Mentally Unstable Soldiers Redeployed to Iraq
By BOB WOODRUFF, JAMES HILL and JAIME HENNESSEY
Oct. 23, 2008
Two weeks before his second deployment to Iraq last September, Army Specialist Michael DeVlieger broke down.
Army Specialist Michael DeVlieger, who was redeployed to Iraq, with his wife, Christine. More than 600,000 Americans have served multiple tours in Iraq and Afghanistan.
At first, I thought it was something that everybody experienced," DeVlieger told ABC's Bob Woodruff, "and just through time and perseverance I guess it would pass." It didn't pass.
After an 11-day hospitalization, DeVlieger was given a diagnosis of major depressive disorder, three psychiatric prescriptions -- and deployment orders.
"Eighteen hours after he got out of the hospital, he deployed to Iraq," DeVlieger's wife, Christine DeVlieger, recalled. He left for Iraq despite Pentagon policy requiring that service members establish three months of "stability without significant symptoms" before deploying.
"I was a ticking time bomb," Michael DeVlieger said.
Watch "World News" Tonight at 6:30 p.m. ET for the full report
Citing privacy, officials at DeVlieger's base in Fort Campbell, Ky., declined to comment except to say there was a combat stress unit assigned to DeVlieger's base in Iraq.
'Stretched Too Thin'
More than 600,000 Americans have served multiple tours in Iraq and Afghanistan.
"Psychological trauma is cumulative," explained Dr. Paul Ragan, a former Navy psychiatrist who is an associate professor of psychiatry at Vanderbilt University. More deployments can mean more mental stress, and for some, more mental illnesses, he said.
Army surveys show that for those soldiers deployed once, the rate of anxiety, depression and post-traumatic stress disorder is 12 percent. For those deployed three or more times, the rate is 27 percent.
"People who have psychiatric symptoms, actively symptomatic with PTSD or depression, are being sent back to the very situation that caused their PTSD and depression," Ragan said.
The Army's chief psychiatrist, Dr. Elspeth Ritchie, agrees with the Rand Corp.'s estimate that 300,000 service members have demonstrated post-traumatic stress disorder symptoms. Some are returning to the battlefront, although the Army is not keeping track of how many.
"I certainly would not want to lump all soldiers who have experienced post-traumatic stress disorder and say they are impaired and not able to do their job," Ritchie told Woodruff. "I think that would be very stigmatizing."
Many soldiers, as Ritchie points out, receive treatment and cope successfully with PTSD or depression.
(AP Photo)"We have a number of reasons for sending the soldiers back to war -- we have a mission, clearly," Ritchie said.
The mission asks a lot of a few. Less than 1 percent of the population serves, and serves again.
"We know the Army is stretched too thin. We know how busy we are. We know we need more forces," Ritchie said.
While Ritchie said she was unfamiliar with the details of DeVlieger's case, she added that if it were true, it "clearly violates our policy." Ritchie said the Army works hard to screen veterans, but there will always be some missed cases.
Medicated Soldiers
The military is increasingly medicating its warriors, and in some cases, returning them to the fight.
Ritchie defended the concept. "You have to remember, PTSD is a treatable disorder, and you can have symptoms and still do your job quite well."
The Wages of War: Alcoholism, SuicideWoodruff Reports: Soldier's Iraq Tour Extended, Then an IED Hits U.S. Special Forces on a Lifesaving MissionTwelve percent of soldiers in Iraq and 17 percent of those in Afghanistan reported taking antidepressants, anxiety medications or sleep medications in the Army's most recent mental health survey.
The use of psychiatric drugs on the battlefield has not been scientifically studied, and some say the practice carries risks.
"The black box on the label talks about side effects like suicide, poor judgment," retired Army psychologist Bart Billings warned. "It's really not a good idea to put people in a battle situation where the side effects of the medications they're taking could be suicide -- when they're carrying weapons."
