Hearing of the Military Personnel Subcommittee of the House Armed Services Committee - Military Advocacy and Beneficiary Groups
Interview
Hearing of the Military Personnel Subcommittee of the House Armed Services Committee - Military Advocacy and Beneficiary Groups
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REP. CAROL SHEA-PORTER (D-NH): Thank you. I've been very interested, Mrs. Moakler, when you started naming day care as the top priority for you. Could you expand on that a little bit and tell us exactly why that came first with all the other issues that we've heard about?
MS. MOAKLER: I think that as families continue to lose through deployment, the need for respite care has grown, and that's a segment that we really haven't addressed in child care before because when you're a single parent or a deployed service member, you need a break. You need a break. And there's really not enough drop-in care -- designated drop-in care for folks for most military child development centers.
There's a real need to feed the kids for a day or so and have that open, and a lot of instillations are opening up their child development centers for respite care.
We also have the added need for the parents of children with special needs, where they need respite care as well, and -- (inaudible) -- we're going to look for that excellent child development center on the installation to be available to them as well as one of their benefits, so that's why we're refocusing a little of this issue on the basics, on the basic benefits we want for military families in peace time and in war.
REP. SHEA-PORTER: Okay, thank you. And could you tell us a little bit about the children who are at the day cares right now, the changes in what you see is necessary for the day cares to treat the special conditions that the children are experiencing?
MS. MOAKLER: I think we're looking forward to some of the research that's going to be done on the effect of deployments on children. We are doing some of that within the National Military Family Association. We have our Operation Purple Camp and we are surveying children and parents as to how the children are dealing with deployments -- (inaudible) --, and how parents perceive children dealing with deployment and the war. We are also working with the folks from Zero to Three, who look at the very young children who previously people might not have considered how they were reacting to the absence of a parent for a great amount of time, reacting to the stress that the single parent is going through. But more and more research is being done into that and we're hoping that as they come out with the -- (inaudible) -- that this should be able to be offered to the caregivers of the young children.
REP. SHEA-PORTER: And Congressman Jones tells the story, and it keeps sticking in my mind about going to read to some children at a military facility, and when the children say to him, "My daddy's not dead yet." And I'm wondering, you know, obviously, if it's having an impact on these children, and if they're able to take care of them through the day care centers, and if there's special training, and if there's money available to train the people who are working with these children every day, and those kids have the same kind of anxiety that Congressman Jones talked about seeing.
I mean, educating these young parents, too. I know that we have new parent programs within the military, but in our testimony we sat down with one young man who happens to be the son of one of our staff members. His dad was deployed for six months, and they were getting ready to go to the airport to pick him up, but he seemed very reluctant to go with his mom to the airport, and his mom couldn't understand what the problem was. And part of the problem was is he wanted to know "would daddy still like me." And, of course, his mother was just floored that she hadn't thought to consider what his feelings might be, what his worries might be with his father coming back. So just making parents aware to ask the right questions, to kind of anticipate the reactions of their children to the deployment is very important. Thank you, my time's expiring.
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REP. SHEA-PORTER: Thank you. I have to ask, because I had a relative who went in the commissary in Europe years ago, and nothing's changed. And this sounds like a conversation from decades ago. But I'm going to ask Colonel Strobridge, I'm going to talk to you a little bit about what I heard yesterday in the (hearing ?) the Secretary of Defense gave, and your reference to some of the health care issues, tri-care specifically.
I was looking at the Defense budget yesterday, and they are looking for co-efficiencies and ways that they plan to save money, and it said at least the monkey on their backs how much the cost of health care is. And then I listened to your reference about tri-care, and the increasing fees, and I wanted to have you take the opportunity to talk about it for a moment or two and if you think any of the fees should be raised, and if not if you have any other ideas.
MR. STROBRIDGE: Yes, ma'am. Number one, we think DOD is vastly overstating the concern about the cost relative to the rest of America when health care is 15 or 16 percent of the national economy. And we're worried about the Defense budget going from eight percent to 11 percent. From our perspective, gee, that's a lot better than the rest of the country is doing to start with.
