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Army leaders have promised to leave family support
programs intact when looking for ways to lean out the
service's massive budget.
"We want to ensure that the family programs we're operating
are run well and efficiently and if we need to make adjustments
so they can be more so, that's fine," said Secretary of
the Army John McHugh. "But what we won't do particularly
as a first reaction, is look to those programs as a source of
budgetary savings."
During the opening presentation at the 2010 Association
of the United States Army's Annual Meeting and Exposition
in Washington, D.C., late last year McHugh discussed the
Army's challenge of operating in a constrained budget environment
as well as efforts to modernize the Army. He and
Chief of Staff of the Army George W. Casey Jr. went into
more detail during a press conference immediately following
that ceremony.
In regard to a challenge by Secretary of Defense Robert
Gates to the military services to find ways to trim some $100
billion from the defense budget over the next five years, the
Army's two senior leaders said they won't look to family
support programs -- which they say are important to supporting
the all-volunteer force -- but will instead look to things
like restructuring commands and doing "portfolio reviews" of
Army capabilities.
"A lot of what we're finding is coming out of capability
portfolio reviews and it's basically redundant programs or
nonperforming programs," said Casey, also adding the Army
is looking at force structures. "We're asking ourselves, for
example, do we still need a four-star general in Army Europe
and what should a support force structure in Europe look like?
I suspect we'll be able to garner some significant military and
civilian savings at those headquarters."
Those portfolio reviews, said McHugh, "already show great promise in bringing better discipline to our programs-- better evaluating and realigning our requirements with the
reality of today and where we think tomorrow is going."
The secretary said a task force is working now and will
provide a report within 90 days, though he is getting updates
on their progress. He also said a good budget policy starts
with people.
"We can't have an Army without people," he said. "All our
efforts must start with them, with training and education -- the
things that create our greatest hedge against future threats.
That hedge: adaptive, innovative, thinking enlisted soldiers,
officers and NCOs -- folks who will make a difference."
McHugh also discussed a new project, an effort to
modernize the institutional Army, or generating force. That's
the portion of the Army whose primary mission is to generate
and sustain the operational Army's capabilities for employment
by joint force commanders.
"The operational Army has changed dramatically,"
McHugh said, explaining that 10 years of conflict in Iraq and
Afghanistan have changed the way the Army fights and reacts.
But the institutional Army, he said, the generating force, has
not changed. "It looks pretty much the same as it did structurally
since the early to mid-1970s."
The secretary said there are examples of changes in the
institutional Army in the past, including a reorganization of
the War Department by Gen. George C. Marshall, and, after
the Vietnam War, Operation Steadfast, which reorganized the
Army and built an all-volunteer force.
"But these models really don't address what I call the new
paradigm," McHugh said. "America's enemies are no longer
solely defined by nations or contained by borders. Our combat
formations quickly adapt to changes in terrain, mission and
the enemy they face. I believe the institutions and processes
we have to help those forces do better, need to change as well."
The Army's chief of staff also discussed the Army's effort
to restore balance to the force, which it has been working on
since 2007.
"With the drawdown in Iraq, we are getting to a situation
where we can breathe again," he said. "When you're only
home for 12-15 months between deployments, you really
don't have much time to breathe -- you take a break then you
get back on the treadmill and get ready to go."
He said as a result of the increased growth the Army
completed in 2009 and a temporary end-strength increase of
22,000, units are home for 15 to 18 months now, and the units
that are deploying toward the end of this year will end up in
the 18 to 24-month range.
"Increasing the time the soldiers spend at home is the
most important element of getting ourselves back in balance,"
Casey said.
The general also touched on other Army efforts, including
modular conversions. He said the service has converted
about 290 of the 300 brigades to modular designs. Also, he
mentioned an effort to move soldiers out of Cold War-era
career fields and into specialties more relevant to today's
conflicts. He said so far some 124,000 soldiers have been
converted, and by this time next year that number will be
150,000. That move, he said is "significantly increasing our
ability to do the 21st-century tasks."
