Healthcare Task Force Releases Interim Report

The Congressionally-mandated Task Force on the Future of Military Healthcare released its interim report. It came as no surprise to learn that they are recommending an increase in TRICARE fees for some beneficiaries.

The report recommended:

--Increasing drug co-pays for those who do not use TRICARE mail order pharmacy programs or generic prescription drugs.

--Increasing costs for those who get their prescriptions filled outside the military system.

--Raising out-of-pocket expenses for retirees under age 65, but giving them a one-time increase in retired pay to offset part or all of the higher expenses.

--Indexing annually the premiums and deductibles paid by under-65 retirees to account for inflation, and increasing military retired pay to help with those higher costs.

--Increasing premium and cost shares for under-65 retirees to a level comparable to private sector health insurance plans.

--Creating a tiered-system for under-65 retirees based on their retired pay grade.

The final report will be released in December 2007.

In a letter to Congress, the Task Force pledged that the final report would be “specific, compassionate and practical in its recommendations.”

View the report in its entirety - http://www.dodfuturehealthcare.net/images/Task_Force_Interim_Report_053107.pdf.


Mental Health Topic at Press Briefing

Mental health was the topic at a Pentagon press conference last week as the Mental Health Task Force released its report.

Dr. Ward Casscells, Assistant Secretary of Defense for Health Affairs, said, “This issue of how to reduce the stigma is one where we need all the input we can get. We're out there talking to soldiers, line commanders, people in the corporate world, people in the university world, Institute of Medicine. We've got two eyes open, two ears open, a lot of eyes and ears open, so we're looking for ideas on that.”

Dr. Casscells, who served in Iraq as an Army reservist, added, “This is a very important issue, also, from the standpoint of the pain and suffering for the families and then the financial implications. And as all of you know, we do not have a perfect understanding of mental health and of neurological health, so this is a great challenge on the research front as well. So this has for me now become job number one, and it impacts everything we do from our determination to improve the frustrating disability process to improvements at Walter Reed, and planning our improvements in our medical education and the like.”

Shelley MacDermid, Director of the Center for Families at Purdue University, and the civilian expert serving on the task force said, “I think the task force members would say number one, more resources are needed. And that's a job for both Congress and DoD.” This would be above the $600 million included in the recently-passed emergency defense spending bill for mental health care, specifically Post-Traumatic Stress Disorder and traumatic brain injury.

“Number two, service members and their families need more access to providers. For service members, that means the placement of providers closer to where they are. For family members, that means access to more providers at military treatment facilities, and it means improving the depth of the TRICARE network around the country with regard to mental health,”

MG Gale Pollock, acting Surgeon General of the Army, said that reducing the stigma of seeking mental health care remained an issue for service members who felt that it could affect their chances for promotion, holding on to security clearances and even remaining in uniform.

“Because of that stigma, it's very important that people have easy access. So one of the changes that we've made is a program that we've called respect.mil, in which -- instead of requiring the soldiers or the family members to go to a designated location because you're getting behavioral health, it's now done inside the primary care area so that we can do the assessment, and people can just come to the clinic for behavioral health issues the same as they would come for any physical health. Because we need to bond together the psychological and physical components of ourselves so that we can stay well.”

Other recommendations to reduce stigma include embedding health-care providers in units and offering treatment at military clinics and hospital, rather than in a separate facility. The report also called for training, beginning at entry level for soldiers, sailors, airmen and marines, in how to become more resilient in the aftermath of difficult events.

The report contained 95 recommendations needed to transform the military’s mental health care system designed for peacetime operations to one that can address the needs of hundreds of thousands of service members who have served at least one tour in Afghanistan or Iraq.

In creating the task force, Congress required the defense department to develop a plan of action in six months. The task force visited 38 military care facilities in the United States and overseas and held a series of hearings at a number of those sites. Gen. Gordon R. Sullivan, USA, Ret., and president of the Association of the United States Army, testified at one of the hearings held in Arlington, Va.

At the hearing, he said, “With 51 years of being a soldier, I am pleased to see our nation paying attention to mental health and you have brought this out of the closet. Many of the casualties you are talking about you cannot see,” such as sleeplessness, chronic fatigue and reconnecting with family following deployments. It’s tricky stuff. It’s not all going to Disney.”

Gen. Sullivan, citing the example of Fort Lewis, Wash., in addressing mental health concerns, said, “I don’t believe there should be a stigma to seeing face-to-face a mental health professional.” Adding, “I don’t care if you are a colonel, a general or the lowest private.” He also voiced his concern over the mental health care that medics, doctors, chaplains, casualty assistance officers and mortuary affairs specialists might require and the isolation that guardsmen and reservists might feel when they have no one to share their experiences with. “Is there anyone there to listen?”

Other high-risk populations include wounded service members and their families, families of the deceased and wounded soldiers in long-term treatment and rehabilitation, Gen. Sullivan, a former chief of staff of the Army, said.

“Not since Vietnam have we seen this level of combat, Vice Adm. Donald Arthur, co-chairman of the task force, said. With that as a fact, “we now find that we have not enough providers in our system. We have a deficit in our availability of mental health providers.”

