Veterans healthcare, disability, now on chopping block

[ShadowDragon8685]

You know, Shadow, Zaune has no reason to know how our system works. That's why I explained it to him. I think he realized pretty quickly that it's not a matter of veterans being selfish, it's a matter of them getting any care at all... or none.

The government promised to take care of them if they got hurt. For decades that promise was rock solid. It was, in fact, the rationale for the civilian companies being allowed to exclude war injuries - the government had it covered. So long as the promise was kept it worked well. Civilian companies covered civilian problems. The Federal government covered problems acquired in its service.

Now the Teaparty jackasses want to renege on that. The fact that there is no other coverage? They don't care.

Yes, I know that. That's one of the reasons to hate the Teaparty morons. Not that there's not plenty of reasons, but maybe this will get a 'respected', theoretically 'conservative' bloc to speak out loudly against them...

Assuming they don't just quietly drop the matter and get the Teaparty back into being quiet.

I suspect Bachman is unaware that there is not other recourse for these men and women. Ideology over all.

Fair enough.

[Zaune]

So do us a favor and stop calling us Americans selfish when we're facing the prospect of something that might help us find medical care being cut and we start getting up in arms about it.

If I came over like that, I am really and truly sorry. I never intended to imply that veterans deserved anything less than what they currently receive. I just happen to think that everyone, from all walks of life, should be entitled to the same safety-net.

[Broomstick]

Well, I do, too. Unfortunately that's simply not the case here in the US.

[Phil Skayhan]

Because it's likely neither of those payments is adequate to live decently.

Then that is also true for a disabled civilian who can receive only Social Security disability. Why should the military get to double dip into the public trough?

Because if they got hurt fighting for the country maybe they deserve a little more? Think of it as a sort of worker's comp.

How much more do they deserve? Under the current policy, the veteran could receive benefits approaching 150% base pay. This is regardless of whether the disability is combat-related.

I would prefer if it was more like how Social Security Disability benefits are managed for retirees. The retirement payment is reduced by the amount of social security disability received unless the disability is combat-related. But again, this is something that can be handled solely by the VA if there is to be an increase benefit for those disabled in combat. For one, it would reduce the paperwork the vet had to file and the number of agencies he would have to deal with.

But otherwise, it's an unnecessary redundancy.

[ShadowDragon8685]

So do us a favor and stop calling us Americans selfish when we're facing the prospect of something that might help us find medical care being cut and we start getting up in arms about it.

If I came over like that, I am really and truly sorry. I never intended to imply that veterans deserved anything less than what they currently receive. I just happen to think that everyone, from all walks of life, should be entitled to the same safety-net.

Well, I do, too. Unfortunately that's simply not the case here in the US.

Exactly. But as it is not the case, I won't blame anyone for anything they have to do to take care of them and theirs, be it striking or screeching in political rags or marching on Washington, and I really hate it when people try to piss down on those who are doing what they must to take care of them and theirs.

[Broomstick]

How much more do they deserve? Under the current policy, the veteran could receive benefits approaching 150% base pay. This is regardless of whether the disability is combat-related.

If you have a disability it costs more to live than if you don't have a disability. And, as you point out, a veteran could receive that large of an aware, it doesn't mean they will receive it.

But otherwise, it's an unnecessary redundancy.

Clearly, you have never looked into just how little social security disability winds up paying some people. Also, the criteria for disability under social security tend to be much more stringent than for VA benefits. And don't get me started on the delays and bullshit involved with getting someone onto SS disability in this country.

You also need to distinguish between retirement benefits and disability benefits. They are not the same thing.

[Serafina]

No, I was not aware of that. I was in fact paralysed with incredulous astonishment and more than a little horror for a number of seconds by that information.

And yes, it really and truly does.

Zaune, when talking about US-healthcare, always assume the worst - that's generally a guideline that works. The system is not as alien to me as to you (germany has a two-fold system: public insurance "companies" and private insurance companies - but even the latter are heavily regulated by law (and still make profits), but it's really hard to grasp it as first still.

From all i have gathered, healthcare in the USA works like this:
-Get coverage while you are a member of a low-risk group. If you have any "pre-existing conditions", which can even include having been pregnant once in your life, you will have serious trouble getting insurance.
-Having a job does not always provide ensurance. However, jobs are one of the ways someone with a "pre-existing condition" can get health insurance, tough it typcially won't covery anthing related to that condition.
-When you actually get sick/injured and it will cost a lot to fix, expect serious resistance from the insurance - they will try almost everything in order to not pay. Often, your insurance policy will include strict limits for coverage - so they might pay for a broken leg, but if it's open-heart surgery you need for survival - sorry, it's above your limit, you have to pay the rest out of your own pocket.
-Premiums will skyrocket once you actually get payouts from your insurance.

