Obama: National health plan won't hit Tricare, VA care

Tom Philpott

President Obama says his push to reform the nation’s health care system will not diminish health benefits for service families or retirees who use TRICARE, or for veterans who rely on VA hospitals and clinics.

In fact, he suggested, as health reform takes hold across the country, veterans who, for example, live far from VA health facilities, could see reasonably affordable alternatives being offered closer to home.

“If you're in the VA [health system] or TRICARE, this will not force you to change systems,” Obama said.  But those eligible for VA benefits also should know that, with national health reform, “veterans would be eligible, potentially, for this health care exchange where they could select from a different set of plans,” Obama said.

Under such exchange plans, he added, veterans might receive “some help in paying for their premiums, depending on what their income levels were.  So it'll actually give them more choice and more flexibility.”

Whatever system a person is in -- VA, TRICARE, private insurance or Medicare – Obama said, “we have a problem with health care generally in this country.  We pay about $6,000 more per person than any other advanced nation, and our health outcomes are not much better and in some cases a little bit worse.”

Separate from the issue of national health care reform, however, Obama acknowledged that Defense Secretary Robert Gates remains worried about the rising cost of TRICARE.

“Bob Gates will talk to you about the degree to which his budget is being sucked up by health care inflation,” Obama said.  “And, obviously, in the private sector as well as in Medicare and Medicaid, it's a huge problem.”

He stopped short, however, of supporting another push by Defense officials, as occurred annually under the Bush administration, to raise TRICARE fees on working age retirees, though fees have not changed since they were set in 1995.   

Obama and VA Secretary Eric Shinseki sat down Tuesday for 45 minutes at the White House with a small group of journalists who cover pay and benefit issues for military members, retirees, veterans and their families.

The president said that as Congress goes into summer recess and some major service organizations hold annual conventions, he wanted to point out what his administration had accomplished for veterans during his its first seven month.  He ticked off the details for five minutes without consulting notes.  Among them:

-- The largest VA budget increase in 30 years.

-- An additional $25 billion over five years to improve diagnosis and treatment of Post-Traumatic Stress Disorder and Traumatic Brain Injury, signature injuries of wars in Iraq and Afghanistan; to open more VA clinics in rural areas, and to hire more claim adjudicators to address a growing backlog of disability claims.

-- A more aggressive “outreach” effort to educate veterans about their benefits.  “Although there are hundreds of thousands of veterans who are using services, we know that there are hundreds of thousands more who may not know that benefits are available,” said Obama.  VA is “working hard to make sure that every single veteran -- not just of our active forces but also the National Guard and reservists -- are aware of the benefits that are available to them and [we’re] guiding them through that process.”

-- Congress, with Obama’s endorsement, is near to allowing advance funding of VA health care budgets, thus ending chronic budget delays each fall that forced hospitals and clinics to operate for months short of staff, supplies and money to maintain facilities or buy equipment.  

-- Implementation of the Post-9/11 GI Bill, which Sen. Jim Webb (D-Va.) introduced and pushed through Congress last year.  The president said the new GI Bill, like the one offered after World War II, will produce “a highly educated workforce…to help to drive economic growth for many years to come, even as it provides a tangible reward for people who've made such extraordinary sacrifices on behalf of our country.”

Obama was asked if he would support a legislative change to the new GI Bill to make National Guard members activated under Title 32, in response to domestic emergencies or homeland security missions, eligible for the education benefits.  Currently, only those activated under Title 10, to serve under the president’s command in Iraq and Afghanistan, are eligible.

The president gave a qualified yes, saying he didn’t know all of the details “my budget people” are discussing with congressional committees in their effort to end various glitches in last year’s law.

“My general philosophy is that somebody who's served in uniform on behalf of our safety and security…should be eligible,” Obama said. 

Obama and Shinseki conceded there are other tough challenges ahead including how to make compatible VA and DoD electronic health records for seamless transition of care and how to help 131,000 homeless veterans.

“Homelessness is sort of the last indicator that things [are] in a downward spiral,” said Shinseki.  “It's about jobs; it's about education…it's about mental health and depression amongst veterans.  They happen to lead in that category [of] substance abuse.”

Shinseki said something in the system failed homeless vets, and it won’t be solved by physically taking them off the street.  VA is working with the departments of Health and Human Services, Labor and Education, as well as with the Small Business Administration, on “collective efforts” to help.

“Addressing the homeless problem in this manner solves a lot of other issues that veterans wrestle with,” said the VA secretary, alluding to the need for mental health counseling, job training and small business support.

To comment, e-mail milupdate@aol.com, write to Military Update, P.O. Box 231111, Centreville, VA, 20120-1111, or visit: www.militaryupdate.com