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OFFICIAL ISN'T KEEN ON TRICARE FEE HIKES --
"Just from
the standpoint of doing the right thing for the
patient, I think
abrupt changes in fees and deductibles could be
unsettling."
Story here...
http://www.heraldnet.
com/stories/07/06/09/100b
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Story below:
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Official isn't keen on TRICARE fee hikes
Tom Philpott
Dr. S. Ward Casscells is a cardiologist. But he has more than medical
skills now to ease the stress on military retirees from recent proposals
to raise sharply their health care fees, co-pays and deductibles.
Five weeks ago, Casscells became the new assistant secretary of defense
for health affairs, arriving from the University of Texas' Health
Science Center in Houston, where he was a distinguished professor and
its vice president of biotechnology.
His appointment could be good news for under-65 retirees and their
families because Casscells isn't a fan himself of the steep fee
increases for the military's TRICARE program that Defense officials
proposed early last year.
"Just from the standpoint of doing the right thing for the patient, I
think abrupt changes in fees and deductibles could be unsettling," he
said.
As the Pentagon's top policymaker on health issues, Casscells will be
working with lawmakers next year on a more palatable set of increases.
"I would look for some small, gradual increases in fees and deductibles
over the years. Not this year, because we've got plenty on our plate
right now - more than we can say Grace over," said Casscells in a
45-minute phone interview, his first since becoming assistant secretary.
Casscells, 56, exudes the good will of a country doctor rather than the
caution of new political appointee who fears moving off message. "I'm
trying to be a policy guy," he said. "I haven't graduated to politics
yet."
He peppers his remarks with homespun humor and self-deprecation. He
compared his first weeks on the job to riding the mechanical bull at the
Houston Livestock Show and Rodeo. He acknowledged that the military
surgeons general are upset about "efficiency wedges" imposed on their
budgets. They probably liken that term, he said, to the bedside manner
of Procrustes from Greek mythology, who invited travelers to stay for
the night and then either stretched their bodies or amputated their feet
to fit the bed.
Casscells wants beneficiaries to feel they are partners in actions ahead
to make military health care more efficient and effective. He praised
the work of his predecessor, William Winkenwerder, saying that "in a lot
of areas he had the ball on the 10-yard line," which makes a new
quarterback's job easy.
But Casscells doesn't sound the same alarms over the doubling of
military health costs since 2001. He noted that 17 percent of the
nation's gross domestic product last year went for health care, yet
health spending by the military is only 8 percent of the defense budget.
"By that metric we're doing okay. There are other metrics which make us
look less efficient in the civilian health world. And there is no doubt
we can be more efficient because we're not at full capacity" in base
hospitals.
But the private sector is different, Casscells said. They "fill their
hospitals the way airlines keep their planes full. There is no excess
capacity for emergencies such as pandemic flu or a hurricane. They are
not required to be mobile and expeditionary. They are not required to
practice overseas. They are not required to practice under gunfire. They
don't have to have redundancies - a [back-up] system in the event a
system takes a direct hit."
Casscells describes a kind of a mid-life romance with military medicine.
Awarded Army research grants over the years, he got to work closely with
the U.S. Army Medical Research and Materiel Command at Fort Detrick, Md.
"I was really struck by their work ethic and their integrity and team
spirit. Frankly, the tone of discussion was invariably at a high level,
wanting to do that right thing for soldiers and for discovery and
invention."
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Larry Scott --