As a psychiatrist in Kuwait during the first Gulf War, Ragan saw a vastly different military opinion of psychiatric medications. "Clearly, in 1990, if someone was on antidepressant medication, we sent them back to the United States."
The Army has 200 mental health professionals in Iraq to treat soldiers and monitor medications. This number has remained constant since the start of the war, even as the number of troops has increased.
'It Still Sticks With Me'
Former Marine Cpl. Michael Cataldi, an Iraq war veteran, remembers the dark days that followed his first deployment.
"I was taking anti-psychotics, narcotics for pain and drinking at least 30 beers a night," he said.
He came home to Camp Pendleton, Calif., haunted by the horrors of war, including a helicopter crash that killed 30 fellow Marines.
Even though he was diagnosed with PTSD, Sergeant Chad Barrett asked to return to Iraq for the third time. He never came home.
(Courtesy of Shelby Barrett)"I saw a Marine Corps sergeant who had the majority of the top of his head missing, and he had the look of a scream on his face," Cataldi recounted. "And that stuck with me, and it still sticks with me."
Cataldi said he went to see a military psychiatrist who brushed aside his concerns. "I tell them, `I'm having nightmares. I feel like I'm having out-of-body experiences. I feel like I'm watching myself in a movie. I'm losing memory, coordination.' This whole time he said, `You're not feeling that way.' Exact words: `No, you're not.'"
Cataldi was prescribed several psychiatric medications and deployed to Iraq for a second tour of duty.
When asked for comment, Marine public affairs officer Cpt. Carl Redding told ABC News that Cataldi's records were "private and not releasable." Redding continued, "Marines with a psychiatric disorder in remission or those whose residual symptoms do not impair their duties may be considered for deployment."
Cataldi's wife, Monica Cataldi, believes the decision was wrong. "In my opinion, anybody who has to be on medication just to function, just to do their job, shouldn't go to Iraq."
A month into his second tour in Iraq, Cataldi said he ran out of his psychiatric medication.
"I went cold turkey on a narcotic in a combat zone," Cataldi said. "I woke up lying in the dirt in the middle of the night. I don't remember how I got there, with my rifle buried next to me."
"I wasn't mentally safe. I was a liability. I could have got someone hurt," Cataldi said.
Redding emphasized the military's focus on mental health. "Providing proper mental health care and assessing mental fitness to deploy are of the highest importance to Marine leaders."
Sgt. Barrett Wanted to Go Back
Last fall, Sgt. Chad Barrett stood before an Army medical evaluation board in Fort Carson, Colo., and asked to return to Iraq, even though his medical record included a PTSD diagnosis, a suicide attempt and a commander's recommendation that he be "removed from the United States Army and receive the treatment he needs."
On Christmas Day last year, the Army sent Barrett to Iraq for the third time. He never came home.
"This was a slow, progressive mental illness that never would have come about had he not been deployed repeatedly in a short period of time, had he gotten the care that he needed, had he gotten the best that the Army had to offer," said Chad's widow, Shelby Barrett.
In February 2007, Army Sgt. Brian Rand took his life in the park in Clarksville, Tennessee where he had been married a year before. He never met his son, who was named Brian in honor of his father.
(Courtesy of Dena Rand )A month into his third tour, 35-year-old Chad Barrett committed suicide in his barracks. He overdosed on the medications the Army had prescribed to help him cope.
Officials at Fort Carson, citing privacy, said they could not comment on Barrett's death.
"In a body bag is not how I wanted my husband back," said Shelby Barrett.
Half of Suicides Followed Treatment
The most recent Army Suicide Event Report showed suicides climbed to the highest number on record last year. Half of those who committed suicide had visited a medical program or clinic within 30 days of death and twenty-seven percent had a history of psychiatric medication.
ABC News looked into a dozen suicides that followed multiple deployments and had showed clear signs of mental distress.
In February 2007, Army Sgt. Brian Rand took his life in the park in Clarksville, Tenn., where he had been married a year before.
