Letters to the Editor

Positive outlook on Incoming
Health cover: take care
Going postal
Injured feelings over reservists' treatment
An alternative view

WRITE TO US

Positive outlook on Incoming

MY partner, an Army reservist, often brings home the Army newspaper to read and I usually like to have a look also.

In a recent issue he brought home, there was a copy of Incoming: the Soldiers' Magazine, which was the first issue I had seen.

I enjoyed it so much, I had to write to you. Excellent photographs, great stories, interesting book reviews, and a really enjoyable read overall. Many thanks for it.

I particularly enjoyed reading the article about the Brigade Advisory Detachment in East Timor, as I have just returned from two months voluntary work there, and actually visited Los Palos. That article brought back memories.

I also enjoy reading the Army newspaper each time see it, but had to compliment you all on the great job you have done with the April 2005 issue of the magazine.

Maggie McCafferty
Mulwala
NSW

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Health cover: take care

IT was interesting to read "Premium rise a health shock" (WO2 Krell and Capt McNamara, Letters, May 5) and the response from Defence Health, which unfortunately did not cover some of the bigger picture issues.

Your correspondents identify an often exasperating aspect of membership of private health funds that is not confined to members of Defence Health.

Premium rises in health insurance are strictly regulated because of their highly political nature. Taxpayers contribute to any rises in the form of the 30 per cent rebate. Therefore, rises must be approved by Canberra before they take effect, and are considered in light of funds' financial viability.

The decision to take out or retain private health insurance is one which all Australians make on their own economic grounds.

While it is true that young, fit people generally have a lower share of the expenditure of any insurer, when this group does claim, the claims are higher, because of the potential for more catastrophic events (such as trauma) leading to their hospitalisation.

What must also be considered is that Members with Dependents (who are not serving members) are still subject to the 1 per cent Medicare levy surcharge if their income exceeds certain thresholds. Considering this, as well as lifetime health cover (which penalises health fund members who join after their 30th birthday), many are choosing to retain their insurance despite its increasing cost.

In the December to March quarter, the overall consumer price index rose by 0.7 per cent, while the health contribution to this was a 4 per cent increase. Health is subject to increasing costs across the board as a result of government policy, medical indemnity and the rising price of medical consumables. Health care consumers are becoming more demanding, too.

In summary, private health insurance is a product in the health marketplace that is available to purchase. Just as we do when investing in a car, a new bike, pool table or a set of steak knives, we are bound to consider whether we are getting value for money. In the case of health insurance, it's little more complicated because of the carrot and stick incentives the government has introduced.

However, given the length of waiting lists in the overcrowded public system, Defence members, used to a very high level of care for themselves should consider that with insurance, their loved ones will receive care similar to what they get through the system.

Maj Isaac Seidl
SMO
1HSB

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Going postal

I NOTICED with mild amusement that the postal address of my Vietnam unit (the AATTV Association) at Vic Bks in Brisbane now has mail delivered via the MILPO at Enoggera, Qld 4051.

This is amazing as when I was young subaltern at Enoggera in 1966 all mail to Vic Bks, Brisbane, was delivered in a similiar fashion.

This meant the tying up of a RAASC driver and RAASC vehicle for two morning and two afternoon deliveries to Brisbane and other suburbs (DONR deliveries)!

In the 1980s Vic Bks had their own postal address while I was a staff officer there. Now we are back to the 1960s in 2005?

Ex-Maj Bernie McGurgan
Capalaba
Queensland

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Injured feelings over reservists' treatment

SOME time ago one of my soldiers was injured, requiring stitches to the head. He was presented to 2HSB while still on duty and was told to see his civilian doctor, as he was a reservist. After some heated discussions the duty doctor agreed to sew him up.

I believed that medical treatment was to be provided to reservists while they were on duty and that this incident was a misunderstanding. Not so.

Recently I attended 2HSB for an injury. This was at 10am on a training day. I was promptly told to see my civilian doctor as I am a reservist and not covered by the Army medical system.

I was given two Panadol and some Dencorub by the desk nurse and sent on my way. Although my thoughts regarding the situation cannot be printed, I reluctantly accepted the response as I was not conversant with Army directives and returned to duty.

As I waited for transport my frustration increased regarding the unfairness toward reservists as I watched the privileged being seen to by the duty physician. What would have happen if my injury compounded itself due to a failure to quickly diagnose? I have since researched directives and from what I have read, I believe I should have been treated by the system, until MCRS accepts liability and then takes over. Is this the case?

Subsequently I have sought civilian treatment from my GP, including X-rays and ongoing physio. I have paid these ongoing costs and I'm currently in the process of recovering them through MCRS.

