Tag Archives: military healthcare

healthcare, Military, Trump

Some Trump supporters finally turned blue…

This morning, I read about how some folks in Omaha, Nebraska ended up having to visit a hospital after spending several hours stranded in below freezing weather. Why did this happen? Because they decided to attend a late night Trump rally at Omaha’s Eppley Airfield, a site served by a two-lane road. There were so many people there that the demand for shuttle buses was very high and people had to wait, apparently unprepared for prolonged exposure to the frigid temperatures.

According to The Guardian, there were thousands of people waiting for shuttle buses hours after Trump’s plane had already departed the area. Some people attempted to walk to the distant parking lots where their cars awaited, about two or three miles away from the rally site. Then, once they got to their cars, they were stuck in snarled traffic for hours. Many of the people who were at the rally were elderly people, and several of them were so badly affected by the cold that they needed urgent medical attention.

I imagine a scene much like the one Bill and I experienced after we saw Elton John in concert in Stuttgart in May 2019. He happened to be performing at the same time as the 2019 spring festival, so traffic was hellish. It took a couple of hours to make it the few kilometers to our hotel, but at least we weren’t freezing cold. I just remember really having to pee.

In a Washington Post article about Trump’s rally, Johnathan Sundat, a 19 year old attendee from South Dakota who had driven four hours to the rally with his girlfriend, posted a tweet demanding an explanation from the Trump campaign. Sundat is quoted:

“There’s this belief that Donald Trump is for the common people, and that’s part of the reason why he won in 2016. But the reason why I wanted to tweet it is because I do believe in part of his message; I believe in some of the things he said that night, and it was kind of disappointing that a campaign would treat you like that.”

Interestingly enough, when I tried to read Mr. Sundat’s tweet, it had been deleted. I kind of wonder if maybe he got some backlash for daring to question Trump after being quoted by a major newspaper. Other people also tweeted their dismay that they were literally left out in the cold by Trump just days before the election. Add in the fact that all of these people were gathering during the pandemic, and a lot of them weren’t following social distancing guidelines. According to The Washington Post, there were about 25,000 people at the rally. And although the campaign staffers took temperatures and provided face masks, many people didn’t bother to wear them. Instead, they all crowded on risers. When the event was over, some of the people who attended were still waiting for a bus back to the parking area 3.5 hours after Trump had left on Air Force One.

Frankly, I think this event nicely illustrates what Trump has done since 2016. He’s figuratively left a lot of people “out in the cold”. And I think Mr. Sundat was quite astute when he realized that Trump’s image of being a plain speaker like the “common folk” was not actually based in truth. I hope that means Mr. Sundat will reconsider voting for Trump next week, but somehow, I have my doubts that he’s learned from his own newly acquired insight. Indeed, in the article, Sundat was quoted as saying that his feet were a little numb, but he’d probably do it again:

“Like I said in my comment, it was pretty disheartening,” he said. He added that he didn’t blame Trump himself: “It’s probably not him scheduling the buses.”

No, it’s not him scheduling the buses, Johnathan, but it is his event and ultimately, it’s his image on the line. People hired on his behalf to set up this rally let down you and thousands of other people. He’s been doing that for years now. Haven’t you learned? And those people who needed medical assistance will be stuck with the bill, not Donald Trump. The buck should stop with Mr. Trump, but you want to give him a pass because he’s not scheduling the buses? Why didn’t he expect his people “scheduling the buses” to foresee this disaster and avoid it? Why isn’t he concerned about the people who came out in the cold to support him, at great personal and financial risk?

My husband spent thirty years in the Army. He’s often told me what the Army expects of its leaders. For example, in the early days of Bill’s career, he had a company command. That duty entailed leading enlisted Soldiers in training, rather than sitting behind a desk. Bill told me that in the Army, good leaders make sure their followers get their needs taken care of first. For example, after a full day of training, everybody’s tired and hungry. But as an officer in charge of a large group of young Soldiers, it was Bill’s duty to see that they all had a chance to eat and drink. That meant waiting until every last man or woman was served, and potentially not getting any food or being stuck with whatever was left. A good leader also never asks anyone to do anything that he or she is unwilling to do.

Trump literally left those people who came to support his re-election standing out in the cold. It’s the kind of thing he’s been doing for decades. Why his supporters can’t see that, I will never know. And now, some of those people had to visit a hospital, which is especially risky right now, thanks to the pandemic. And some of them will end up with hefty medical bills that they may not be able to pay– bills that they would have avoided if they had simply stayed home. And the longer Trump stays in office, the more emboldened and reckless he seems to get with other people’s lives and livelihoods.

