Waiver Of University Of California Medical Insurance: Fill & Download for Free

Yes. There is a grass-roots organization providing letter templates, telling people which senators to call, and so on.:Vaccinate California SB 277 has a powerful roster of supporters, as of April 8 (I haven't updated the list since then):Vaccinate California (sponsor)American Academy of PediatricsAmerican Lung AssociationBiocomCalifornia Association of Nurse PractitionersCalifornia Chapter of the American College of Emergency PhysiciansCalifornia Children’s Hospital AssociationCalifornia Coverage and Health InitiativesCalifornia Immunization CoalitionCalifornia Medical AssociationCalifornia Optometric AssociationCalifornia School Nurses OrganizationCalifornia State Parent-Teacher AssociationChildren NowChildren’s Defense Fund CaliforniaChildren’s Specialty Care CoalitionCounty of Los AngelesCounty of Santa CruzHealth Officers Association of CaliforniaInsurance Commissioner Dave JonesKaiser PermanenteMarch of Dimes California ChapterProvidence Health and Services Southern CaliforniaSan Francisco Unified School DistrictSecular Coalition for CaliforniaSilicon Valley Leadership GroupSolano Beach School DistrictThe Children’s PartnershipHundreds of individualsBy contrast, here are the organizations (with my commentary) opposing SB277.[Health Committee Analysis] Association of American Physicians and Surgeons (AAPS)"The Association of American Physicians and Surgeons Inc. state that the need for informed consent is a firmly established principal of medical ethics and human rights and that the state has no right to force medical interventions on people without their consent"About AAPShttp://www.aapsonline.org/Rational Wiki:Association of American Physicians and SurgeonsThe Association of American Physicians and Surgeons is a small group of physicians who advocate for far-right conservative values in the practice of medicine. While purporting to have high regard for the Hippocratic Oath, "the sanctity of the patient-physician relationship, and the "practice of private medicine"[1], it appears to treat these concepts as terms of art. Despite also calling itself "non-partisan", its main focus appears to be opposing abortion, vaccination, universal health care coverage and Obamacare in particular, and birth control.---------------------[Health Committee Analysis] California Chiropractic Association"The California Chiropractic Association mentions that the Mayo Clinic warns against undermining the principle of informed consent in favor of universal vaccination and further states we ought not let a handful of measles cases at Disneyland turn into a full-scale assault on civil and human rights in America. "About CCAhttps://www.calchiro.org/Oppose SB 277 - Elimination of Vaccination Personal Belief Exemption"Stay with the framing of the issue provided. It’s about choice/informed consent. We are NOT anti-vaccine we are pro-informed consent and choice. Make the case that the data (provided in our talking points) demonstrates there are risks to taking the vaccine so there should be choice. "-------------------------[Health Committee Analysis] California Naturopathic Doctors Association (unless amended)"California Naturopathic Doctors Association (CNDA) states that it supports immunization for the prevention of disease and the public health objective of achieving high rates of immunity to infectious disease. CNDA states that as licensed primary care doctors who can diagnose medical conditions such as anaphylaxis and immunodeficiency, reasons outlined in the CDC’s list of contraindications to common pediatric vaccinations, naturopathic doctors must also be able to sign medical waivers for vaccination, when such medical conditions exist. CNDA opposes this bill unless it is amended to include NDs as providers who can sign medical waivers for vaccination."About CNDAhttp://www.calnd.org/[nothing on the website about SB277. Marty Block toured Bastyr University California in October 2014., and is the author of an expansion of practice bill for naturopaths.During the tours, students spoke about their education and their chosen profession. Says Adam Silberman, a third-year naturopathic medical student, “Being able to walk Senator Block and his staffer Roberto Alcantar through our clinic – explaining to them our philosophy of care and strong clinical training – brought me a strong sense of pride and excitement. How we are learning to work with patients will transform health care in California, and I think Senator Block and Congressman Hunter both saw that first-hand during their visits.”Lawmakers Tour Bastyr University CaliforniaMarty Block is the only sponsor for SB538, a bill that would greatly increase naturopaths' scope of practice.Bill StatusCuriously, there's nothing about the bill on his website.Senator Marty Block Legislative Update--------[Health Committee Analysis] California Nurses for Ethical StandardsAbout CNESBig issue is opposition to abortion and sex ed in schools.http://ethicalnurses.org/http://ethicalnurses.org/?p=2703SB277 seeks to remove the Personal Belief Exemption and mandate full vaccination of any pupil, from daycare through secondary school, public and private, in order to attend. Additionally, SB277 does not limit the ever-expanding vaccine schedule or the requirement of additional vaccines to attend school; in 2012 there were nearly 300 new vaccines in the pipeline. CNES strongly asserts principals of informed consent, personal belief, medical, religious, and philosophic exemptions, in accordance with the AMA and in the interest of maintaining ethical integrity in our public health laws. California Nurses For Ethical Standards oppose SB277.