"He shot himself in the head," Rand's widow, Dena Rand, told Woodruff. "It was like a nightmare."
Dena Rand has paperwork showing that her husband sought mental health care and was referred to the mental health department during his second tour in Iraq. But nothing ever came of it.
"He knew he needed help, and he tried and he wasn't very successful," Rand said.
In a physical exam for discharge from the military, a psychiatrist wrote that Brian Rand was "mentally unsound."
"Someone got that report showing that my husband was mentally unsound. Someone should have notified his chain of command, or at least myself," said Rand. "I want to know who dropped the ball."
For more information, visit the Army's 'Battlemind' program for mental health: www.battlemind.army.mil
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I am an Army Staff Sergeant Infantry, I served as a Platoon Sergeant, a Squad Leader, a Team Leader, a rifleman, a mortarman 81mm and 4.2 I served from the Vietnam War thru 1982 and then joined the National Guard and was activated for Operation Desert Storm or Gulf War One as it is now known, I coped with the symptoms of PTSD for decades and I did not seek treatment or acknowledge I had a problem until October 2002, stubbornness or the refusal to admit I had problems, I can't explain, I blamed everyone else for my 4 ex marriages, my kids refusal to let me see my grand children, my DUI's etc, why did it take more than three decades for me to seek help? I had to destroy myself before I could admit I had a problem, why? Because the military pushes the men to do so, to admit you are weak is letting down your fellow soldiers, your chain of command, your troops. They use to take your security clearances away if you went to a shrink. They need to end the stigmatism attached to PTSD before the troops will change, it may have been more than 3 decades since Vietnam ended, but the Army is still the Army, they will use you up, and then use you some more, then tell everyone you have a personality disorder.
Monday, October 27, 2008
Mentally Unstable Soldiers Redeployed to Iraq
The Latest on Concurrent Receipt, SBP Payments
10 October 2008
The Latest on Concurrent Receipt, SBP Payments
The Defense Finance and Accounting Service (DFAS) gave a special update this week to The Military Coalition on that agency's progress in implementing various compensation fixes for tens of thousands of disabled retirees, SBP enrollees and survivors.
VA Retro Payments - This three-year joint effort by DFAS and the VA recalculated concurrent receipt and VA payments due to disabled retirees because of multiple changes in concurrent receipt laws in recent years.
The review of 230,000 retirees' cases has been completed, and all the payment adjustments have been made. The affected retirees received a total of $174 million in retroactive payments.
Paid-up Survivor Benefit Plan (SBP) - As of this month, SBP payments ended for retirees who are at least age 70 and have paid 30 years (360 cumulative months) of SBP premiums.
This affects 137,000 retirees, who will see their retired pay go up in the November checks. The net increase in the check won't be quite as much as the premium, because retired pay is taxable, whereas the SBP premiums were deducted before taxes.
In December, DFAS will display an "SBP Counter" on a retiree's Retiree Account Statement. It will show the total months of SBP premiums paid to date, so individuals can better project when their premiums will end.
Individual Unemployability Payments - Last year's defense bill authorized full concurrent receipt, retroactive to Jan. 1, 2005, for retirees designated as "unemployable" by the VA. But the effective date was delayed until this month.
Affected retirees will see their first monthly payment increase in November, and some will be eligible for additional retroactive payment. DFAS is notifying all who are due retroactive payments, and says those payments should be completed by the end of February.
Special Survivor Indemnity Allowance (SSIA) - Last year's defense bill authorized a monthly SSIA of $50 (which will increase in annual increments to $100 by 2013) to survivors who now have VA survivor benefits deducted from their SBP.
All of those survivors - whether the military sponsor died on active duty or in retirement - will see the first SSIA payment in the November check. The payment will be automatically paid to all eligible survivors.
