Since 06-17-05
Higher User Fees Eyed To Slow Rising Military Health Costs
Since 06-17-05
From: Waspscpo@aol.com [mailto:Waspscpo@aol.com]
Sent: Friday, June 17, 2005 3:37 AM
To: undisclosed-recipients
Subject: Higher User Fees Eyed To Slow Rising Military Health Costs
Military Association Internet Exclusive for the FRA
(The Fleet Reserve Association)
http://www.fra.org
By Tom Philpott
June 16, 2005
The content of Military Update does not necessarily reflect the views of the FRA
Defense Department officials say it’s time users of military health care pay a
greater share of rising medical costs, perhaps through higher co-payments and
enrollment fees which haven’t been raised since TRICARE, the military’s managed
care program, began a decade ago.In an interview, Dr. William Winkenwerder, Jr.,
assistant secretary of defense for health affairs, said he and other senior
defense officials, alarmed by a doubling of military health care costs over the
last five years, are discussing ways to slow the growth with military leaders
and Congress.
Those talks, he suggested, include a range of options to raise out-of-pocket
costs for beneficiaries.In 1995, when the triple-option TRICARE plan began to be
phased in for retirees and family members, enrollment fees for TRICARE Prime,
the managed care option, were set at $230 a year for an individual and $460 for
family coverage. They have not changed. Retiree and family member co-payments
have been frozen too at $12 for a visit to a civilian doctor and $11 for a day
for hospitalization.
In fact, five years ago Congress eliminated all TRICARE Prime co-payments for
active duty family members. Their co-payments for inpatient care also ended.
Medical care for active duty members is free and will not change. Regarding fees
for retirees and family members, Winkenwerder declined to discuss any specific
option under review.
Other sources said the menu being studied includes not only higher TRICARE Prime
fees and co-payments but possibly an enrollment fee for users of TRICARE
Standard, the military’s traditional fee-for-service option; payouts or buyouts
to entice beneficiaries to use other health insurance options; a plan to combine
any higher fees and co-pays with the offer of tax-deferred military Health
Savings Accounts. Winkenwerder indicated that stagnant fees and co-pays have
been a factor in rising health costs, encouraging many younger retirees working
in second careers to use TRICARE rather than employer-provided health insurance.
With TRICARE, retirees under 65 see average out-of-pocket costs of about $700 a
year, he said, versus $3800 or so if they use employer-provided insurance. That
gap is growing and has led to a steady migration of retirees and families into
TRICARE and away from private sector options.In year 2000, Winkenwerder said, 60
percent of retirees under age 65 relied on TRICARE. Today, the figure is 72
percent and rising two to three points a year. It is expected to hit 85 percent
by 2010.
Reliance on TRICARE, said Winkenwerder, is being encouraged by civilian
employers, including some state governments. Alabama, Nebraska, the Carolinas
and Washington now entice employees who are retired military to rely on TRICARE
by offering to cover their fees and co-pays with TRICARE "supplemental"
insurance.The biggest rise in military health care costs, however, has involved
the elderly, through TRICARE for Life (TFL) and TRICARE Senior Pharmacy benefits
begun in 2001.
Before Congress enacted these plans, beneficiaries eligible for Medicare saw
access to a guaranteed military health benefit end. As the department phased in
managed care, the "greatest generation" of World War II and Korean War retirees
also were being squeezed out of base hospital and clinics, denied what they saw
as a promise of free lifetime care. Congress responded by passing TFL, a
"golden" supplement to Medicare that pays almost all health costs that Medicare
won’t.
TFL and a new senior pharmacy benefit now cover 1.7 million beneficiaries. The
combined cost in 2005 is $6 billion and will rise to $9 billion by
2010.Winkenwerder said total military health spending will hit $50 billion in
2010 -- up from $18 billion in 2001-- if Congress takes no action to curb costs.
Indeed, costs will grow even faster if lawmakers continue to expand medical
benefits for drilling Reserve and National Guard members. Frederic W. Cook, a
member of the Defense Advisory Committee on Military Compensation, suggested
June 7 that TRICARE fees and co-pays should be raised for retirees and then
indexed to inflation like their annuities.
He called such a move "perfectly fair and equitable.""I know this is going to be
a passionate subject with some people but I think we have to take on sometimes
controversial, passionate subjects and put a stake in the ground," Cook said.
Before eyeing higher fees for beneficiaries, Winkenwerder said the department
took other actions to curb costs including redesigning TRICARE support
contracts, consolidating the retail pharmacy contract to win deeper discounts,
and making more efficient use of military treatment facilities.
"Then there are other ways I believe we will have to consider, and certainly the
structure of our benefit, and the incentives that it currently creates, is among
those changes," Winkenwerder said. Internal discussions about restructuring the
benefit have involved Defense Secretary Donald Rumsfeld’s "leadership team" as
well as senior military officers, Winkenwerder said. There’s recognition, he
suggested, that unless health costs are curbed, they will consume a larger and
larger share of defense budgets, impacting weapons and other readiness programs.
"This is a set of priorities that just have be balanced, and we will be turning
to our most thoughtful leaders to help set that balance," he said. He didn’t
rule out raising fees on some active duty families but noted, "There’s great
sensitivity to the challenges" lower-income families face. Winkenwerder wouldn’t
say when specific proposals might surface."It’s very important that we take the
steps sooner rather than later so that we can sustain this great medical
benefit," he said.
Syndicated columnist and freelance writer Tom Philpott has covered the military
for more than 25 years including six as senior editor of Navy Times. He is also
associate editor (U.S. section) for Jane's Fighting Ships.
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Editor,
Tom Philpott's piece above points out another example of government bureaucrats
disgusting, hypocritical, and callous attitude toward our fighting men and women
as well as past retirees/veteran warriors.
The only fiscal issue on the cutting block appears to be benefits earned through
sacrificial service to our nation.......service by our men, women and
families.....
Well, I'll add the likes of Assistant Secretary Winkenwerden, David Chu,
Frederic W. Cook, and all the other high muckety mucks that continually chip
away at military retiree and veterans benefits.........to kiss my battle worn
ass.......hell will freeze over before I send my grandchildren into harm's way
when the leadership in Washington reflects a "use and abuse"
attitude....politicians like Senator Dick Durbin who compare our troops to
"Nazis, Soviets in their gulags, or some mad regime - Pol Pot or others - that
had no concern for human beings". These people are hell-bent on destroying the
only protection we have against tyranny........
Grandfathers and fathers of WWII/Korea/VietNam have a less than positive view of
the US government in so far as keeping faith with it's past warriors. Senator
Dick Durbin is the straw that broke this camel's back...........
The bottom line is that our government has not honored commitments and
obligations made to the "greatest generation" which is resulting in negative
feedback to the generation now being asked to risk their lives.......past
warriors are not receiving the medical care they were promised; disabled troops
are required to fund their own disability, widows are ignored....in summary,
troops leave blood and body parts on the battlefied but are considered a funding
drain when it comes time to honoring commitments to them.
Now, ignorant bureaucrats sitting in their ivory towers only view penalizing
those that guantee their soft, cushy pentagon jobs as the answer to fiscal
shortfalls, a problem if there is one, brought on because of our free-fall
spenders in government.
Apparently the US government has not learned that treating past warriors in a
shabby manner translates to current recruiting shortfalls and it will get worse
before the numb-nuts in the Administration, Congress and the Pentagon understand
what they are doing.
Harry Riley, COL, USA, Ret
111 Overview Drive Crestview, FL 32539
850-582-7334 - cell
850-689-1818 - home
hmriley@cox.net
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Contributed,
YNCS Don Harribine, USN(ret)