“If there is a risk then there should be a choice”[from hearing ] 1:30:03 California Nurses for Ethical Standards--------[Health Committee Analysis] California ProLife CouncilAbout California ProLife CouncilAction Alert!SB 277 – Mandated Childhood Vaccines Intrude on Parental Rights (Pan) – OPPOSEThis bill strives to eliminate the personal belief exemption option from the school immunization law forcing parents to vaccinate their children from all diseases deemed necessary by the Department of Public Health (DPH). Some immunizations use tissue from aborted babies.------------[Health Committee Analysis] California Right to Life Committee, Inc.http://www.calright2life.org/[nothing on webpage, most likely similar to California ProLife Council.]------------[Health Committee Analysis] Canary Party"The Canary Party maintains that the United States Justice System deems each and every vaccine on the market as “unavoidably unsafe”, which means that even when used as directed, someone will be harmed, or may even die from the vaccine. "About the Canary Party"The Canary Party is a tiny organization focused on promoting the idea that vaccines cause autism. They have branched out some with GMOs and “health freedom”, but their core seems to be the failed idea that vaccines cause autism. "More Canary Party financial documentsJennifer Larson, who is with the tiny “Canary Party”. Tax documents indicate that Ms. Larson is a large financial backer of the Canary Party. Searching for what donations Ms. Larson has made (using OpenSecrets.org, the Center for Responsive Politics) I found a total of $40,000 donations to Congressman Issa, his PAC and the Republican National Committee though Ms. Larson and her company Vibrant TechnologiesOne year and $40,000 later and another hearinghttp://www.canaryparty.org/[almost defunct organization; has been replaced by Barry Segal's Focus for Health, it appears. ]You Simply Have To Be Pro-Health - Focus for Health[from hearing ] 1:21:03 Canary Party------------[Health Committee Analysis] Capitol Resource Institute"The Capitol Resource Institute notes that following the passage of AB 2109 the personal belief exemption rate fell from 3.1 percent in 2013 to 2.5 percent in 2014 after only a partial implementation of the law, and that this bill is far reaching and unnecessary. "About the Capitol Resource Institutehttp://capitolresource.org/about-us/"CRI’s mission is to educate and strengthen families and we do that by working to influence public policy. It’s imperative that citizens join with us in staying up to speed on current legislation affecting family values! As your watchdog for family values here in Sacramento, CRI is committed to keeping you informed about important legislation. So, stay tuned!"Against LGBT issues being taught in school, against same-sex marriage, extremely Christian oriented.------------[Health Committee Analysis] Educate. Advocate."Educate. Advocate. writes that every medical intervention has both benefits and risks and that parents, not the State of California, have the right to decide which medical interventions their children receive"About Educate.Advocate."To assist and provide support to anyone with or connected to someone with special needs and/or disabilities at any age in the area surrounding mainly San Bernardino and Riverside county in California."Board members:Kristie Reneé Sepulveda-Burchit, Amy Carrillo, Marilyn Interian, Jerri Carpinteyro[many members believe their children are vaccine injured][from hearing ] 2:12:24 Educate Advocate------------[Health Committee Analysis] Families for Early Autism Treatment [FEAT]" Families for Early Autism Treatment contend that this bill is contrary to the rights protected by the State and Federal Constitutions as it denies rights to privacy, education, free assembly, religious expression, consensual use of one’s physical body and liberty. "About FEAT"FEAT is a non-profit, volunteer-driven organization of parents, family members, and treatment professionals dedicated to providing best outcome Education, Advocacy and Support for the Northern California Autism Community."[many members believe that vaccines caused their children's autism]------------[Health Committee Analysis] Homeschool Association of California"The Homeschool Association of California states this bill will negatively impact the freedom to homeschool and would make it impossible for many families to choose to homeschool legally. They argue that almost all homeschooling families use a legal option that involves attendance at some form of public or private school, either operated by a third party or operated by parents who file a private school affidavit, yet current law requires children admitted to private schools be fully vaccinated in accordance with existing law."AboutHSC[nothing on the website.][from hearing ] 1:25:40 Home School Association of California------------[Health Committee Analysis] National Vaccine Information Center"The National Vaccine Information Center argues that it’s particularly disturbing that physicians in the American Medical Association Code of Ethics affirm philosophical and religious exemptions for themselves yet want to remove this right for California parents."About NVICDespite its name, it is not a government body. It is a nonprofit whose mission is to create fear and doubt about the safety and efficacy of vaccines. The best introduction:NVIC? Know the Omissions------------[Health Committee Analysis] Pacific Justice Institute Center for Public Policy"The Pacific Justice Institute argues that statewide vaccination rates exceed the threshold for herd immunity and, to the extent that a few communities have fallen below vaccination levels needed for herd immunity, the Legislature could consider approaches that allow greater local decision-making and accountability rather than imposing across-the-board statewide mandates."About -- from Wikipedia.PJI provides pro bono representation in matters involving the exercise of religion and other civil liberties. It has supported the recitation of "under God" as part of the Pledge of Allegiance in public schools, homeschooling, and the enforcement of the Religious Land Use and Institutionalized Persons Act.In 2014, the Southern Poverty Law Center designated the Pacific Justice Institute as an anti-LGBT hate group.