Pentagon fears healthcare costs will erode
readiness
Aging population is driving up fees
By Laura M. Colarusso and Bryan Bender
Globe Staff
WASHINGTON -- Like the many major corporations
that insist their competitiveness is undermined by rising medical bills,
the Pentagon is warning that mounting healthcare costs could jeopardize
the military's ability to wage war.
Because of an aging population and skyrocketing medical fees, the annual
cost of military healthcare has more than doubled from $19 billion to
$39 billion since 2001, according to Defense Department data. That
number is expected to climb to $64 billion by 2015, Pentagon officials
estimate, consuming roughly 12 percent of the defense budget.
"Without relief, spending for healthcare will . . . divert critical
funds needed for war fighters, their readiness, and for critical
equipment," Dr. William Winkenwerder , assistant defense secretary for
health affairs, recently told Congress. "Healthcare costs will continue
to consume a growing slice of the department's budget."
The military health plan, known as Tricare, covers approximately 9
million people, including active-duty troops, veterans, and family
members. It was expanded in 2001 to allow retirees over 65 and their
spouses to tap into the Pentagon's medical coverage. The new plan,
called Tricare for Life, is a free supplement that covers any charges
not paid for by Medicare.
At the same time, annual premiums for younger Tricare consumers have not
changed for more than a decade, even as medical costs have steadily
ballooned. Defense officials attempted last year to raise these fees,
which range from $150 to $460, but faced stiff resistance from a
Congress unwilling to take on veterans' groups.
Still, many specialists note that the cost growth is coming not from
injuries on the battlefield -- because most beneficiaries never came
close to combat -- or from problems at military hospitals or the
Veterans Administration.
The biggest increases are from the same basic-care expenses that have
weakened General Motors and other corporations that have agreed to cover
large numbers of retirees. And the Pentagon's plan is far more generous
than most.
"It's been one of the biggest areas of growth [in the military budget]
in recent years," said Steven Kosiak , vice president of budget studies
at the Center for Strategic and Budgetary Assessments, a nonpartisan
think tank in Washington. " Most developed countries . . . probably
don't spend as much on their militaries as we spend on military
healthcare."
Kosiak and other independent defense analysts say the growing price tag
underscores a larger financial problem confronting the Defense
Department. As costs for everything from healthcare to aircraft continue
to rise at rates far greater than inflation, the Pentagon's budget is
not keeping up.
"The problem that they have is that, over time, it's not clear that the
total defense budget is going to increase at a rate that's sufficient to
absorb these healthcare costs," said Susan Hosek, a senior economist at
the Rand Corporation , a nonprofit research organization. "So the
concern is that over time they're going to have to shift their resources
from military personnel or equipment to pay for healthcare costs."
The Pentagon has seen temporary relief from Navy and Air Force personnel
cuts, which have lessened the demand on the healthcare system. The two
services plan to eliminate more than 100,000 jobs in the hope of saving
billions in pay and benefits over the next several years.
In 2008, for example, the Navy and Air Force together will slash
manpower by roughly 15,000. Pentagon officials estimate those reductions
will save the health system $138 million per year.
"If we weren't at war now, I think the path would be that the services
would all start cutting their force structure a bit in order to help
reduce the number of people they have and save money that way," Kosiak
said.
Instead, the opposite is happening. President Bush has proposed that the
Army and Marine Corps add a total of 92,000 troops over the next five
years, which would mostly offset the savings achieved by the Navy and
Air Force cuts.
Meanwhile, unlike the private sector, which has shifted more of the
burden to employees, Congress seems unwilling to allow the Pentagon to
raise premiums on military health plans.
"The Pentagon has tried before to raise the cost of healthcare for our
servicemen and women, and Congress has soundly rejected it," said
Senator Edward M. Kennedy, Democrat of Massachusetts and a member of the
Senate Armed Services Committee. "Our forces have dedicated their lives
to our country, and we shouldn't ask them to pay more."
That means the Pentagon must find other ways to pay for healthcare, such
as cutting personnel, said Christopher Hellman , defense policy analyst
for the Center for Arms Control and Non-Proliferation, another
Washington think tank.
"You can't really go back and reduce benefits," Hellman said. "That's
never worked. You have to go back and reduce the number of people."
---------------
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