September 29, 2011 | WebMemo on National Security and Defense
Washington has a problem. The men and women who serve and have served in uniform and their families deserve quality health care. Delivering first-class care, particularly in time of war, is a daunting challenge. Furthermore, care for military members, retirees, and their families in an all-volunteer force must be portable. Service members should not have to choose between volunteering and quality health care.
The Pentagon, however, has built a system that is increasingly flawed. At a press conference on January 6, then-Secretary of Defense Robert Gates admitted that he had no solution for “the department’s unaffordable health costs, and in particular the benefits provided to working-age retirees under the TRICARE program.”
In order to provide an adequate defense, the nation has to achieve three vitally important objectives with respect to compensation and benefits for all those who serve and have served in the armed forces:
What Is Wrong with Military Health Care?
The state of unpreparedness of the military health care system was reflected in the difficulty of surging care to provide for wartime needs, including dealing with emerging concerns such as post-traumatic stress disorder, traumatic brain injury, and suicide prevention, as well as spiraling per capita health care costs. The stress on the system has revealed a cascade of systematic problems.
Lack of Choice. TRICARE restricts the choices of military service members and retirees. As a result, the members and their families cannot tailor their coverage according to their preferences and needs.
Inflexibility. Today’s labor force is highly mobile. Many choose to rotate between active and reserve service. Others choose not to make the military a career. No individuals should be penalized for the choices they make in how and when to serve their nation. In addition, TRICARE does not prepare serving military personnel to exercise greater responsibility for managing their health care after they complete their service.
Unfairness. Under TRICARE the government extends health care benefits regardless of need. That means that limited resources are spread to provide ever more limited coverage to all. Thus, the Pentagon strains to provide retirees who have reasonable access to private coverage the same benefits as active-duty service members who are serving in harm’s way.
Spiraling Costs. The Department of Defense’s health care budget request for FY 2012 was $52.2 billion. If the cost of health care continues to grow in the future as it has in the recent past, it would “crowd out” spending for other military essentials. Thus, service men and women would likely find themselves receiving mediocre, costly health care and going into battle without the training and equipment they need to do their jobs, do them right, protect the nation, and come back home.
Honest, Fair, and Sensible Reform
Given this array of weaknesses in the existing system for military health care coverage, it is appropriate for Congress to consider comprehensive changes. The changes should:
Such changes should track those recommended by The Heritage Foundation for reforming the system of health coverage for broader American population described in Saving the American Dream fiscal plan. This just makes sense, since most service members do not remain in the military for the entirety of their careers. The right plan would:
What Those Who Serve Deserve
It is past time Congress do something to protect the quality of care for members, retirees, and their families, establishing sustainable programs that promote the principles of choice and flexibility.
Systemic change would provide military personnel with flexibility and access to opportunities that they do not enjoy today. Congress should adopt this kind of systemic reform now.
Baker Spring is F. M. Kirby Research Fellow in National Security Policy in the Douglas and Sarah Allison Center for Foreign Policy Studies, a division of the Kathryn and Shelby Cullom Davis Institute for International Studies, at The Heritage Foundation.