OTb Where have all the baggers gone?

I only tolerate very low doses of ACE inhibitors. Normal dose causes my serum potassium to go too high for safety. My internist believes that if the patient is reliable and compliant, multiple meds for a condition, each with a different mechanism of action, in lower than usual doses, is less likely to produce unacceptable side effects than high doses of fewer meds. It's worked for me for >20 yrs.

Fortunately, I have no need to be concerned about higher cost of filling multiple Rxs because as a veteran, I qualify to get all meds dispensed at the Walter Reed pharmacy at no cost (no cost for drug, no co-pay, no deductible).

I was off lisinopril for about a year with no drastic problems. My primary feels it is optional but can't hurt. At around $12 for a 90 day supply I agrees. I spend more than that for tumeric capsules that seem to alleviate joint pain.

Just another example of how bad socialized medicine can be.

I assume and hope you're being sarcastic. Military medicine is the best example I know of demonstrating that "socialized medicine" can work. I've experienced the system as a provider and as a recipient of care for myself and my family. My postgraduate clinical training and earliest days in practice was exclusively at civilian facilities and prior to my entry into the Navy. I experienced my internship and residency at a world famous hospital system in Boston. My early days of clinical practice was with a fee for service practice located in a suburban/rural community served by a community hospital. My observation is that clinical care for active duty and their dependents in the Navy is of essentially equal quality to what I observed in Boston and substantially better that what I observed in the community setting.

Why does the local new often have stories of Vets that cannot get appointments, treatment, and other health issues?

You assume correctly. Why the GOP hates the concept of everyone getting good health care despite lack of wealth I will never comprehend. A healthy population is much more likely to be productive, which benefits everyone.

On 12/27/2023 10:12 AM, Ed P wrote:

You are making an extremely common factual error. The VA medical system is a separate entity from the military health system. Their primary missions are different, their facilities are different, their staff are different, and their budgets are different. Retired and/or their dependents are only provided access to military treatment facilities (the tip of the spear in the military health system) on a space available basis. The primary mission of the military health system is care of the active duty population. The simplified space available priority for seeing non-active duty patients is (a) dependents of active duty, (b) retired from active duty, and (c) dependents of retired from active duty.

In my case, my wife (never in the military) is defined by the military as my dependent (I know, I know; I'm not responsible for that designation). We are fortunate to live in the catchment area of one of the largest military treatment facilities in the Department of Defense. There is space available for both of us to be seen as appropriate in the E.R. and internal medicine clinic and for both of us to have full lab, radiology, and pharmacy benefits. Some specialty clinics have space available for me but not my wife. Some specialty clinics don't have space to see either of us. After I retired and when we were younger (both under 65), we had to enroll in the Tricare insurance program and pay a modest premium to continue the access we had when I was on active duty. When the first of us reached the age of 65, that individual was no longer eligible to participate in Tricare. If that individual wished to continue to receive military health system eligibility, they had to enroll in Medicare Part B. When the other spouse turned 65, same same. However, at that point, we were automatically enrolled in "Tricare for Life" which can be thought of as a free (no premium) fairly comprehensive Medicare supplemental insurance policy. So, when ever we wish, or whenever we cannot get an appointment at a space limited clinic, we use our Medicare Part B/Tricare for Life benefits and see a civilian provider. In almost 30 years, that's happened only once for one of us and not at all for the other spouse. There are more details but I've summarized here. The entire system is quite complicated and subject to change at the whim of Congressional changes in the applicable rules in the annual budget appropriations. Oh, and with respect to the VA system, I could enroll. However, I would be required to forgo my care benefits at military treatment facilities and due to my income, pay the VA's highest schedule of costs for care. What's worse, my wife would no longer be considered my dependent with respect to medical benefits and would lose all her access as well. I'm not sure if either or both of us would also lose Tricare for Life benefits but I have no intention of swapping VA for military health system care.

All that should be perfectly clear :-) !

The same with everything the government does.

Perfectly clear as mud.

From what I know socialized medicine gives good but mediocre health care. When it comes to something like hip or knee replacement you might have to wait months or years in a wheel chair before it is done and if you are very old it might not be available.

If there's something you'd like to be restated, referenced, explained further, why don't you ask instead of making generalized negative comments? You seem to enjoy tearing down instead of offering alternative solutions to build up our society.

In other words, you don't know. You're either guessing or parroting the right-wing soi disant conservatives.

The median wait time in the USA is 3 weeks. In Canada it is 8 weeks.

The latter is as much due to the lack of physicians than anything to do with socialized medicine or single payer. The latter, of course would simplify the existing US system significantly and remove all the current middleman overhead which is something like half of overall health care costs.

Nonsense from the assholes that famously claimed that the ACA would include "death panels".

Educate yourself before spouting off.

Good suggestion for anyone and you obviously need to do it yourself.

Could be worse. The Medicare Advantage programs seem to be difficult to get proper care. They don't go by what the doctor recommends, but what some clerk at the insurance company approves.

Our United Healthcare supplement is not cheap but coverage has been great.

I imagine there are regional differences in availability and quality of treatment in the VA system.

I have not found that to be the case.

I had small co-pays for the physical, occupational, and speech pathology therapies after I fell down the stairs in September. All testing was covered, even outside the ER. None of the tests requested by my primary care physician have ever been questioned.

My husband had a catheter cardiac ablation. Same thing. No trouble whatsoever.

Our Medicare Advantage is cheap and coverage has been great. Blue Cross/ Blue Shield of Michigan Medicare Advantage PPO.

My wife had to wait about a month for an operation on her foot just due to the doctor was booked up for that long. That was in Charlotte, NC, largest city in the state.

I do not know how it is now, but at one time the medical profession would only let there be so many schools for medical people. To get into the schools you often had to get on a waiting list.

I do not have a good solution to medical care but think there should be some kind of control on it. Especially medicine. Each pharmacey can set their own prices and it is difficult to compair prices. They should all charge the same price for the same medicine.

Good for you. Don't you also say something like anecdote does not equal data?

Some doctors and hospital don't accept the advantage plans and some don't cover you out of network traveling.

The death panels operate under the guise of vaxxines.

Yep. My anecdote also includes the fact that I live in a wealthy, educated county. There are a lot of providers and two excellent hospital systems.

It would be foolish not to accept the Advantage plans provided by the largest insurer in the state. I never checked what happens about travel; I don't intend to leave Michigan every again. As for ordinary out-of-network stuff: it's a PPO, not an HMO. I can choose any doctor I want and pay a larger co-pay if they're not in the PPO.