April 20Despite arguments among Americans about whether it should exist, there is already socialized health care in the United States.
Under federal programs such as Medicare and Medicaid, the elderly and low-income people have access to health coverage. There is federal support for prenatal care and disability coverage.
Include those under tribal health care and the Veterans Administration, and about 40 percent of Americans receive some degree of health care or insurance supported with federal funding. That figure does not include subsidies under the Affordable Care Act that partly cover insurance premiums even for some middle-class households.
In Northeast Oklahoma, the Cherokee Nation provides health care to it citizens at W.W. Hastings Hospital and a network of eight clinics.
"We see patients from any federally recognized tribe," said Connie Davis, executive director of health services for the Nation. "If you have proof of citizenship with any tribe, you can be seen in our facilities. The coverage offered includes primary care services, some surgeries, some orthopedics, some physical therapy, optometry, pediatrics. There is no charge for anything offered as a direct care services."
Non-American Indians are sometimes treated at Hastings Hospital, especially in emergencies. The hospital accepts insurance, and Davis said the federal government does not fund all expenses.
"There are some people who resent that American Indians are covered," Davis said. "We offer good services, but the amount for those services is only funded by the federal government at about 40 percent. We rely on third-party revenue and tribal funding including casino profits to provide more services to patients."
The Cherokee Nation urges its citizens to carry employee or private insurance coverage. The ability to bill insurance allows the tribe to extend federal and tribal funding.
Davis called the Nation's health care service "incredible."
"I have family who are non-Native, and they don't have access to insurance," she said. "They are quite envious of the services we provide. Our pharmacy service saves us a tremendous amount of money. You don't have to think about spending $100 for an office visit. With a CT scan, you're normally looking at an expense of two grand. Most people can't afford those kinds of services, and would be without health care, but we can do those at the hospital."
Veterans of the U.S. armed services are also eligible for a form of socialized medical care. Vets who serve at least 24 continuous months of service and are honorably discharged are eligible. Exceptions are possible for a medical discharge before 24 months, particularly if due to a service-related injury or illness. The dishonorably discharged are ineligible.
The nearest veterans hospital to Tahlequah is the Jack C. Montgomery VA Medical Center in Muskogee.
Leon Briggs, an artist and former journalist, was a combat veteran in Vietnam, and he says the Veterans Administration treats him "exceptionally well."
"The VA treats vets with disabilities very well, from what I've seen," Briggs said. "They have a MyHealtheVet website where we can talk with our doctors, order meds, via the internet."
That cuts down on wait times for services, he said.
"I get my meds a lot quicker than before," he said. "I can talk to the nurses online. If I need special procedures that aren't available in Muskogee, they send me to Tulsa [Oklahoma State University] Medical [Center] or [Oklahoma City]."
There is sometimes discussion, or complaints, that combat veterans are given greater consideration than non-combat veterans, but the perception may arise because, once enrolled, veterans are categorized.
The "priority groups" are:
Group 1: Veterans with VA-rated service-connected disabilities 50 percent or more disabling, or determined to be unemployable due to service-connected conditions.
Group 2: Veterans with VA-rated service-connected disabilities 30 or 40 percent disabling.
Group 3: Veterans awarded either the Purple Heart or Medal of Honor; veterans medically discharged for injuries incurred or aggravated during their service; veterans with VA-rated service-connected disabilities 10 or 20 percent disabling; former prisoners of war; or resulting from medical mistreatment, as established by law.
Group 4: Veterans who receive aid and attendance benefits, housebound benefits, or who have been determined to be "catastrophically disabled."
Group 5: Veterans receiving VA pension benefits; veterans eligible for Medicaid; veterans who do not have a service-connected disability, or whose service-connected injury is non-compensable, but with income below geographically means-tested limits.
Group 6: Veterans with compensable, VA-rated service-connected disabilities of zero percent; combat veterans; "atomic veterans"; Project SHAD participants; veterans on active duty at Camp Lejeune during its water contamination.
Group 7: Veterans with gross household income below the geographically-adjusted income limits for their resident location and who agree to pay copays.
Group 8: Veterans with gross household income above the VA and the geographically-adjusted income limits for their resident location and who agrees to pay copays.
The VA does use "disabled" and "non-disabled" designations for patients, but not "combat" or "non-combat."
Veterans can use any of the administration's medical services. A Community Care program allows veterans to use non-VA facilities with pre-authorization. Veterans are reimbursed or health care providers paid for any emergency care to veterans, regardless of where the treatment was received.
There is also a reimbursements agreement program between the VA and the Indian Health Services Tribal Health Program, which allows reimbursement of tribal health care programs for direct care services to American Indian veterans.
(c)2017 the Tahlequah Daily Press (Tahlequah, Okla.)
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