Casey also said in the Army's second decade of combat
it faces several challenges, including maintaining a combat
edge, reconstituting the force and building resilience.
by Chuck Partridge, Government Relations
Active Duty Pay Raise
As this issue of the Advocate goes to
press, the pay raise for active duty and
reserve component personnel still has not
passed as a result of Senate inaction on
the National Defense Authorization Act
for 2011. The House of Representatives
is proposing a 1.9 percent increase and
the Senate position is 1.4 percent. The
one-half percent difference supported
by the House is the result of a longstanding
policy to increase military pay
over the Employment Cost Index (used
to measure the annual change in private
sector pay) by one-half percent each
year until military pay is equivalent
to private sector pay. AMS supports
this increase while disagreeing with the
reasoning. There is no accurate way to
compare military pay with civilian pay,
because you can't compare military
service with civilian employment. It is
remarkable that during wartime especially,
the Senate would object to adding
the one-half percent. We are urging the
Senate to support this small incremental
increase.
Military Absentee Voting
AMS belongs to the Alliance for
Military and Overseas Voting Rights
(AMOVR) which is an alliance of 36
military and overseas advocacy groups,
elected officials, students and voting
rights advocates. AMS has worked long
on this issue and we believe this is the
most effective effort yet to solve the
problem of disenfranchising military
voters.
In the 2008 election, more than one
out of every four military votes were
not counted. It is disgraceful that we
send our young men and women to fight
wars, then do not take the necessary
action to see that they have the most
precious right in a democracy -- the
right to vote.
The 2010 National Defense Authorization
Act included provisions that
improved the process for absentee
voting and required state election officials
to send ballots to military and
overseas voters no later than 45 days
before the election. This provision is
designed to get the ballot to the voter
and then make sure there is time to
get it back and be counted in the vote
totals. This is a significant advance in
procedures for military absentee voting
and we hope the results reflect that there
were fewer cases of missed opportunity
to vote by our men and women in the
Armed Forces. We will continue efforts to improve absentee voting. Much of the improvement must
come from the state and local voting officials.
Military Health Care
TRICARE continues to come under attack by Secretary
of Defense Robert Gates and senior uniformed officials in
the Pentagon. Gates has said that health care costs "eat us
alive." His idea is that by shifting costs to military retirees
the Defense Department will have more to spend on weapons
systems. AMS's position is that the entire nation is responsible
for providing funds for national defense. To single out
retirees to take the equivalent of a pay cut in their earned and
promised retirement benefits is reneging on the health care
promise and creating a climate of distrust.
Dr Gail Wilensky, who co-chaired the Task Force on
the Future of Medical Care, a DoD sponsored effort clearly
designed to question the cost of military medicine, said
passing TRICARE for Life was "a mistake." DoD is spending
a lot of effort to lay the groundwork for increasing
TRICARE fees, reduce the benefit and lower DoD's medical
costs while shifting them to military retirees.
Much of the problem of increasing military medical care
costs is the direct result of unwise decisions made by officials
in DoD. Studies done years ago showed that providing care
in military hospitals and clinics could be done for 25 to 40
percent less than having it done in the private sector. However,
DoD for years has reduced uniformed military medical
personnel authorizations, closed clinics, and downgraded
hospitals. This has forced military patients and their families
to obtain care in the private sector. The result is higher costs
and increasing exposure of the military health care system to
medical inflation. These factors, coupled with the fact that we
are at war, has certainly increased medical costs.
AMS opposes increasing fees and urges Congress
to continue to reject increases in fees, co-payments and
deductibles.
Concurrent Receipt
We continue to work toward concurrent receipt of military
retired pay and veteran's disability compensation without a
reduction of either. Currently several steps have been taken to
reduce the impact of disabled retirees being forced to forfeit
one dollar for every dollar received from the VA in disability
compensation. However, over 540,000 disabled retirees with
a service connected disability rating below 50 percent must
pay for their own disability compensation by giving up an
equivalent sum of their retired pay and will not be included
in the phase out of the forfeiture.
Despite the historic number of House members who were
defeated in this election, we still have champions of concurrent
receipt in Congress and will work with them in the 112th
Congress.
Survivor Benefit Plan
Another inequity related to concurrent receipt applies to
the spouses of service connected disabled military retirees.