The only alternatives to this right now are medicare and some other social security. And as we have seen in this thread, they are not only not that good (when compared to first-world country systems), but also in danger of being made worse or getting removed.
(if i got anything seriously wrong here, please correct me).

[Gullible Jones]

To put things further in perspective, there are apparently about 45,000 deaths in the US per year due to people not being able to afford care for treatable diseases. This is comparable to the yearly number of car accident fatalities in the US. Some states (like Massachusetts) provide their own insurance, but as I understand it doctors are not required to accept any particular brand of insurance - they can refuse to accept the state insurance, so it's not that big a help.

[Phil Skayhan]

How much more do they deserve? Under the current policy, the veteran could receive benefits approaching 150% base pay. This is regardless of whether the disability is combat-related.

If you have a disability it costs more to live than if you don't have a disability. And, as you point out, a veteran could receive that large of an award, it doesn't mean they will receive it.

The odds are that for veteran to qualify for the stringent Social Security disability benefit they would be receiving close to 100% VA benefits. Social Security does not do percentage disability; it's all or nothing. So right there the veteran is over 100% base pay.

But otherwise, it's an unnecessary redundancy.

Clearly, you have never looked into just how little social security disability winds up paying some people.

I didn't pull that 150% out of thin air. I used the online benefit calculator from the Social Security website; accurate enough for this discussion.

Also, the criteria for disability under social security tend to be much more stringent than for VA benefits.

And therefore the veteran is likely receiving more in disability than his civilian counterpart even before the Social Security compensation is taken into account.

You also need to distinguish between retirement benefits and disability benefits. They are not the same thing.

Actually, I simply misstated the source of the disability benefits; VA and not Social Security for the deduction in retirement pay.

[PhilosopherOfSorts]

-Having a job does not always provide ensurance. However, jobs are one of the ways someone with a "pre-existing condition" can get health insurance, tough it typcially won't covery anthing related to that condition.

Some people end up not being able to get insurance through their jobs even if its offered. I was eligible for ensurance through my last job, but I couldn't get it, because the amount that would have come out of my pay to cover it would have left me unable to pay my rent.

So I find myself in the same boat as Shadow, if I break my leg, I get to walk it off, rub dirt in it and take a lap. But hey, at least it builds character, right?

[Phil Skayhan]

I need to make a large correction:

Above I repeatedly say % of base pay. This is not how it works.

Link to tables

[Zaune]

To put things further in perspective, there are apparently about 45,000 deaths in the US per year due to people not being able to afford care for treatable diseases. This is comparable to the yearly number of car accident fatalities in the US.

Why am I reminded of that scene in Monstrous Regiment where Vimes muses about whether it's possible for a whole country to be insane? Not the people, mind you, just the country. It made more sense in the book, but I can't find the exact quote.

[Broomstick]

Serafina - you explained that very well, and I think you covered it all accurately.

As for US social security disability - you have to be completely unable to work to receive benefits. Under the SSD rules Stephen Hawking is not disabled. Why? Because he has a paying job.

So... if someone has an artificial leg under SSD they are not disabled because there are jobs that do not require you to have two flesh and blood legs. Can't find one? Sucks to be you, but because those jobs exist somewhere you, Mr. One Leg, are not disabled. Well, sure, maybe you can work with your artificial leg, but you know, there are maintenance costs to those things that flesh and blood legs just don't have. So, again, sucks to be you.

That's why it's much easier to get SSD for mental disability than physical disability. If your brain doesn't work it's damn hard to get any sort of job, but missing a limb or whatever? Find some sort of work you can do, you lazy bastard!

So, yeah, by the time someone qualifies for SSD they are not just a little disabled, they are a LOT disabled and probably racking up out of pocket costs for their case that the healthy and able-bodied aren't. So no, I don't have a problem with 150% of base pay for them, because having a disability is fucking expensive.

[Zaune]

Serafina - you explained that very well, and I think you covered it all accurately.

As for US social security disability - you have to be completely unable to work to receive benefits. Under the SSD rules Stephen Hawking is not disabled. Why? Because he has a paying job.