Included in the report were findings from earlier surveys that 38 percent of active duty soldiers, 31 percent of active duty Marines, and 49 percent of soldiers in the Army National Guard and 43 percent of Marine Corps reservists reported symptoms of Post Traumatic Stress Disorder, anxiety, depression or other problems with 90 to 120 days after returning from deployment.

“If you have a post-traumatic stress reaction, it’s not your fault,” Vice Adm. Arthur said. “It’s up to leadership to say to folks that post-traumatic stress reactions are an absolutely normal part of combat operations.”

The task force’s report also cited the special difficulties facing guardsmen and reservists and their families who do not live near military facilities with their networks of mental health providers, chaplains and family readiness components.

“We're very concerned about how we keep track of them. So a vital aspect of this is how we keep track of the reserves and the National Guard, and especially for reserves and National Guard, how -- with what frequency we have them come back together as a group and assess their psychological status, assess whether we need to do some training or certain intervention,” Vice Adm. Arthur said.

At the same time as the need within the services are rising for more mental health providers, more are choosing to leave the services. The Army lost 8 percent of its active-duty mental health providers from 2003 to 2005; the Air Force lost 20 percent from 2003 to 2007.

Vice Adm. Arthur said, “I would add that one thing we have highlighted in the report is the value of uniformed providers, or, better said, the value of providers who have experienced the military milieu, especially combat, that they can understand the active duty and service members' families' issues better.

“When I testified in front of the House Armed Services Committee a month ago, Congressman Walter Jones from North Carolina came in -- he was one of the members, and he said that he had been to Camp Lejeune to a grade school, and he asked the kids, ‘Is your mom or dad deployed?’ And one of the young children, a second grader, said, ‘Yes. My dad's in Iraq, but he's not dead yet.’ It gives me goose bumps just to think about it, to think about the impact on families and the fact that we have to have a military system and a surrounding civilian school system that understands the military life, and that it's not normal to expect that your father might not come back. So we concentrate on the families as well.”


Tax Relief Legislation Introduced

Sen. Harry Reid, D-Nev., is cosponsoring legislation that would provide tax relief to members of the military, National Guard, Reserves and their families and employers.

"People who serve in the armed forces are willing to put their lives on the line to protect our country and we should make sure that they are properly taken care of," said Sen. Reid. "This is good legislation that will help deliver significant tax relief to members of our military and their families here at home."

The Defenders of Freedom Tax Relief Act would:

--Continue to allow veterans to be eligible for the mortgage revenue bond program irrespective of that program's requirement that it be limited to first-time homebuyers. This provision currently is scheduled to expire at the end of 2007.

--Continue to allow service members to elect to count combat pay as income for purposes of qualifying for the Earned Income Tax Credit. This provision currently is scheduled to expire at the end of 2007.

--Extend the time that military retirees can file amended returns to obtain refunds of tax on non-taxable VA benefits that are awarded retroactively.

--Treat differential pay received by National Guardsmen and Reservists from their employers to help reduce the gap between their military pay and their civilian pay as wages for purposes to ease tax reporting for both the employer and employee.

--Provide small employers an income tax credit to encourage them to provide members of the Guard and Reserves differential pay to help reduce the gap between their military pay and their civilian pay.

--Continue to allow reservists called to active duty to receive distributions from a qualified retirement plan without having to pay the 10 percent penalty for early withdrawals and provide a 2-year period for the reservist to re-contribute such amounts to an IRA. This provision currently is scheduled to expire at the end of 2007.

--Allow survivors of soldiers killed in the line of duty to contribute gratuity payments received from the Defense Department to a Roth IRA account.

--Continue to allow intelligence officers to suspend the time period for qualifying for the tax-free sale of a home when stationed overseas. This provision currently is scheduled to expire at the end of 2007.

--Codify the tax-free treatment of payments made by States to members of the military as thanks for their war service.


Finally…

Rep. John Lewis, D-Ga., introduced H.R. 1921, a bill that would give taxpayers the right to refuse to have their tax dollars support the Pentagon. Instead, those opposed to the war and to military spending could opt to have their tax dollars sent to a Religious Freedom Tax Fund instead. The bill was referred to the House Ways and Means Committee.



Question of the Week
Which President declared war on Great Britain in 1812?(Click on link for answer)

Answer -
On June 18, 1812, President James Madison signed a declaration of war against Great Britain, marking the beginning of the War of 1812. Frustrated by Britain's maritime practices and support of Native American resistance to western expansion, the U.S. entered the war with ambitious plans to invade Canada, a goal that was never realized.

The strength of the British army proved too great for U.S. forces. Both on land and at sea, U.S. troops suffered great losses. In August 1814, British troops entered Washington, D.C., and burned the Capitol and the White House. By December, both the Americans and the British recognized that it was time to end the conflict. Representatives of the two nations met in Belgium on December 24 and signed the Treaty of Ghent, which ended the war and restored previously recognized boundaries between the United States and British territory in North America.

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