The Military Retiree Medical Care Broken Promise Issue
Back to the Basics
~ NAUS had it right in 1997 ~
This web page is dedicated to the memory of the late Maj Gen James C. Pennington, USA (Retired), one of the true pioneers in the fight to regain the medical care that was promised to military retirees prior to their retirement.
( Extracted from the cover of the National Association for Uniformed Services [NAUS] Uniformed Services Journal for September/October 1997 )
Health care is provided to you and your family members while you are in
the Army, and for the rest of your life if you serve a minimum of 20
years of Federal service to earn your retirement.
Take a close look at the health
care promise that was being made as late as 1991. Not only does it
promise health care, but it promises "superb health care". It clearly
indicates that health care is promised to you (the service member), and
also to your family members while in the Army and for the rest of your
life if you earn retirement. Note the numbers in the boxes. Note that
the poster was printed in the United States Government Printing Office
|MILITARY MEDICAL CARE PROMISES|
- ARMY RECRUITING BROCHURE, "Superb Health Care. Health care is provided to you and your family members while you are in the Army, and for your life if you serve a minimum of 20 years of active Federal service to earn your retirement." (RPI 909, November 1991 U.S.G.P.O. 1992 643-711)
- LIFE in the Marine Corps, p. 36 "Benefits...should you decide to make a career of the Corps, the benefits don't stop when you retire. In addition to medical and commissary privileges, you'll receive excellent retired pay..."
- Guide for Educators and Advisors of Student Marines, p. 35. "Retired Marines are generally eligible to receive any type of health and dental care at those facilities provided for active duty personnel."
- Navy Guide for Retired Personnel and Their Families, p. 51 "Covered under the Uniformed Services Health Benefits Program (USHBP) are retired members, dependents of retired members and survivors of deceased active duty or retired members. This care is available anywhere in the world either in uniformed services medical facilities and under the part of USHBP called CHAMPUS." (NAVPERS 15891D November 1974)
- The Bluejackets Manual, p 257. "What Navy Retirement means to you - pay. Continued medical care for you and your dependents in government facilities." (1969)
- Air Force Preretirement Counseling Guide, Chapter 5 Medical Care 5-2f.."one very important point, you never lose your eligibility for treatment in military hospitals and clinics." 1 April 1986
- Air Force Guide for Retired Personal, Chapter 1. "Treatment authorized. Eligible members will be furnished required medical and dental care." (1 April 1962)
- United States Coast Guard Career Information Guide, USGPO. "Retirement...You continue to receive free medical and dental treatment for your self plus medical care for dependents." (1991)
- U.S. Coast Guard Pamphlet Be Part of the action, "Reap the Rewards...you can earn retirement benefits - like retirement income...Plus medical, dental care..." (1993)
- Hearings on CHAMPUS and Military Health Care, HASC No. 93-70, 93rd Congress "...the government has a clear moral obligation to provide medical care to retired personnel and their dependents...this Committee has found numerous examples of recruitment and retention literature which pledged...medical care for the man and his family following retirement." (Oct-Nov 1974)
( Extracted from page 1 of the National Association for Uniformed Services [NAUS] Uniformed Services Journal for September/October 1997 )
Military and Government Leaders Emphasize Importance of Lifetime Military Medical Promises on Readiness
"I ...consider the dismemberment of the Military Health Services System as breach of implied contract."
General H. Norman Schwarzkopf, U.S. Army, Retired.
"Health care benefits are extremely important to the quality of life for military beneficiaries. The Chiefs and I are committed to providing affordable and accessible care for uniformed members, as well as all retirees who have proudly served the Nation."
General John N. Shalikashvili, Chairman of the Joint Chiefs of Staff
"I believe OSD is coming around to understanding the importance of continued medical care for our retiree population. We must continue to make the point that retiree benefits have a profound impact on the Services' ability to recruit and retain quality soldiers. It is a readiness issue. Let me assure you that I, as well as the other Service Chiefs, have agreed that we must collectively strive to protect critical quality of life elements such as medical care, housing, pay and retirement benefits."
