Wednesday, May 16, 2012

Healthcare: A Catch-22 for Reservists

In the early hours of Thursday morning, May 16, 2012, the House Armed Services Committee approved a $643 billion defense budget for FY 2013. Notable among the HASC approved amendments to the FY13 National Defense Authorization Act (NDAA), is broad rejection of changes to the current TRICARE fee schedule With deference to TRICARE’s 9.3 million beneficiaries, including 5.5 million military retirees, Chairman Howard P. “Buck” McKeon offered a different approach in amending the bill; one that ensures fiscal responsibility while protecting the benefits earned by those who risk their lives to defend the nation. While rejecting the majority of the President’s proposal concerning TRICARE, McKeon’s mark does include an increase to pharmacy copays in 2013, and a cap on pharmacy copays beginning in 2014. More importantly, for the Reserve service members, McKeon’s mark extends Tricare Reserve Select for 180 days for members of the Selected Reserves who are involuntarily separated from service.

The decision to avoid a substantial fee hike along with the 180 day extension for Tricare Reserve Select should be applauded as an appropriate step towards meeting the health care needs of today’s 21st century Reservists. However, it is not the ultimate solution. Unlike previous conflicts, veterans of Iraq and Afghanistan represent less than one percent of the total U.S. population. More than 840,000 National Guard and Reserve troops have served in Afghanistan and Iraq during the past decade, many having been deployed multiple times. Upon returning home, these men and women represent a battle hardened force of combat veterans. Yet despite progress as a total force, the individual toll for each service member is undeniable.  Reservists have been hastily channeled through a post-deployment process that does not adequately identify or address the personal challenges these veterans face, including signature wounds like post-traumatic stress and traumatic brain injury. While their active-duty counter parts return to military bases with free, comprehensive medical care and support networks, Reservists return to their civilian homes, often far and away from their fellow veterans and the networks of support at the military base. Ultimately identification, diagnosis, and action fall into the hands of the Reservist and his or her family.

In 2005, the NDAA established a health plan to give Reservists access to Tricare for a monthly fee. However, as it comes with a monthly fee, many still choose to go to Veterans Affairs facilities that provide free care from specialists. These facilities, like their fellow veterans, are often far and away. Further, these facilities often encumber the patient with long, many times tedious clerical steps before receiving initial treatment. Finally, with the total troop withdrawal from Iraq and the increased troop withdrawal from Afghanistan, these facilities are often overcrowded and do not give veterans the necessary time and attention they need.  Between the Tricare fees and the VA facilities, Reservists face a Catch-22 when it comes to healthcare. Coming off deployments, often carrying untold burdens, these veteran Reservists many times opt to avoid seeking help and put their healthcare on the back burner.

This Catch-22 scenario has historically been passed to successive generations without a comprehensive solution. With over ten years of conflict and the vast number of Reserve and Guard troops slated to return from deployment in the coming years, now is the time for serious consideration and review from all levels of the government to ensure that these men and women receive the services they deserve after sacrificing so much for their country.


Anonymous said...

While our health care upon retirement is a vital concern for all of us the significant and unending problem of trying to obtain prompt and optimal medical care for almost 300,000 of us who are disease and non-battle injury casualties from operation desert storm and now over 750,000 disease non-battle injury casualties from operation iraqi freedom, operation enduring freedom and operation new dawn in addition to those who were wounded in action remains extremely difficult if not impossible because neither the VA or DOD leaders want to admit we have generated so many casualties as a consequence of complex toxic exposures due to our actions of failure to act to protect the troops. With 15% of the active duty army on medical profiles- nence non deployable and with over 320,000 OIF OEF OND veterans of the guard and reserve who have deployed and now are back home to their units of discharged after release from active duty already listed as casualties and who are already receiving or trying to obtain prompt and optimal medical care that is being delayed, denied, or ineffective we must do something now. Just last week the VA's own IG confirmed PTSD care was broken and the Army Times (
Fire dishonest VA staff) called for firing all of those in the VA who have failed to provide us the care we have earned. Now the Army even admits PTSD care is broken too ( ) and they will review all cases going back to 2001 but it should go way back.

Anonymous said...

What are "they" doing about lowering the bill for Tricare Retired Reserve Healthcare for a family of two or more? It's over $1,000 a month! I think this probaby makes it the highest of all Tricare Fees out there! Raising Tricare fees? Don't forget gray area retireee's are a mobilization asset and subject to recall until they are 60! This is the healthcare plan that reserve memebers face when they retire. And this is when they need it the most!