------------[Health Committee Analysis] ParentalRights.orgAbout"ParentalRights.Org's mission is to protect children by empowering parents through adoption of the Parental Rights Amendment to the U.S. Constitution and by preventing U.S. ratification of UN Conventions that threaten parental right:" It is primarily organized in opposition to the UN Convention On The Rights Of The Child, which has long been a dog-whistle element in the far right.------------[Health Committee Analysis] SafeMindsAboutSafeMinds is an acronym for Sensible Action For Ending Mercury Induced Neurological Disorders. It is a parent-advocacy group that originally advanced the belief that thimerosal in vaccines cause autism; it has since morphed into a general-purpose anti-vaccine, autism-hating organization. It used to have rather a lot of clout; the failure of the mercury-causing-autism hypothesis in the Omnibus Autism Hearing (OAR) seems to have made the organization much less relevant.SAFEMINDS board:Sallie Bernard (New Jersey)Lyn Redwood, RN, MSN (Georgia)Heidi Roger (New Jersey/New York)Laura Bono (North Carolina)Maria Dwyer (New York)Albert EnayatiStephen D. KetteScott LasterJackie Lombardo (Virginia)Cynthia Nevison (Colorado)Katie Weisman (New York)Katie Wright (Connecticut)------------Hundreds of individuals------[from hearing ] 1:16:25 Ruth Westerich (sp) claiming to speaking for a San Diego "group of over 500,000 healthcare practitioners"-------[from hearing ] 1:17:59 Wendy Silver; Million Mamas MovementPrimarily a peace movement but also no vaccines, evidently.Become a Million Mama - Million Mamas Movement-------[from hearing ] 1:18:35 Slow and No Vax Moms"extensive yahoo group in your area for parents. It's called slow and no vax moms. Look it up, and they should be able to help you."Yahoo! Groups"This group does not advocate any vaccine over another as they all have adverse effects. All discussion is from a "con" stance for each and every vaccine. This is not a place for debate of the vaccine issues. Discussing the "pro" viewpoint of any vaccine is not a part of this forum in any way."---------[from hearing ] 1:18:55 Campaign for Liberty, asks Senator Allen for a dateRon Paul's groupCampaign for Liberty - Reclaim the Republic. Restore the Constitution.---------[from hearing ]1:21:56 Laura Hayes; Mind Institute, FEAT, California Coalition for Health Choice, Canary PartyHayes of the founding families of MIND Institute; still fixated on vaccines cause autism. She's been published at the anti-vaccine, autism-hating blog Age of Autism.David Gorski, writing as Orac, has addressed her issues:No, no, no! Fifteen times, no!Tactics and tropes of the antivaccine movement (2014 edition)The annals of “I’m not antivaccine,” part 14: Vaccine “Trafficking” and beyond-----------[from hearing ]1:27:51 Our Kids, Our Choice(seems to be a subgroup of the other antis, focusing on producing Youtube Videos)-------[from hearing ] 1:30:30 Congressional Prayer Conference of Washington DC, spoke about the letter they sent to Senator Pan the day before and is very aggressive in tone. Laughter from oppo when he finishes------[from hearing ] 1:40:35 Dr. Bob Sears[anti-vaccine pediatrician]-------[from hearing ] 1:48:20 Environmental Voiceshttp://environmentalvoices.org/index.htmlRocklin-based anti-GMO, anti-toxins organization.--------[from hearing ] 2:00:03 National Autism Association of CAHelp and Hope for Families Affected by Autism[believes that vaccines cause some or most cases of autism. National organization with state chapters -- several in California]-----[from hearing] Dana Gorman, Thriiive.com and #b1less

If you have the opportunity to earn a master’s degree (MS or MEng) from an American university, you should do it. Obviously, the more prestigious schools are… well, more prestigious, but even a less-famous university can help. I’m faculty in the California State University system, and I can tell you that the CSU MS programs in computer science and software engineering are incredibly competitive (single-digit admissions in some) and very successful, due to the state tech economy.However, as Danielle Fraser points out, a degree will cost money. I think that Fraser’s estimate of costs is high; I’d say about $60,000 is more reasonable. Much depends on which school and how you choose to live. Many students take campus jobs, and they can be easy to find for computer science majors, but that will only offset a small portion of the total cost. A few MS CS programs will guarantee support (tuition waiver, medical insurance, and stipend) for top applicants, but really, top applicants only.If you choose this route, you will probably have three years of work eligibility on your F-1 visa, via OPT, followed by access to a special group of H1-B visas if you choose to stay. However, the path to permanent residency is long.Another option, if you are not from an excluded country, is the Diversity Visa Lottery. It’s free to enter, and you can enter each year and continue to enter while in the US. Here are the current excluded countries:Bangladesh, Brazil, Canada, China (including Hong Kong SAR), Colombia, Dominican Republic, El Salvador, Guatemala, Haiti, Honduras, India, Jamaica, Mexico, Nigeria, Pakistan,Philippines, South Korea, United Kingdom (except Northern Ireland) and its dependent territories, and Vietnam.

