It looks like the Army and the Navy are recapturing Tricare Prime members and forcing them back to MTFs. I can't say I'm surprised to read this since there's so much wanking about health care costs for service members and dependents. But still. This is fucking infuriating.
The article touches on one reason -- despite the claim that a significant percentage of appointments go unfilled, it's nearly impossible to get an appointment, especially not a same-day.
I've encountered this issue at the Boone clinic in Virginia Beach. I call the appointment line to ask for an appointment today or tomorrow - first available, please, because a sprog or I cannot breathe/eat/get a temp down/stop screaming from pain and haven't been able to for X many days/hours. Each time, I'm transferred (usually unsuccessfully) to the clinic's direct line.
And nobody picks up.
So I call back to the appointment line, and they say I should call at 7am tomorrow because that's when the openings will be filled. So we wait out another several hours of coughing/puking, fever hallucinations/screaming, and straight up at 7am, I call the clinic.
And nobody picks up.
So I call back. And call back. And call back. And nobody picks up. I get the husband to call the appointment line. And voila. We get an appointment. In three days.
The point is there are no appointments. Since we moved from Champus to Tricare, it's been impossible to get a timely appointment. In most places we've lived, we're told to head to the MTF's ER if we have same-day needs. Now I'm curious about these "unfilled appointments" they're apparently paying double for. How many of those were no-shows? How many of those were set aside for same-days that were somehow unneeded? How many were left empty for late patients or emergencies or long appointments? How many of these appointments are truly unfilled for lack of patients?
The other issue the article doesn't touch on is the fact that MTFs exist to treat service members. Families aren't just secondary priorities. We're considered a burden on the system. We get appointments only if no service member needs one. We get treatment only if there's room and time and money. And this makes sense. The military can't function if all their medical staff is focused on family when service members need attention. But at the same time, we rely on the insurance covering our family, and if our only option under that coverage is to be seen at an MTF whose command doesn't include us as anything more than a tertiary morale issue for the service member, how valuable is this insurance?
I remember when Tricare was born, and Champus died, and Balboa in San Diego was trying to convince everyone to go Prime. All the "prime" appointment times went to Prime members, even if we were dependents. They had special parking close to the entrance for Prime. Even dependents. But nowadays, that's gone. Standard members have freedom Prime members don't--they have to pay a small copay, but they can be seen by civilian doctors (though, to be fair, the number of docs is dwindling because Tricare doesn't pay for shit, and doctors have bills to pay) and still take their civilian prescriptions to the MTF pharmacy, which means their meds are free. They aren't part of the MTF cattle call, and they don't get the shit medical care that Prime members pay extra to be subjected to.
I'm starting to wonder if this isn't how the Pentagon slides the bulk of its healthcare burden into the service members' hands. Prime seems to cost them money, considering the restrictions and the aim for 100% appointment fill and the increasing cost passed to the service members. So are they trying to incentivize Standard?
One of the interviewees in the article mentioned she was losing a doctor she'd had for six years and would now have to start over with a new doctor who doesn't know her. What isn't mentioned is that doctor will have max 2 years with her. And then s/he will PCS. So continuity of care and a healthy patient-doctor relationship don't exist when you're treated at a MTF.
And we won't even get into the standard of care that MTFs have. For more information regarding my feelings on that issue, just look under the "navy medicine" label on this blog and check out my experiences at Pendleton's hospital.
This is sad news for all dependents, and it bodes ill for our medical future.
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