Monday, September 20, 2010

Air Force’s Top Officer Provides Tough Talk on Health Care Entitlement

At a recent hourlong commander’s call with Chief of Staff Gen. Norton Schwartz and Chief Master Sgt. of the Air Force James Roy, airmen were encouraged to ask real, tough questions. Among them was a question about expanding support to health care beneficiaries. Please see the exchange below, reported in an Air Force Times article, “Leaders address airmen’s concerns”:

Gen Norton Schwartz, Air Force Chief of Staff
Airman 1: Since health care is the No. 1 concern for retirees, what is being done to expand the support to beneficiaries?

Schwartz: Can I give you the straight story? I am not looking to expand the entitlement. Here is the problem we got and it’s a serious-ass problem.

Roy: That’s serious.

Schwartz: We’re talking a big number. The Department of Defense health care bill for active-duty [airmen] and retirees this year is about $40 billion. By the middle of the decade, or 2015, it will be about $60 billion. That’s more than 10 percent of the entire DoD budget just for health care. If we are not careful, we could end up like General Motors, where General Motors had personnel costs – including health care – that were so great that they stopped making good cars for awhile. So, here is the problem: If General Motors didn’t make good cars, you had other choices. What happens, though, if the Air Force or the other services aren’t able to produce the national security product that the American people expect? Where else do you go? This is a real problem.

And so I think what’s likely – and this won’t be popular and it won’t be easy to do – but we have not changed co-pays in Tricare since 1985. And health care costs have exploded since 1985. My take is that there is going to have to be a change that allows higher co-pays, more participation and so on. The bottom line is I am not an advocate for expanding yet again an already very lucrative Tricare entitlement. …You won’t be able to make it cheaper, but at least you can keep it from escalating. The deal is we can’t afford it or we’re going to stop flying F-16s or B-2s or C-17s or satellites or HH-60 helicopters, you name it. And that’s not where I want to be and – I’ll tell you what – I know it’s an emotional issue, but I don’t think the retiree community wants to be there either. Now we don’t want to put people in dire need on the street because that’s not what we are about because this is still a family.


ROA’s advocacy focuses on a number of entitlements such as Tricare with the caveat that they are connected to protecting National Security, our mission, by ensuring recruiting and retention are strong.

What are your thoughts on Gen Schwartz's comments? What are your thoughts on ROA’s continued advocacy for such entitlement programs?


Anonymous said...

Let's stop maintenance on our aircraft. It is too expensive to maintain those aircraft. If we cut maintenance dollars we have more operational dollars.

Too expensive to maintain the health of the military? Not when you compare it to maintenance.

Health care costs will continue to rise just like R&D, all acquisitions, etc. That is why we budget. The long-term consequences of not funding health care (which increased co-pay is) are decreased operational readiness and war fighters who are less healthy than they should be.

Anonymous said...

I am a retired Colonel and I agree with General Schwartz. We should raise the co-pays and fees for TRICARE. Active military are provided with full health care, as they should be. However, retirees and their families, who are under age 65 (at age 65 they become eligible for MEDICARE Part B and TRICARE For Life) can afford it and should be expected to pay considerably more than the unrealisticly low fees and co-pays in place now.

Dsrtknght said...

I agree with Gen Schwartz. Over the past 25 years, co-pays have remained the same while costs, military and retirement pay have increased. As co-pays are directly linked to using Tricare, only those placing a demand on the system would pay. Most retirees are in better health than their civilian counterpart, so our need for care is reduced. The alternative is to reduce Tricare services (ration care) or risk a decrease in defense capability.

Anonymous said...

I agree with the General. Our AF is flying planes that are expected to be operational up to 100-years old. I think the priority is renewing our fleet versus keeping health care costs down for our retirees. It is obvious that with a DoD budget exceeding $700B there are competing priorities and health care should NOT be the priority. I do think health care is important for men and women who made defending our country a career; however, they reap a benefit the rest of the American population doesn't--full retirement after 20-years. For some soldiers, sailors, airmen, and marines, that's a paycheck beginning at age 38-for life.

