Adding Insult to Injury: The Mishandling of Money for the Sick

Written by Joshua Patton,

Much of the news out of the Capitol this past week has focused on Rep. Anthony Weiner (D-NY) and his Twitter picture scandal, which has taken away attention from the continuing battle over the budget.  The economy and federal spending is the hot-button political football that dominates much of the serious news that filters through the hoopla and carnival barkers wasting our time with the scandal.  The massive Defense budget and the much less significant Veterans’ Affairs budget are often lumped together when the talk turns to how Washington can tighten its belt.  As a nation at war for almost a decade, the amount of Veterans that are seeking health care from the VA is going to hit record numbers.

For the veterans that use Tricare – which is separate from the VA and operated out of the DoD budget – they are already prepared to see an increase in their premiums.  According to a Connecticut State Medical Survey 78% of Doctors said they would limit the number of Tricare patients (both retired Veterans and active servicemembers and their families) because the plan doesn’t fully cover costs.  The question is what is to blame?  The amount of money allocated to Tricare has risen 300% since 2001 and will be 10% of the almost $800 billion DoD budget.  The culprit may be the rising cost of health care in this country across the board, for military and civilians alike. 

 Things are even worse for the VA.  For some folks, such as the man profiled in this report from The Kansas City Star, have to travel hundreds of miles just for access to a VA medical care facility.  In the same report, the Inspector General’s office can’t even be sure that the money spent to non-VA providers “does any good.”  Again begging the question if the problem is with the VA itself or with the larger problem that is health care in America.

In fact, the VA Inspector General also found that the VA is not billing private insurers for 46% of health care costs that these private insurers should be covering. This oversight could be costing the VA about $110 million per year.  The VA blames an ineffective medical billing system that lacks the ability to track such fees.  Veterans are required to inform the VA about their access to private insurance, including policies held by their spouses, and these insurers are required to cover costs that aren’t due to service-related illness or injury.  Any balance left or gap in coverage does not result in an out-of-pocket expense to the Veteran since the VA picks up that bill. 

However, the VA is shouldering the entire cost and private insurers are “walking away with taxpayer money,” according to Senator Patty Murray (D-WA), the Chairperson of the Senate Veterans’ Affairs Committee.  The medical centers and health care providers themselves have “no written guidance,” on how to properly bill for these services or had no record of the charges at all, according to The Army Times. 

With a battle over every penny allocated to veterans, especially in terms of healthcare, everyone seems to be dropping the ball.  The VA is getting caught up in its own confusing bureaucracy and the providers end up billing the VA alone, leaving them to bear the burden of the cost.  Those opposed to government-run health care say that this proves they are incapable of running a system, but to those on the other side of the issue, it only further reinforces the idea that for-profit medicine is the root of all the trouble.  Yet, no matter which ideological position proves to be correct, the cost is being paid by the sick and the wounded.