Health Care Happenings

The recent budget proposal put forth by the White House has the explicit intention to “Make the military’s healthcare more in line with and like other civilian healthcare plans.”  What exactly does this mean?

It implies that the Military’s plan is too good a benefit and should be put more in line with the average civilian plan such as Blue Cross/Blue Shield, Aetna etc. which the federal government among other corporate entities offer to their employees.  The military will no longer have the EARNED “gold standard”, but will be relegated to the middle of the pack in healthcare plan rankings – as evidenced by achieving parity in pharmacy co-pays for example.

It should be noted that while these drug co-pays do not apply to the active military member, that member is still responsible for higher co-pays for their family.  This particurlarly affects active duty Guard and Reserve families who are mostly assigned away from military facilities.  Additionally, changing retail medications to a percentage of the cost of the medication penalizes the sickest most, for example military children with disabilities and chronic  illnesses.

This move to make “the military more like civilian plans” is inappropriate and fails to distinguish the very radical difference between military and civilian working conditions.  It ignores that fact that military people and their families pay large premiums up-front for their health coverage through decades of service and sacrifice.  Those “healthcare premiums” have been earned and should continue to earn “gold standard” health coverage that is significantly better than typically offered for civilians who do not incur those sacrifices for their country.

The United States military both past, present and future deserve a benefit which should be in the top rung … not the middle rung.

What exactly are the specifics of the President’s plan to cut military health benefits?

TRICARE For Life:

(a) Establish an annual enrollment fee of $200 per person, starting in FY2013

(b) Authorize the Secretary of Defense to increase that fee in subsequent years based on growth in health costs

TRICARE Pharmacy copays:

(a) Switch retail copays from a flat dollar amount to a percentage of DoD costs. For FY13, that would be 10% of cost for generics and 15% of cost for brand names. the White House plan envisions further increases in subsequent years to 20% of cost for generics and 30% for brand names.

(b) Leave generics at zero copay in the mail-order system, but increase the mail-order copay for brand names to $20 and non-formulary medications to $35 for FY13. The White House plan envisions increasing both of those to $40 in subsequent years.

MOAA strongly objects to these proposals. You can help by sending your legislators this MOAA-suggested message.

According to a new fact sheet about the Virtual Lifetime Electronic Record (VLER) project, the VA plans to expand its capabilities to exchange health care information with DoD and select private sector healthcare providers.  The ultimate goal of this Presidentially directed project, is to provide seamless communication of health records and benefits history between the DoD, VA and the private sector “from the day they first enlist to the day that they are laid to rest.”

Currently, 5 regions are covered in the exchange; however, this will increase to cover 6 additional ones.  Testing will begin in all of these 11 regions this month.  Performance data collected during a 6 month trial period will help determine whether the program will be expanded nation-wide in 2012.  The $53.4 million being used to fund this extension was approved by the Senate subcommittee on VA appropriations in June.

Data exchange between private health care providers and hospitals in San Diego California, plus additional test sites in Virginia, Washington State, Utah, and Indiana, have been used by the VA in conjunction with Health and Human Services (HHS) standards for the National Health Information Network.

In addition to the expansion of the data exchange program occuring this month, the VA plans to open a Web portal which will give veterans the ability to authorize the release of specific medical information, held by the VA, to designated providers.  Exchange capability for this function will be tested later this fall, allowing two health care providers to directly provide information to one another.

Progress is slow but sure!

Can you believe it?  

            Sunday marks the 10th Anniversary of 9/11     –     how quickly the time has past. 

For me, as for many of my colleagues here on the MOAA staff and for Americans across the country, that tragic day seems only yesterday -  a blink of the eye. 

Every year since the attacks I reflect back on the events of that day.  

     I bet you do too–perhaps you would be kind enough to share your story     …     Tell us what you were doing that day     …     what was your first response or thoughts when you heard about the attacks.

For me 9/11 was personal and especially pungent — and each year that day is a day of celebration and a day of bittersweet memories. 

A celebration, because I, like my colleagues who served in the DoD Military Community and Family Policy (MC&FP) Office we survived the Pentagon attack and each year we celebrate our ‘alive day,’ reaching out to let each know they are in our hearts and in our thoughts, though many of us have moved on to other stages in our lives.

