More "HOW WE TREAT OUR WOUNDED"

HEALTH INSURANCE. Many people assume that Veterans receive free health care based solely on their status as Veterans. Nothing could be further from the truth.

Let's start by saying that Noah has received the best and most compassionate care imaginable from the two VA Medical Centers at which he has received care since his discharge (except for the truly uncaring imbecile woman who makes his appointments in Phoenix -- but I'll save that for another post.) However, the VA Health Care system has an enrollment "priority" system -- from 50% or greater service-connected disability (Priority Group 1) to Group 8 for "higher income" veterans (income must be less than $36,000 for Vets with 2 dependents... here's the chart). And that's gross income, not net.

However, because so many vets enrolled in the VA system between 1996 (after passage of the Veterans Health Care Eligibility Reform Act) and 2002, the VA was ordered in 2003 to stop enrolling Veterans in Group 8 (with it's 4 subcategories). So even people like my husband who was promised "free health care for life" if he made the military a career (he did -- 25 years) and served two deployments to Vietnam but was not wounded, is not eligible for enrollment in the VA Health Care system.

Here's what my research and some new Veterans have told me: Veterans of the current conflicts in Iraq and Afghanistan who are medically unable to continue in the service but receive less than a 10% disability from their service branch, receive no medical insurance once they separate. For those with service-connected disability ratings of 10 or 20% (ratings are 0% or greater in 10% increments), they receive UP TO 12 months of medical insurance (Tricare) for themselves and their families after separation; for 10% and 20% ratings it is typically 6 months but can be 9 or 12 months depending on the medical condition. If a service member receives a disability rating of 30% or greater from the service branch (a medical retirement), medical insurance for themselves and their families continue at no cost to them FOR LIFE.

Remember: 90% of Soldiers, 83% of Marines, 73% of Airmen and 64% of Sailors who were injured, wounded or became chronically ill while in the service received a disability rating of 20% or less. Unless they were covered by an employer or can afford other insurance within say 6-9 months after their discharge, they and their families have no health insurance coverage.

Here are some (appalling) numbers:

Army soldiers approved for permanent retirement disability (30% or greater rating) in 2001 (2 years BEFORE OIF): 642

Army soldiers approved for permanent retirement disability in 2005 (2 years into OIF): 209 (hmmm... 2/3 less while at war...)

Army soldiers receiving medical discharge (20% disability or less), 2001: 4,544

Army soldiers receiving medical discharge, 2005: 4,468 (hmmm... fewer while at war...)

(wounded and not returned to duty within 72 hours: 7,988 in 2004; 5,598 in '05)

Percentage wounded/injured soldiers receiving disability retirement (30% or greater rating), 2001 (BEFORE OIF): 10%

Percentage wounded/injured soldiers receiving disability retirement, 2005 (2 years into OIF): 3% (hmmm... fewer while at war...)

I know this has been covered (perhaps ad nauseum) in many publications in the past, but in case you hadn't read anything on this (or you forgot), these soldiers are then shifted out of the military medical system and into the VA... keeping in mind that the service branches only are required by law to compensate a member for the single condition (or combination of conditions) that make him unable to continue his military service, while the VA is mandated to compensate all injuries and conditions which were received during military service.

Note that annuities paid by the services (DoD) for medically retired individuals are charged to the services; "moving" a disabled member to the VA system shifts the financial burden to the VA. For example, we know of one Veteran who received a "does not meet retention standards" but a 0% rating from the Army for his burns and injuries received in a tank fire; the VA rated that same condition at 40%. Another Veteran was determined fit for duty even after a serious shrapnel wound to his thigh that his Navy physician determined should make him unfit and which the VA rated after his end-of-service discharge at 30%. Another veteran received a 10% disability rating from the Army for severe PTSD, and the VA rated that condition at 50% disability. The two soldiers medically discharged received the exact same lump sum severance payment when they left the Army (which both are reimbursing from their VA benefits) and none of these soldiers now has health insurance. (I know that now the military services and the VA are supposed to be using the same schedules and interpretations of those schedules, but that doesn't help previously discharged Wounded Warriors.)