Social Security Announces Nationwide Launch of Compassionate Allowances
A list of the first 50 impairments http://www.socialsecurity.gov/compassionateallowances/conditions.htm
Monday, October 27, 2008 Mark Lassiter, Press Officer, For Immediate Release 410-965-8904, press.office@ssa.gov
News Release
SOCIAL SECURITY
SSA Press Office 440 Altmeyer Building 6401 Security Blvd. Baltimore, MD 21235 410-965-8904 FAX 410-966-9973
Social Security Announces Nationwide Launch of
Compassionate Allowances
Process Will Fast Track Applications For People with Cancers and
Rare Diseases
Michael J. Astrue, Commissioner of Social Security, today announced the national rollout of the
agency’s Compassionate Allowances initiative, a way to expedite the processing of disability
claims for applicants whose medical conditions are so severe that their conditions obviously
meet Social Security’s standards.
“Getting benefits quickly to people with the most severe medical conditions is both the right and
the compassionate thing to do,” Commissioner Astrue said. “This initiative will allow us to
make decisions on these cases in a matter of days, rather than months or years.”
Social Security is launching this expedited decision process with a total of 50 conditions. Over
time, more diseases and conditions will be added. A list of the first 50 impairments -- 25 rare
diseases and 25 cancers -- can be found at www.socialsecurity.gov/compassionateallowances.
Before announcing this initiative, Social Security held public hearings to receive information
from experts on rare diseases and cancers. The agency also enlisted the assistance of the
National Institutes of Health.
Compassionate Allowances is the second piece of the agency’s two-track, fast-track system for
certain disability claims. When combined with the agency’s Quick Disability Determination
process, and once fully implemented, this two-track system could result in six to nine percent of
disability claims, the cases for as much as a quarter million people, being decided in an average
of six to eight days.
"This is an outstanding achievement for the Social Security Administration," said Peter
Saltonstall, President of the National Organization for Rare Disorders. "It has taken Social
Security less than a year to develop this much-needed program that will benefit those whose
claims merit expedited consideration based on the nature of their disease. Disability backlogs
cause a hardship for patients and their families. Commissioner Astrue and his staff deserve our
thanks for a job well done.”
“Unfortunately, many hardworking people with cancer may not only face intensive treatment to
save their lives, but they may also find themselves truly unable to perform their daily workrelated
activities and as result, may face serious financial concerns, such as the loss of income
and the cost of treatment,” said Daniel E. Smith, president of the American Cancer Society
Cancer Action Network. “The Social Security Administration’s Compassionate Allowances
program will help streamline the disability benefits application process so that benefits are
quickly provided to those who need them most.”
“This is America, and it simply is not acceptable for people to wait years for a final decision on a
disability claim,” Commissioner Astrue said. “I am committed to a process that is as fair and
speedy as possible. The launch of Compassionate Allowances is another step to ensuring
Americans with disabilities, especially those with certain cancers and rare diseases, get the
benefits they need quickly.”
###
A list of the first 50 impairments
even more on Shreddergate
“On October 22, 2008, the New York State Division of Veterans' Affairs held a Counselor Refresher Training Seminar at Stewart Air National Guard Base in Newburgh, NY. Early in the meeting a New York VARO representative, who gave his name as John B., said problems found by VAOIG were improper entry dates on documents and improper procedures. John B. stated 20,000 pieces of mail were not opened and paperwork files were not collated or properly attended to. Apparently, this had been going on for some time."
Source and full story at :http://www.vawatchdog.org/08/nf08/nfoct08/nf102708-1.htm
Larry Scott -VA Watchdog - said it all this morning:
"And, it's time for more VA employees to come forward with information to help the VBA and VAOIG, and the veterans they serve. Can one person make a difference? Remember, this entire shredder scandal story started with just one VA employee in Detroit who cared enough to do the right thing."
Doing the right thing is what will help resolve this problem.
VBA employees are actually posting on the comment section at Watchdog and other vets sites-anonymously-
while I applaud their willingness to confirm what we claimants have known for years-and of course who really knows if they are a RO employee or not-
the unsung hero of this whole story is a Detroit VARO employee who
had enough and was brave enough to come forward.
