Health System Seeks Savings While "Retaining Excellence"
By Jim Garamone, AFPS, WASHINGTON, March 9, 2012 - Iraq and Afghanistan have been dangerous places over the past decade, but deployed troops often passed a saying on to new arrivals: "If you've got to get shot, this is the best place to do it."
The saying spread because the medical care for wounded service members was state-of-the-art, with the survival rates significantly higher than in previous conflicts.
Dr. Jonathan Woodson, assistant secretary of defense for health affairs, told the House Appropriations Committee's defense subcommittee yesterday that he wants to retain this excellence while controlling spiraling costs.
"Over the last 10 years, the men and women of the Military Health System have performed with great skill and undeniable courage in combat," Woodson said. "Their contributions to advancing military and American medicine are immense. The Military Health System's ability to perform this mission and be able to respond to humanitarian crises around the globe is unique among all military and nonmilitary organizations on this globe."
Military health System officials are taking four roads to savings, Woodson told the panel. The first is to find efficiencies inside the system. The second is a continuation of efforts to "appropriately pay" for private-sector providers. [Charging Retirees up to $2100 for health insurance.] A third initiative promotes healthy lifestyle choices while seeking to reduce illnesses, injuries and hospitalizations. [Tell Retirees how to eat, instead of treating the issues.] The last is proposed changes to beneficiary cost-sharing under the TRICARE military health plan. [Charge Troops and Veterans for combat related & work related medications due to injuries. It means women in the Tri-Care will have to pay 5x what civilian sector insured women pay for their birth control medication.]
The fiscal 2013 defense budget request includes this recommended path "to reorganize the military health system," [That's charging the Troops, not just the washed out old retirees that have already sacrificed their bodies for the country.] Woodson said. "We have learned a great deal from our joint medical operations over the last 10 years," he added, "and we recognize that there is much opportunity for introducing even a more agile headquarters operation that shares common services and institutes common clinical and business practices across our system of care." [This means fewer Soldier-Doctors that deploy to combat with Our Troops and more more expensive contracted or Tricare Doctors that the Troops have to pay premiums to see.]
Woodson noted that the recommended changes to TRICARE fees came about only after officials had explored other avenues of potential savings. "Before we even considered TRICARE fees, there were a number of initiatives and considerations taken," he told the committee. [In Woodson's opinion, the agreements made with the Troops can be tossed out on a whim by a politician.]
DOD health affairs is looking to control headquarters costs, Woodson said, and it has had some success eliminating 780 full-time equivalent positions from the headquarters. Other efforts, he added yielded further savings.
"We put in a number of management reforms that have yielded very positive results in reducing costs, including a robust fraud and recuperative program that has yielded $2.6 billion over the last four years," he said.
In addition, Woodson said, a pharmacy management program has saved $ 3.4 billion, medical supply and acquisition standardization has saved $31 million, and an amalgamation of other efficiencies that saved about $1 billion. [Yes, they first started pushing for charging Troops & Retirees for their medications in 2009, and have successfully instituted the program by charging a "nominal" fee and are now asking for huge increases in that fee.]