THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Wednesday, May 31, 1995 TAG: 9505310475
SECTION: MILITARY NEWS PAGE: A8 EDITION: FINAL
SOURCE: TOM PHILPOTT
LENGTH: Medium: 68 lines
The Commission on Roles and Missions of the Armed Forces wants military medicine to stop treating older retirees and dependents as castoffs by denying them access to care under TRICARE Prime, the new managed-care system.
The Defense Department ``must ensure high accessibility to quality care for all beneficiaries (including the Medicare-eligible),'' the commission says in its May 24 report.
The Defense Department bars people age 65 and older from enrolling in TRICARE Prime as it is phased in throughout the United States and Europe over the next two years. People eligible for Medicare also are warned they will be turned away from military hospitals unless Medicare provides $1 billion a year for the cost of such care.
The commission, established a year ago to streamline the military, endorses the TRICARE concept, which encourages enrollment in a provider network in return for lower costs and guaranteed access to care. But the system should not exclude older beneficiaries, the report says.
``I love it,'' said Dorsey Chescavage, reacting to the report. She's a health care specialist with the National Military Family Association in Alexandria, Va. ``It's the first group I've seen that has taken seriously the Defense Department's obligation to provide all of us with a health care benefit.''
The timing couldn't be more welcomed by older retirees. Defense attempts to get Medicare reimbursement have fallen flat this year. The White House won't endorse the transfer of funds, called Medicare subvention, until Defense proves that in-service care of Medicare-eligible people is more cost-effective than forcing them to use Medicare and civilian providers.
The commission wants the medical system downsized to where it still can handle wartime requirements, treat nondeployed forces and returning casualties, and support families assigned ``outside the country and in remote areas.'' Other beneficiaries, including retirees, should rely increasingly on private care but be given a wide choice of plans.
Defense officials decided to limit TRICARE options, Chescavage said, so families and retirees provide a steady stream of patients to military facilities. This protects graduate education requirements and justifies large medical staffs.
``They can't take care of us all, but they like having us out there when they need us. But it can't continue. We have a right to a secure health care plan, not one that yanks us in one day, pushes us out the next.''
Many military retirees, she said, would be delighted to buy into a plan like the Federal Employees Health Care Benefit Program. ``It's available all over the world. It gives us a choice of seven national plans and hundreds of local plans.'' Perhaps most important, she said, ``beneficiaries retain coverage when they hit 65.''
Military associations that sell supplemental insurance plans have been slow to endorse options like the federal employee health benefit, which don't require supplemental coverage. But even some of these groups are changing their positions as more retirees get pushed out of the military medical system.
Chescavage said she expects the commission's medical recommendations to trigger change, not only because they make sense but because commission chairman, John P. White, is slated to become deputy secretary of defense - the man responsible for implementing many reforms he recommended. MEMO: Reader comments and suggestions are welcomed. Write to Military
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