Jim Strickland -VA Watchdog -will be my guest at SVR on November 5th.
By then it will probably be worse-
I feel that any vet or widow with active denied claims whose evidence was Never
considered by the VA should send the VA (and the OIG too) a letter
demanding that in light of the recent news, they want their evidence
found and properly assessed for their claim.
Of course this isn't to replace a formal NOD (but you could throw this
into a formal NOD)
Vets and widows have never had this power before to demand that their
ignored evidence be properly assessed by the VA.
and they should write to
House Committee on Veterans Affairs October 25,2008
335 Cannon House Office Building
Washington, DC 20515
Subcommittee on Oversight and Investigations
335 Cannon House Office Building
Washington, D.. 20515
and
Department of Veterans
Affairs January 8, 2006
VA Office of Inspector General Hotline (53E)
P.O. Box 50410
Washington, D.C. 20091-0410
and tell these entities how the VARO must have lost, misplaced,or
destroyed your evidence-
because they did not consider it all and denied your claim -violating your basic rights for DTA.Duty to Assist and all other evidentiary regulations in 38 CFR, 38 USC and M21-1MR.
I am sending my letters in an hour.
Only if vets and widows step up to the plate on this -as well as more RO employees- and overwhelm
these entities above -will anything really be done-
And I am counting on more VA employees to have a conscience and step
up to the plate too.
Berta Simmons veterans claims advocate NY
-
When You Need Long Term Care, Don't Look to Medicare
When You Need Long Term Care, Don't Look to Medicare, Agency Warns
Social Security Statement, Unread by Many, Recommends Private Long Term Care Insurance
Last update: 6:30 a.m. EDT Oct. 27, 2008
KIRKLAND, Wash., Oct 27, 2008 /PRNewswire via COMTEX/ -- "Many Americans assume that Medicare will cover their long-term care expenses," says Cameron Truesdell, CEO of LTC Financial Partners LLC (LTCFP), one of the nation's largest and most experienced long term care insurance agencies. "But it just isn't so. The Government expects people to cover the expenses on their own -- out of pocket or through long term care insurance."
The Government's position is plainly stated in the Social Security Statement, available online and sent in print form to Social Security recipients. "But not everyone reads the fine print," Truesdell says. He recommends that everyone do so, at: http://www.socialsecurity.gov/mystatement/sample4.htm.
The section titled "About Social Security and Medicare" reads as follows:
Social Security pays retirement, disability, family and survivors
benefits. Medicare, a separate program run by the Centers for Medicare &
Medicaid Services, helps pay for inpatient hospital care, nursing care,
doctors' fees, drugs and other medical services and supplies to people age
65 and older, as well as to people who have been receiving Social Security
disability benefits for two years or more. Medicare does not pay for long
term care, so you may want to consider options for private insurance.
"Unless you're without means and qualify for Medicaid," Truesdell emphasizes, "the Government is just not prepared to help you when you need extended care for performing the tasks of daily living." He says it is vital, especially in recessionary times, "to do exactly what the Government says, look into private LTC insurance options."
Truesdell's organization offers help from over 550 independent long term care agents. "They're available by phone or in person to advise everyone on the best policies from leading insurance companies," he says. "They know which policy options fit specific needs; and they know which companies have the best track records."
A listing of LTCFP's agents, by state, is available at http://web.ltcfp.com/ltcfp/find-agent.aspx.
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Most veterans and especially disabled veterans do have access to long term care thru VA facilities and most states have veterans homes for this purpose to keep the veterans families from going broke while caring for a bed ridden veteran, or one needing hospice care.
U.S. insurers consider sending patients overseas for cheaper treatment
U.S. insurers consider sending patients overseas for cheaper treatment
By Corrie MacLaggan
AMERICAN-STATESMAN STAFF
Monday, October 27, 2008
CHENNAI, India — This is not how Jay Tronson pictured the hospital. In photos online — though maybe he was looking at pictures of the wrong hospital — he saw a modern glass structure sitting on a grassy hilltop, not this older building crammed into a busy neighborhood.