Anonymous said...

I guess this wasn't a big concern when we were being promised free healthcare for life if we completed a career in the military. The comment about retiring at 38, what percentage is that and I bet for the most part, medical costs for most is relatively low until about 50-60 or more. We have changed benefits before only to discover we have a recruiting problem and had to change back. I'm positive that using 1985 as a starting point is absolutely rediculous. Look at the growth since TriCare for Life was put in place and then measure the cost growth from there--much more realistic comparison if you are truly trying to make a real comparison. In my case, I am a retired LTC and did not become eligible for Tricare until 2 years ago, so I haven't been riding the system for years as some of you would have people believe. Even though I was promised "free" care, I would be willing to pay some small reasonable co-pays that increase as COLAs increase--none for two years now. However, I do not think it is fair to try now to relate the cost of civilian health care to military retiree health care. The ways both were earned are entirely different, with the latter almost always requiring much greater sacriface to earn. In some cases (not mine) the sacrifices were much, much, much greater. It would be better for everyone if DOD retiree healthcare was taken out of the individual services budgets and maybe out of DOD's budget altogether. Then, DOD and the services could be assessed some or all of the costs if desired. But, this would take it out of the individual services (and maybe DOD's) control and they could stop there bellyaching and see how much they could get for their precious planes, ships and tanks.

Anonymous said...

So, while Congress is trying to pass the DREAM act and give entitlements to aliens living in our country - the good General is saying we need to ask veteran's to pay more for their entitlements. Yeah, that's logical.

He states that 10% of the DOD budget is for healthcare, but statistics are relative numbers. I was at a ROA presentation 2 years ago, where they stated that it would be desireable to have the DOD budget floor at 4% of the National Budget. But, we weren't there, and aren't there, and the expectation is that the DOD percentage of the overall budget be lowered. So, while military healthcare is less than .4% (10% of less than 4%) of the overall National Budget...what percentage is Social Security, Medicare, and the new Healthcare Law of the National Budget?

Heard today that the President is talking about lowering the military's retirement pension amounts. Whenever budget cuts are required, we always hear about ways to cut military spending, which is constitutional under national defense. When do we ever hear about the cuts to all of the unconstitutional programs?

Anonymous said...

I recently checked my healthcare expenditures from January 1 thru July 31 of 2010. I am now on MEDICARE and Tricare for Life.

The amount billed by providers was a bit more than $96K. The amount paid by MEDICARE and TFL was approximately $23K, with TFL paying $4.7K of the $23K.

So, there seems to be a lot of room to maneuver in healthcare costs. But I have to believe that the DoD contribution for me will ground airplanes and tanks and ships!

Anonymous said...

How about if Congress takes retiree health care out of the DoD budget?

It took angry retirees to force DoD to own up to Tricare for Life in the 1990's. They were ready to throw retirees under the bus. Still, trying to get a retiree appointment on a base is tedious.

Congress just needs to get everyone off base, onto Tricare Remote, Medicare, VA etc. and quit trying to DREAM up an new give away program that will take benefits away from Veterans.

Let the military do what it does best and not be an auxiliary health care provider.

Anonymous said...

Just one more excuse for the ROA to not represent our needs. If the ROA doesn't believe that we are so much smarter than that and can see through this smoke, they are as far removed from their members as is possible.

We have fought independently more than the ROA for these benefits, even though these benefit driving initiatives were the promises made to us to get us to join by local chapters.

All we have seen is minimum efforts in reserve retirement, inequities in benefits, and now an effort to take away the little we have.

I can see you through the smoke ROA and you don't look pretty.

Anonymous said...

