military providers seeing far fewer patients per week than civilian providers; and
inadequate case management of the highest-cost or at-risk health care users. One of the biggest problems is a
serious disconnect between rhetoric and reality on DoD health care costs. Every year, defense leaders offer
dire budget projections of health costs they say are spiraling out of control. But history shows those projections have been consistently wrong. The chart [above right] reflects
the reality: DoD health costs have been flat or declining for the past five years. Figures through FY 2014 are actual expenditures. FY 2015-16 are projections in the latest DoD report to Congress and the FY 2016 budget. TRICARE For Life costs have
dropped significantly, and purchased care costs have been flat or declining. A prime source of cost increases
has been in-house military care, which is mainly a factor of medical readiness and system inefficiency. Concerning the proposals of the
Military Compensation and Retire- mentModernization Commission [MCRMC],MOAA supports the recommendations on DoD/VA col- laboration and needed changes for families with special needs. But the commission proposal for
a Joint Readiness Command would add a new level of bureaucracy with-
ON THE WEB
Read MOAA’s full written state- ment, which in- cludes additional comments and
recommendations for military health
care delivery, at
www.moaa.org/ hasc-testimony.aspx.
PHOTO: FACING PAGE, STEVE BARRETT; CHART SOURCE: DOD REPORTS TO CONGRESS AND FY 2016 PRESIDENT’S BUDGET
DoD Health Costs Are NOT Growing, Let Alone “Out of Control” (cost in billions)
TRICARE For Life Deposit Purchased Care
Total Unified Medical Program
FY 10 FY 11 FY 12 FY 13 FY 14 FY 15 FY 16 10.8 14.3
11.0 10.9 8.5 14.8
7.4 7.0 6.6 15.4 14.7 14.8 14.8 49.9 51.6 52.9 48.4 49.3 48.5
out addressing the inefficiency of the current three-service organization. In assessingwhat changes should
be pursued, our statement for the re- cord offers a number of guiding prin- ciples. Key ones include: Means-testing is inappropriate for military health benefits. Reducing benefits for longer and more suc- cessful service has very negative career retention effects.
Readiness costs should not be passed to beneficiaries. When military providers are deployed or military facilities are inefficient and more beneficiaries are pushed into private care, that’s a cost of doing military business, not a personnel benefit.
The military health benefit should be the “gold standard”—a top-tier program that’s substantially better than those offered by the best civil- ian employers.
Each similar group of eligibles should be provided similar cov- erage. We are not in favor of an FEHBP [Federal EmployeesHealth Benefits Program]-style system that means those with more income can buy better coverage. Finally, our written statement of-
fers 12 specific recommendations, four ofwhich include: First, test the concept of a unified health care budget and oversight authority in two of the multiser- vice-area markets. If given proper
JOIN THE CONVERSATION
What is your recommenda- tion to improve military health care? Share your ideas with other MOAA members at
connect.moaa.org. Search for the “Military Health Care” discussion.
authority, the DefenseHealth Agency is in an excellent position to oversee these pilot projects.
Second, consider implementing a MCRMC-style insurance system for the Guard and Reserve. This is one areawhere starting over wouldn’t pose much risk.
Third, provider payments should be structured to reward quality care.
And finally, seek some form of agree- ment on the premium value of a service career. This is at the crux of every disagreement with DoD over how much beneficiaries should have to pay for their health care andwhy. Mr. Chairman, our written statement, which is endorsed by 15 fellow associations in The Military Coalition, includes other comments and recommendations for your consideration. In closing, I can assure the entire committee thatMOAA stands ready to assist you and your staff in any way that would be helpful. We all want to get this right.
MO FEBRUARY 2016 MILITARY OFFICER 55
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