Health Care Happenings

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.

Yesterday, the Secretary of Labor the Honorable Hilda Solis, introduced the Trauma-Informed Care for Women Veterans Experiencing Homelessness:  A Guide for Service Providers, also known as the “Trauma Guide.”  This comprehensive guide was created to address the unique psychological and mental health needs of women veterans.  Specifically written for service providers, it’s primary goal is to improve the engagement effectiveness of the female veteran population.

Through the effort to better understand the factors which would lead women to become homeless, the Women’s Bureau at the Department of Labor conducted extensive qualitative research, which revealed that the experience of multiple traumas increases the risk of homelessness and severely impacts women veterans’ ability to re-adjust to civilian life.

Consider these facts about our growing number of military women:

Women are now 20% of new recruits, 14% of the military as a whole, and 18% of the National Guard and Reserve.  While women represent only 8% of veterans, their risk factors are rising disproportionately to their numbers.  Women veterans are at 4 times greater risk of homelessness than their non-veteran civilian counterparts.  Over the last decade, the number of homeless women veterans has nearly doubled, with a significant number having children.  Further research suggests that 81-93% of female veterans have been exposed to some type of trauma either during their service or prior to joining the military.

Thus, the experience of trauma and the subsequent impact on daily functioning can present a significant challenge as women veterans re-adjust to civilian life, and can be a risk factor for homelessness. Women veterans also have unique challenges compounded by their military experiences and multiple roles as breadwinner, parent, and spouse.

• Female veterans who are homeless have significant histories of trauma.
• Exposure to trauma impacts all aspects of daily functioning.
• Female veterans do not always self-identify as veterans.
• Female veterans often find themselves without a support network.
• Few current services exist which address and are tailored to the needs of female veterans.       

So as we seek to further understand how the experiences of trauma impact our female veterans, it is the hope that by using this guide as a framework to tailor services to women;  that providers, organizations and we in the community will be better able to facilitate the recovery and re-entry of our women.

For more information please go to www.dol.gov/wb

Despite all of the political turmoil which surrounded health care reform last year, it turns out that according to a survey by a leading online health insurance broker, that less than half of the parents who were surveyed, said they would be willing to provide their college graduates with coverage on the family’s health insurance plan until age 26.

The survey indicated that most parents “are ready to let their young adults take responsibility” said the survey authors.  Insurance.com which sponsored this survey of 1,000 parents, college students and recent graduates completed this in April.

In addition, Aetna and Medical Mutual – two of the largest Mid-Western region’s insurers report that while they have added 19-26 year olds to their parents plans, the demand has not been “overwhelming”.  Even despite the fact that most of the civilian health plans do not charge high rates for adding an extra child or two.

So far in the Department of Defense’s TRICARE Young Adult insurance coverage program, there also has been modest enrollment to date with good satisfaction.  A few points to remember about the plan are:

• The individual to be covered must be a dependent of an eligible uniformed service sponsor.
• Unmarried
• At least age 21 (or age 23 if enrolled in a full-time course of study at an approved institution of higher learning and if the sponsor provides at least 50 percent of the financial support), but have not yet reached age 26.
• Not eligible to enroll in an employer-sponsored health plan offered by your own employer.
• Not otherwise eligible for any other TRICARE program coverage.
• Remember:  after enrolling in the program, the sponsor will need to visit a uniformed services identification card issuing facility to obtain an ID card for the young adult.

Lastly, the survey noted that college students and recent graduates may have more original ideas on how to obtain health insurance without spending too much. 

For instance, Question no. 9 on the survey hints that insurance can be sexy: “If you were already attracted to a date or potential significant other and then found out that he or she had health insurance, would you be more likely to be…?”

Ninety-three percent of graduates responded that they would be “more attracted”.     Interesting!

On Tuesday the Defense Health Board met here in Washington DC to discuss several findings and to review an interim report on Psychotropic Mediction and Complementary and Alternative Medicine.  The Defense Health Board is a Federal Advisory Committee to the Secretary of Defense.  It provides independent scientific recommendations on matters relating to operational programs, health care policy development, health research programs and requirements for the treatment and prevention of disease and injury, and the delivery of health care to DoD beneficiaries.  It is a board comprised of the country’s top leaders and medical specialists.

One of the charges of the group was to examine the prescription practices and psychotropic medication use of troops and to take into account the context of specific military-unique challenges that might impact the well-being and psychological health of Service members.

One of the key findings was that was identified was that our troops experience a plethora of sleep problems and issues.  This is not suprising when you consider that troops in combat zones must maintain themselves in a hyper-vigilent state and are under constant pressure to perform as needed.  Under these circumstances it must be very hard to relax and take a “power nap”.  Think how you feel when you do not get a good nights rest….now imagine that multilplied over an extended period in austere conditions. 

The problem of sleep (and rest) was reflected in the pharmacy data studied.  Sleep medications are the predominant prescription psychotropic drug used in theater.  Specifically the drug Ambien was identified as the most popular.  There also appears to have been a trend towards an increased use of psychotropic drugs in theater over the past three years.

Recognizing that good sleep is the foundation of good health and troop readiness, one of the recommendations that will come out sometime in the near future will be the establishment of a Task Force on Sleep. This Task Force will be essential to identify emerging scientific findings and define the best operational and medical practices to optimize our troops readiness and performance.  One promising area is to explore alternative treatment strategies such as accupuncture and other mindfulness practices which can be employed to reduce combat stress and pain.

As sleep and adequate rest are of the utmost importance, we can look forward to a lot more focus and study in this area and hopefully some advances in treatment.