Health Care Happenings

We met with the staff of Sen. Max Baucus (D-MT) last week to discuss the potential impact of national health care reform on military and VA beneficiaries. 

We were advised in no uncertain terms that Sen Baucus’s Finance Committee has no intention of having the national health care reform initiative affect military or VA health coverage in any way, and no intention of taxing military or VA health care benefits.

The draft bill just publicized in the House of Representatives also provides similar exclusions for DOD and VA care.

Summer’s here in full swing, though it has been a little milder here in the Washington, D.C. area than in other parts of the country.

This past weekend I read a comment in an article of a local homeless publication that surprised me. It said that “warmth doesn’t hurt as badly as the cold does so you forget to think about it as an issue.”

Wow—so simple and so true!

Heat does have a way of sneaking up on you, especially in the “dog days of summer.”

What’s that saying?  “You put a frog into a pot of boiling water, it will leap out right away and escape danger. But, if you put a frog in a kettle that is filled with water that is cool and pleasant, and then you gradually heat the kettle until it starts boiling, the frog will not become aware of the threat until it is too late. The frog’s survival instincts are geared towards detecting sudden changes.”

Heat can be especially dangerous for the very young and for those over the age of 65 because our bodies either aren’t use to severe changes in temperature or our bodies don’t adjust as quickly to temperature changes as when we were younger.

Those who take certain kinds of medications or have chronic medical conditions also may be vulnerable to severe heat.

So have a wonderful summer but just keep an eye out for those around you who may be experiencing heat-related illnesses and get them out of the heat.

All of us should remember to:
• stay hydrated,
• dress for the weather,
• not over exert yourself, and
• spend at least 2-hours in an air conditioned room

Oh, and don’t forget to wear sunscreen and stay out of kettles of water! 

Some of you read in your morning papers that the Department of Defense (DoD) announced today the selection of new TRICARE Managed Care Support (MCS) contractors for the North, South and West TRICARE regions in the United States. Most of what’s posted below is lifted from the Tricare Management Activity (TMA) press release about the contractor selections.

The selected contractors in both North and South Regions are new. Aetna Government Health Plans, Hartford, Conn., is selected for the North Region where Health Net Federal Services is the current contractor. UnitedHealth Military & Veterans Services, Minnetonka, Minn., is selected for the South Region where Humana Military Healthcare Services is the current contractor. The TRICARE West region retains its current contractor, TriWest Healthcare Alliance Corp.

States included in each region and other contract information can be found at a special Web page at http://www.tricare.mil/T3contracts.

This is the third generation (T-3) of TRICARE managed care support contracts. They are worth an estimated $55.5 billion over the base and five options periods. Transition from the current contracts is scheduled to begin immediately, with the start of health care delivery under the new contracts anticipated to be April 1, 2010. The transition will occur during the base period and health care delivery will begin with the first option.

TRICARE Management Activity (TMA) is the Defense Department activity that administers the health care plan for 9.4 million members of the uniformed services, retirees and their families worldwide. MCS contractors provide health, medical and administrative support services to eligible beneficiaries in each of the three TRICARE regions within the United States.

Although two new contractors have been selected, the three-region structure in the United States and all of the TRICARE benefit options offered under the current contracts remain the same.

The T-3 contracts feature financial incentives to encourage exceptional customer service; high quality care; detection of fraud, waste, and abuse; increased electronic claims processing; better program management, improved preventive care and cost savings. To apply these incentives fairly, TRICARE has improved methods to measure and assess network provider, beneficiary, and military treatment facility commander satisfaction.

As with the current contracts, the new contracts require prime service areas around Military Treatment Facilities and Base Realignment and Closure (BRAC) sites. Under T-3, some prime service areas may be discontinued, and as a result some beneficiaries will no longer be offered Prime. These beneficiaries still retain TRICARE coverage under the Standard or Extra plan. TRICARE Standard is the most flexible of the TRICARE options and is available everywhere. TRICARE Extra is a discount given to TRICARE Standard beneficiaries when they use a TRICARE network provider. Officials remind beneficiaries that both TRICARE Prime and Standard are excellent options with high satisfaction rates.

