By Tom Philpott
Military Update focuses on issues affecting pay, benefits and lifestyle of active and retired servicepeople. Its author, Tom Philpott, is a Virginia-based syndicated columnist and freelance writer. He has covered military issues for almost 25 years, including six years as editor of Navy Times. For 17 years he worked as a writer and senior editor for Army Times Publishing Co. Philpott, 49, enlisted in the U.S. Coast Guard in 1973 and served as an information officer from 1974-77.
Military leaders and Defense Department health officials locked arms two years ago to rescue a mismanaged military health-care system chronically short of appropriations.
Last fall, Congress approved the biggest increase in military medical benefits in more than 30 years, and the alliance between the Joint Chiefs and Tricare officials was at least partially responsible. The partnership had a bigger role in a recent sharp drop in complaints from patients and health-care providers over access to care and claim-processing delays.
The alliance is turning its attention now to a $1.4 billion health budget shortfall for the current year, and to reorganizing Tricare networks and support contracts to reduce hassles for patients and improve efficiency.
Defense Department officials credit Army Gen. Henry "Hugh" Shelton, chairman of the Joint Chiefs, for keeping high-level attention on health care. He shifted the focus there in 1999 after helping to secure impressive military pay and retirement gains from the administration and Congress.
Shelton soon had plenty of company. Four-star colleagues and military associations who had led the charge for health-care reform for years were joined by a groundswell of individual retirees, angry over broken health-care promises.
When advocacy failed to win the support Shelton wanted from the Clinton White House, particularly for disenfranchised elderly retirees, spouses and survivors, Congress took up the cause. Military leaders and Tricare officials still sound surprised by the richness of benefit gains passed in 2000.
For active-duty families, they include an end to co-payments for doctor visits when enrolled in Tricare Prime, the managed care program. This change will take effect April 28 but, in some regions, co-payments will continue to be collected for additional months. These patients later will be reimbursed.
On Oct. 1, Tricare Prime remote benefits will be extended to the families of 80,000 service members assigned 50 miles or more from the nearest military base. Only service members themselves who live in remote areas have the full health benefit now.
About 1.4 million elderly beneficiaries will become eligible April 1 for the same pharmacy drug options as younger retirees. On Oct. 1, when Tricare for Life begins, military beneficiaries enrolled in Medicare Part B will be able to use Tricare as a second payer to Medicare. Many elderly will be able, in time, to drop private supplemental insurance plans.
Given the increase in new benefits, defense officials sound satisfied that health promises to older retirees are being kept.
Besides adopting better business practices, Defense Department officials are moving to fully appropriate for health-care budgets, which were chronically shortchanged during the Clinton years. The Defense Medical Oversight Committee has the lead.
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