General Dennis J. Reimer, U.S. Army, Chief of Staff
I believe very strongly that our retirees have earned lifetime medical care. I think it is critically important to protect those benefits, especially as these senior veterans become 65 years of age."
General C.C. Krulak, Commandant of the U.S. Marine Corps.
"The people --- past and present --- who make up the total Air Force team are the most important thing for our service to focus on. Rest assured, I will continue to do all I can to ensure they receive the benefits [medical care] they have earned and so richly deserve"
General Ronald R. Fogleman, USAF, (Ret), Former Air Force Chief of Staff
"Caring for those who served our country so heroically is not a policy option or a partisan program. It is a national tradition and a national responsibility. We know what we owe them. We must and we will fulfill that promise. I am committed to seeing that pay and benefits [such as medical care] earned through service to this country are not sacrificed in our efforts to reduce the budget."
President Bill Clinton
"One area of growing concern to the military community is medical care. We must remember our responsibilities to the military and that commitments made to the military personnel were earned --- the result of honorable and faithful service. If we do not keep faith with our veterans and retirees, it will be extremely difficult, if not impossible, to recruit and maintain the high quality personnel necessary for a strong national defense."
Former Senate Majority Leader and Presidential Candidate Robert Dole
"I believe the promise of earned lifetime military medical care in exchange for service is valid."
Former Assistant Secretary of Defense for Health Affairs, Dr. Stephens Joseph
"We promised people over the past three to four decades that we would be there for them, cradle to grave, with no-cost health care. I believe that in the'60's, the '70's...but in the 90's, as we got smaller, we closed 40% of the Air Force beds. Health care for life, [is] perhaps the most treasured benefit and one of the strongest inducements to military service."
LtGen Edgar R. Anderson, Jr., USAF (Ret), former Air Force Surgeon General
"I believe very strongly that our retirees have earned lifetime medical care. Military retirees have dedicated the best years of their lives in defense of our nation and I believe we have responsibility to meet the country's commitments to our retired personnel."
Sergeant Major of the Marine Corps, L. G. Lee
In order to attract and retain the best and brightest to military service, this nation must provide them with a standard of living that is commensurate with the sacrifices that they are asked to make for their country...a combination of poor pay and benefits, reduced healthcare...have created an atmosphere that is driving quality personnel of the military service."
House National Security Chairman Floyd Spence (R-SC)
"Military retirees were promised lifetime healthcare as a condition of their military service. The Pentagon is breaking this promise as it attempts to disavow responsibility for the healthcare needs of these retirees."
Rep. J.C. Watts, (R-OK)
"The Federal Government has been telling young Americans that if they signed up for service to our country, healthcare would be provided for the rest of their lives...the government now claims there's not enough space for the demand...To keep the high quality personnel we must provide the kind of care our personnel require and deserve."
Rep. Mac Thornberry (R-TX)
"This country has a profound obligation to honor its commitments to our veterans - including the lifetime medical care they were promised. Moreover, healthcare is an important incentive in attracting quality recruits to today's all-volunteer armed forces, on which our very national security depends."
General Colin L. Powell, USA, (Ret), former Chairman of the Joints Chiefs of Staff
"Retirees over 65 were excluded from CHAMPUS because it was felt they could receive care on a space available basis from local military hospitals and they would not require healthcare services from the private medical community. And for many years, there were few problems and plenty of space, but as military bases and their hospitals have closed, more and more retirees are finding it difficult to receive the care they have been promised."
Sen. Phil Gramm (R-TX)
"America's fighting men and women are getting short-changed by a little-known policy that denies them access to free, quality healthcare when they need it most --- after they have retired from the service and are in need of medical care and become eligible for Medicare."
Jim Moran, (D-VA)
"We must maintain our ability to provide quality medical care to all of our beneficiaries."
LTG Alcide M. LaNoue, USA (Ret) Former Army Surgeon General
"There is no doubt that our government authorized recruiters and military leaders to make promises of lifetime medical care in return for 20 years or more of service. As Deputy and The Adjutant General of the Army (1973-1981), I printed these publications with full Pentagon knowledge."
