MILITARY UPDATE
Task force urges coordination of veterans healthcare systems

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, 50, enlisted in the U.S. Coast Guard in 1973 and served as an information officer from 1974-77.

By Tom Philpott

Why do the departments of defense and veterans affairs conduct separate, duplicative physical exams of veterans — one before, and one after, discharge?

Why do these government health programs have separate purchasing systems when medical supply needs are nearly identical?

Why are their medical record systems incompatible when the populations served overlap?

Why is the VA healthcare system, which is under strain just to care for the most deserving, forced to make room for thousands of veterans who have decent outside incomes and no service-connected ailments?

Answers to all of the above vary but, according to a new presidential task force report, it's time for Congress and the president to end the nonsense and demand closer coordination of staff, facilities and other resources between two mammoth healthcare systems.

The 129-page report of the President's Task Force to Improve Healthcare Delivery of our Nation's Veterans, delivered to President Bush May 28, recommends aggressive collaboration between departments to control the combined $50 billion cost and to ensure a "seamless transition" from military to VA healthcare.

One of the more controversial recommendations calls for future VA budgets to be set high enough to ensure full financing of healthcare for enrolled veterans in Priority Groups 1 through 7.

Group 1 comprises veterans with service-connected disabilities rated 50 percent or more disabling. Group 7 comprises veterans with no service-connected ailments but with incomes or net worth below a poverty line set locally by the Department of Housing and Urban Development.

If mandatory financing is approved, Group 1 through 7 veterans, whose numbers climb by 360,000 a year, should see access and services improve. Left out would be Group 8 veterans, those who have no service-connected ailments, and incomes or net worth above the HUD geographic index.

These veterans first were offered access to VA healthcare in 1998 in return for agreeing to co-payments. Their enrollment has grown by 220,000 a year and was suspended last January to ease an access problem for all veterans.

The report urges the president and Congress to work together to end this "unacceptable" access status and an obvious mismatch between demand and resources.

The report also calls for:

• Making electronic medical records between DOD and VA compatible by fiscal 2005.
• New authority and incentives for local and regional DOD and VA managers to increase cooperation to improve healthcare delivery and control costs.
• A joint DOD-VA formulary for prescription drugs, and tools to track what medicines go to beneficiaries with dual DOD-VA eligibility.
• Joint procurement of medical services and equipment whenever possible.
• More joint construction ventures between the departments.
• An "interagency leadership commission" to report annually on the departments' progress implementing task force recommendations.

Both chambers of Congress support a package of tax breaks for military personnel, including provisions to restore capital gains protection for service homeowners and new deductions on travel expenses for drilling reservists.

But every time the House, which by law must initiate tax legislation, approves a "military tax fairness" bill, it seems the Senate improves upon it, usually to the benefit of one more group of service members, and the bill must go back to the House for modification.

In mid-May, with the Senate backing more new ideas, it sought a short cut to passage by folding the "military tax fairness" bill into what remained of the president's original $750 billion tax cut and economic stimulus bill. But a host of last-minute amendments were dropped and President Bush signed a $350 billion tax bill without military provisions on May 28.

Senators are revising their strategy. Senate action, when it comes, will dictate whether the House again must revise its military tax bill or whether a final compromise can be worked out in a House-Senate conference committee.

The Bush administration's Office of Management and Budget has sent separate letters of complaint to the chairmen of the House and Senate armed services committee over objectionable features in their respective 2004 defense authorization bills. Some of the criticism targets pay and benefit gains for deployed forces.

For instance, the administration opposes in the House a provision to pay reservists who maintain demolition and parachute duty qualifications the same hazardous duty pays as active duty members receive. It opposes a $5-a-day incentive pay for ground duty in Antarctica and special pay of $150 a month for members of weapons-of-mass-destruction civil support teams.

Questions, comments and suggestions are welcomed. Write to Military Update, P.O. Box 231111, Centreville, VA 20120-1111, or send e-mail to: milupdate@aol.com.