Coordination Of Idiocy

If you have health insurance, you know about Coordination of Benefits; if you have a family and have a spouse or partner who might have health insurance, your plan wants to get their plan to chip in for part of the costs. It’s understandable…

…when treating run of the mill illnesses.

The Administration wants to extend this idea to veterans; he wants the Veterans Administration to coordinate benefits with veterans’ civilian healthcare providers to help pay for care of vets’ service-related conditions.

The commander of the American Legion is not amused:

It became apparent during our discussion today that the President intends to move forward with this unreasonable plan,” said Commander David K. Rehbein of The American Legion. “He says he is looking to generate $540-million by this method, but refused to hear arguments about the moral and government-avowed obligations that would be compromised by it.”The Commander, clearly angered as he emerged from the session said, “This reimbursement plan would be inconsistent with the mandate ‘ to care for him who shall have borne the battle’ given that the United States government sent members of the armed forces into harm’s way, and not private insurance companies. I say again that The American Legion does not and will not support any plan that seeks to bill a veteran for treatment of a service connected disability at the very agency that was created to treat the unique need of America’s veterans!”

I’m a tax hawk, who is all about finding ways to cut government spending and privatize government functions.

I also believe in restricting government to the places and functions that it’s supposed to be dealing with.

One of those – one of the few, really – is defense.

And so while I’ve mercilessly mocked those stupid “happy to pay for a better Minnesota” signs, and am very penurious about taxes as matter of principle, taxes related to defense, and to taking care of those who volunteer to defend this country (especially their service-related injuries) are among the very few I’ll pay without a whole lot of pushback.

It’s a stupid plan.

And I’m trying to picture what would have happened if a Republican administration would have suggested it. Thousands of addlepated leftybloggers would launch “Why Does The President Hate Veterans” posts; Jon Stewart would snark and smirk; Anderson Cooper would furrow his brow and scowl.

But now that it’s The One?

Posted

March 17, 2009

Democrat Party, Money, President Obama

Mitch Berg

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Comments

11 responses to “Coordination Of Idiocy”

Dog Gone

March 17, 2009

I have only heard a little about this proposal so far. On the face of it, it sounds like a really awful idea.

I do find that often in media reporting of any proposal connected to politics, right OR left, where it appears objectionable on the face of it, that significant information is missing that drastically alters our understanding of the proposal. This idea is so bad, that I have to wonder if that kind of information is missing here, and may come out as discussion proceeds.

But if this is all there is? This is awful.
angryclown

March 17, 2009

Sure, why shouldn’t insurance companies get a free ride? You’d hate to see them actually have to pay claims instead of just collecting premiums.
Night Writer

March 17, 2009

Next up, make the troops buy their own bullets. Of course, no ammo with lead in it; bad for the environment, you know.
thorleywinston

March 17, 2009

I agree with Dog Gone regarding the lack of some rather significant information to fully understand the proposal. From what I can tell doing a little googling, the Obama administration would like the VA to increase the amount of reimbursement it receives from other third-party payers from $2.5 to $3.4 billion by FY 2010. So far it hasn’t released any details on how it plans to increase the reimbursement it receives by over a third (it says the information will be released in April with the budget for the VA) but some people like the VFW are speculating that it plans to charge third-party insurers for service-related injuries of veterans instead of just charging them for non-service related treatment as it does now.

Rather than speculate, I think it might be better to wait until April when they release the budget, including the information about how they plan to increase third-party reimbursement, and then we’ll have something concrete to discuss.

Also if I could make another point, the line from the commander of the VFW about how the Obama administration has supposedly “refuesd to hear arguments about the moral and government-avowed obligations that would be compromised by [its proposal]” smacks of hysterical B.S. If what we’re talking about involves a legislative change, there will be hearings in Congress. If it involves a rule change by the VA, there will probably be a notice and comment period under the APA where everyone who is interested will get a chance to weigh in.

Much as I generally oppose the Obama administration’s policies – particularly anything in the area of health care – it’s premature to criticize this one until we have the facts. I can see the logic behind the VFW in trying to plant the meme in the public that the Obama administration plans to charge veterans for their service-related injuries as early as possible but I cannot in good conscience join that bandwagon until we even know whether it’s true.
angryclown

March 17, 2009

Thorley Winston said: “I cannot in good conscience join that bandwagon until we even know whether it’s true.”