MG J.C. Pennington, USA (ret), NAUS President
"You ought to have the best [medical] care, the best technology, the best medicine because of the risks you took for your country."
Speaker of the House of Representatives, Newt Gingrich (R-GA)
"Promises made, entitlements earned and the quality of life benefits [such as medical care] are those initiatives that maintain the volunteer force and military readiness."
(The late) Admiral J.M. Boorda, Former Chief of Naval Operations
"Those military retirees who have served their fellow Americans on the battlefield and through public service deserve the benefits [medical care] they have been promised."
Senate Majority Leader Trent Lott (R-MS)
"We have incurred a moral obligation to attempt to provide healthcare to military retirees who believed they were promised life-time healthcare in exchange for a lifetime of military service."
Senator Max Cleland (D-GA)
( Extracted from page 1 and 2 of the National Association for Uniformed Services [NAUS] Uniformed Services Journal for September/October 1997 )
The following article appeared in the September/October 1997 issue of the Uniformed Services Journal, the bi-monthly magazine of the National Association For Unifored Services (NAUS). Maj Gen Jim Pennington, USA (Retired), was the former Adjutant General of the Army, and President of NAUS from 1985 until his death in in June, 1998. Keep in mind, as you read this article, that it was written in 1997 and that many of the references are not available and are not current.
NAUS PRESIDENT MESSAGE
Made - Promises Broken!
A Call for Military Health Care Justice!
is provided to you and your family members while you are in the
Army and for the rest
of your life if you serve a minimum of 20 years of active Federal service
to earn your retirement, " - Army Brochure, USJ Cover
Doesn't that sound like a promise to you? Especially when it is printed by the Government Printing Office (GPO) in a government publication and you are advised of this information by an agent of the US Government? This promise of lifetime medical care was made not only by the Army but in personnel and leadership manuals such as the Navy's "Blue Jackets" Manual, the Air Force Guide for Retired Personnel and the US Coast Guard Career Information Guide as indicated on page 1.
These promises weren't made by "rogue" recruiters as some members of Congress have alleged; these publications were printed with the full knowledge of the Pentagon and other government leaders (including myself as I mentioned in the last USJ), see quotes on pages 1-2. We were counseled to advise recruits and military members considering re-enlistment of this important, earned benefit.
Now, some government leaders claim there is no legal contract. However, as retired Admiral Jeremy Taylor states in his excellent article, "Retirees' Coverage Unfairly Cut,", "The promises made are now promises broken."
Changes to Law Didn't Revoke Promise
After relying on the promise of lifetime military medical care since the medical corps was founded in 1775, now government lawyers (in the recent Florida lawsuit brought by Col Bud Day, see p. 18) declare the promise was changed by the amendment to Title 10 of the US Code referred to as the Dependent's Medical Care Act (P.L.84-569) in 1956. This stated that active duty dependents were "entitled" to space available medical care in military treatment facilities. Authority was also provided to retirees and their dependents to receive care on a space available basis in this amendment.
However, no government lawyer stepped forward to explain that this amendment to Title 10 was an excuse to break the lifetime military medical care promise. As a matter of fact, most retirees and their dependents had no problem getting space available care in MTFs until around 1966 when, because of the increasing numbers of retirees, access to space available medical care began to become a problem. CHAMPUS was then passed into law by Congress to provide care to active duty dependents, retirees and their dependents when no space available care could be provided in MTFs.
On September 30, 1966, Congress passed the Military Medical Benefits Amendments (P.L. 89-614; 80 Stat.862) recognizing "the fading promises to retired military personnel, as well as the plight of dependents of active duty members who were located away from military medical facilities and passed the CHAMPUS program to be effective the first day of 1967. This legislation also resulted from the comparatively disadvantageous position in which the military dependents and retirees were placed," compared with Federal government employees. Their health plans were blossoming profusely, while the ability of military facilities to provide health care for all concerned was diminishing.