When a military retiree enrolls in SBP and pays the monthly
premium he expects his spouse will receive the benefit when
he dies. However, if the retiree has a service connected
disability which entitles the widow (er) to VA Dependency
and Indemnity Compensation (DIC), the widow must forfeit
a dollar from SBP for every dollar in DIC she receives. The
government then refunds a proportionate amount of premium
that was paid in and the IRS taxes it. If an insurance company
had a program like this, the officials of the company would go
to jail. The SBP/DIC offset is a grave injustice that we must
fight in the 112th Congress.
Physician Payment Rates under TRICARE and
MEDICARE---The Doc Fix
Under a law passed several years ago in an attempt to try and
keep the Medicare program financially solvent, the payment
rates to doctors were supposed to be reduced each year. But
ever since then Congress has refused to allow the cuts to go
into effect for good reason -- doctors would drop out of the
Medicare and TRICARE programs. The problem is that by
preventing the rates from being cut each year, Congress did
not solve the problem but simply "kicked the can down the
road" each year. Because of that, we are now at a point where
if those cuts are allowed to go into effect it would reduce
physician compensation by a whopping 23.5 percent. Until
this is properly fixed, the TRICARE program has a serious
problem.
The fact is, when Medicare rates for doctors' services are
too low TRICARE patients get hurt. TRICARE rates are tied
to Medicare and doctors are much more likely to turn away
TRICARE patients than Medicare patients. Congress must
act or the cuts will go into effect with devastating results for
TRICARE patients.
As this is written, Congress is under the gun to fix the
looming cuts in Medicare reimbursement rates that are scheduled
to go into effect by the end of the year. However, most
political observers believe they will once again pass a shortterm
"fix" that will merely delay the cuts for 30 or 60 days
and pass the problem along to the newly elected Congress
that begins in January. Permanently fixing the problem will
cost billions of dollars and the mood of the electorate in the
November elections seemed to be one of cutting back on
government spending, not increasing it. On the other hand,
millions of America's seniors, the group of citizens that votes
most faithfully, depend on Medicare and TRICARE. So how
Congress decides to solve this crisis is something we all are
waiting to see. You can rest assured that AMS will stay on
guard to make sure the Congress lives up to its responsibility
to fix this problem and keep the promise that it has made to
America's seniors and especially to military retirees.
First, I want to thank all who gave me your vote of
confidence as National President of the Armed
Forces Top Enlisted Association. It's an honor to be
given the opportunity to lead this organization with such a
fine history of service by senior noncommissioned officers.
I also want to thank Past National President CSM Albert
Ybanez, USA (Ret), for his dedication and leadership over
the past five years.
As I take on this role, I want to focus our influence to
defending the benefits military men and women earned
by years of service and sacrifice -- because we are facing
possibly the toughest budget fight about personnel and
retirement issues in a decade.
In their efforts to reduce the federal deficit, we expect
national leaders to target military benefits, including family
issues and retiree health care. The President's Commission
on Deficit Reduction and Reform has just announced
a massive package of proposed spending cuts and tax
reforms they said would be necessary to get the country
back on the right fiscal track. Their package envisions deep
cuts in virtually every category of federal spending, as well
as a dramatic simplification of the tax system that would
eliminate many popular deductions for homeowner interest,
capital gains, and more.
Proposed initiatives affecting the military and veterans'
community would, among many other things: reduce
COLAs; require beneficiaries to absorb a greater share
of healthcare costs; freeze military and federal civilian
pay; over-haul the military retirement system, consolidate
commissaries and exchanges; raise the Social Security
retirement age; curtail future Medicare and TRICARE
payments to doctors; and require nondisabled veterans to
pay more to use VA facilities.
Spending cuts, tax increases, and shared sacrifice are
all required to address the spiraling national debt. Our challenge
will be to work to prevent members' disproportionate
sacrifice.
Ours must be a voice of reason in urging realistic
legislation to control the deficit. And we are determined
to ensure that government leaders properly acknowledge
the government's unique obligation to those who rendered
decades of service and sacrifice for the rest of the country,
and that any allocation of "shared sacrifice" must recognize
that this tiny segment of Americans has already shouldered
a heavy burden.
To put the benefits retirees earned first-in-line to help
pay for today's defense needs or to pay down the national
debt is unacceptable.