Yes, as an active duty military member during the period of this answer, I was covered by single-payer healthcare almost identical to the UK’s NHS system. The only real differences are that in the UK everyone is enrolled, but can opt out by paying private doctors, while in the active duty military system, only the active duty, retirees, and military dependents are enrolled. Also, active duty can't opt out: we're prohibited from procuring outside care due to military readiness concerns.In 2013, I had a tumor in my foot removed. When the fat pad didn’t grow back, I requested a fat graft to replace it, which is something done very frequently in plastic surgery centers (but usually so rich women can wear high heels more easily). Tricare denied me, so I appealed. The appeal took 1.5 years to maneuver the bureaucracy before I transferred across the country with it unapproved.Once I arrived on the other side of the country, I had to start all over. It took me 2 months to get an appointment at Langley with a podiatrist; he concurred with the request for a fat graft. The military medical system recaptured the request and made me see another podiatrist in Portsmouth, which took another month to get an appointment. He didn’t understand why I was sent there because Portsmouth isn’t experienced with fat grafts, and concurs that fat graft is the most conservative option. He requests a fat graft out in town, but Portsmouth Naval Hospital exercises their right of first refusal and makes me schedule an appointment with their Plastic Surgery clinic, which takes another month to get an appointment.When I see Portsmouth Naval Hospital Plastic Plastic Surgery, he also can't understand why I was sent there because Portsmouth Naval Hospital has zero experience with weight bearing fat grafts, but concurs that fat grafting is the most conservative option. He puts in a referral for a specific doctor who is experienced in weight bearing fat grafts. Tricare tries to refer me to Portsmouth Naval Hospital Podiatry again, but I fight back for a month and was able to make an evaluation appointment with the doctor (ironically, his only availability was on Veteran's Day, which is two months away from this time frame).Two months later I see the surgeon, who declares I’m a prime candidate for fat grafting, although the 2 years I’ve now had to wait has increased the risk of failure significantly.1 month later, Tricare marks the surgery request as received. Tricare refers me to Portsmouth Naval Hospital Podiatry for the surgery, and even to the specific doctor who told me he can’t do the surgery. Three days later, the surgery is denied as “not a covered procedure.”An O-5 in Portsmouth Plastic Surgery states via email that she "was told to instruct [me] to contact [my] congressman to help get this resolved. Please let us know if there is anything else you might need assistance with. Have a Happy Holiday Season." I call the supervisor of Patient Advocacy; he tells me that Tricare only approves procedures that have a large number of finished studies for that specific procedure addressing my specific condition, and that the DoD has given HealthNet sole authority to determine what is and is not covered. He wouldn't address my questions regarding what responsibility (if any?) Tricare bears in getting me healthy. He told me that filing for the Defense Health Agency waiver referred to in the letter was "worthless," as "in three years of being here, I've only seen it succeed once, and it was almost too late for the person who needed the lifesaving cancer treatment." He also told me that my only real recourse was to call my Congressional Representative(s).2 weeks later I’m able to get my PCM to write a referral to Walter Reed. Referral sits in limbo for 2 weeks. I also officially request a waiver for the fat graft procedure.At this point, it’s probably easier just to copy my journal notes into the answer so you can see what life is like for a someone in the military medical system:25Jan13 - Removed neuroma.22Mar13 - "mild erythema with continued fibrosis" - hydrocortisone injection.03May13 - "mild edema with acute tenderness to palpitation of the fibular sesamoid. We discussed possible capsulitis. Treatment today included a TPI with 5mg of Kenalog instilled into the symptomatic joint space." Dr. <redacted> discussed removal of the sesamoid bone; I requested a second opinion. Did not receive any response from Tricare on approving the request (even w/ significant followup from me) until 05Sep13.Sep13 - Went to see Dr. <redacted>, DPM, Oxnard, CA for second opinion. He recommended fat grafting into the area. I asked him to put in the referral request. Due to the poor communication skills of himself (limited English) and his staff (other reasons), I did not understand until 15Dec13 that he already knew that Tricare will not cover this treatment, and even if they did, there isn't a single plastic surgeon in Los Angeles or Ventura Counties that accepts Tricare.25Sep13 - MRI Right foot, Oxnard, CA: "ball of foot subcutaneous edema, consider changes related to altered weightbearing. A previously noted fluid signal structure about the first metatarsal is no longer evident."06Nov13 - I saw Mr. <redacted>, patient advocate at Port Hueneme Clinic. He was markedly unhelpful, essentially telling me to call Dr. <redacted> in Oxnard back.03Jan14 - Dr. <redacted>, PCM at Port Hueneme, CA specifically requests Tricare to "please authorize for surgical procedure to correct the loss of natural cushioning essential to prevent foot pain with walking or running."No action from Tricare, in spite of regular follow up, January through June of 2014.15Jun14 through 11Jul14 - Permanant Change of Station from California to VirginiaAug14 - I see Dr. <redacted> at in Hampton Roads who sends me to Langley Podiatry for consult.11Aug14 - I see Dr. <redacted> at Langley Podiatry. He takes an XRay and MRI. Xray information: Impression: 1. Bilateral pes planus. 