Sadly, I think a lot of people just plain don’t understand what a good leader is and what should be expected of them. Just this morning, as I was waking up, I read an article in the Military Times about how medical personnel from the United States are being flown to the Czech Republic to help take care of people with COVID-19. The virus is overwhelming the medical system in the Czech Republic and there is a critical shortage of medical personnel and equipment there. Many of the people taking care of COVID-19 patients in countries like the Czech Republic and Poland are getting sick themselves, compounding the shortfall.

I read some of the comments on the Facebook page for the Army Times, which is where the article was posted. Many people, who had clearly not bothered to read the article before commenting, were opining about “socialized medicine” and how it’s “so bad”. First of all, anyone who has been in the military and received treatment from a military facility ought to know something about what socialized medicine is. Yes, we have it in the United States, although it’s only for a certain segment of the population. And secondly, socialized medicine has nothing to do with the spread of COVID-19. It’s a very contagious virus about which we still know very little. Even before the pandemic struck, there was a shortage of medical personnel in parts of Eastern Europe. One commenter had this to say:

You didn’t see the US having other countries come in to help with our surge….🤷‍♂️

However… quite a lot of healthcare providers in the United States come from other places, too. And some of them are undocumented immigrants who have been at risk of being deported, thanks to Trump’s draconian anti-immigrant policies. So… actually, YES, we in the United States do depend on people from other countries to take care of our healthcare needs, too. Moreover, I saw a lot of ignorant comments made by people who have either clearly never lived abroad, yet spouted propaganda about socialized medicine that doesn’t reflect reality, or are tragically misinformed about what the healthcare systems in other countries are like.

I got quite a kick out of a German woman’s comments to an ignorant poster who believes that Germany’s healthcare sucks because he thinks it’s government run. First of all, it’s obvious that this fellow hasn’t the foggiest notion about Germany’s healthcare or how the United States compares to other countries in terms of healthcare quality. Let me put it this way– despite the idea that “you get what you pay for” (which is literally what one uninformed guy wrote)– that ain’t necessarily so when it comes to healthcare delivery. According to a nice, America friendly, U.S. based layman’s source, US News & World Report, as of January 2020, the United States ranked 15th in the world for the most well developed public health system. Given our response to COVID-19, which dates after this article, I’m sure the U.S.’s reputation has slipped. Wanna know where Germany stands on that list? Number 5. Yep… the guy who wrote this:

you get what you pay for. Exactly why The US leads in medical innovation. 
I would be scared to live where health care is free and you wait months on end for a visit while you die. And the “authorities” decide if you “deserve “ treatment… Dear God that is horrid. The VA not much better… mostly treats symptoms and sends you on your way…

clearly has no idea of what he writes. Yes, we spend a lot more on healthcare, but that doesn’t mean our healthcare is the best. In fact, it surprises me that someone who clearly identifies as a political conservative would believe that “throwing money at healthcare” will make it better. Aren’t Republicans the ones who criticize Democrats for spending money to solve problems rather than taking a more restrained fiscal approach?

The German woman who took the above guy to task wrote this to two different commenters who think they know what German healthcare is like:

I am literally laughing. You served? Got some Tricare, eh? What do you think that is? Paid for by WHO? 
Dude, I am from Germany. I had universal healthcare all my life. You know how great it feels when you are REALLY sick and don’t have to worry about how to pay the medical bills, if your house gets foreclosed, or if you still have a job once you get better? 
No you don’t. Go sit down in the corner somewhere. 🤣🤦🏻‍♀️

Guess she’s married to an American serviceman or retiree. She added this comment later.

I am about to fall off my couch. Typically you get way better care at a german hospital. Why? They don’t kick you out 3 days after heart surgery, because ‘insurance won’t cover it’. 
Oh you don’t feel good? Well, too bad…later. 🤣🤣🤣
You get the 250,000$ bill in the mail. 😏

And then she added this for the guy who thinks the US system is better:

what makes you think healthcare is free? We all pay for it. We just are smart enough to understand that getting ill can happen to everybody. 
Who do you think, picks up the bill of american uninsured folk who, when they really can’t take it anymore, show up at an ER. WHO? 😏
Anyways, I understand pretty much everybody who has big opinions about other countries universal heathcare has NEVER experienced it and is clueless about how it works and what the actual benefits are. 😏
Btw ‘made in Germany’ still means something way better than ‘Made in the USA’. 
Where do you think, do 90% of all surgical instruments come from? 😎
You too, go and sit down somewhere.

