Healthcare fee increase defended
By Tom Philpott
Ignoring the intimidating props — boxes of angry letters from thousands of military retirees — senior defense officials and military leaders appeared before a contentious House subcommittee to make their case for hiking TRICARE fees sharply for under-65 retirees and their families.
In the verbal sparring that ensued last week, Pentagon leaders gave as good as they got. But no lawmaker took the role of referee. All threw punches on behalf of retirees, and treated with kid gloves a second panel of witnesses representing dozens of pro-retiree military associations and veteran groups.
The Pentagon's plan to boost out-of-pocket TRICARE costs for three million beneficiaries includes a tripling of managed care enrollment fees for retired officers and a doubling for senior enlisted retirees.
Republicans and Democrats together questioned whether projected cost savings from raising TRICARE fees were realistic and whether increasing the fees was wise while war was being waged. The active duty four-star officers in the room spoke in support of the increases. Retired officers led the opposition.
Rep. Vic Snyder of Arkansas, the ranking Democrat on the panel, challenged the use of the word "crisis."
"A crisis implies we're not going to pay for anything. We're going to pay for health-care for our men and women in uniform, and retirees. We're going to sustain the program. The question is how ... and right now there's not a lot of ... enthusiasm for the method you all have proposed," Snyder said.
David S.C. Chu, undersecretary of defense, and William Winkenwerder Jr., the Pentagon's health affairs chief, reminded the armed services' subcommittee on military personnel that since 1995, TRICARE benefits and the beneficiary population have grown. While program costs have soared, TRICARE fees have remained the same. They said military health costs, which have doubled since 2001, could double again by 2015.
Defense leaders were joined by the vice chiefs of the Army, Navy, Air Force and Marine Corps who echoed the contention that a prized benefit will be difficult to sustain unless fees are raised.
To the charge that the planned fees would climb too far too fast, Chu noted that for 11 years, "our beneficiary population has enjoyed a relief from indexing."
Defense officials estimate the higher fees will save $11 billion by 2011. The assumptions are that 144,000 current users will decide to leave TRICARE and another 350,000 beneficiaries, who would have shifted to TRICARE if fees stayed frozen, will stay with their private sector plans.
Retired Navy Vice Admiral Norbert R. Ryan, Jr., testifying on behalf of The Military Coalition, a consortium of service associations, called the planned fees "disproportional and inappropriate."
Ryan said the greater danger would be raising future health-care costs for careerists facing their second or third wartime deployment.
For a chart showing the proposed TRICARE Fee changes visit www.military.com/TRICARE_Chart