The good general has a disconnect with the Reserves and Reservists. Many like myself have spent the past ten years almost completely on active duty. Reserves are used as active duty on the cheap and when we retire with a couple of years short of the 20 active duty required for real benefits we receive nothing but the great gray area. Reservist were told that they were back fill for national emergencies--not active duty on the cheap. Add to that we no longer have jobs to go back to. Net result is that retiring Reservists can find it difficult to support the concept of Reserves because we no longer have Reserves. We have part time active duty that receive few benefits and employers shirk because they know they may be gone for years. If you use us as active duty then give us some of the benefits--not cut them! Do you honestly believe that cutting what few benefits left is going to help USAFR recruiting/retention or are you just relying on the high unemployment rates, especially for the Reservists? I no longer recommend Reserve service to anyone because it will ruin their civilian retirement and they will get nothing but the great gray from DoD.

wymapper said...

I believe that Gen. Schwartz needs to looks at the whole picture for the Reserves and National Guard. Our medical doesn’t cost that much. Except for five years of active duty (no dependents) I have footed my own healthcare for 35 years for my family, with 32 years in the Reserves at no cost to the military, except for an annual flight physical and a few shots. The military has covered 4 years in Tricare, and now two in Tricare for Life, with maybe 12-15 more years if I’m lucky. My reserve pension is not that much, and the medical is our main benefit. It’s even a more vital benefit for those who make much less, in the military or post military careers. It’s the cost of doing business, especially with the increased demands placed on our Reserves, today.

Maybe healthcare needs to be separated from the military budget, but it should remain in DOD, as its essential to the warfighter and the daily mission. I feel DOD can still make many cost saving moves, especially in training with it’s many redundant schools. How many flight schools do we need? Each service has it’s own intelligence schools, along with many other disciplines. It only appears that healthcare careers are merging their support structures with any speed. The current SecDef says we have to many at the top of the structure, and I agree, most senior officers try to build or add to their our empires. I get tired of senior staff saying they don’t have any problem paying more for healthcare, when most of their soldiers make much less. We do need to support our military, but it needs to be more streamlined. Our citizens are having to pay for two wars on borrowed money, and this contributes to underfunding personnel support. I’m not asking for more, but I would like to maintain a reasonable healthcare system.
Maybe we do need to increase the taxes on the upper two percent, to pay for our military sacrifices over the past ten years.

Anonymous said...

ROA: Are you paying attention to these responses? Can you begin to represent your membership?

As a close friend of mine once said, "This dog don't hunt." We earned these benefits. We are entitled to these benefits. This is no longer cutting into hide; it is cutting into bone - our bone.

ROA - 1) Do you care? 2) What do you intend to do? We want you to represent us. That is why we joined. That is why we paid membership fees. Our right is to be represented. Your duty is to represent us (your membership).

ReserveOfficer said...

We are indeed paying attention to the comments. Most helpful have been the comments that give testiment to the fact actual costs of using Tricare are less than represented by those taking aim at this benefit.

Having said that, Schwartz' comments are more of a warning shot than a threat to this particular benefit. He is not advocating getting rid of Tricare. He is, though, saying we have to reign in its cost to the government. This is a particular concern because if serving as an Operational Reserve gets more expensive than we are now, we are going to cost ourselves out of existence althogether.

Yes, ROA is representing the membership. Most recently we have helped the Congress establish a continuum of care in the form of Tricare Reserve Select and Tricare Retired Reserve.

We focus on these programs because a continuum of care is a readiness issue for the Reserve Components, not out of any level of perceived entitlement. Benefit to the member is simply a residual perk. You should have joined ROA because of our focus on National Security and our protection of the Reserve mission and the Reservist way of life.

That is what we continue to do today. Check out to see what we've done for you lately. It's only a brief list of both historical and recent triumphs.

Anonymous said...

The ROA has lost touch with membership. End of story.

Anonymous said...

I agree ROA has lost touch....get rid of them...stop apying your dues.

Anonymous said...

With all due respect the General is being payed to make the call. But, health care is something all active and retired military members have earned and should be FREE to all military (active and retired). Don't compare to civilian plans, let them come fight and die if the want free health care.
Threats of the world are changing and maybe some expensive weapon systems are not needed.
General, you make to call, but people over machines wins with me everytime.
Air Force is not General motors and should never be, the country, Congress, and President should know this.