As TRICARE officials explore
ways to control costs while
continuing to provide the best
health care possible, they are encouraging
beneficiaries, especially those
taking long-term medications, to get
their prescriptions delivered to their
doorsteps. Navy Rear Adm. Christine
S. Hunter, Deputy Director for the
TRICARE Management Activity, cited
increased usage of the health care
system's home delivery option as a
win-win situation that saves patients, as
well as the government, money.
TRICARE's almost 9.7 million beneficiaries
filled 10.5 million prescriptions
through home delivery in 2009, officials
noted. That is up from more than
9 million in 2007, but still represents
only about 8 percent of the 130 million
prescriptions filled in 2009.
Thirty-seven percent of those
prescriptions -- just over 48 million
-- were filled at military medical
facilities, which is the least expensive
delivery method for the Defense
Department, and patients pay no
co-payment, Admiral Hunter said. But
getting prescriptions filled at a military
facility is not always convenient
for beneficiaries, who are increasingly
turning to retail pharmacies within the
TRICARE network.
Last year, beneficiaries filled more
than half of their prescriptions -- 71.4
million -- at retail pharmacies. This is
the fastest-growing of the TRICARE
delivery options, officials noted, up
from more than 67 million retail pharmacy-
provided prescriptions in 2008
and just less than 63 million in 2007.
While retail pharmacies may be
convenient and often the best choice
for patients needing short-term medications,
Admiral Hunter noted that
they are also the most expensive.
Beneficiaries pay the same co-payment
for a 30-day supply of medication at the
corner drugstore that they would pay
for a 90-day supply delivered through
TRICARE's home-delivery option.
"So the cost to them is one-third"
using home delivery, Admiral Hunter
said. "That's a real incentive there."
Mail order is the hands-down best
choice even for those who value convenience over cost, she said. "I don't
know how it gets more convenient than
in your own mailbox at your house,
not having to go anywhere to get your
prescription," she said.
TRICARE can mail prescriptions
almost anywhere in the world, including
deployment sites where specific medications
may not be available. The only
exceptions are extremely hot climates
that may affect some temperature-sensitive
drugs.
In addition, beneficiaries who sign
up for home delivery can get automatic
refills -- a big plus for anyone taking
medications for a chronic, long-term
condition. "We'll send you an e-mail
saying, 'It looks like your refill is due.
Unless you say you don't need it for
some reason, we are going to ship it,'"
Admiral Hunter said.
That eliminates last-minute dashes
to the drugstore when a prescription
runs out, or worse, gaps before patients
resume taking the drugs they need.
"The key to staying healthy and using
medications to help you manage your
health is to take them," Admiral Hunter
said. "And if you don't have them, you
can't take them."
Regardless of where beneficiaries
get their medications, they are protected
by a safety feature built into the
TRICARE pharmacy program, Admiral
Hunter said. The patient data transaction
service monitors the medications every
TRICARE beneficiary receives to flag
potential adverse drug interactions or
allergic reactions.
"Both the military services and
TRICARE are very focused on prevention
and keeping people healthy,"
Admiral Hunter said. "All of these
programs are designed to support
patients partnering with us to stay
healthy."
Partnering is a new emphasis in
health care, she said, with patients
playing an increasingly key role in their
health. "We are really moving toward
partnering for health, and giving you the
information and the services you need
to be active and healthy for as long as
possible," Admiral Hunter said.
For more information and to register,
visit www.tricare.mil/pharmacy/
tmop_order.cfm.
Donna Miles
American Forces Press Service
By the time the Army meets its goal to have soldiers
home for twice the time they're deployed, the service
could face the problem of having nearly one in five
soldiers unable to deploy. Today, nearly 14.5 percent of
soldiers in a brigade combat team are unable to deploy by the
unit's latest arrival date in theater. That number is up from
a little over 10 percent in 2007. By 2012, it's expected the
number will be as high as 16 percent, said Lt. Gen. Thomas P.
Bostick, the Army's Deputy Chief of Staff.
"We don't want it to grow, but the reality is, we're tracking
what's happening with our soldiers and we're making our
best assumptions and assessment of what's going to happen in
the future," Bostick said. The general spoke to a gathering of
Army personnel in Washington, D.C. He said medical issues
are a prime factor in the increase of non-deployable soldiers.
