We Mister Chairman and distinguished members of this committee. greatly appreciate having this opportunity to present our views on behalf of the 170,000 members of the Air Force Sergeants Association (AFSA) and all enlisted personnel of the Air Force, active, Guard, Reserve, retired and veteran. Health care is an issue of increasing importance to our members and their families. It is ironic that we are presenting our views on this issue to you, because we are very much aware of all the persistent efforts that your committee has expended over the past several years to improve the military health care system. The adage, "preaching to the choir," is the most appropriate way to describe the situation that we are experiencing. However, we are taking this opportunity with optimism and hope that the administration, and specifically the Department of Defense (DoD) will get the message loud and clear to take the most responsible courses(s) of action without delay. We cringe when we think of the shape our military and veterans health care systems would be in if we did not have the benefit of your oversight and prodding to those departments and agencies whose responsibility it should be to "take care of its own:" The deserving military personnel and their families and survivors. In our testimony we will bypass the tendency to reiterate the reasons for our government's obligation to provide medical care and the current problems and deficiencies that currently plague the military health care system, because you are already fully knowledgeable of those facts. Neither will we expound upon the advantages and successes of the CHAMPUS Reform Initiative (CRI). The extensive testimony that you have already received to support our position on Department of Defense's (DoD's) recent Request For Proposal (RFP) to replace CRI with the Coordinated Care Program (CCP) is more than sufficient to convince anyone that continuing and expanding CRI is the only sensible decision Why would anyone elect to replace a program that not only has a 95 percent satisfaction rate among beneficiaries, but also saves money for the government (and taxpayers)? We will limit our remaining discussion to encourage your support of several additional Recommendations: Recommendation: That CHAMPUS become second payer to Medicare for all DOD beneficiaries. Toward this end, we encourage your support for legislation already introduced (H.R. 1124 introduced by Representative Charles E. Bennet (D-FL) and S. 177 introduced by Senator Daniel Inouye (D-HI). Recommendation: That authority be granted for HCFA to reimburse Military Treatment Facilities (MTFs) for treatment of Medicare eligible DoD beneficiaries. This concept, called Medicare Subvention, would allow military retirees and dependents age 65 or older to be treated in a DoD medical facility with the cost at a discount rate, paid by Medicare. The desired result would be to motivate military facility commanders to increase patient load with the knowledge that the reimbursement would enable them to expand the capacity of their facilities. With MTFs operat ing at less than maximum capacity, subvention would result in several ad Better access to health care for our military retirees by eliminating existing discentives to treat medicare dependents in MTFs. - Significant savings of taxpayer dollars because treatment in military facilities generally is less costly (approximately 40% less) than in comparable civilian facilities which would otherwise be used and paid for by Medicare. • Recommendation: Guard against legislation that, while attempting to improve health care quality and availability for the majority of Americans, would discriminate against a minority, such as military retirees. For example, two bills (H.R. 3205 and H.R. 1444) would reduce the age of eligibility for Medicare from age 65 to 60 or 62. As a result, military retirees and their spouses would lose CHAMPUS, which is more generous then Medicare, three to five years earlier than they do now. AFSA opposes these bills, unless an amendment were included that would prevent the loss of CHAMPUS prior to age 65 for military retirees. • Recommendation: Funding Two of the previously discussed recommendations (CRI and Medicare Subvention) would result in significant savings. After this savings is applied toward the projected costs of implementing the other recommendations the remaining costs (if any) should be funded by a small percentage of the projected "peace dividend". With the drawdown of Armed Forces, a sizable peace dividend (estimated to be from a low of $50 billion to $150 billion) will be realized within the next two to five years. Before all of this peace dividend is committed toward reducing the deficit, reducing taxes, providing economic growth incentives, or other legislation, it is imperative that each member of Congress and each member of the administration stand back and take a close and unbiased look at how this dividend was earned then ask, "who earned it for our country? who fought. sacrificed. bled and died to win the peace that is providing the dividend?" Once those questions are answered honestly, there should be no doubt that the first part of the dividend resulting from reductions in defense spending must be used to keep this government's promises to our military personnel, veterans and their families and survivors, who deserve the very best benefits and entitlements our country can provide. And, Military medical care should be among the highest priorities. Summary: We hear many horror stories about beneficiaries who experience tremendous personal and financial hardships as a result of the inadequacies in the DoD Medical Care System. Of course, you are explicitly familiar with one of the most drastic examples, the story of Mr. and Mrs. Andrew Cox. The responsibility of the government to provide adequate health care to all beneficiaries, including military retirees, has been clear for decades and it is finally time to learn from past mistakes and successes and to implement those policies and programs that will provide the best health care, with the highest accessibility at the lowest possible cost. Those policies and programs are: |