As he walks into the crowded, noisy lobby of Apollo Speciality Hospital, he tries to stay focused on the fact that he will be operated on by a well-regarded surgeon, that the reason he traveled here from Pearland, near Houston, is to end the pain in his hip.
"As long as the operating room is sterile and the doctors are competent, I don't really care" what the hospital looks like, he says, leaning on his cane.
In the lobby, a hospital staffer is waiting to whisk him up the elevator to the fourth floor, past a nurses' station and through double doors under a sign that says "Platinum Ward."
Suddenly, the slightly sour smell gives way to a sweeter aroma. Elevator music plays. There are leather couches and an aquarium. He walks into his hospital room, which includes a flat-screen TV and a laptop.
This is where the foreigners stay. He is pleasantly surprised — and relieved.
A recent report estimates that hundreds of thousands of Americans go abroad each year for medical procedures, primarily to save money.
They are not the only ones eyeing the bottom line. Some U.S. insurance companies — including Aetna and UnitedHealthcare — are considering paying for patients to go overseas for care, which could spark major growth in the medical travel industry. Wockhardt Hospitals officials said major insurers are requesting data that show how well the Indian company's hospitals treat patients, a sign that the insurers are investigating options in India.
"I don't know where this will stop," said Dr. Kushagra Katariya, a cardiothoracic surgeon and CEO of Artemis Health Institute in Gurgaon, near New Delhi.
Quests for care
Medical tourism isn't new. For decades, people from around the world have come to Houston, for example, in search of good doctors. Americans have long traveled within their country for specialized care — take U.S. Sen. Edward Kennedy, D-Mass., who went to North Carolina for surgery on a brain tumor.
And the American health care industry, like many businesses, is already outsourcing functions like reading X-rays to overseas providers.
Now, more and more Americans are traveling to countries like Singapore, Thailand and Costa Rica for medical procedures that are cheaper there than at home. Sometimes, they don't have insurance; sometimes, their insurance doesn't cover what they need.
"The American health care system has pushed itself into a corner where even the most routine care is not financially accessible for the average family," said Dr. Steven Tucker, an American oncologist in Singapore who is president of the International Medical Travel Association, a nonprofit group of health care providers and medical travel agents.
Estimates of the number of medical tourists vary widely and depend on how the term is defined. A new report by the Deloitte Center for Health Solutions, a research arm of the accounting firm Deloitte LLP,says that 750,000 Americans traveled abroad for medical care in 2007. Meanwhile, Josef Woodman, author of the consumer guide "Patients Beyond Borders," puts the 2007 number closer to 180,000.
The global consulting firm McKinsey & Co. released a study in May that said the trend is far smaller than commonly reported. It put the number of all medical travelers — not just Americans — at 60,000 to 85,000 per year. But that study, unlike the Deloitte one, used a definition of medical travel that does not include people who get outpatient procedures or go to neighboring countries for care.
A November 2007 report by the Dallas-based National Center for Policy Analysis, a research institute, said India "arguably has the lowest cost and highest quality of all medical tourism destinations, and English is widely spoken."
Almost everything that hospitals need is cheaper in India, including labor. Nurses earn $2 an hour "if they're lucky," Katariya said. They earn $1.60 an hour at Artemis.
In "Patients Beyond Borders," Woodman says that if the estimated out-of-pocket cost of treatment in the United States — including consultation, procedure and hospital stay — is $6,000 or more, "you'll probably save money traveling abroad for your care. If it's less than $6,000, you're better off having your treatment at home."
Traveling long distances for medical care isn't right for every patient or procedure, said Dr. Charles Cutler, who recently retired as medical director of Aetna's national accounts. For example, he said, you wouldn't want to put someone with significant heart disease on a long flight.
"You can come down to a fairly short list of things that make sense," Cutler said. Joint replacements would be on the list because they're a one-time procedure, he said, but treatment for chronic ailments would not.