[This is according to a Congressional Research Service Report for Congress, "Military Health Care/CHAMPUS Management Initiatives" prepared by David F. Burelli, Analyst in National Defense and Foreign Affairs May 14, 1991.]
Therefore, Congress, recognizing the responsibility for keeping the lifetime medical care promise, enacted the CHAMPUS program since space in military treatment facilities (MTFs) could no longer be guaranteed. CHAMPUS was designed to provide a benefit similar to the Federal Employees Health Benefits Program (FEHBP) for Federal civilian government personnel. Unfortunately, CHAMPUS has been allowed to deteriorate to the point that many medical care providers will no longer accept assignment for payment of services because the allowable fees are so low. Now, many doctors consider taking CHAMPUS patients as charity.
Unfortunately. the CHAMPUS Program ignored responsibility for those over age 65 and assumed that Medicare in conjunction with space available care in MTFs would be sufficient. NEVER WAS IT STATED THAT THE LIFETIME MILITARY MEDICAL CARE PROMISE HAD BEEN REVOKED!
The promise of lifetime medical care continued to be made in military service publications as indicated on the cover of this USJ and on page 1. This promise of lifetime medical care in exchange for 20 or more years of service continued to be a powerful incentive to attract quality men and women to serve in the US military force during the Cold War and hot wars into the nineties and since World War II.
Quotes from government and military leaders verify that. For example, former Chairman of the Joint Chiefs of Staff, General Colin Powell, recently emphasized the importance of keeping the medical care promise in a letter to me: "This country has a profound obligation to honor its commitments to our veterans --- including the lifetime medical care they were promised. Moreover, health care is an important incentive in attracting quality recruits to today's all-volunteer armed forces, on which our very national security depends."( See pages 1-2 for his and other leaders' quotes.)
Recruitment and Retention Affected
Today, pilots are leaving the Air Force, the Marine Corps and the Navy in record numbers and the Army is having difficulty in meeting its quality recruiting goals. Although numerous factors are impacting this exodus, such as changes Congress made to the military retirement system in 1986, more lengthy deployments and a good economy with increased availability of jobs, a major part of the problem involves breaking the promise of lifetime health care.
Military retirees are fed up with broken promises. They have made retirement plans based on these promises. Now bases and hospitals are being closed all across the country as the drawdown continues after the Cold War victory these retirees won. As I have mentioned previously, up to 60% of today's recruits are from families that include former and active duty members of the military. Now these veterans say they can no longer recommend a military career to young people because the government cannot be relied on to keep earned, quality of life promises, especially that of lifetime medical care. (See Admiral Taylor's article on page 8.)
These broken promises are impacting older retirees particularly hard. Some 30,000 World War II veterans are dying monthly. These heroes who saved the world in World War II and fought aggression and Communism in Korea, Vietnam and numerous Cold War battles are being denied medical care when they need it most. They can't afford to wait for Department of Defense (DoD) promises that eventually military medical care will be better when TRICARE and Medicare subvention are fully implemented. They need accessible, quality medical care now before it is too late!
Medicare Subvention Test Approved
Provisions for a Medicare subvention test have been included in the Balanced Budget Act of 1997 after an almost 10-year battle. Although this is an important step in the right direction and an initiative for which NAUS has long fought, it's a very small step, not a major triumph as some have declared. In fact Dr. Edward Martin, Acting Assistant Secretary of Defense for Health Affairs, warned we must not expect too much of this small demonstration because of the small number of beneficiaries who can participate. The test will involve only 10,000 of the 1.2 million military Medicare eligible beneficiaries and according to a recent General Accounting Office (GAG) report, only 75,000 in MTFs if fully implemented.
We appreciate the efforts of the Senate Majority Leader Trent Lott, Senators Phil Gramm and William Both, and House members Bill Archer, Joel Hefley and Bill Thomas as well as President Clinton who acted on his promise made to me last year when I urged him to support Medicare subvention at a meeting at the White House and in later meetings and communications.
Also, we appreciate the comments of Dr Martin, at a recent Pentagon ceremony, when he recognized NAUS' efforts with the President as being "critical in breaking the logjam on Medicare subvention within the Administration." (See article on page 13 for more details.)
