Another healthcare system

By Bill Taylor

It seems to me that now the US Senate has decided to keep the Affordable Care Act, better known as “Obama Care”, by blocking a proposed substitute, interest in healthcare in Washington appears greatly subdued. Oh, there are still some questions about whether the Administration will continue to pay those subsidies for the insurance exchanges – even though Congress has never approved money for them – but in general, Obama Care, Medicare, Medicaid, and such are not front burner subjects. There is, however, another healthcare system that is being addressed very quietly by Congress – it’s known as Tricare.

Tricare is the healthcare system covering our military, including retirees, and their families. It is administered by the Department of Defense (DoD) and is funded under the annual National Defense Authorization Act – along with other acquisition and operations programs. In general, Tricare, which comes in several versions, covers outpatient care, hospitalization, and prescriptions. As with most other healthcare programs (except Medicaid), Tricare has enrollment fees, deductibles, copays and such – which are all determined by Congress each year.

Most everybody knows that the DoD budget has been subject to massive cuts under what is known as “sequestering”, that is, a reduced limit on the amount of money available to the DoD. At the same time, the DoD is faced with operational and readiness challenges that require significant outlays. Instead of asking taxpayers to fund these demands the DoD and its allies in the Senate are proposing dramatic increases in the Tricare fee structure as a source of revenue to fund operational readiness accounts and other DoD projects. Yep, that’s right – the burden of providing financing for operations would fall on both active duty and retired military and their families. How about them apples!

So what order of increases are we talking about? Well, My Sweetheart-for-Life is an insulin dependent diabetic who gets her diabetic supplies (insulin, needles and such) through Tricare. Under the current DoD/Senate proposal the cost for her diabetic supplies would incrementally increase, starting next year, by 190 %. (The cost of these supplies more than doubled just two years ago in a similar revenue raising move.) Studies show that the cost of prescriptions for typical generics under the proposed DoD/Senate prescription plan rise to the point that it is no better than going to WalMart and paying WalMart prices.

What about other fees, copays, deductibles and such? For an active duty family, the cost for 2018 would increase by 14 % rising to 45 % by 2023. For a retiree under 65 with a family the cost for 2018 would increase by up to 122 % and 198 % for 2023 – depending on which version of Tricare the retiree is enrolled in.

Anything else? Yep. The DoD/Senate plan would also change the rate of increase in Tricare costs currently based on the COLA index growth (around 2-3 %) to the National Health Expenditure (NHE) index which is projected to rise at 6% a year. And remember, these increases are all out-of-pocket expenses.

So why isn’t this subject getting more attention? Well, for one thing the size of our active duty forces is the lowest since before WWII. To put this in perspective, the total number of our active duty military ( Army, Navy, Marines, Air Force, and Coast Guard) is less than four % of our country’s population – and the military is banned from political activism.

In addition, there are virtually no advocates for the military with the exception of veterans organizations. The numbers of those in Congress who have served in the military continues to decline while the number of those who claim military healthcare is a financial sinkhole steadily increases – despite the fact that the cost of DoD healthcare has steadily declined over the past five years.

You know, there’s a lot of “support the military” and “thank you for your service” floating around out there, but when push comes to shove, actions speak louder than words. In reality, Tricare as a source of revenue is “low hanging fruit” and easily targeted by politicians ever eager to find new sources of money. Kinda makes a body wonder where our priorities are, doesn’t it?

Well, there you have just a peek into the way our military is actually treated by this country. Lotsa talk in Congress, but, as the saying goes, “Why not put your money where your mouth is.” At least that’s how it seems to me.

By Bill Taylor

Bill Taylor, a Greene County Daily columnist and area resident, may be contacted at [email protected]

Bill Taylor, a Greene County Daily columnist and area resident, may be contacted at [email protected]