2. Degenerative changes at the 1st metatarsophalangeal joint bilaterally. 3. Mild right hallux pelvis." MRI Information: "Findings: There is soft tissue distortion and blooming artifact at the base of the 1st MTP joint adjacent to the medial plantar sesamoid. This is most likely post surgical. The sesamoids themselves appear grossly unremarkable. Impressions: Postsurgical change at the plantar surface of the 1st MTP joint. Artifact is present here which limits visibility. No definite acute fracture or dislocation was seen. Edema in the 3rd interdigital space may be postsurgical. No soft tissue mass was identified." He tells me that there are two options - amputate sesamoid bone(s?) and hope for the best, or take the more conservative option and do a fat graft. He puts in a request for a fat graft out in town, but Portsmouth Naval Hospital exercises their right of first refusal and makes me schedule an appointment with their Podiatry clinic.03Sep14 - I see Portsmouth Naval Hospital Podiatry Dr. <redacted>, who can't understand why I was sent there at all, and concurs with Dr. <redacted from Langley> that fat graft is the most conservative option. He requests a fat graft out in town, but Portsmouth Naval Hospital exercises their right of first refusal and makes me schedule an appointment with their Plastic Surgery clinic. He does an Xray, which results in the following statements: "1. Mild hallux valgus deformity, 2. Small enthesophyte at the Achilles tendon insertion, 3. Flatfoot."25Sep14 - I see Portsmouth Naval Hospital Plastic Plastic Surgery Dr. <redacted>, who concurs with Dr. <redacted> and Dr. <redacted> from Langley and Portsmouth that a fat graft is the most conservative option, but can't understand why I was sent there at all since Portsmouth Naval Hospital has zero experience with weight bearing fat graft. He asks me what research I have done on my own. I tell him about Dr. <redacted> at the University of Pittsburgh Medical Center, who specializes in this treatment for foot injuries. He recognized the stature of both the Medical Center and Dr. <redacted> in this field once I mentioned the names and immediately requested a fat graft through UPMC. After fighting with Tricare over Portsmouth Naval Hospital exercising their right of first refusal again, I was able to make an appointment with Dr. <redacted> during his first available appointment - Veteran's Day 2014.11Nov14 - I fly to Pittsburgh and see Dr. <redacted> (a plastic surgeon) and his wife (a podiatrist). They tell me I am a perfect candidate for this procedure and put in a request for the fat grafting surgery.16Dec14 - After not hearing from Tricare I spend hours on the phone trying to get an update. They tell me they ignored the request (their words) because one number was missing in my identifier data from Pittsburgh. I provide the number and Tricare marks the surgery request as received. Portsmouth Naval Hospital exercises their right of first refusal again and an referral is automatically input for Portsmouth Podiatry. I call Tricare and after an hour on the phone got them to assess it internally.19Dec14 - Surgery denied by Tricare / Health Net. Reason given is "not a covered procedure." CDR <redacted> of Portsmouth Plastic Surgery stated that she "was told to instruct [me] to contact [my] congressman to help get this resolved. Please let us know if there is anything else you might need assistance with. Have a Happy Holiday Season." I call Mr. <redacted>, the supervisor of Patient Advocacy; he tells me that Tricare only approves procedures that have a large number of finished studies for that specific procedure addressing my specific condition, and that the DoD has given HealthNet sole authority to determine what is and is not covered. He wouldn't address my questions regarding what responsibility, if any, Tricare bears in getting me healthy. He was very forthcoming in advising me on filing for the Defense Health Agency waiver referred to in the letter: he said it was "worthless," since "in three years of being here, I've only seen it succeed once, and it was almost too late for the person who needed the lifesaving cancer treatment." Mr. <redacted>also told me that in his opinion, my only recourse is to call my Congressional Representative(s).22Dec14 - CDR <redacted>, Portsmouth Hospital Plastic Surgery: " I apologize for this inconvenience that you are going through. I called around and I was told that there should have been "appeal" instructions on the letter that you received. If not, I was told to instruct you to contact your congressman to help get this resolved. Please let us know if there is anything else you might need assistance with. Have a Happy Holiday Season."29Dec14 - My primary care manager, LT <redacted> writes referral to Walter Reed. Referral sits in limbo for 2 weeks. I also officially request a waiver through LT <redacted> for the fat graft procedure.15Jan15 - Portsmouth attempts to take the referral away from Walter Reed per right of first refusal. I spend an hour on the phone to get it reconsidered.22Jan15 - Podiatry clinic at Portsmouth approves transfer of referral to Walter Reed.26Jan15 - Walter Reed appointment line tells me that all National Capitol Region clinics are full until April and to call back on 30Jan15.30Jan15 - Walter Reed appointment offers appointment 37 days away . I