Author Topic: Feds Cut Reimbursements for Military Health Care  (Read 2652 times)

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Offline Haggis

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Feds Cut Reimbursements for Military Health Care
« on: October 08, 2019, 18:46:58 »
I haven't seen this posted elsewhere on the site.

The Liberal government quietly cut the reimbursements it pays out to civilian hospitals that provide services to CAF members putting them on the same schedule and the same level of service as out-of-province patients.

- mod edit to change case of thread title -
« Last Edit: October 08, 2019, 19:20:50 by milnews.ca »
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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #1 on: October 08, 2019, 18:52:47 »
What is the practical effect of this, if any, for CAF members?
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Offline Humphrey Bogart

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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #2 on: October 08, 2019, 19:00:51 »
What is the practical effect of this, if any, for CAF members?

The practical effect is that if you need any sort of outside treatment like an MRI, you might be pooched.

Explains why I've been going through endless amounts of diagnostic BS to get a hip scan.  It basically means our members are last on wait lists and receive worse service than joe public.

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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #3 on: October 08, 2019, 19:01:26 »
Unless they start turning away military patients, there should be no impact. Considering they're only obligated to provide emergency care for uninsured patients though, this would not be an unexpected outcome.
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Offline Ostrozac

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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #4 on: October 08, 2019, 19:16:13 »
This has been percolating for a while. One version of the story is that by calculating higher charges for patients outside of the primary provincial health care plan that provinces are in fact price-gouging and using military health care spending to in effect subsidize the rest of the system. Another version of the story is that the provinces are funded, manned and organized to provide health care to provincial residents eligible for provincial health care, and that providing such health care to those outside the system, like military members, is inherently a hassle and a burden, and they are well in their rights to charge a premium to those patients outside their core mandate.

The truth? Probably somewhere in between. It’s health care, it’s expensive, it’s complicated, and somebody has to pay.
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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #5 on: October 08, 2019, 19:26:27 »
Unless they start turning away military patients, there should be no impact. Considering they're only obligated to provide emergency care for uninsured patients though, this would not be an unexpected outcome.
Zackly.  Turning away, putting them lower in the priority list, loooooooooooooooooooooooonger waiting times - toe-MAY-oh, toe-MAH-oh.
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Offline Humphrey Bogart

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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #6 on: October 08, 2019, 19:32:48 »
Zackly.  Turning away, putting them lower in the priority list, loooooooooooooooooooooooonger waiting times - toe-MAY-oh, toe-MAH-oh.

It's all good, maybe I'll get that MRI on my hip by the time I pension out!

I can go through more rounds of voodoo magic pseudo-science physio until then lmao. 


Offline garb811

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #7 on: October 08, 2019, 19:42:56 »
Quote
In August, Ontario Health Minister Christine Elliott wrote to her federal counterpart, Ginette Petitpas Taylor, as well as Defence Minister Harjit Sajjan, to express her concerns.
...
“That’s why I was surprised and extremely disappointed to learn that the federal government, through the Canadian Armed Forces, is attempting to unilaterally impose a new fee schedule for the delivery of health care to serving members and veterans. These changes, which were communicated without consultation, could result in either undue burden on hospitals or, worse yet, military members and veterans being charged to access health care services. Neither of these options are acceptable.”

I have heard of a member receiving a bill from a specialist in the mail in the last month. At the time, I wrote it off as being an error that would be easy to fix because several years ago I was billed directly by an anesthesiologist because they weren't told I was military and I didn't have a provincial health care number on file. All it took then was for me to drop the bill by medical claims and they took care of it.

Now? If the Provincial Health Care systems decide to start to try to recover the difference between what CAF will pay for the in province schedule and the out of province schedule directly from members, this is going to get messy for folks really quickly.  What choice do you have if the options are paying a bill for several hundreds, or possibly thousands, of dollars that CAF is refusing to pay or letting it go to collections with all the good fun that brings...
« Last Edit: October 08, 2019, 19:45:36 by garb811 »

Offline Humphrey Bogart

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #8 on: October 08, 2019, 19:52:15 »
I have heard of a member receiving a bill from a specialist in the mail in the last month. At the time, I wrote it off as being an error that would be easy to fix because several years ago I was billed directly by an anesthesiologist because they weren't told I was military and I didn't have a provincial health care number on file. All it took then was for me to drop the bill by medical claims and they took care of it.

Now? If the Provincial Health Care systems decide to start to try to recover the difference between what CAF will pay for the in province schedule and the out of province schedule directly from members, this is going to get messy for folks really quickly.  What choice do you have if the options are paying a bill for several hundreds, or possibly thousands, of dollars that CAF is refusing to pay or letting it go to collections with all the good fun that brings...