'Willing to innovate'
Some people who have health insurance can already travel overseas for care as part of their health plan.
One example is Hannaford, a self-insured grocery chain in New England and New York whose health plan is administered by Aetna. This year, in what Aetna calls a pilot program, Hannaford started giving employees the option of going to National University Hospital in Singapore for knee and hip replacements. Hannaford will waive the co-payment, saving the employee $2,500 to $3,000. Hannaford will also pay for the plane ticket.
No one has gone to Singapore yet, and Hannaford spokesman Michael Norton said the company is hoping that the program will stimulate competition to reduce the price difference between U.S. hospitals and the Singapore hospital.
"We're willing to innovate to make it clear there is a barrier to employers in terms of getting the quality and the cost that they need," Norton said.
BlueCross BlueShield of South Carolina has a wholly owned subsidiary called Companion Global Healthcare Inc. that has a network of 10 hospitals in Costa Rica, India, Ireland, Singapore, Thailand and Turkey. Companion has been serving patients from self-insured employers — companies like Hannaford that fund their employee health plans — as well as people who have BlueCross BlueShield health insurance and need a procedure that is not covered because the condition was pre-existing.
Companion President David Boucher said that in the future, BlueCross BlueShield of South Carolina and other insurance companies will encourage employees of fully insured companies — those that pay health insurance companies to cover their employees — to go overseas by offering a reduced co-payment or deductible.
"I'm fairly bullish on where I think this is going," Boucher said. "I think we'll begin seeing actual changes in that benefit structure for BlueCross groups come January." He stressed that BlueCross wants to offer options, not force a patient to go overseas.
Last year, the Texas Legislature passed a bill that made it illegal for insurance companies to mandate that patients go overseas for care.
The bill's author, state Sen. Carlos Uresti, D-San Antonio, said that medical travel raises too many questions about continuity of care, liability, language barriers and what happens if a patient dies overseas.
"I'm sure it's a beautiful country," Uresti said of India. "But if I were to have to have surgery ... I wouldn't want to have to travel to a foreign country. I don't think it's fair to put our consumers in that position where they're required to go."
A dose of skepticism
Some insurance companies are also skeptical about medical tourism. Humana, for example, does not pay for treatments abroad, spokeswoman Anna Hobbs said. "We find that there's difficulty determining quality standards for physicians and hospitals abroad," she said.
Standards can vary widely from hospital to hospital. The Joint Commission International — an affiliate of the organization that inspects U.S. hospitals that receive Medicare dollars — checks everything from whether hospital workers wash their hands to how hospitals procure, secure and administer medication.
The Joint Commission International is so well-respected that some medical travel companies work only with hospitals that the organization has accredited — about 200 worldwide, including 10 in India.
American Medical Association President-elect Dr. James Rohack of Bryan said, "If I'm going to travel internationally and I get sick, I'm going to look for a Joint Commission-accredited hospital."
However, Paul Keckley, executive director of the Deloitte Center for Health Solutions and the author of a recent report on medical tourism, said Joint Commission accreditation isn't performed with "the same intensity" overseas as it is in the United States.
Dr. David Jaimovich, chief medical officer of the commission, disputed that, saying that quality standards for foreign hospitals are comparable to those in the U.S.
India churns out more than 40,000 new medical professionals each year, and many of the top graduates emigrate. More than 23,000 Indian doctors practice in the United States, according to the forthcoming "Patients Beyond Borders: India Edition."
"There is a huge group of Indian clinicians who have become very successful in the Western world," said Vishal Bali, CEO of Wockhardt Hospitals. "There is a familiarity which is already there" with Indian doctors.
Keckley said insurance companies might be more tempted by medical tourism than they're willing to admit.
"What will happen is the plans will tiptoe into this," Keckley said. "Plans are fearful of saying, 'We're going to invest some money.' The minute that's in the press, every local hospital, every local doctor says, 'Over my dead body.' "
Like Boucher, Keckley sees the trend growing exponentially — unless there's a "major blowup," he said. "The thing that could really derail this is if one person came back disfigured from a botched procedure somewhere and it got in the newspaper ... and health plans backed off."