"Some of it is temporary medical, where we fix the
soldiers and they are not ready to go at the deployment
time," Bostick said. He also said about 68 percent of those
injuries are musculoskeletal issues, including knees, backs or
muscles, for instance.
The Army's leadership asked the Secretary of Defense
for a temporary end-strength increase in 2009 to help alleviate
problems associated with non-deployable soldiers. As a
result, about 22,000 additional soldiers were approved above
and beyond the Army's congressional mandate of 547,400.
Also adding to the roster of non-deployable soldiers is
the elimination of stop-loss. That policy allowed the Army to
extend soldiers' enlistment beyond their end-of-service date,
so they could deploy with their unit. Without stop-loss, some
soldiers stay behind when their unit deploys.
"We have to make up for those losses," Bostick said.
"They are on our books and we have an end strength, so we
can't recruit against them. So you have to find a way to have
three-to-one, about 12,000 soldiers, to make up for 4,000 that
might be stop-lossed." Non-deployable soldiers are a "huge
issue we are working across the Army that we have got to fix,"
Bostick said.
The need for additional soldiers can also be attributed to
the service's wounded warrior program, Bostick said. The
number of soldiers in that program is increasing.
"We thought that number was going to actually start
coming down, but with what is happening in Afghanistan, the
number is going the other direction," he said. Today, there's
about 9,000 soldiers in the wounded warrior program from
both the Active Duty and Reserve Components, Bostick said.
The general said the temporary end-strength increase
is not forever. By September 2011, the Army will have to
drawdown again to 547,000, the end strength prescribed in
law. Bostick said a challenge with such a temporary increase
is balancing the need to grow to what is needed, but at the
same time dealing with the fact of cutting back at the end and
having to tell people that want to stay that they can't. "From a
personnel point of view, you have to care for soldiers and their
families and treat them with dignity and respect," he said.
Maj. Gen. Donald Campbell, commander, U.S. Army
Recruiting Command, said the Army is working to fill gaps
and targeting recruiting efforts to find the kind of soldiers the
service needs. He said the Army is focusing on making sure
recruiting is supporting the Army Force Generation model.
Campbell said the Army's recruiting mission for fiscal
year 2011 is 67,000 new soldiers, and that already there are
some 33,276 in the entry pool. Nearly half the mission is
already complete, he said
The nation has not begun to comprehend the long-term
consequences of protracted war, the military's top
officer said recently. "The human toll -- the fear, the
stigma, and the hard work of recovery ahead for our troops
and their families -- these are the real costs of war," he said.
Navy Adm. Mike Mullen, Chairman of the Joint Chiefs of
Staff, spoke at a Business Executives for National Security
dinner in New York honoring David and Mary Boies with
the organization's Eisenhower Award. He said the Boieses
and other BENS members' efforts demonstrate their passion
to give back to the country.
"National security is not just the purview of the military
or the government," Mullen said. "But ... I think for many
of our fellow citizens, the military remains an abstraction."
While it's clear Americans love and support the nation's
troops and their families, he said, "My fear is that we're
losing touch."
Service members and their families commonly have
endured five year long or up to 25 shorter deployments since
2003, he said. "From the everyday sacrifices of missed
birthdays, soccer games and special moments each family
cherishes, to the physical and psychological repercussions
attached to the post-combat experience, these are lives
forever changed," Mullen said.
"Long and frequent absences are testing their resilience,"
he added. "They want to know, 'How many deployments can
a marriage take?'"
Veterans struggle with the combined stress of combat
missions, family separations and eventual reintegration into
civilian life, Mullen said. "Military families live in a war
zone of their own," he said. "The pressure to try to bear up
with a stiff upper lip is driving some to leave the service or
-- most tragically -- to leave this life."
He said many veterans have a hard time translating
military experience into viable jobs, particularly in a
burdened economy. Transition challenges, post-traumatic
stress, strain on families, health care demands, rising
homelessness among veterans, and the silent epidemic of
suicide all paint a stark forecast, the chairman said.
"There must be a sense of urgency here," Mullen told
the audience. "The sooner we empower our veterans and
their families through these transitions, the less likely they
will spiral downward."