ask about the 28 day Tricare standard of care for specialty appointments; the appointment desk tells me that if I want to inquire about the procedure for when the clinic cannot meet standards of care, I should leave a message with referral management and someone will call me back. I leave a message asking for a nurse to call me back so we can discuss a way forward to get my foot treated.04Feb15 - Nurse <redacted> at Walter Reed cancels my appointment without contacting me. The reason given in the notes was “Service member refuses available appointments.”06Feb15 - I call Walter Reed to check on the referral and am told the referral is canceled.09Feb15 - I speak to <redacted> in Patient Advocacy at Walter Reed who doesn't help until I tell her that I want to file an official complaint against Nurse <redacted>. She tells me that active duty never get appointments that meet the 28-day requirement and that I need to stop insisting on being seen within 28 days or I'll never be seen.11Feb15 - <redacted> calls me back and says my referral is reinstated, but I will have to wait until 13Feb15 to make an appointment.13Feb15 - First available appointment is 20Apr15. I make the appointment, and specifically ask whether they had the ability to perform fat grafts and/or Restylane injections, and the appointment line said someone would get back to me.02Mar15 - Mr. <redacted> at Portsmouth takes first official action on my waiver request of 29Dec14. He forwards it to the grievance coordinator, Ms. <redacted> and promises a phone call from her on 03Mar15.09Mar15 - No contact from Portsmouth. I call Mr. <redacted>, who promises Ms. <redacted> will call on 10Mar15.11Mar15 - Ms. <redacted> via email: "I wanted to follow-up with you regarding your request for the fat pad graft procedure and/or treatment. I have emailed both Dr <redacted> and Dr <redacted> requesting that they both chime in with my leadership so we can try and formulate a decision. I am waiting still and as soon as I have something to pass on, I will contact you."16Mar15 - Ms. <redacted> via email: "Your request is being discussed among leadership. Im waiting for confirmation on who will draft the request for waiver for DHA. As soon as I have a definitive decision to forward, rest assured I will."18Mar15 - Ms. <redacted> via email: "It is my understanding that the DHA waiver is being drafted by the Plastics clinic folks. Im standing by waiting further details."20Apr15 - Dr. <redacted> at Walter Reed walks in to my appointment and immediately states "I'm not sure why you're here. We don't do the kind of thing you're requesting here at Walter Reed." He couldn't answer me as to why Walter Reed accepted a referral for something they don't do and/or didn't call me to inform me that the appointment would be a waste of time. I mention to him that I requested information as to their ability to do the procedure and no one got back to me. He prescribed insole and recommended that I see a pain management specialist as well as a rheumatologist for my hip and knee pain <as of 2017 this still hasn’t been approved either>. I made an appointment with the PCM for Monday, 27Apr15 to get these referrals and discuss the way forward.I forwarded my concern to the Officer in Charge at <redacted> Clinic, LCDR <redacted>, about how I was referred to a clinic who can't do the procedure requested. His response was "My only suggestion is that you contact the Patient Relations Department for Walter Reed at (301) 295-0156 and voice your concerns."22Apr15 - Ms. <redacted> via email: "I am touching basis this morning with my Chain of Command as well as Health Benefits regarding the current referral concerns you are experiencing. Please allow me a little time this morning to reach out to a few of the folks here at Naval Medical Center Portsmouth regarding what is best needed at this juncture to better assist you."24Apr15 - Commanding Officer Portsmouth returns Waiver for more information. <redacted> at Patient Advocacy tells me he will keep me informed.29Apr15 - I discuss my situation with Maj. <redacted> at Walter Reed Podiatry, who states she will not authorize Walter Reed to assist me beyond providing orthotics.May15 - Dr. <redacted> at Walter Reed Podiatry convinces his chain of command to allow Ossatron and Stem Cell Therapy. I make the appointment for surgery.10Jun15 - Ossatron and Stem Cell Therapy surgery is conducted at Walter Reed. As of 15Jul16, this has not improved the situation.17Jul15 - I request an update on my Waiver Request from Mr. <redacted> at Portsmouth Patient Advocacy via email. No response. I request Physical Therapy through my doctor to address the continuing degeneration of my Hips and Knees due to the lack of treatment for my foot.31Jul15 - I request an update on my Waiver Request from Mr. <redacted> at Portsmouth Patient Advocacy via email. No response.17Jul15 - I request an update on my Waiver Request from Mr. <redacted> at Portsmouth Patient Advocacy via email. No response.03Aug15 - I request an update on my Waiver Request from Ms. <redacted> at Portsmouth Patient Advocacy via email. No response.17Aug15 - I request an update on my Waiver Request from Mr. <redacted> at Portsmouth Patient Advocacy via email. No response.19Aug15 - I request an update on my Waiver Request from Mr. <redacted> at Portsmouth Patient Advocacy via email. He emails me back and states, "this has gone up the chain to Navy Medicine East. Mr. <redacted> and Mrs. <redacted> are aware of you contacting me regarding this matter and Mr <redacted> is following up with NAVMEDEAST on the status. I will contact him again today and advise to contact you regarding this matter." No one contacts me.I never hear from Ms. <redacted> or Portsmouth Hospital