Veterans can enroll for temporary health care coverage under the "Continued Health Care Benefit Plan" within 60 days of losing their military health care -- at a cost for family coverage of $665 per month -- a little out of reach if you're trying to go to school full time on the GI Bill AND the government is taking 50% of your VA disability benefit (for the next 17 months!!) to pay back the Army (or Marines, Navy, AF or CG) -- even if your wife went back to work three weeks after the birth of your child to help pay bills (you know -- things like rent, food, gas, utilities...)

As Noah quickly discovered, there is some less expensive health care insurance ("less expensive" being a relative term when you have no money), but when he put in an application with an insurance agent, the agent said, "Let me get this straight: you were wounded in combat and have shrapnel in your skull and chest, you had a neck and spinal injury, a fractured elbow, you have a torn ACL in one knee, a possible torn rotator cuff, traumatic brain injury, lost a portion of your hearing in both ears, have tinnitus -- not to mention PTSD... and you want US to insure YOU?"

Noah assured him that the VA would cover his service-connected conditions (he's Priority 1)... but the agent told him that his company already had millions of claims in dispute with the VA and wasn't interested in more. (I should also point out that the VA has many, many millions of dollars of claims for non-service connected medical services provided to individuals in VA facilities for which they are awaiting reimbursement from Veterans' insurance companies as well.) Noah has been unable to find health insurance and, as of last week, he, his wife and their 2 month old son have no health insurance. (Please do not give me, "This is why we need socialized/socialist health insurance." We only need figure out how to insure the less than 10% of Americans who lack insurance.)

According to this Harvard Medical School Study, there are 1.6 million American Veterans and family members who lack health insurance. That is about 12% of the approximately 47 million uninsured in America. (Now I'll caution that the study and report were authored by a physician who is pushing for the socialist system of national health care, but I don't doubt the empirical numbers.)

The Dole-Shalala Commission recommended that all combat-wounded service members retain their insurance but I believe the legislation proposed as a result of that Commission's recommendations (the legislation that everyone made a big deal about in October but doesn't exist on paper apparently since no one can seem to provide a copy for review...) went further and recommended that all service members medically discharged from the service retain their insurance

If they continued Tricare for those medically discharged and assuming that if only half of those medically discharged from 2000 to 2006 lack medical insurance there would be at least 33,000 fewer uninsured Veterans and perhaps another 33,000 family members. I don't completely disagree with the VA priority system -- after all, there has to be some way to manage limited resources (on the other hand, perhaps we should be building MORE facilities and not restricting access to any Veteran??!!) That being said, Veterans -- who served this country and her citizens in war or peace -- who cannot afford or cannot acquire medical insurance for themselves and their families should be covered by either Tricare or the VA.

MEDICAL INSURANCE SHOULD BE CONTINUED FOR THOSE MEDICALLY DISCHARGED FROM THE SERVICE AND THEIR FAMILIES -- AT THE VERY LEAST IT SHOULD BE CONTINUED FOR THOSE WOUNDED IN COMBAT. EVERY VETERAN IN AMERICA SHOULD HAVE HEALTH INSURANCE OR ACCESS TO HEALTH CARE. IT IS THE LEAST OF WHAT WE OWE THEM.

P.S. I have wondered recently why our government doesn't sell "Veterans Bonds" like our government used to sell "War Bonds" (and like the Savings Bond Program). I can't think of a person (or politician -- since those groups are occasionally mutually exclusive) who wouldn't buy them to support our Veterans (if you wouldn't -- you need to consider another country of residency... really). I'd like to do my part to assure that our Veterans' needs are met forever and are not held hostage to the budgeting processes of Washington or the threats or whims and flops (as in flip-flop) of "say one thing, do another" politicians. I'd like to be sure that no other agency could EVER touch the money we as citizens commit to our Veterans... until we have no more Veterans that need care. If there is a law that forbids it, the law should be changed.