By Karen Parrish, American Forces Press Service
Physician Questionnaires to Boost
Disability Exam Efficiency
The Department of Veterans
Affairs (VA) has released three
new disability benefits questionnaires
for physicians of Veterans
applying for VA disability compensation
benefits. This initiative marks
the beginning of a major reform of
the physicians' guides and automated
routines that will streamline the claims
process for injured or ill Veterans.
"This is a major step in the transformation
of VA's business processes that
is yielding improvements for Veterans
as we move to eliminate the disability
claims backlog by 2015," said Secretary
of Veterans Affairs Eric K. Shinseki.
These new questionnaires are the
first of 79 disability benefits questionnaires
that will guide Veterans' personal
physicians, as well as VA physicians,
in the evaluation of the most frequent
medical conditions affecting Veterans.
Accurate and timely medical evaluations
are a critical element of VA's
continued commitment to high-quality
and prompt decisions about the nature
and degree of conditions afflicting
Veterans. Streamlining this process
by directly involving Veterans' treating
physicians in providing specific
information needed to evaluate their
claims will lead to completeness in the
examination and faster compensation
decisions.
VA's goal is to process all claims
in fewer than 125 days with a decision
quality rate no lower than 98 percent, a
mark Secretary Shinseki has mandated
by 2015. The physician questionnaire
project is one of more than three dozen
initiatives actively underway at VA,
including a major technology modernization
that will lead to paperless claims
processing.
The disability benefits questionnaires
are part of VA's automated
health records system which prompts
VA physicians conducting disability
examinations to include precise
information in a standardized way to
assist claims adjudicators in ensuring
Veterans receive the benefits they
deserve as quickly as possible. These
VA examination results are electronically
available to claims adjudicators in
VA regional offices.
For Veterans who receive their care
from private physicians, VA has placed
the disability benefits questionnaires
on its Internet site (http://www.vba.
va.gov/disabilityexams) with instructions
for physicians to submit examination
results on Veterans' behalf.
The first three questionnaires
cover B-cell leukemia (such as hairycell
leukemia), Parkinson's disease and
ischemic heart disease. VA recently
established the presumption of eligibility
to VA disability compensation
benefits for Veterans with one of these
three conditions who were exposed to
Agent Orange, a herbicide agent used
extensively in Vietnam.
In practical terms, Veterans who
served in Vietnam during the war who
have a "presumed" illness do not have
to prove an association between their
illnesses and their military service. This
"presumption" establishes eligibility to
VA compensation if their condition is
disabling to a compensable level.
For additional information on the
VA disability compensation program or
additional presumptive disabilities for
Veterans exposed to herbicide agents,
contact VA at 800-827-1000 or visit
http://www.vba.va.gov/bln/21/AO/
claimherbicide.htm.
When it's time to turn up the heat in your home this winter to battle the icy cold, follow these simple tips to prevent the chance of fire:
1. Hire a professional to inspect and clean your furnace. Maintaining your furnace and ensuring that it's operating properly and efficiently will save you money and keep you free from worry.
2. Open your windows when you first turn on your furnace. Choose a warm day to let your furnace burn off the dust and dirt that have collected on its heating element. A residual odor is not harmful, but if the furnace rumbles or produces black smoke, call 911 and evacuate the premises.
3. Clean your chimney. Before you cozy up to the fireplace, open the flue and check for obstructions that can cause a build-up of harmful carbon monoxide. Hire a chimney sweep to inspect for creosote, a substance that gradually builds up as wood burns and can ignite in the chimney flue.
4. Use electric heaters sparingly. Don't let a space heater run for hours on end. Turn it off at night or when you vacate a room. Move bedding, clothing and other flammable items at least three feet away from the heater. And never leave children and pets unattended near a space heater.
5. Handle propane-powered equipment carefully. Follow the manufacturer's instructions, store cylinders outside, and call 911 if you smell a strong odor of gas.
For more information on home fire safety, go to BeFireSmart.com.
This information brought to you by USI Insurance Services, Liberty Mutual and the American Military Society. Our partnership with Liberty Mutual offers competitive rates and superior service to AMS Members. For more information or to request a quote, please call 1-800-524-9400 or visit us at www.libertymutual.com/ams. Please mention client #3825 when you call.
© 2009 Liberty Mutual Group. All rights reserved.
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