9/11 is also a bittersweet time because so many died, so many surviving families suffered–yet through that tragedy and suffering a great deal of good came out of what was an extremely difficult time.

I’d like to share, just a little glimpse of the response efforts of that small office in MC&FP immediately after the attack on the Pentagon through a few excerpts of a report that was published — a report I was previleged to have a hand in drafting and coordinating that historic effort, entitled:

     Response to the Terrorist Attack on the Pentagon:  Pentagon Family Assistance Center (PFAC) After Action Report – March 2003

“…Like New York City’s heroic firemen, police, and emergency workers, military personnel and civilian employees at the Pentagon joined local emergency responders and risked injury and death to save their colleagues.  Many of these individuals who were themselves not physically injured, collaborated to assist the families of their fallen colleagues.

In a hotel in the shadow of the Pentagon, in the middle of all the chaos of that day, the Office of Family Policy, within the Office of the Under Secretary of Defense (Personnel and Readiness), created something new–the first joint military service family assistance center.  The center served as a safe place where families could obtain accurate information, receive counseling, and take advantage of a wide range of support services… 

…The PFAC was committed to providing immediate and sustained support to the families of all Pentagon victims and the passengers and crew on board American Airlines Flight 77.

     Over the course of the next several weeks, the PFAC developed quickly into a muliti-agency emergency response effort.  Various military components, Federal, State and local government, and non-government agencies came together to support the families…

I will always consider it an honor to have served these families and to have played a small part in changing the course of history for them, as well as our troops, veterans, wounded warriors and their families. 

As I approach this year’s 9/11 anniversary I still do remember the personal terror, fear, panic, anxiety, and so many other emotions of that day     …     some days as though it were yesterday.

Thankfully those emotions and trauma have been replaced with gratefulness. 

I even smile a little to know that a small office in DoD played a significant role in not only developing such a valuable historic account of the Pentagon response efforts, but also to know we created an off-the-shelf emergency response plan that has since served as a template that has been used by a number of federal, state and local government and non-government agencies as a road map for caring for families in times of a mass casualty event. 

And, it’s heartening to know that the lessons learned from 9/11 have also served to guide our military health care, personnel and family support policy and program response efforts as we executed the wars in Iraq and Afghanistan.

Please share your look back to 9/11 and how you responded to the news…

                We look forward to hearing your stories!

Your feedback is valuable! 

TRICARE would like you to tell them how you get your prescriptions filled and what you think about saving 66% or more on the medications you use on a regular basis.

As part of our effort to partner with TRICARE , they are requesting participation by our MOAA members to provide information on a short questionnaire which can be found here:  https://tricare.inquisiteasp.com/cgi-bin/qwebcorporate.dll?idx=D9GAC7

Please take a minute or so to offer your opinion on recieving your medications via the cost effective home delivery method.      Thank You!

The initial agreement on the nation’s debt limit is done, with the promise of more targeted reductions to come.  Now what does this mean? and more specifically how does, or will this, impact DoD’s healthcare program TRICARE?

There is more that we do not know at this point, than what we do know.  However, we can do some speculation on the matter.  Keep in mind that TRICARE physician payment rates are tied to Medicare payment rates, in other words, for example, DoD pays doctors the same amount for an office visit  as Medicare does.

This becomes important when you consider that based upon the Sustainable Growth Rate or SGR, ( a formula which calculates Medicare doctor payment rates )  is due to decrease the existing doctor payment rate by nearly 30% on January 1 2012.  This is a formula which already requires close to $300 Billion over a 10 year period to fix, and may be potentially compounded by another 2% “trigger” across the board reduction if the newly established debt “super committee” cannot meet agreement on spending reductions. 

While we hope that this bi-partisian committee will address and fix the SGR formula, but with the savings levels to be achieved, there will be significant challenges to getting there.  Any cut in provider reimbursement can adversely affect both TRICARE beneficiary and seniors access to care.

Therefore, a one or two year patch, as has been the recent norm, will probably occur once again.  We at MOAA will continue to educate Congress on the impact to beneficiary access as these debates start.

As of now, the future of healthcare in the US is still uncertain. We do know that demographics in the US point to an aging population,  but with deficit reduction a “Sisyphean sequestration”, healthcare spending will be in the cross hairs.