However, as we told Senate Majority Leader Lott in our meeting with him in May. this demonstration and full implementation of subvention will take care of less than one-third of the old retirees who saved the world in World War II and fought the hot wars. The test is to take three years, and implementation five years. These old warriors are now in their mid-70's and 80's. They can't wait that long: they need medical care now. The time frame should be accelerated to take much less than three years and the number of Medicare subvention demonstration sites and participants should be greatly increased.
We believe that even when TRICARE is fully implemented and Medicare subvention completed, only 50-60% of the eligible beneficiaries will be able to receive military medical care. Although Medicare subvention is a part of the complete medical care plan NAUS proposes to take care of all 8.2 million beneficiaries, another alternative option such as the Federal Employees Health Benefits Program- (FEHBP) is absolutely essential. We must accelerate our plans to get military health care justice for all and bring it to a successful conclusion in two years or less as indicated in the Senate's Defense Authorization Bill.
Military Health Care Justice Plans intensified
We must "strike while the iron is hot" to win military health care justice for all. As we have reported in past USJs, numerous bills have been introduced in the House and Senate to provide accessible, quality care to all military beneficiaries regardless of age and where they live. [See Legislation at a Glance on pages 10-11.] We must mount an all-out campaign to get legislation passed to ensure military medical care for all before the 1998 elections.
To accomplish this we have accelerated our efforts and urge you to make an all-out push to win this crucial objective.
We have instituted a special NAUS sponsored Capitol Hotline 1-800-833-2745 to allow you to call members of Congress to urge their support to pass military medical care bills and are continuing our mailgram campaign on page 32 to keep pressure on Congress. We urge you to use both the Hotline and send the mailgram as well as contact the local district and state offices of your members of Congress to urge them to act. And, encourage others to do so as well. [See Footnote 1.]
As you may recall, our March/April USJ cover on this page showed our meeting with Sen. Max Cleland (D-GA) and Rep. J.C. Watts (R-OK) urging their introduction of bills to allow the FEHBP option and their support of a plan to provide quality, accessible medical care for all eligible military beneficiaries. As a result, Rep. Watts introduced HR 1356 to authorize FEHBP as an option for all military retirees including Medicare eligibles who cannot be guaranteed other DoD sponsored care.
And, Sen. Cleland subsequently induced a Sense of the Congress resolution on the Senate floor which was included in the FY98 Senate Authorization Bill directing DoD to conduct a comprehensive study of the feasibility of authorizing FEHBP for all non-active duty military beneficiaries while maintaining a combat medicine capability by March 1. 1998 and to solve the military retired medical care problems within two years. In doing so, he stated: "We have a sacred responsibility to take care of those who took care of us. We have incurred a moral obligation to attempt to provide health care to military retirees who believed they were promised lifetime health care in exchange for a lifetime of military service"
It Seems funding can be found for every other conceivable program and project but not for military retirees and veterans. Comparatively speaking, the cost of providing FEHBP is a minor expenditure.
Chuck Partridge, NAUS Board Member MG Hank Mendez, USA (Ret), a former Assistant Secretary of Defense for Health Affairs, and I recently visited with all three military Surgeons General: LtGen Ronald R. Blanck, U.S. Army; VADM Harold Koenig U.S. Navy; and LtGen Charles Roadman II, U.S. Air Force. We urged them to develop a plan which would for the first time provide for DoD (employer-provided) health care to all 8.2 million beneficiaries and include FEHBP as an alternative option for military beneficiaries who cannot be guaranteed care under other options. The total plan would be similar to what we have proposed in our NAUS plan and would be submitted to meet the requirements of the Senate Authorization Act. (See page 15)
Chuck Partridge and I also met with Rep. Randy (Duke) Cunningham (R-CA), a member of the House Appropriations Committee and one of the congressional leaders who helped us win the cost of living adjustment (COLA) battle. Rep. Cunningham has agreed to help organize a coalition of members of Congress in sup port of FEHBP as an alternative health care option as part of a total plan to keep the health care promise. We believe it will take a major effort of members of both houses of Congress -- both the Senate and House -- to get this initiative passed. (See page 14.)