So... if someone has an artificial leg under SSD they are not disabled because there are jobs that do not require you to have two flesh and blood legs. Can't find one? Sucks to be you, but because those jobs exist somewhere you, Mr. One Leg, are not disabled. Well, sure, maybe you can work with your artificial leg, but you know, there are maintenance costs to those things that flesh and blood legs just don't have. So, again, sucks to be you.

This is actually true in Britain as well, though disabled people also get a small amount of extra money towards said maintenance expenses regardless of employment status. Personally, I'm all in favour of this; not because I don't like my taxes going to benefit the lives of people other than myself, but because I've been out of work for damn near four years now, and being dependent on government handouts is a whole load of no fun whatsoever.

But the big difference with our system is that unemployment benefits in this country have no time limit, and cover all one's basic necessities with enough left over for occasional small luxuries if you budget carefully enough. My problems are psychological, not material.

[Serafina]

Well, we have two steps of disability benefits:
-When you are only physically/mentally capable of working 3-6 hours a day. This generally does NOT carry and disability benefits, unless you are deemded unable to find proper work under such conditions (which is not often the case).
-When you are only capable of working less than 3 hours a day. Note that this also applies if you are, say, incapable of travelling to your work , even if you were capable of working once you were there. This also applies if your ability to wok can rapidly raise or drop due to your condition and this puts you in this bracket on average.

The payout is calculated like other pensions. Basically, you receive your retirment pension with small or no cuts, eventually reduced further if you can still earn some money.
Note that this is in addition to social security - if your payouts are not large enough, you will get that as well. Our social security covers rent, electrical bills etc, and enough money to live somewhat decently.
Any costs incured by the disability itself are of course covered by medical insurance - so if you prosthetic needs maintenance, insurance will cover it, if you need drugs insurance will cover it, if you need a wheelchair or a stairlift insurance will cover it etc.


I actually don't think that you should get extra money just because you are disabled. If you have a disability that makes you unable to work, i see nothing wrong with treating you like a person who is incapable of working due to old age - the situations are pretty comparable.

[Broomstick]

Yes, that's a key difference Zaune. In the US no one gets unemployment benefits past 99 consecutive weeks, or just under two years. All the extensions in the world won't help, the 99 weeks is a firm limit not to be exceeded.

After that, an able-bodied adult can get food stamps. Which pay for food and absolutely nothing else.

So... it's possible you can eat, but you have zero, absolutely zero income other than that. No means to put a roof over your head, buy clothes when yours wear out, or even purchase soap and toothpaste. This is one way people can wind up homeless in the US.

The safety net here is exceedingly thin.

[Broomstick]

I actually don't think that you should get extra money just because you are disabled. If you have a disability that makes you unable to work, i see nothing wrong with treating you like a person who is incapable of working due to old age - the situations are pretty comparable.

In the US the "extra money for the disabled" is intended for things NOT covered by medical insurance. If we had a system like yours where extra costs resulting from a disability were covered I agree, the extra money would not be needed. However, that is not the case here. Medicare - the health coverage for the disabled - has peculiar gaps in it, so a needed medical device might be wholly covered for purchase, but nothing whatsoever is done for maintenance.

[Serafina]

I actually don't think that you should get extra money just because you are disabled. If you have a disability that makes you unable to work, i see nothing wrong with treating you like a person who is incapable of working due to old age - the situations are pretty comparable.

In the US the "extra money for the disabled" is intended for things NOT covered by medical insurance. If we had a system like yours where extra costs resulting from a disability were covered I agree, the extra money would not be needed. However, that is not the case here. Medicare - the health coverage for the disabled - has peculiar gaps in it, so a needed medical device might be wholly covered for purchase, but nothing whatsoever is done for maintenance.

I think we agree on all terms - in your system the "money because you are disabled" is just a fix for a flaw in the system, and as such entirely appropriate.
And our system is not perfect either, a disabled person will often be stuck on a low standarf of living and/or struggle with money. While rare, it can also happen that the insurance coverage just isn't entirely appropriate - but i think that this is somewhat inevitable if you have a bureaucracy dealing with something as variable as disabilities - due to all the different needs, misjudgements will of course be made. That is quite unfortunate (and i have been somewhat affected by this inherent flaw in the system as well and witnessed it in some relatives), but i don't see much to fix that other than pumping vast amounts of money and manpower into our system.