Now it is a paper war. I am told that this process may take three months and that I have to run around in my civilian work time, to chase up all of my medical records, including entry records from 18 years ago.

What is further demeaning is that I also have to prove who I am and provide 100 point ID - birth certificate etc - as my military ID is not an acceptable form of ID for a service-related injury. What a joke.

If this is how, after 18 years' service, minor injury is treated, God help a soldier who experiences a greater medical need, especially if he or she is not financially secure or self-employed. Treatment that is individually sought is not automatically recoverable until liability by MCRS is accepted.

In which case: do I seek the best treatment and pay up front, or take the pain (maybe compound an injury) until liability is accepted, as I cannot afford treatment? Luckily I have the resources to look after myself, however others might not be so lucky.

The ADF can send medical teams all over the world at short notice, but when it comes to their own it appears we are second class. I believe that the system needs to be improved, or reservists need to seriously consider how an injury during reserve service could affect their civilian life.

Sgt Foreman
1 Fd Regt
Enogerra

Air-Cdre Tony Austin, DGDHS, replies:

Sgt Foreman raises significant concerns regarding the medical treatment of reservists. Health care should be provided to reserve ADF members in accordance with DI(G)PERS 16-1: Health care of ADF personnel.

DI(G) PERS 16-1 states that the Defence Health Service is required to provide the following health care for reserve members serving on other than CFTS: Reservists will receive health care for injury or illness resulting from their Defence service until the transfer of the member into the military compensation system, administered by the DVA, is completed.

Given the sensitive nature of health care issues, I would recommend the best course of action is for the member(s) to raise a health care complaint with the unit concerned, as outlined in Health Directive 914: Management of health care related complaints in the ADF.

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An alternative view

I WOULD like to know why Defence still does not refer personnel to alternative medicine practitioners, specifically chiropractors and osteopaths but also other practitioners like remedial massage and acupuncture.

All these practitioners are now highly regulated with national bodies and specific standards for registration so the number of cowboys is significantly reduced.

Defence can also conduct background checks on all contractors who it chooses, so they can avoid those practitioners with a poor reputation.

These services are almost all covered by Medicare and/or health insurance funds who would not use the services if they were a waste of money.

I would like to know the reasons why, be they medical or financial, that the decision to allow Defence personnel access to these types of treatments is still not possible except to pay full price for them ourselves or take out our own medical insurance.

Capt James Dugdell
AMM Branch, ASD
DMO

Gp-Capt James Ross, Director Health Projects, replies:

Alternative or complementary medicine remains a very contentious area. There are many different types of practitioners, with varying governance arrangements.

Defence Health Service is firmly founded on the principle of providing quality health care which is based on evidence of effectiveness.

That health insurance companies rebate certain activities is not evidence of effectiveness of the service. It is evidence that there is demand for the service, and the insurance company will attract clients if it offers rebates, rather than that Defence Health Service should be utilising them. There is very little evidence of effectiveness of alternative or complementary medicine.

The use of alternative medicine practitioners is covered by Health Directive 233.

This specifically refers to chiropractors, osteopaths, homoeopaths, naturopaths and non-medically qualified acupuncturists.

Referral is permitted when certain criteria are met: members will not be reimbursed if they self-refer; all referrals must be by a Defence uniformed or civilian medical practitioner; it is only to happen if the treatment is cost effective when compared to mainstream interventions and is deemed to be in the patient's best interests.

Any subsequent investigation ordered by the alternative practitioner must be approved by a Defence Medical Officer prior to being undertaken if it is to be paid for by Defence.

A member is at liberty to selfrefer at own expense; this is best done following discussion with a Defence Medical Officer.

All members need to be mindful of the potential impact on their medical employment classification from the effect of their condition, and from any impact of alternative therapies.

Defence Health Service continues to monitor the field and will consider liberalising the policy if the evidence supports it.

For now, this firm policy on the use of alternative medical practitioners remains, for the overall health of Defence members and for appropriate use of Defence resources.

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WRITE TO US

Soldiers wishing to air their views through letters to the editor have access to the newspaper without using the chain of command.

Letters will be edited for spelling and grammatical errors and newspaper style, and may be edited for space.

Preference is given to typed letters of fewer than 300 words. Letters will be rejected where they are too long, abusive, cover a subject that has been exhausted or can be answered by the author's unit.

They will be published only when they include the author's name, unit (where applicable), location and contact number.

Send letters to: The Editor, Army newspaper, R8-LG-037, Russell Offices, Canberra, ACT 2600; fax (02) 6265 6690 or email: armynews@defencenews.gov. au (note this is not an internal email address and therefore requires Sec: Unclassified in the subject line when sending from a DRN terminal)

The opinions expressed in letters to the editor do not represent the views of the editor or the Army.