Rethinking The United States’ Military Health System

Hello Sir, I appreciate your response to this article, & although I can not speak to the majority of your response related to cost/benefits etc, I can speak from the patient's perspective. I serve veterans in a civilian hospital who have purposely chosen not to seek care from the VA because they report that their previous experiences at the VA have caused them to feel neglected & overlooked. Whereas in the civilian hospital these same patients feel they are "prioritized" & are "being heard" & are presented with the best possible treatment options, pertaining to their care. This drives me to be an even stronger advocate for my patients when I'm working my shifts at the VA. I don't necessarily agree with outsourcing patient care. I feel that the VA is more than capable of updating their systems to ensure that our veterans receive the same level of care that they expect from civilian hospitals.

SSG Shavonde Chase great read/share, much appreciated:
The Current Challenge

Some critics allege that the military health system’s stateside mission costs too much, delivers care of uneven quality, and doesn’t attract enough complex cases to keep provider skills sharp between deployments. They want the Department of Defense to close most of its remaining facilities, outsource the care to the private sector, and position more military providers in civilian hospitals. Before these ideas receive serious thought, it is worth examining the assumptions on which they are based:

Costs

According to the Congressional Budget Office (CBO), the Department of Defense spends $52 billion, about 10 percent of its budget, to provide a variety of services to 9.4 million beneficiaries. This total includes costs not counted by civilian health systems, such as $1 billion annually for military health research and billions more for “TRICARE for Life,” a first-dollar, wraparound plan Congress mandated to supplement the Medicare coverage of military retirees. In fact, yearly spending varies by $2 billion or more due to fluctuations in military construction. To put this in context, in 2016 Kaiser Permanente collected $64.6 billion to care for its 11.3 million members. The Department of Defense’s FY2017 budget for military health is $48.8 billion to care for its 9.4 million beneficiaries.

Growth in health care spending is not limited to the military. Civilian health spending has outpaced our nation’s economy as far back as 1950. Between 1999 and 2009 alone, health spending grew so fast, it wiped out the income gains of average US families. Military health spending grew too, but recently it has increased at a far slower pace than civilian health spending. According to the Centers for Medicare and Medicaid Services (CMS), between 2009 and 2015, civilian health spending increased 32.6 percent. During the same timeframe, military health spending grew 13.9 percent (Table). A recent analysis produced by the CBO attributes most military health spending growth since 2000 to congressionally mandated expansion of TRICARE benefits, including the establishment of TRICARE for Life, an insurance option that eliminates most out-of-pocket costs faced by Medicare-eligible military retirees and their families.

US health care is not only costly; it is inefficient. The National Academy of Medicine estimates that our nation wastes $750 billion per year on “unnecessary or inefficient services, excessive administrative costs, high prices, healthcare fraud and missed opportunities for prevention.” In 2015, aggregate health care spending approached $3.2 trillion dollars. Only 1.5 percent is devoted to military health. Given these facts, it is hard to see how outsourcing more care will save money.