Tronson's wife, Delia Williams-Tronson, says a botched procedure is exactly what she fears most for her husband.
In Tronson's hospital room, a staff member checks him in, and another takes him down the hall to be weighed. The scale reads 88, which sounds wrong until he realizes that it's in kilograms. He's confused when the nurses keep calling him "Jay Alfred," his first and middle names.
The next morning, he's wheeled out of the Platinum Ward and toward the operating room.
cmaclaggan@statesman.com; 445-3548
Medical cost comparison
Here are estimated prices for surgery, including hospital stay in a private room. Add about $5,000 for hotel and coach airfare for the patient and a companion. For example, a hip replacement in Thailand would cost about $18,000, which would be a savings of at least $15,000 compared to the estimated U.S. price.
Procedure U.S. India Thailand Singapore Malaysia South Korea Taiwan
Heart bypass $70,000 to $133,000 $7,000 $22,000 $16,300 $12,000 $31,750 $27,500
Heart valve replacement with bypass $75,000 to $140,000 $9,500 $25,000 $22,000 $13,400 $42,000 $30,000
Hip replacement $33,000 to $57,000 $10,200 $12,700 $12,000 $7,500 $10,600 $8,800
Knee replacement $30,000 to $53,000 $9,200 $11,500 $9,600 $12,000 $11,800 $10,000
Face-lift $10,500 to $16,000 $4,800 $5,000 $7,500 $6,400 $6,650 $8,500
Gastric bypass $35,000 to $52,000 $9,300 $13,000 $16,500 $12,700 $9,300 $10,200
Prostate surgery $10,000 to $16,000 $3,600 $4,400 $5,300 $4,600 $3,150 $2,750
Source: 'Patients Beyond Borders' by Josef Woodman
U.S. insurers consider sending patients overseas for cheaper treatment
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I know this is not veterans, but we all have family members that may be affected by this, there is something wrong when our medical system would even consider this, we supposedly have the best medical system in the world why would we as citizens allow this to happen?
New Veterans cemetery opening next to Fort Jackson
New Veterans cemetery opening next to Fort Jackson
Updated: Oct 26, 2008 05:29 PM EDT
New Veterans cemetery opening next to Fort Jackson
FORT JACKSON, SC (WIS) - There are nearly 3 million grave sites in military national cemeteries across the nation and on Sunday, Fort Jackson became part of that special group.
"Today we give witness to a promise made and a commitment kept," William Tuerk, the memorial affairs secretary, said.
That commitment is a new Veterans National Cemetery opening up next to Fort Jackson. Fifteen acres are now complete, but the goal is to expand to 585 acres.
Cuy Brooks served in the Marines in World War II. He's seen the dedication of veterans around him, and hates knowing the greatest generation vets are quickly disappearing.
"These veterans should be given preference because they gave a lot, some gave their life and that was it," Brooks said.
Fort Jackson became the nation's 125th National Veterans Cemetery -- a tradition of honoring America's finest that's been a long standing one.
"It was a promise that was made at the height of the Civil War by President Abraham Lincoln when he ordered that national resting places be established to honor as he said the soldiers who shall die in the service to the country," Tuerk said.
Reported by Brian DeRoy
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Well my wife and I now have a lace for eternal rest less than 15 minutes from our home, there is something special about being buried among other people that all have the same thing in common uniformed service to this great nation, with our spouses. It is a comforting feeling, my parents are buried in Riverside National cemetary, my step father served in Korea and WW2 and he is among his peers. It is a bueatiful and very scenic location there near March Field, now a National Guard Air Force base, it use to be home to B-52s during the Cold War and many of the nations nuclear arsenal, I also remember getting caught on the base many times when President Nixon use to land Air Force One there on his way to San Clemente.