Boy are you ever following the wrong blog.
K-Rod

March 17, 2009

Obama is sending troops into harms way in Afganistan but he doesn’t care about them if they get wounded in combat. The cowards like AssClown won’t even admit when their Obamassiah is wrong. Hey AssClown, you Useful Idiot, pull your head out. The insurance company did not send troops into harms way.
penigma

March 17, 2009

Mitch,

Frankly, there’s not enough information here to know what’s being done.

If we are talking about pushing some of the cost of veteran’s service related injury care to private insurers, I oppose that. Frankly, I’d be surprised if that’s what’s going on, though.

Instead, I expect this is basically saying to private insurers, you have to pickup the unpaid costs. COB is a complex matter, but essentially, as you described in a very high level, requires that the primary insurer pay first (in this case the VA) before any other carrier pays.

When I paid claims (which was from 1986 to 1996) inclusive, the VA was always primary on service care, and always secondary on other care, no matter what. Service care was to be paid at 100%, but I don’t know if that has changed. Like you, I think it should be 100%, however.

But, if it has changed then there are a couple of scenarios –

First, standard COB applies, in that case the primary plan pays as if the secondary doesn’t exist, if it is supposed to pay 80% after a $1000/deductibe, that’s exactly what it does.

Then second, there’s something referred to as “Preservation of Benefits”, this is an idea I never liked, but it effectively is where the primary plan assumes that the secondary plan will pay something, and thus the primary plan reduces its payment to assure the patient pays out of pocket whatever the patient would have absent the secondary plan. Examples below:

$100 bill @ 80% – traditional COB- Primary pays $80, secondary pays $20.
Preservation COB – $100 Bill, Primary assumes the secondary will pay $20, reduces the eligible bill to $80, and pays 80% of $80, or $76, thus preserving the 20% coinsurance.

If Obama is looking to have private carriers cover unpaid costs for veterans, my preference would be to have Uncle Sam – for the reasons you noted, and because I believe service related injuries are the responsibility of the citizenry. However, if the share the VA pays has been reduced, I see NO reason why a private carrier should not pay, zero, none, in lieu of making the service member pay, and hyperventilation about billing the servicemember is out of bounds – the coordination is a pain – and preservation COB should be prevented (meaning any reduction in payment by the VA if the service member in fact has other coverage), but rather than leaving the service member to pay for service related care (coinsurance and deductibles), if they are paying for secondary coverage, or provided it through their employer, I prefer strongly that they be allowed to take advantage of that benefit.

Perhaps you can clarify this before we start calling anyone names or inferring someone is being irresponsible. I think if Obama is looking to protect the service member, if the VA isn’t going to pay full boat, that’s not irresponsible, it’s decent.
Dog Gone

March 17, 2009

K-Rod, that Obama doesn’t care about the armed forces in harm’s way has not been demonstrated.

One of the biggest problems that I understand the VA is contending with is the problems of patients who don’t live anywhere near the locations of current VA facilities, making it difficult for them to receive care. One of the things I am waiting to hear is if this proposal to use private insurance might be some way to expand the services of the VA to local non-VA health care providers, with that care initially paid for by existing private iinsurance that could later be reimbursed by the VA – just to get the care delivered where it is needed. Or, alternatively, to have the VA reimburse all or part of their private insurance premium.

This may or may NOT turn out to be a case of abandoning vets to their own resources.

I’ve seen a lot of things derided where important information was omitted; sometimes intentionally to mislead, other times just because of laziness on the part of those reporting.
Master of None

March 17, 2009

Did you guys see that the Angry Clown was visiting Minnesota recently.

http://www.startribune.com/galleries/41244207.html?elr=KArksUUUU
K-Rod

March 17, 2009

“This reimbursement plan would be inconsistent with the mandate ‘ to care for him who shall have borne the battle’ given that the United States government sent members of the armed forces into harm’s way, and not private insurance companies…”

That you support such a plan speaks much about you, Dog Gone. How many licks does it take for you to polish Obama’s shoes?
angryclown

March 18, 2009

Typical wingnuts. Obama’s sticking it to the insurance companies, you pretend he’s dissing veterans. Good lord you’re dumb. Hey, even Thorley won’t tough that pile of crap with a stick.