Health Care Happenings

For the last three years, we’ve had to fight mightily to stave off Pentagon proposals for huge increases in TRICARE fees that would have doubled or tripled costs for most retirees under age 65.

And for three years, Congress has supported us in barring those big increases.

That’s given many military retirees the impression that Congressional leaders think TRICARE fees shouldn’t rise. 

But that impression couldn’t be more wrong.

What they agree on is that it’s wrong for the Pentagon to keep fees flat for 10+ years and then propose doubling or tripling them in one fell swoop.

They also agree that Pentagon leaders were out of line in seeking those big increases without first pursuing other obvious ways to holding down defense health costs, such as encouraging more mail-order pharmacy use, implementing preventive care programs, and finding more economies of scale in interservice care delivery.

But they also believe that fees can’t stay flat forever, and that’s pretty hard to disagree with that.  There’s simply no way to argue effectively that if it’s reasonable to charge a person X dollars on the day he or she retires from service, then it’s wrong to charge that person even one dollar more 20 or 30 years later, even though his or her retired pay check will have doubled or tripled.

MOAA has never argued that fees should never rise.  We’ve said the DoD proposals to double or triple them all at once were wrong, and a breach of faith.

Our alternative is simple.  Start with congressional recognition that military retirees’ decades of service constitute a huge up-front, in-kind premium.  Acknowledge that military retirement (including health) benefits are the primary offset to the extraordinary demands and sacrifices inherent in a military career.

And put a statutory limit on annual fee increases so that key decision isn’t left to the whim of any new Secretary of Defense.  From MOAA’s standpoint, the right thing is to limit the percentage increase in TRICARE fees to the percentage increase in military retired pay.

For 2010, it doesn’t look like there will be a COLA, so there shouldn’t be any TRICARE fee increase, either.

Last year at the SILVERDOCS documentary film festival one of the films entitled Does Your Soul Have a Cold? caught my attention in part due to curiosity with the title and part conjecture about what it might entail. Come to find out it addressed the cultural stigmatism associated with mental health in an interesting way.

 
With men’s health month, the MHS Blog posts signs of depression highlighting studies showing that boys don’t cry, but are often depressed. While it may be true that men are often the last to seek help or self-identify with symptoms of depression,  these traits are not unique to the male population; rather, they readily cross age, gender, and cultural lines.

Given the current ops tempo and activations affecting our men and women in uniform along with the increased stress incurred by their spouse or significant other and family members as well as our retired servicemembers and their families, this topic bears repeated mention to ensure all are fully aware of how to seek help for self or others.

That being said, anonymous self-assessment screenings for Depression, Alcohol, PTSD, Bipolar Disorder, Generalized Anxiety Disorder, and the Parent Version of the Brief Screen for Adolescent Depression are available 24/7 online at www.militarymentalhealth.org. Additional anonymous self-assessments screenings are available for Depression or Alcohol by phone at 877-877-3647. Finally, these screenings are just that screenings and are not intended to take the place of a clinical evaluation.

Please pass the word.

I just read an article that talked about the upward spike of troops needing counseling for alcohol problems. It was sort of a dejavu moment for me as my mind raced back to earlier days in my career when the military launched an all-out campaign to eliminate alcohol and drug abuse.

Almost 30 years later and the military, yet again, must build up its substance abuse and counseling programs to target the one in eight combat troops returning from Iraq and Afghanistan as referenced in this article.

It’s great to see the defense department using tools like the post-deployment health assessments to identify troops in trouble. And, truly the services are working hard to find creative ways for members and their families to get the kind of counseling and support they need so as not to negatively impact careers.

What about the real consequences for those members who come clean? While the military appears to be there for our troops today, will it still be there for troops down the road when the war fades or money gets even tighter and people, medical and weapons programs get cut? Will those who sought help get the short end of the stick—all in the name of the “needs of the military?”

I sure hope not. Somehow though, scenarios like this have a tendency to repeat themselves in history.

How much choice do military beneficiaries really have when it comes to choosing a DoD health plan?  DoD advertises choice between TRICARE Prime, Standard, and Extra, but for many there is no real choice.

More and more military families are choosing to live outside a Prime Service Area (PSA) while their spouse is deployed.  Most guard and reserve families don’t move when their service member deploys and don’t live within a PSA.  For these folks Prime is not an option.  TRICARE Extra is normally not an option since the Managed Care Support Contractors (MCSC) are not required to establish a network outside the PSA.  TRICARE Standard is the only choice.

With the new TRICARE contracts to be awarded soon and TRICARE policy changes looming I have been concerned with the possible elimination of TRICARE Prime in many areas.  I am not sure if incentives in the upcoming TRICARE contracts are enough for MCSCs to establish networks outside the PSAs.  Only when the new TRICARE contracts are awarded will we see what the proposals are.

Nevertheless, beneficiaries deserve the added support and monetary savings that comes with using network providers.  DoD should require the MCSCs to establish networks wherever military beneficiaries reside.  By doing this at least beneficiaries will have a choice between using TRICARE Standard or Extra.  It would also fill a huge void that exists for those paying for TRICARE Reserve Select and those forced to use TRICARE Standard by providing support in finding providers. 

I realize that networks cost money to establish and maintain and without the benefit of data it is hard for me to quantify the actual costs to DoD.  But, I do know that if networks are established everywhere in the country the beneficiary gets the support that is needed and saves because of the lower copays that TRICARE Extra provides.

June is Men’s Health Month

This is a “listen up” to all the males out there. The Military Health System has rolled out a number of articles and links to help us mark June as Men’s Health Month, and the week of June 12th as Men’s Health Week (Father’s Day is coming up, after all). It does give us reason to pause and consider why men tend to skip checkups, ignore health warning signs to a greater degree than women and die at an earlier age than women. I’m well past the age when I might have felt invincible, so I pay attention by at least scheduling an annual physical. I’m enrolled in Tricare Prime and annual checkups are covered in Prime, but regardless the plan you’re in, by talking to your doctor you can probably get the screenings you need. I also get my two dental checks each year and exercise regularly. I try to watch my intake of things that aren’t good for me, but hey, a man doesn’t live by bread alone; there’s room for the occasional beer and brat!

So in observance of Father’s Day, whether you’re a Dad or not, take a minute to think about all the folks who care about you. Remember your spouse, your children, parents, siblings, or buddies, and check out some of the info that the Military Health system provides to keep us healthy. Visit: http://www.health.mil/Pages/Page.aspx?ID=44, follow the links, and have a healthy June.

It’s that time of year – College Graduation! While we celebrate the completion of four-years (or more) and the impending independence of our offspring, they may not yet have landed that job with benefits. So what are their options for health care coverage?

First, you can continue their TRICARE benefits under the Continued Health Care Benefit Program (CHCBP), a COBRA like benefit that mirrors TRICARE Standard to provide interim coverage for up to 36 months. This currently runs at a cost of $933/quarter for single coverage.

Next, you may want to pick up a Short Term Medical Plan (STM) primarily used for catastrophic coverage but it also can provide comprehensive temporary medical coverage. The above STM links to the MOAA’s endorsed plan.

And finally, you can purchase a health plan in their state of residence. For these you’ll want to do a comparison search of policies and benefits.

Congratulations!