She’s absolutely right, too. In fact, Bill has an American colleague whose wife was recently diagnosed with stage four colon cancer at Landstuhl, the American military hospital located about 90 minutes from where we live. You would think a diagnosis like that would inspire healthcare workers to want to get cracking on treatment. But no… she couldn’t get a timely follow up appointment from Landstuhl to address the cancer, so she ended up calling on the local system. The German doctors told her to get her ass to the hospital within a couple of hours because they were ready and willing to take care of her NOW. Moreover, the treatment costs less, although since Landstuhl is a military hospital, the cost factor would depend on a lot of things. I’m not sure if her husband is a retiree, for instance, and whether or not she would qualify for free “space available” care at Landstuhl as a family member.

I noticed the guy came back with a smart-assed answer to the German woman who took him to task. I could try to take him to school myself, but I’ve gotta go wash my hair. In any case, it’s clear that he doesn’t know what he’s writing about and has no clue about what constitutes “good” medical care. He would prefer the American system because that is what he knows, and he is convinced that paying a fortune for basic care is what makes medical care in the United States superior to that of what you can get in Europe. It’s a myopic viewpoint that costs people their lives and livelihoods. The fact is, the United States has comparatively poor outcomes, especially considering how much money is spent. Moreover, we have a lot of unhealthy people who can’t access care because they can’t afford it. What good is all that so-called “medical innovation” if you can’t access it? This, my friends, is a topic in my wheelhouse. If I weren’t an “overeducated housewife”, I might have been using my master’s degree in public health to research this stuff.

But anyway… I have already rambled on long enough. I’m glad it’s Friday. Bill will come home later to telework as we gear up for another partial lockdown. Meanwhile, I’m going to pursue making myself a better and more interesting person by practicing guitar. Ciao, y’all.

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healthcare, Military, rants

Repost: EFMP… There’s nothing “exceptional” about it.

I am rerunning this post that appeared on my original blog, back on March 10, 2013. I am no longer an “Army wife”, since Bill retired in 2014. However, we know the lifestyle and this post got tons of hits… plus, it came up last night as we were remembering how I was FORCED to join EFMP because I had taken antidepressants. And then, once we got to Germany after I had dutifully enrolled in EFMP, Bill got a shitty email from some uppity guy at Walter Reed Army Medical Center in Washington, DC, wanting to be “apprised” of my “condition”.

We were laughing about it, though, because unlike “Big Army”, the National Guard didn’t give a fuck about EFMP. They cut Bill’s orders for Germany before I ever visited the medical people in DC, so I probably could have skipped the whole thing and totally gotten away with it. Of course, that was in 2007, and things have probably changed.

Anyway… Bill was funny last night as we were remembering that time because he said, as we remembered the email, “No, you don’t. We’re already here. Fuck off.” He’s obviously benefiting from my “charms”, which have rubbed off on him. To clarify, no… that’s not what he actually said. Bill is very good at politely telling people to fuck off. He basically told the guy to leave us alone and they complied. But thirteen years later, he might say it. That makes me proud. So here’s the post from 2013. Maybe it will be interesting/helpful to someone while I wait for fresh inspiration.

Back in 2007, my husband was deployed to Iraq.  We were also planning to move to Germany.  Because Germany is not in the United States, I had to do some things to prepare for the move.  One of the things I had to do was get a physical.  I was really dreading having to do this for a lot of reasons.  First off, I’m not a big fan of going to the doctor’s office.  I especially hate going to military doctor’s offices.  It’s a pain in the ass to set up the appointment.  Military medical providers tend to talk to their patients as if they are either children or in the military, even if they are civilians.  I also had a very traumatic incident with a military provider in the 1990s that continues to haunt me today.

Anyway, I had to get this physical and then I had to be screened for the Exceptional Family Member Program, a supposed benefit for military families.  Basically, what EFMP does is allow a servicemember’s command to consider the medical and educational needs of a family member before moving their “sponsor”.  I have already ranted about the term “dependent” to describe spouses.  My husband is considered my sponsor.  How’s that for demeaning?

So I got a friend to help me set up my appointments.  I saw a physician’s assistant who turned out to be really kind and patient with me, especially after I told her about my first and last disastrous attempt to get a pap smear when I was 22 years old.  She thought I had high blood pressure, but it turned out my high readings were caused by white coat hypertension.  That was proven by 24 hour ambulatory blood pressure monitoring, which involved wearing a sphygmomanometer for 24 hours.  As soon as I stepped out of the military hospital, my blood pressure readings dropped to normal.

Finally, I arranged to be screened for the EFMP, which I had been told involved having a doctor look at my records and determining whether or not I had any conditions that warranted special consideration as to where my husband could be assigned.  From 1998 until 2004, I took antidepressants and went to therapy for depression and anxiety.  The worst of my issues were from 1998-99.  I chose to stay on antidepressants while I was in grad school mainly because I didn’t want to feel shitty while I was dealing with such a stressful time of my life.  At the time, I had no idea I would ever marry a military man.  I could have gotten off the antidepressants earlier than 2004.  I got off them because I dropped civilian health insurance and was hoping I might get pregnant.  I got off the drugs with no incident and didn’t even miss them, except they helped me keep my weight down.

