With the chairmen and ranking members of the House and Senate Armed Services Committees agreeing to take on the military healthcare system in next year’s budget, a former Pentagon comptroller said the recommended changes the panels will consider would “protect the family” while the Defense Department’s plans would only increase co-pays and reduce benefits.
Speaking Wednesday at the Heritage Foundation, a Washington, D.C., think-tank, Dov Zakheim, who also served on the Military Compensation and Retirement Modernization Commission, said by putting the overhauled healthcare system under the Office of Personnel Management (OPM) “not only will it help the families; it will save DoD money.”
He said the commission estimated the savings at $6 billion. “The comptroller wears the black hat” when it comes to making decisions on Pentagon spending. In healthcare, “you can’t tinker around the margins.”
“The comptroller has priorities” that civilian-sector healthcare managers do not have. The civilian side “has to offer something people want.” Michael Higgins, longtime personnel expert on the House Armed Services’ Committee and commission member, said.
Stephen Buyer, a former chairman of the House Veterans Committee and also a member of the modernization panel, said, “We made the recommendation that TRICARE should be replaced.” He added that unlike Medicare Part D and the Federal Employees Health Benefits Program, also administered by OPM, today’s military healthcare is the “ultimate socialized system. These beneficiaries don’t have choice.”
There is “a fundamental disconnect . . . between peacetime healthcare and military [healthcare] readiness,” said Michael Higgins, longtime specialist in personnel issues on the House Armed Services Committee staff and also a member of the commission.
By examining military healthcare from the battlefield back to military hospitals and clinics, rather than the other way around, he said the focus under a new four-star position would be on combat readiness. “We changed the emphasis” of the military treatment facility.
Zakheim said today there “are twice as many OB-GYNS at Fort Bragg, [North Carolina] than orthopedic surgeons… If you broke your hand playing tennis, would you go to an OB-GYN?”
Buyer added, “The number one procedure [in the military system] is pregnancy and childbirth. . . . Ask the moms where they want their care. Are these not procedures that can be delivered” in the civilian sector?
The military, their families and retirees “need to have the same level of [specialized] treatment we would give ourselves,” Zakheim said.
Inside the military system, he added, “People are being trained for the wrong thing” because of the emphasis on peacetime care.
Higgins said that the commission did not recommend changes to the pharmacy benefit, dental care, TRICARE for life and some other areas of health care. He said the recommendations focused “on giving our people choice and access.”
Families and reservists can remain in the military healthcare system, for example, Buyer said.
Even with these recommendations in place, Buyer said he expected “the gargoyles who will defend” the present system will wage a serious fight on Capitol Hill in the coming year.
Buyer said the commission’s healthcare recommendations were in line with Hippocrates’ teaching, “First, do no harm.”
As for reforming the disability system, Higgins said that while the commission understood “it’s a source of frustration” in Congress, to service members, veterans and their families, “we thought it was a bridge too far.” From him personally, “I didn’t see a path forward . . . that would make a difference in people’s lives.”
Zakheim and the others said the commission was not formed simply to save money but “to provide for the 21st-century military.” This year, the oversight committees’ addressed “the third rail” of military compensation—the retirement system—and adopted a number of the commission’s recommendations.
Unlike other blue-ribbon panels’ reports, there was no minority annex or footnotes. Buyer said the unanimity came from the panel members’ intent on listening to what service members, their families and others had to say about the broad range of compensation issues. “We came to the Hill and DoD in a united way, Zakheim said.
President Obama has signed the authorization bill.