WE MUST MOVE QUICKLY TO TAKE ADVANTAGE OF THE PROGRESS MADE SO FAR AND THE GOOD ECONOMY IF WE ARE TO GET CONGRESS TO PROVIDE ADEQUATE FUNDING TO PROVIDE MEDICAL CARE FOR ALL 8.2 MILLION ELIGIBLE BENEFICIARIES BY ME 1998 ELECTION.
The Money is There and Costs are Reasonable
When DoD officials, members of Congress or their staffs state that providing FEHBP to military retirees costs too much and ask where the money is coming from: we must explain that the Cold War Victory allowed the defense budget to be reduced from a high of $400 billion to $250 billion providing a peace dividend of $150 billion annually won by our military forces. Also, the strong economy has produced a windfall of some $225 billion found by the Congressional Budget Office (CBO) in the recent budget negotiations. This budget reconciliation agreement provided over $100 billion in funding for children's health care, Medicare funding for non-citizens, as well as dozens of other welfare and education programs and tax cuts. Therefore, it seems funding can be found for every other conceivable program and project but not for military retirees and veterans. Comparatively speaking, the cost of providing FEHBP is a minor expenditure.
Cost estimates to provide FEHBP as an alternative option are now becoming more reasonable. The GAO report estimates it will cost $1.6 billion (assuming 83% participation --- we estimate only about 31% participation) and a recent CBO estimate is only $900 million We believe that if all of the offsetting costs of allowing each beneficiary to use only one medical plan option are considered, the costs would be even less -- only about $300-$600 million annually. (The U.S. government now appropriates $4 billion annually for FEHBP for Federal civilian government retirees.)
Military Health Care Justice Plan
Urge your members of Congress to support the Military Health Care Justice Plan to provide care for all 8.2 million beneficiaries. This can be done through the primary providers - military treatment facilities and DoD's TRICARE network and by using the secondary providers -- Veterans Administration (VA) medical facilities and FEHBP for those who cannot get care through the primary providers.
Both Medicare reimbursement and FEHBP could be used in ~Fs and VA facilities when additional space is available which would continue to help provide for military medical readiness, mobilization training and care for as many retirees as possible. However, these primary sources of care will never be able to meet the needs of more than 50-60% of eligible beneficiaries.
A secondary system of care providers through the VA medical system and FEHBP is also needed to accommodate retirees who do not live near MTFs (26 states now have no major MTFs) and TRICARE networks which will never be feasible in all areas of the country.
With Liberty and Justice for All
Military retirees are not asking for any special new benefits -- only what has been promised and earned by their service to our country.
Our strong national security and national defense depends on the quality of the men and women in the volunteer force. If critical quality of life promises such as lifetime medical care are not kept, high quality men and women will not continue to enlist and reenlist, eventually destroying our strong national defense and endangering the security of our great nation. (See National Security/Defense Model on page 8.)
"With liberty and justice for all," so ends the Pledge of Allegiance to our Flag. That means military people too! Adequate, accessible medical care must be provided for all 8.2 million military beneficiaries.
Promises made must be promises kept.
( Extracted from page 4 thru 7 of the National Association for Uniformed Services [NAUS] Uniformed Services Journal for September/October 1997 )
Footnote 1. The Hotline and Mailgram services referenced in
the article are not currently in service.
Thank to "Boyce Allen", Co-Chairman of the Executive Committee of the National Association for Uniformed Services (NAUS), for giving me permission to use the information posted on this web page. The information was extracted from the NAUS Uniformed Services Journal for September/October 1997.
I also thank "Jim Whittington" for typing the "Military and Government Leaders Emphasize Importance of Lifetime Military Medical Promises on Readiness" used on this web page.
And, I thank "Boyce Allen" for providing the Maj Gen Jim Pennington, USA (Retired), Promises Made - Promises Broken, A Call for Military Health Care Justice, article. It saved me a lot of typing.