After Eric Massa’s press conference today I decided to chat with a veteran and health care provider to see what the reality is on the ground.  Here’s what I’ve found out:

TRICARE is the military health care program and this is how it is explained on the website:

TRICARE is the health care program serving active duty service members, National Guard and Reserve members, retirees, their families, survivors and certain former spouses worldwide. As a major component of the Military Health System, TRICARE brings together the health care resources of the uniformed services and supplements them with networks of civilian health care professionals, institutions, pharmacies and suppliers to provide access to high-quality health care services while maintaining the capability to support military operations.

To be eligible for TRICARE benefits, you must be registered in the Defense Enrollment Eligibility Reporting System.

When speaking with a private health care provider about accepting TRICARE in a private office setting (as opposed to a V.A.), the person said “It’s crap for reimbursement and the paperwork is a nightmare.  It’s like Worker’s Comp times two.”  Still, this provider does take TRICARE, saying “Absolutely, because I’m a former soldier.  They [veterans] already go through a battle as it is.“

Indeed.  This is what I like about Massa’s plan—it is an attempt to simplify the administration aspect of care our veterans need and deserve.  The best place to start is by streamlining the process so that it’s easier for doctors’ and therapists’ offices to be reimbursed, which provides incentives for more private offices to accept TRICARE.

This former soldier went on to say that “There’s not enough TBI centers and the ones that are there have no idea how to treat ‘em.  It’s challenging to get proper care.”  Again, this soldier is correct.  The incidence of TBI and PTSD is on the rise due to the wars in Iraq and Afghanistan, with a Rand Corporation study finding that about 300,000 of our returning veterans suffer from PTSD and TBI.  The study also found that:

“Among those who met diagnostic criteria for PTSD or major depression, only 53 percent had seen a physician or mental health provider to seek help for a mental health problem in the past 12 months,” the study said.

“The gap in care was even higher for TBI: 57 percent of those who reported experiencing a probable TBI were never evaluated by a physician for a brain injury,”

Some of the lapse in care is related to the stigma attached to admitting a mental problem in the military and in society in general.  Other reasons for the lapse in care are in the nature of these afflictions themselves: those with mental problems may not realize it nor have the ability to seek the help they need.  All of this points to an increasing need in proper post-deployment medical observations by military personnel and easier access to follow-up appointments for veterans.  Again, simplifying the paperwork bureaucracy can greatly aid in this area.

For example, the turn around time for TRICARE reimbursement is 2-3 months and the reimbursement rate is about 60-80%.  “They’ll pay once you get in the system but it’s the same nightmare with each patient,” according to the private health care provider I spoke with.

Another problem is that many soldiers just don’t utilize their health care because of all this red tape.  Said the soldier I spoke with today “I have it now and I never use it.  It’s hard finding people who accept it.”

Here’s hoping Eric Massa gets elected to Congress and his Veterans Plan is enacted.  Our soldiers already fought one battle.  Why make them fight another once they come home?