On this Veterans Day, our military forces are engaged in continuing conflict that has lasted longer than any war in our nation's history. As a Marine Corps veteran, I have experienced men and women who served for decades, returning home to find the country's promise of medical care for them and their families being unfulfilled.
Medical care for military personnel, military retirees, some members of reserve units and their dependents is administered through a government-created health insurance system called TRICARE. It was established in 1966 -- originally under the name CHAMPUS, short for the Civilian Health and Medical Program of the Uniformed Services -- to provide military families with healthcare from civilian practitioners. The program is managed under the Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson, who is a graduate of City College of New York and New York University Medical School.
The War against Terror has created a new generation of veterans who are eligible for healthcare under TRICARE. Unfortunately, that care is often unavailable. As a recalled Marine Reservist, I have personal experience with this dilemma. Immediately after 9/11, I was called to active duty in and around Ground Zero. When I would return home from time to time, to visit my newborn daughter, I would throw away my uniform because of the acrid smell and the potential for hazardous particles embedded in the fabric.
After my retirement from active duty, I resumed my civilian job as a Wall Street financial research analyst. My job is to evaluate all aspects of healthcare – new biotechnology products, new medical devices and healthcare services. When men and women with whom I served told me how difficult it is to find TRICARE coverage in New York City, I turned my analytical skills to quantifying TRICARE availability for active, reserve, or retired service members and their families within the New York City limits beginning at Ground Zero.
Using skills I learned at business school, I conducted a statistically valid survey of 100 primary care physicians in New York City. I asked their offices if they accepted TRICARE, Medicaid, or another major insurance plan. I repeated the survey with a different group of 100 primary care physicians 10 months later to ensure consistent results.
Here is what I found: 96 percent of the called offices accepted some major insurance. Medicaid was accepted by 40 percent and TRICARE accepted by only 25 percent of those surveyed. If you extrapolate the findings from these 200 practices to the possible 22,000 primary care practitioners with offices in NYC, these results suggest that you are almost twice as likely to receive medical care funded through Medicaid than TRICARE. The fact that the majority of respondents were unfamiliar with TRICARE is even more disappointing.
This weekend there will be many events celebrating our men and women in uniform. Politicians and prominent citizens will be extolling the sacrifice and courage of our military. Others will be expressing their gratitude for our service. As a group, military people have special medical needs; some serve 20 years of arduous duty that can be as physically challenging as professional sports with much lower pay. Military people carry heavy loads of up to 100 pounds over difficult terrain for days, they are exposed to noise and concussion from artillery pieces, serve in cramped and noisy spaces aboard ships and experience collisions with the ground when they jump from airplanes and helicopters.
In my experience, our uniformed service members aren't asking for any special "deal" for their service. What they do expect is that we fulfill our pledge of medical care for them and their families. They are not looking for elite care. Very few will be looking for treatment by the proverbial "Park Avenue" practitioners.
The sad truth is that when TRICARE clients need medical treatment from the same people who woke up to the horrors of 9/11, they have to go "out of network" for treatment. As anyone who has had this experience knows, going "out of network" is a financial and emotional strain. First you must pay the practitioner for medical care, which is a burden for those with few financial resources, then you need to submit multiple complex documents, and in the end, you are uncertain of how much reimbursement will be allowed.
It is also true that New York City medical practitioners have little risk of being overrun by wounded warriors, even if all of them accepted the TRICARE plan. It would be a fitting and symbolic thank you if more practitioners in and around Ground Zero were to accept TRICARE as a recognition of the service of the few for the many.
Commentary by both the advocates labeled the right and the left mean little if our veterans cannot identify with the people they defend. It is no small irony that our "first soldier", George Washington, faced the same decision even while the beginning of our country was in grave doubt. He made it clear by saying: "... it must be laid down as a primary position and the basis of our (democratic) system, that every citizen who enjoys the protection of a free government owes not only a proportion of his property, but even his personal service to the defense of it." On this 11/11/11 let's see if we as Americans can return to that primary position.
Steve Brozak is a retired U.S. Marine Corps lieutenant colonel and president of WBB Securities, an independent broker-dealer and investment bank specializing in biotechnology, medical devices and pharmaceutical research.