The Managed Care Support contractors who served our members over the past five plus years did a fine job by most accounts, and there is every reason to expect that the new MCS comntractors will also. MOAA reps will work with TMA, and the existing and new contractors as the transition gets underway. We will continue to post information and developments on our web site and blogs, and our magazine and electronic newsletters as details become known.

Ever wondered how environmental contaminants in the community affect your health or that of your family?

Now you can find this information online by using the Environmental Public Health Tracking Network.

This network, developed by the Centers for Disease Control and Prevention (CDC), provides health and environmental data in one easy to find location that allows scientists, health professionals, and members of the public to track environmental exposure and some non-infectious health conditions.

Some of the ways it seeks to help prevent chronic illnesses, such as asthma, heart disease, lead poisoning and cancer are by educating people on the health risks possible from contaminants such as air pollution and the relationship to asthma, along with lead in drinking water and how it’s related to premature birth.

For the first time the Tracking Network connects a body of environmental and health information from multiple states and national sources that serves as a launching pad for further research.

Furthermore, this allows scientists and the public to better understand connections between environmental exposure and chronic health conditions.

For more information visit the CDC’s Tracking Network.

As of July 7, MOAA members have generated 32,000 messages to Congress urging their legislators to ensure that any national health care reform initiative will protect TRICARE and VA care — and their tax-exempt status for eligible beneficiaries.

And all those messages have been getting attention on the Hill.

We’ve received an invitation from the staff of Sen. Max Baucus (D-MT), Chairman of the Senate Finance Committee (which will have a major input on the issue) to come to the Hill to discuss the issue later this week.

We’ve had a good relationship with the Baucus staff after working with them last year to win legislation preventing a major cut in Medicare and TRICARE payments to doctors.

There are multiple cooks working on this soup in both the House and the Senate, so assurances we might receive from any one of them can’t be taken as binding.

But it’s certainly helpful to get the invitation and get a personal hearing on our concerns.

It’s certainly a sign of the times that the Centers for Disease Control (CDC) announced yesterday that it will convene a forum to discuss what can be done about our nation’s growing weight problem. The forum, entitled Weight of the Nation, will be held on July 27-29, 2009 in Washington, DC. The primary audience includes elected and appointed public policy makers; federal, state and local public health leaders; as well as partners and researchers engaged in policy-related obesity prevention and control initiatives. The announcement didn’t mention whether or not donuts would be provided.

In case you missed the news last week, the media report about obesity in America was sobering. While obesity rates varied among the fifty states , no state in the nation recorded a decline in overweight or obesity rates in its population over the past year. Many states recorded significant increases.

It’s not just adults either; some 40% of children in America are overweight or obese. The likelihood that overweight or obese children will become overweight or obese adults are seven in ten.

While discussing health care a few weeks ago, the President of the United States said that the epidemic of obesity in America is almost entirely preventable. It certainly wasn’t always this way. I watched a World War II newsreel on the History Channel the other day, and I was struck by how slim the fighting force was. The general population was about the same. Have you been to Disney World, or on a cruise ship, recently? We are bigger people today, and not in a good way.

The weight issue affects national readiness too. Excessive weight is one of the most common disqualifiers for military service, and can significantly reduce the pool of recruitment-eligible candidates among our nation’s youth. Some motivated recruiters help prospects overcome their weight issues to eventually become eligible for military service. However, as many of us know, weight control can be a lifelong struggle, whether in the fighting force or later in civilian life.

The reasons for our American weight epidemic are well understood: obesity and overweight are diseases of prosperity; food is plentiful and relatively inexpensive; and our environment no longer demands the same level of human energy output as was required in the past. Today, for some in America, the energy equation is out of balance – our “Energy Intake” is greater than our “Energy Output”. The Weight of the Nation forum probably won’t reveal to us a lot that we don’t already know. (See CDC web site at http://www.cdc.gov/obesity/index.html).  Still, I predict that the forum’s findings will present a grim picture of America’s out-of-shape society.

Unless our society can get a handle on this growing problem, there will be great drag on the U.S. health care and economic systems from the costs of treating the diseases (hypertension and diabetes to name two) linked to our unhealthy weight. That’s something to think about as we contemplate the challenges facing our health care system. Simply stated, this weighty issue begins and ends with us.