Bunch of people posted the same on CAF Reddit, about receiving bills from specialist appointments and being confused.

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #9 on: October 08, 2019, 19:52:33 »
Don't military members pay provincial taxes ?  I hope none of that is going towards provincial medical funding then.

Be awful shitty if they we taking our taxes and turning us away from the services we are in part paying for.
« Last Edit: October 08, 2019, 19:57:54 by Halifax Tar »
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Offline hattrick72

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #10 on: October 08, 2019, 19:57:40 »
If we pay the same taxes as residents why not switch health cards on posting the way we switch licences? We save them money by having our own primary health care doctor. Should be no different than a civilian GP sending the paperwork for an MRI or specialist appointment.

Offline Jarnhamar

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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #11 on: October 08, 2019, 20:02:12 »
What is the practical effect of this, if any, for CAF members?

As it was explained to me, previously DnD would pay a premium  to have time slots open for DnD mbrs, say, to get an mri in the hospital. Need an mri? Probably get in next week or two weeks. Now you could be waiting 8 months.

Where is someone going to be in 8 months?

Some specialists can also deny services to blue cross, which my MO said some of them have been as a sort of *** you to DnD.
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Offline Eye In The Sky

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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #12 on: October 08, 2019, 20:38:05 »
As it was explained to me, previously DnD would pay a premium  to have time slots open for DnD mbrs, say, to get an mri in the hospital. Need an mri? Probably get in next week or two weeks. Now you could be waiting 8 months.

Where is someone going to be in 8 months?

Some specialists can also deny services to blue cross, which my MO said some of them have been as a sort of *** you to DnD.

This was explained to me just last week by a military MO specialist I was referred to, a LCol.

He said the changes were actually recommended from within the CAF as a cost-cutting measure.  Effectively, the military will pay the same for a service to a hospital, Dr, etc as the provincial health system would pay, vice the "out of province" rate which is higher. 

Obviously, that means that health care providers have no motivator to prioritize CAF members;  we will go into the same waiting list 'hopper' as everyone else.  This is where the effect will be felt by the CAF.  Let's say Aircrew Bloggins is grounded until he/she sees a specialist for reason Y, or needs a test that can only be done 'downtown' (because the CAF also has reduced the number of specialists it employees as it is 'cheaper' to get things done 'downtown'...another cost saving measure implemented in the past).

So...the question is...how long can a CO afford to lose aircrew, divers, tankers, sailors, etc...and how much productivity will be lost from the total number of CAF members nationally who are all on MELs/T Cats/etc while waiting for specialist services from a given province??

That is the risk that someone has to assume, IMO.
+300 « Last Edit: October 08, 2019, 21:12:12 by Eye In The Sky »
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Offline garb811

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #13 on: October 08, 2019, 20:56:25 »
EITS:  You're right that we used to employ way more specialists in the past. When I first got in we even had fully equipped hospitals with surgical suites, labs, diagnostic equipment, the works, not only in Germany but at a few locations in Canada as well. We were pretty well set up to provide the services we have come to rely on from downtown but in the transition to the Health Clinic model did away with all of that and we've ended up embedding our specialist medical folk into civilian hospitals to try to maintain their skills, in some really strange locations as well. ie. A relative was treated by a Reg Force military surgeon in Calgary several years ago, why they were in Calgary as opposed to Edmonton where they could at least continue to be a resource for the military members there, I have zero clue...

It's pretty sad when at O-Gps the Base Surgeon is continually reminding everyone not to attend the Health Services Center for an emergency but to call 911 instead because they just aren't equipped to deal with anything serious.
« Last Edit: October 08, 2019, 21:12:24 by garb811 »

Offline Furniture

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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #14 on: October 08, 2019, 21:30:49 »
This was explained to me just last week by a military MO specialist I was referred to, a LCol.

He said the changes were actually recommended from within the CAF as a cost-cutting measure.  Effectively, the military will pay the same for a service to a hospital, Dr, etc as the provincial health system would pay, vice the "out of province" rate which is higher. 

Obviously, that means that health care providers have no motivator to prioritize CAF members;  we will go into the same waiting list 'hopper' as everyone else.  This is where the effect will be felt by the CAF.  Let's say Aircrew Bloggins is grounded until he/she sees a specialist for reason Y, or needs a test that can only be done 'downtown' (because the CAF also has reduced the number of specialists it employees as it is 'cheaper' to get things done 'downtown'...another cost saving measure implemented in the past).