Number two, one of the points that we've made consistently is that DOD seems a lot more interested in shifting costs to beneficiaries than they have been so far in getting more efficient themselves. The example we use is the mail order pharmacy system where DOD constantly talked about the need to raise co-pays in the retail system to shift beneficiaries to the more cost efficient mail order system when they knew for six years exactly which beneficiaries were using which high cost drugs, and never once spent a then 37 cent stamp to go ask them, you realize how much money you'd save if you used this mail order system.
And we offered to partner with them to do that. Our organization produced a brochure trying to push people to do that; DOD never did, and so we've listed a bunch of different things that DOD could do, one of which the Congress did last year was requiring the federal pricing from the retail system. We'd be very interested to see how that works on the dynamics of the pharmacy. Our view is that when we've gone to talk to the Department of Defense, whatever we've proposed that doesn't get enough money out to the beneficiaries. We're not interested in that, we don't want, as a matter of fact they were told point blank we're not interested and (inaudible.) to get tax dollars out of the beneficiaries.
That was some time ago. As I said to Doctor Casseau's (ph) credit, he has reached out to the beneficiaries. More and more we're optimistic that we'll get some more progress on these types of things. But as we certainly have a long way to go, I think one of the things that we overlook is that the military system is inherently inefficient. Initially the military medical system is war, wartime readiness. When we deploy the doctors and then have to shift all the beneficiaries to the private sector, we can't complain that the beneficiaries are costing more money. When we close down access to military facilities and push people out to the retail pharmacies, that we close installations so that people who live next to military pharmacies can't complain that some of the beneficiaries are costing more money.
When Congress says that it's wrong for military retirees over 65 to be thrown out of the military healthcare and have them authorized as tri-care for life, and tri-care senior pharmacy which we did in 2001, it's wrong in our view to come back and then use the numbers that say oh my gosh, look how much costs have increased since 2001. Congress knew that, we knew it was going to happen, we did it intentionally. It was no surprise.
REP. SHEA-PORTER: Before we run out of time, let me ask you a quick question. When my husband was in the military, we didn't have big easy access, we didn't have tri-care, we just went and got what we needed. Are there people making decisions now not to fill prescriptions because in spite of the benefit they still don't have the money to make up the gap. Do you know that people actually are unable to accept service or pharmacy prescriptions that they need?
MR. STROBRIDGE: I'm sure there are some older people who have many medications doing that. The military co-pays for pharmacy right now, I have to say are pretty reasonable. When you start going from nine dollars to 25 dollars or to 45 dollars because we're pushing more and more medications to the non-formulary, then you have older people who take a lot of medications, that's a lot of money that we're asking people to pay. And as I've said, I have some statistics that I went out and got from private sector surveys, so if the committee is interested, the pharmacy benefit proposals they're offering, they're recommending in the budget, are, at worst, the worst civilian plans.
And to us if one of the purposes of the health care system is to say if you've served 20 or 30 years in some of these adverse conditions, we'll give you one of the best deals in America, that's not it.
REP. SHEA-PORTER: Thank you. I might just mention, it would be interesting to me, and I'm sure the committee, do you have some suggestions that you've put forward that you feel have been ignored, you know dismissed, even if they have, maybe some of the marginal effect? I think we would be interested in looking at them.
MR. STROBRIDGE: I would be more than happy to provide those for you.
REP. SHEA-PORTER: It's akin to the impact, and that would be good to see one of the things we are going to do is have an opportunity in members districts to talk about health care at length, and I would be interested in some of those.
MR. STROBRIDGE: If I could offer a couple of modest examples that are just incredible to us. One of the worst things you can do is smoke for your future health, and yet tri-care doesn't pay for smoking association services. What kind of no-brainer is that?
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REP. SHEA-PORTER: Later today I'll be making a statement on the floor about a young man who died in my district recently and left behind a seven month old and a grieving family and community. And this is what this is really all about -- that each one who serves our country takes that risk and every member of the family takes that risk with him or with her, and so it's our commitment here in a bipartisan effort to make sure that you have what you need and that we say thank you in the right way to all of you and to those who serve us each day, so I just wanted to say thank you.
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