grab at additional monies.

    And - doesn't the VA already go after third party payors for non-combat related injuries? So this isn't really a question of the government getting out of the practice of paying every dime for every bit of care a vet receives at a VA facility. At least, that's what my somewhat minimal googling tells me.

    If I'm wrong and there would have been a burden to the vets - say they would have to cover the private insurers deductibles, then I can see why Rehbein was outraged. I would be too, in that case.

  30. Maybe they ought to get rid of VA facilities and give veterans vouchers that can be used at any private medical facility. The ones providing the medical care could redeem the vouchers for whatever private insurance would pay.

    I know it wouldn't solve Obama's problem of wanting soldiers to pay for their own, but it would at least insure that our vets get the kind of medical care enjoyed by most of the public.