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Thursday, June 09, 2005

If you're gonna keep your army you're gonna have to do better than this: 
Melissa Noriega got sick, very sick, and couldn't go to her doctor.

She had the wrong insurance. It was the military's insurance.

"I called a bunch of doctors, and not one of them took it," said Noriega, a Houston resident whose husband was mobilized by the Texas National Guard and sent to Afghanistan last year.

"I went three weeks trying to figure out how to get an antibiotic-resistant infection treated," said Noriega. "Finally my husband's cousin, who is a doctor, treated me for free."

Noriega's experience has highlighted a problem in the call-up of thousands of reservists and members of the National Guard outside dense military areas: access to health care.

Doctors are not lining up to accept Tricare, a government insurance program that in some cases pays doctors less than Medicare and Medicaid and has a reputation for slow payments.

"We stopped taking it three or four years ago," said Susan Blue, a neurologist and president of the Tarrant County Medical Society in Fort Worth. "Reimbursement rates are not high these days with anyone, but the military was the first one to go to a point that it wasn't feasible financially to accept it anymore."


Here's my suggestion: In the case of mobilized reservists and guardsmen, give them the option of maintaining coverage in their employer's plan for their family. The military can reimburse the employer for the premium. The soldier should still be covered under Tricare.

Then there's this bit of nonsense:

Although there is no evidence that families are going without health care or a provider, a reservist's spouse and children might have to switch doctors while in the military system.


You frigging moron, you just TALKED to someone who went without health care!

I'll tell you what - lack of access for our families in and around Miami Florida was a huge stressor for our soldiers when we were overseas. Particularly access to mental health care, as a lot of wives were, understandably, suffering from serious cases of depression and stress. Many of them spoke little English.

The Tricare solution was simply inadequate for families of Guardsmen and Reservists mobilized far from active duty bases with hospitals on base. And it cost us soldiers in the field, because many had to go home on emergency leaves which may well have been prevented had our families had better access to health care and support.

I recall representing the battalion at a combat stress focus group outside Ramadi. There were a bunch of company level officers, first sergeants, and chaplains there. An Army psychiatrist was quizzing us about how his combat stress treatment teams could provide better support to us in the field.

I remember being very blunt, saying the support in the field was alright - we could generally get a soldier to a combat stress team if needed. What we needed was a serious mental health outreach effort in Florida and Puerto Rico, because for our guardsmen, that was where a lot of our combat stress cases were originating. Meanwhile, you had the bulk of the available Army psychiatrists hanging around active duty posts.

Those near active duty posts also had access to a variety of supports, from community activities to day care centers, etc. Our wives had the offsetting benefit of being able to maintain close contact with extended families, and that helped some. But those without relatives nearby pretty much had nothing except their children and Tricare.

And that was inadequate. It hurt our families, it hurt our children, and it hurt our fighting capability in the field.

Splash, out

Jason

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