Observations on The Military’s Health System
Feb 18 2010
Recently, I had the opportunity to attend the annual Military Health System (MHS) Conference held here in Washington DC. This occurred only a few days before the “Blizzard of 2010″, and as I have reflected on what I saw and heard there, I wanted to offer some observations from that excellent and informative conference.
As I listened to some of the plenary speakers, which were principally the service Surgeon Generals, senior Health Affairs officials, and guests such as the Chairman of the Joint Chiefs of Staff and other healthcare industry notables, I was struck with the sheer vastness, mission complexitiy, and the actual impact that the MHS is charged with performing. For contextual purposes, it is worthy to note a few statistics of this system which is composed of over 9.5 million beneficiaries.
Consider that in one week the following occurs:
- There are 21,800 hospital admissions and 1.6 million outpatient visits
- There are 25,800 behavorial health outpatient visits
- 2.48 million prescriptions filled
- and 2,380 babies are birthed
Not to mention that simultaneously the deployed medical staff support our wounded servicemembers in theatre resulting in a 54% return to duty within 72 hours and the lowest disease and nonbattle injury rates ever reported. This, along with a battlefield survival rate that now stands at 97% which is the highest in history. I could not imagine any other “health system” responsible for and able to, achieve so much. How does it remain focused to achieve these complex objectives which seem to be at odds with each other?
We learned that in order to get an arm around all of the vast array of needs in the military medical community and to remain on target, TRICARE and the MHS have adopted the concept of the “Quadruple Aim”. This is an adaptation to a frequently discussed phrase in the healthcare community known as the “Triple Aim”. It is an idea that refers to the three integral factors that determine the overall quality of healthcare: population health, positive patient experience, and per capita cost. The MHS has taken this paradigm and added a necessary fourth determinant – readiness. Thus, to remain “on target” it is imperative that the MHS achieve objectives within these four foundational goals.
During the course of the Conference we had ample opportunities to hear how these goals were being achieved. For instance, it is well known that readiness has steadily grown in the total force for four consecutive quarters. There was initially a great deal of concern beginning in 2007, with an increase in mental health diagnoses. The MHS responded with a 20% surge in mental health providers, the establishment of behavioral health locator lines and tele-health initiatives also added capacity.
The MHS is making significant progress in the preventative health realm. The Enrollee Preventive Health Quality Index which tracks population health shows that MHS health outcomes have been on a steady rise since 2007. Notable areas where the military is ahead of target are in colo-rectal and breast cancer screenings, as well as a reduction in smoking.
There were perspectives offered on the many medical advances that have made a difference both on the battlefield and off. Since 2001, there has been remarkable progress in prosthetics, implants, hand and limb transplantation, skin therapies and in many other areas of regenerative medicine. Other advancements have been made in bandages to stop bleeding, drugs to treat or prevent chronic pain, robotic support for tele-surgery, cranial reconstructions, and the detection and treatment of traumatic stress and traumatic brain injuries. The majority of these advances have improved the lives of service men and women and ultimately can be translated to all Americans.
After attending this for a week, I came away gratified that the MHS, with all of its moving parts, people and missions, can continue to evolve and meet the healthcare needs of the active force, their families, and retirees – day in and day out. No easy feat.
One Response to “Observations on The Military’s Health System”
Dear Captain Beasley–the following is making the rounds again on the internet. I apologize for the length of it. I believe this thing came around once before. It is put out by folks who don’t like the present administration and will do anything to create trouble.
Would you or Steve Strobridge please clarify this and put it out to the membership?
Sincerely,
George S. Harris
CAPT MSC USN (Ret)
Life Member
Subject: FW: MILITARY RETIREES AND OBAMA CARE
Date: Monday, March 1, 2010, 12:14 PM
Have you all seen this?
This is our 1st look at the bill. Finally, Tri-Care for Life Info.
PASS THIS TO ALL MILITARY RETIREES
Please pass on to all your military retired friends so they can be educated on how the “health care reform” will change our tricare benefits. Read article at very bottom of e-mail string for more information. v/r This is true. It is on pages 77, 172, 218, and 434. You have to dig to see the charges.