What I didn’t know was that my time on antidepressants would come back to haunt me.  The EFMP required that I submit ALL of my medical records for the past five years.  Those records included my therapist’s notes about my depression, which were very personal.  I suppose in retrospect, I could have removed the records from before 2002.  I didn’t think to do that.  I showed up for the EFMP screening and was left sitting in the waiting room in the pediatrics department of the local military hospital while the doctor looked at my paperwork.  She finally came out and told me I needed to be in EFMP because I’d had depression and it might be risky to send me to Germany.  She listed the reasons she thought I was at risk.  I might have trouble adjusting to culture shock.  I might get depressed if my husband got deployed (even though he was already deployed when I met with this woman).  I might have problems with the fact that Germany isn’t as sunny as the USA is. 

Our conversation was laughable.  Here was this young doctor in a military uniform telling me that it was a good thing we were bound for Germany, since if we were going to Hawaii, I probably wouldn’t get to go.  She claimed there weren’t enough therapists in Hawaii.  I looked at her dumbfounded and said, “You know, I have an MSW.  The Army could hire me.”  Moreover, this move to Germany would be my third overseas.  I had already survived clinical depression while in Armenia.  I knew Germany would be a piece of cake for me.  But that didn’t matter… my thoughts about my own stability and personal desire to stay out of EFMP meant nothing.  It was fruitless to argue with the doctor, who was just covering her own ass.  She said I could try to disenroll in 2009 and maybe the EFMP would grant my request.

She then told me that if I didn’t comply, my husband could get kicked out of the Army.  And she said he wouldn’t get his orders if I didn’t do what she said.  Her face registered shock when I pulled out a set of orders, already listing me as having command sponsorship.  Apparently, the National Guard couldn’t care less whether or not I have depression.  She spluttered, “You’re not supposed to have those yet!”

It was truly ridiculous.  But because my husband was in Iraq and I didn’t want to cause issues, I complied with the demand that I join EFMP.  I filed the paperwork and we went to Germany.  Some months later, my husband got a nastygram from the very pushy EFMP coordinator in DC, demanding my status.  They needed to be “apprised of my condition”.  My husband sent him an email letting him know that I had no desire to be in the EFMP and didn’t need it.  We never heard another word about it and I got through my time in Germany without incident.

The military is pretty intolerant of head cases… even though if you read my articles about nutty Army folks, you know that the military is rife with them.  The official policy requires that servicemembers who are depressed seek help for their issues.  The unofficial policy is that if you or a family member see a therapist or take psychotropic drugs, your career will probably suffer.  You might lose your security clearance or be stuck in some shitty assignment indefinitely or get sent somewhere you’d rather not be.  I sought therapy for my depression and anxiety when I really needed to.  I’m glad I did it; it probably saved my life.  I had no way of knowing that making the very mature decision to seek help would end up in a ridiculous conversation with an intractable doctor who didn’t know me from Adam and was basing her medical opinions of me on three year old notes from other providers.

I understand why EFMP screening is mandatory for people going out of the country.  I just wish the process involved more subjectivity and people using common sense.  I wish that competent adults were treated more like stakeholders in their own healthcare and given more of a partnership in the process, rather than given the bullshit line about how the screening is for their own good.  The screening is about covering asses, saving money, and controlling people.  Moreover, you can get around the EFMP.  A lot depends on who you are and who you know.  I personally know someone who had her paperwork changed so the EFMP restrictions would be lifted and she could take her kids to Germany.  In her case, it worked out fine.  I know of other people who were not allowed to go abroad because of EFMP and they could not get their EFMP status changed. 

I don’t mean to say that EFMP is not a valuable program for those who need it.  There are families who have kids with special needs that need that special consideration.  It’s not good to go to a new duty station and find there are no suitable facilities to handle someone’s medical or educational issues.  That tends to lead to the family having to be sent elsewhere, which costs a lot of taxpayer money and causes lost productivity.  It’s also a pain in the ass for the family. 

However, the EFMP requirement is not good when it’s forced on a family, particularly when the “exceptional member” is a competent adult.  People know that EFMP can cause plum assignments to get cancelled.  Supposedly, this is not true… the military will tell people that EFMP won’t mess up a person’s career.  But in reality, being limited in where you can go can mess up your (or your sponsor’s) career.  Because of that, some people won’t get help for depression if they need it.  I mean, it’s hard enough to get help for depression because there’s so much stigma.  If it might also mean you can’t go to Germany with your husband, you might also hold off on calling for help.  And that can lead to tragic consequences.

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