Our Money’s Worth

I always get frustrated when the members of the Joint Chiefs of Staff opine about rising healthcare costs in DoD and their assertion that us mean,ole Retirees are what’s causing costs to rise out of control.  One gets the impression from listening to their rhetoric that this is the only way to fix things.  Just make the retirees pay more…..that’ll fix it!  Of course, they say they won’t mind paying higher fees because under their retirement system they stand to make much more money in retirement than they ever made  on active duty.  Look at the pay tables for a four-star…..a four-star retiring with 41 years of active service makes a base pay of about $181,500 a year (the table actually says $237,144, but because of Federal pay cap limitations, they are held to the lower number). That’s not including various allowances.  Once they retire, let’s say with 41 years (about right for a four star) their retired pay is calculated by multiplying their uncapped pay by the appropriate multiplier, in this case 102.5%.  That means retirement pay will be $243,072 bucks a year…….not bad…..I wouldn’t mind paying those additional premiums either!  Not to mention all the high-paying board jobs that they will get………..So they have no credibility with me when they say they don’t think increased premiums for retirees will have much of an impact on the average retiree. My retirement was capped at 75%.  I propose that as a gesture of good faith, all four stars forfeit all money they get in excess of the maximum amount they made on active duty.

A recent CBO study made three recommendations on how to control DoD health care costs, yet we only hear about one of them, increasing retiree costs.  Here is the complete report but the three things CBO cites as ways to control costs are:

  1. Better management of chronic diseases
  2. More effective administration of the military health care system
  3. Increased cost sharing by retirees

How come the brass never mentions the first two?  I can guarantee you we waste a lot of money in administration, special pays, unnecessary medical procedures,  and excessive equipment, but I never hear what DoD is doing about that.  One would think that before off-loading the burden of paying for healthcare cost increases on those who faithfully served, the powers-that-be would exhaust all other possible avenues….but not so here.  Why?  Because it’s just too hard to fix the first two and it’s all too easy to point at retirees as the root of the problem.  Don’t get me wrong….I support yearly increases in TRICARE premiums that track economic indicators…..but don’t make it seem like we retiree are the only problem.  It’s time for those in charge to acknowledge that there is much more to increasing health care costs than just retiree benefits.

I was so inspired by the article in today’s WaPo concerning the Soldier who has received a double arm transplant……It’s makes me proud to be an American when I read those stores.  But that technology costs a lot of money…..and we should spend it without question.  How come one of the Joint Chiefs never points out that we have thousands of casualties from a decade of war who deserve the best we can offer and that the increased costs associated with this high quality healthcare are going to be steep.

I also think that there is no incentive within the medical community to reduce costs.  There is every specialist imaginable in military medicine and we have to keep them busy.  Take dental care for example.   Mr. and Mrs. America go to their family dentist.  When they need a filling, the dentist does it.  When they need a root canal, the dentist generally does it, when they need a tooth pulled, that same dentist does it.  Not so in military dentistry….you have to go to an endodontist to get root canals and an oral surgeon to have teeth pulled.  That care probably cost at least 3 times more than it does in civilian life. That’s just one example of why health care costs so much more in the military.

And just take a look at how long we have been futzing around with electronic medical records and joint records with the VA.  Here’s a quote from an article in NextGov: “Worried that the Defense and Veterans Affairs departments might continue to spend years and billions of dollars in a “futile exercise” to develop their own electronic health record systems “and lose sight of the end-goal of an interoperable record,” lawmakers included funding restrictions in the 2014 Omnibus Appropriations Act the House passed Wednesday.” AMEN.  

So my point is that before trying the easy way out by radically increasing retiree health care costs, why doesn’t DoD get its own house in order.  If DoD can stand up in front of the world and say “We have done all we can to fix the way we manage chronic illnesses, streamline administrative processes, incentivize cost reductions within military medicine and there’s not another dime there,”, then I will cheerfully consider ways to increase the money I pay for my retired health care.  Until then, I ask that they stop beating that horse (the one that died when they first proposed healthcare premium hikes 10 years ago)

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