We (retirees) would lose the Medicare for life benefit and would have to pay. We would lose TRICARE as a total care package. We would not be allowed to keep TRICARE so when Obama stands and says if you like what you have you can keep it, he lies. This is a “Heads Up” on a battle we are facing now and
down the road with the new Administration.
The Congressional Budget Office (CBO) has already drafted proposed legislation that would basically reduce our TRICARE for Life benefits to a system whereby we pay deductibles and co-pays up to $6,301 the first year for you and your spouse, with future years being indexed to increase with inflation. What can we do? The article below, obtained from an Air Force
Association and written by BG Bob Clements, best describes what we can do.
Please read it and check the links for CBO language and do what Bob says-Send this email to every Military Retiree you know and write and email your Congressman often. For those of you that might have voted for “Change”, you should do it more than often!
TRICARE FOR LIFE’S FUTURE…. TRICARE For Life was instituted to correct the broken promise that military retirees would receive free healthcare coverage for life and it covers the Medicare co-pay.
Now a heavy assault has begun on Veterans’/Retirees’ benefits to pay for other programs our President promised during the campaign. And it is a high priority of his administration.
The one item of most interest to Retired Military is in Article 189. If approved by Congress the first assault wave would hit in 2011 and would hit hard. It would initiate cost sharing to require retirees to pay the first $525 of medical cost and 50% of the next $4,725 for a first year cost of $2,888 per person. It would be indexed to increase with inflation. A reason given for this action (for PR effect) is “overuse” by Retirees. For those of
you who are covered by TFL you will want to pay attention (Below) to what BG Bob Clements has surfaced about the future of TFL.
In any case, on page 189 of the Congressional Budget Office report, see the note below on how to get to that spot, there is a strong recommendation to eventually eliminate the program as it is too expensive. Just another move to slight those of us who dedicated much of our adult lives to the defense of our country.
Strongly recommend that you contact your elected officials and register your strong opposition to the elimination of the TFL program.
Heads-up from BG Bob Clements,USAF Ret (P38 Bob).
The following has been added to the Congressional Budget Office Web Site
* http://www.cbo.gov/ ,
* a. Budget, Options, Volume 1: Health Care *
*
http://www.cbo.gov/doc.cfm?index=9925
For those who have never opened one of these web sites from OMB: *
* 1) double click on the above URL *
* 2) click on PDF *
* 3) click on the binoculars (in left shaded sidebar)*
* 4) do a search for TFL .
and do nothing about it as they bring these options forward this coming year, you will lose one of the best healthcare benefits that the Medicare eligible retired military have..It is short of the promises made that we fought so hard for back in the late 90s and early 2000s but it is still the best healthcare program that anyone in the United States has, bar none.
People who are professionals always look for the channel of least resistance when it comes to cutting money out of the Federal and DOD budget. I can tell you this straight on, military retirees are one of those channels of least resistance noted for sitting around, doing nothing, and waiting for ole Joe to do it for them.
You had better wake up. Your medical benefits are prime target. If you lose them, you have nobody to blame but yourself. Let me repeat that … you have nobody to blame but yourself. The way to secure your benefits is to write to
your members of Congress and to keep writing and writing and writing. ONCE IS NOT ENOUGH!! Keep repeating the above statement until you are blue in the face.
Now I’m going to make one more statement to all of you younger people out there who are not yet eligible for TRICARE for Life. HEALTH CARE WILL EVENTUALLY BECOME THE DOMINATING FACTOR IN YOUR LIFE. remember that . . . . it will impact you big time with the utmost in cruelty unless you are
fortunte enough to die from a heart attack or get run over by a truck. The service organizations will put up a fight, but, they will need your help and can’t do it by themselves.
I hope this makes it clear as to what you can expect if you do nothing. To how you how stupid these professionals can be at times just read the data on the noted sites closely. You will see that in spite of the MTFs (Military Treatment Facility) need to get patients back to keep their doctors busy and the hospitals from going to clinic status, these people from OMB would employ a means to keep retirees from using MTF facilities by charging them a fee for services. How dumb can you get.
Even if you are an Obama fan, and believe that changeth cometh, TFL option from OMB will not go away. They need the money they spend on you for other programs for people who produce nothing but votes to keep their boss in
office.
If you know of anyone who is Retired Military, Please forward this on to them. Remember- TFL is an “Earned Benefit” that’s been granted by a previous Congress. *