So...the question is...how long can a CO afford to lose aircrew, divers, tankers, sailors, etc...and how much productivity will be lost from the total number of CAF members nationally who are all on MELs/T Cats/etc while waiting for specialist services from a given province??

That is the risk that someone has to assume, IMO.

Was it recommended from the CAF in the same apparent way that the RCN said it didn't "need" a second interim tanker? Ie; heavily influenced by the political masters, using 'the CAF said it" as the protection from repercussions if it doesn't go over well?

Offline Humphrey Bogart

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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #15 on: October 08, 2019, 21:49:28 »
Was it recommended from the CAF in the same apparent way that the RCN said it didn't "need" a second interim tanker? Ie; heavily influenced by the political masters, using 'the CAF said it" as the protection from repercussions if it doesn't go over well?

Sounds about right  :nod:

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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #16 on: October 08, 2019, 21:57:20 »
Was it recommended from the CAF in the same apparent way that the RCN said it didn't "need" a second interim tanker? Ie; heavily influenced by the political masters, using 'the CAF said it" as the protection from repercussions if it doesn't go over well?

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #17 on: October 08, 2019, 22:04:56 »
RCMP went from CAF-style health services to the provincial civilian health plans back in the DRAP days. A lot of members are sitting off on restricted duties waiting many months for MRIs...

Don’t get me wrong; in a lot of places I see it making sense to get primary care through the civilian system... *But* where delays in specialist diagnostics and treatments keeps people on TCAT, that becomes an operational problem that may call for operational solutions.
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Re: FEDS CUT REIMBURSEMENTS FOR MILITARY HEALTHCARE
« Reply #18 on: October 08, 2019, 22:24:32 »
Was it recommended from the CAF in the same apparent way that the RCN said it didn't "need" a second interim tanker? Ie; heavily influenced by the political masters, using 'the CAF said it" as the protection from repercussions if it doesn't go over well?

Not the way he said it, actually.  It was (IIRC) a recommendation 'at the General level, inside the Health Svcs Group' or words to that affect.
« Last Edit: October 09, 2019, 20:41:26 by Eye In The Sky »
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Offline Kilted

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #19 on: October 08, 2019, 23:16:19 »
Well this effect us for non-service related issues if we have a provincial health card?

Well this work out to the point that if I hurt myself while not on military time I'm covered, but if I hurt myself in uniform I may have to pay for it myself?

Offline Ostrozac

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #20 on: October 08, 2019, 23:26:25 »
Well this effect us for non-service related issues if we have a provincial health card?

Well this work out to the point that if I hurt myself while not on military time I'm covered, but if I hurt myself in uniform I may have to pay for it myself?

I’d be careful with that. If you’re in the Reg Force and using a provincial health card that you are no longer eligible for, that’s getting pretty close to fraud. The Canada Health Act says that CAF members (and prisoners, and newcomers for the first 90 days) aren’t insured by the province.

Offline Kilted

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #21 on: October 08, 2019, 23:33:01 »
I’d be careful with that. If you’re in the Reg Force and using a provincial health card that you are no longer eligible for, that’s getting pretty close to fraud. The Canada Health Act says that CAF members (and prisoners, and newcomers for the first 90 days) aren’t insured by the province.

I'm a Reservist, I figured my name gave that away. Although some reservists are on Blue Cross. That's what I meant by not on military time.

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #22 on: October 09, 2019, 00:28:39 »
It can get complicated, fast, for some reservists WRT which medical system (CF or military) you would seek attention or treatment.

The Reserve Aircrew I know all see military flight surgeons (when you can find one) for anything that may impact their ability to fly. Other than that, they tend to see their civilian GP (if they have one). Some situations/conditions are not cut and dried, however.

Offline Eye In The Sky

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #23 on: October 09, 2019, 15:07:53 »
Well this effect us for non-service related issues if we have a provincial health card?

Well this work out to the point that if I hurt myself while not on military time I'm covered, but if I hurt myself in uniform I may have to pay for it myself?

No, not the way I was made to understand it.  You just won't necessarily get faster service/shorter wait times, as the health care provider won't be getting more for their services to you than they would any covered under the applic provincial health care system.
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Offline Quirky

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Re: Feds Cut Reimbursements for Military Health Care
« Reply #24 on: October 09, 2019, 17:05:23 »
Good. We should not be getting  special treatment and jumping the line at hospitals for specialists appointments and MIRs. If we use provincial services we need to wait like everyone else. How this impacts operations with more people not deployable and on tcats are problems for commanders to figure out.