Patient Advocacy again, even after repeated phone calls and leaving messages asking them to assist.25Aug15 - 14Sep15: Pool Physical Therapy at Fort Eustis. They have me "run" and jump in the water 2-3 times a week. It takes me up to 30 minutes to recover from the pain enough to drive after the therapy. I call it off after 6 weeks because I can't take the pain any more.11Sep15 - I request an update on my Waiver Request from Mr. <redacted> at Portsmouth Patient Advocacy via email. No response.24Sep15 - I call the Patient Advocacy desk and don't take "no" for an answer. I never am able to talk to anyone, but the front desk refers to CAPT <redacted> at Navy Medicine East. He tells me that the waiver has been sent back a few times for format errors and still has not left Portsmouth since I requested it in Dec14 and/or when it was drafted in Mar15.30Sep15 - I call Dr. <redacted> at Walter Reed and ask if there is anything to do since the stem cell treatment failed. He recommends another round of treatment.27Oct15 - CAPT <redacted> forwards waiver to BUMED. No response through the rest of 2015.15Jan16 - I contact Dr. <redacted> for another round of shockwave/stem cell therapy while I wait for fat grafting. He forwards the request to a Ms. <redacted> to set up the surgery.29Jan16 - No response from Ms. <redacted>. I call her and leave a message requesting for her to call me back to set up surgery.10Feb16 - I email CAPT <redacted> to request an update and find out he has retired. I spend most of the day trying to find out who has action. A LT <redacted> is able to find hard copy information and request an update the same day. No response.15Feb16 - No response from Ms. <redacted> on my stem cell surgery. I call her and leave another message requesting for her to call me back to set up surgery.15Mar16 - No response from Ms. <redacted> on my stem cell surgery. I call her and leave another message requesting for her to call me back to set up surgery.16Mar16 - Receive a response from BUMED contractor <redacted> who states that the waiver (initiated in 2014) was submitted to Defense Health in early March 2016. I inform her that I will be changing assignments in July and that I need surgery before then. I also identify a target date of the last week in June for surgery due to my PCS. She promised to update me by close of business on 17Mar16. The update never occurs.12Apr16 - I have not heard from <redacted> since 16Mar16. I request a response and update, and remind her of the target date of the last week in June for surgery due to my PCS. She says she is "still working on my case" and will update me on 15Apr16 by COB. The update never occurs.14Apr16 - LT <redacted> at Portsmouth transfers, turning over my case to LCDR <redacted>.13May16 - No updates from <redacted> or LCDR <redacted>. I email both. <redacted> leaves a message on my voicemail telling me she wants to talk to me, even though my voice message says I’m on leave.26May16 - I hear the email and respond to <redacted> via email asking if I can provide any information, and remind her of the target date of the last week in June for surgery due to my PCS. She says she doesn't need anything and is still working on my waiver, but provides no actual information.06Jun16 - I request an update from <redacted> via email, and remind her of the target date of the last week in June for surgery due to my PCS. No response.20Jun16 - I request an update from <redacted> via email, copying my boss, and remind her of the target date of the last week in June for surgery due to my PCS. Her response is "As discussed I have submitted all of your paperwork to the DHA for consideration of your waiver request. I will send you a status update this Friday (and every week on Friday as previously stated) via email."It is important to note that at this point, not only have I not received "every Friday" updates, but I have received no response at all to many emails, and no information beyond "still waiting" since March 2016.24Jun16 - At 4pm I ask <redacted> if I will get an update and ask when I should schedule travel and surgery. Her answer: "I inquired this week on the status of your case. As of today I have not received an approval/disapproval decision from the DHA. I have a meeting scheduled on Monday of next week to specifically discuss your waiver request. I hope to have an additional update for you on Monday following my meeting."Tuesday, 28Jun16 - <redacted> asks me for my Primary Care Manager's name with no explanation. I provide this information along with all of the Podiatrists and other doctors who have referred me for fat grafting. I also ask when I should schedule surgery, and remind her that I start MBA classes 08Jul16. I also tell her that due to the compressed MBA schedule, I have a single open week starting 08Aug16 that I'm available for surgery.****At this point I have now transferred again, away from a friendly unit who knows my community and my job and into a bureaucratic student unit****11Jul16 - No updates since June. Requested an update from <redacted> via email. No response.14Jul16 - Request update again from Ms. <redacted>.15Jul16 - Email from Ms. <redacted>: "Your PCM will need to request a referral for an evaluation and treatment (to Dr. <redacted> who does the surgery) and submit that to Health Net for approval/disapproval. Once we receive an approval/disapproval from Health Net we can move forward to:(1.) get the surgery scheduled and paid via Health Net or (2) resubmitting the SHCP waiver request to DHA (with the updated information from Health Net) to get the surgery scheduled and paid via the DHAAs discussed during our phone call, I will contact your PCM (Yorktown Clinic) and assist with the request for a referral. I will contact you on Monday if there are any additional updates. Please contact me if you have any questions."It is important to note that I received disapproval from Health Net on 19 December *2014*, and it is only due to the lack of action by Tricare that it has taken this long.18Jul16 - I go to Clinic <redacted> and can't find anyone who knows anything about my issue. They insist I make an appointment, which is backed up until early August. I ask Ms. <redacted> who she spoke to and she emails back that she can't remember but that she would get back to me by COB. LPN <redacted> at the clinic takes my information and promises to discuss with LCDR <redacted> (my PCM) and get back to me by COB. Neither update happens.19Jul16 - Ms. <redacted> emails that she remembers who she spoke to on 15Jul16: Ms. <redacted>, the health benefits coordinator, who evidently did not speak to my PCM team. Ms. <redacted> says that she will coordinate with my PCM team.20Jul16 - A different nurse from the PCM team at Yorktown calls and says that LCDR <redacted> is unwilling to put in the referral (see 15Jul16 above) without an appointment. She sets up an appointment for 22Jul16.22Jul16 - I arrive and LCDR <redacted> doesn't know very much about my case. I ask him what he needs to write a referral, and he tells me I will need to go to Portsmouth Podiatry for an assessment. I relay this information to Ms. <redacted>, who responds "Please allow me to do my job and work through the TRICARE Health Plan program requirements. I will follow up with you and provide you with an update by close of business today regarding referral."She later emails to me: "I spoke with Dr. <redacted> this morning after your visit and he is generating a referral for Dr. <redacted> for an evaluation and treatment. You cannot schedule an appointment until the referral has been approved and an authorization number has been issued. Once the referral authorization number has been issued the appointment with Dr. <redacted> can be scheduled. I will contact you today when I have a status update on the referral request. Please do not make any Podiatry appointments at this time."26Jul16 - I ask whether my unit will need to fund the travel and when I will know what my surgery date is, and Ms. <redacted> response is:"I did not state that any appointments or medical services would be funded due to the fact that an authorization had not been issued. I will be contacting Health Net Federal Services, TRICARE Regional Contractor for the North Region) to confirm if an authorization has been issued. If a referral authorization is issued then funding can be coordinated.**Once again please do not schedule any appointments or initiate any requests for funding at this time. I will provide you with an update no later than 1700 today."Ms. <redacted> then spends a lot of time trying to coordinate a phone conversation with her supervisor without responding to my requests for an actual date of surgery. At the end of the day, she tells me that she will try to coordinate a surgery consult in Pittsburgh for 06Aug16, and will be contacting me with an update by COB Wednesday, 27Jul16. No response until I email her on Friday.29Jul16 - I ask Ms. <redacted> what the status is since I didn't get an update on Wednesday as she had promised, and I need to know what's going on so that I can schedule travel. She emails me back the Tuesday email, implies that I'm being impatient, and says that she will update me by COB Monday, 01Aug16.—————————————————Cue 5 or more additional pages of similar non-effective medical treatment and you’ll understand why I cringe inside anytime I hear anyone say they want to “give the whole country access to the level of care the active duty have.”Edit in response to some questions:1) AHCA doesn’t apply to military Tricare, as it was not only exempted but Tricare is considered full coverage.2) One of the biggest misunderstandings about health insurance, not just in the US but worldwide, is that insurance = care. Charlie Gard’s parents are finding out that there isn’t an unlimited checkbook when it comes to medical care - even government care has limits.3) For military healthcare, only those treatments specifically listed in the care handbook are covered. These treatments have billing codes and rates assigned. Tricare isn’t really a medical treatment plan, it’s a reimbursement plan for those items in the book. If you have a problem that requires a treatment not in the book, there is no burden on Tricare to find a way to treat you, they simply shrug and say “it’s not in the book.” It’s on you to prove that the treatment you want has been studied and the studies must have been published in multiple medical journals. If that’s the case, and you can find them, you might be ok, but otherwise you’re SOL.4) Tricare only allows military doctors to address one problem at a time. Thus, when I go to the doctor to address my back, hips, and knees that have degenerated due to the way I walk after the foot tumor, they tell me I need to make separate appointments for each knee, each hip, and my back - there is no concept of holistic medicine in the military medical system, or at least not since I joined in the mid-90’s.5) I personally know at least 10 people who have been or are currently being medically discharged due to preventable permanent injuries sustained due to the many month wait times in the military. Many have ACL, MCL, Hip, Shoulder, and other injuries which could have been easily fixed but healed improperly while they waited. All of these people will be at least partially supported by the taxpayer for the rest of their life, but there is zero ability to hold anyone in the military accountable to improve the system.