A Slap in the Face

Next Saturday, May 15th, is Armed Forces Day.  On this day, we will celebrate the demonstrated successes and battle-tested professionalism of America's armed forces.  However, underlying this year's celebration there are disquieting indicators that all is not well with our armed forces.

America's all-volunteer military, for the first time since the draft ended in 1973, is faced with its greatest and most fundamental challenge.  This challenge is the military's recent inability to man the armed forces at authorized levels.  Despite a 40% decline in authorized strength during this decade, America's armed forces are experiencing great difficulty in recruiting volunteers and retaining seasoned, middle grade officers and noncommissioned officers.

Recent unfavorable trends, which should concern every American, are illustrative of the military's difficulty in manning the armed forces even at its reduced personnel levels.  For the first time in the Air Force's history, it has embarked on a recruiting advertising campaign.  Compounding its recruiting needs, is the fact that since 1996 the Air Force has been hemorrhaging from the loss of approximately 2,000 highly skilled and experienced pilots.

The Navy, for the first time since it became an all volunteer force, fell short of its annual recruiting goal by over 7,000 recruits last year.  Enlisted retention is also seriously below requirements and all officer warfare specialties are faced with deleterious shortages.  As a result, the Navy has over 22,000 unfilled positions.  Consequently, Navy ships of war are going to sea without full crews. 

Although the Army only fell short of its recruiting needs by over 800 last year, it was a precursor of worse times ahead.  This year the Army is projecting a recruiting shortfall of over 5,000.  While the Army is managing to retain middle grade officers and noncommissioned officers at acceptable levels, its 40% attrition rate for basic trainees is severely mortgaging the Army's future personnel readiness.

The Marine Corps, due to its much smaller size and aggressive advertising, has presently been spared the recruiting and retention problems of the other services.  Nonetheless, there is anecdotal evidence that the Marine Corps may soon be facing similar manning challenges that are plaguing its sister services.

Many factors are contributing to the unparalleled manning challenges faced by our armed services.  A national survey of young men, ages 16 to 21, shows that less than 15% have a propensity toward serving in the armed forces.  A strong economy has attracted young Americans to better paying career opportunities.  And, a three-to-four fold increase in operational tempo has made a stable family life practically impossible.

A seldom noted factor has also contributed significantly to the armed forces' recent inability to adequately man the force.  This factor is our government's callous breaking of a long standing promise.  The promise broken is the promise of lifetime health care for those who serve a minimum of twenty years in the defense of our country. 

Rooted in practice, as well as an implied legal basis for over 100 years, the promise of lifetime health care for military retirees continued to be assured as late as 1993.  Numerous recruiting brochures, personnel publications, retiree guides and other official documents printed by the U. S. Government Printing Office communicated this promise.  In the wake of dramatic cuts in military force structure and defense spending, however, our government has disregarded its moral commitment to fulfilling this promise. 

The breaking of this promise has not only been harmful to the physical well-being of military retirees but also detrimental to the armed forces' ability to recruit and retain the force.  As Napoleon Bonaparte astutely noted, "The best way to encourage young soldiers to continue in the Army is to show great respect for the old soldiers."  However, our government's broken promise of lifetime health care sends a contrary message---  it does not respect the service and sacrifices of its aging warriors. 

Presently, military retirees age 65 and over have the unique distinction of being the only federal retirees disenfranchised from an employer based health care program, thereby forcing them into Medicare.  Acknowledging the inextricable link between the well-being of our nation's military retirees and the personnel readiness of America's armed forces, General Dennis Reimer, Chief of Staff, Army recently remarked, "If we can't fix retiree health care, we can't fix recruiting." 

Thus, the joint chiefs, the armed forces' retiree councils, the national military organizations and individual military retirees, have been pursuing three objectives aimed at restoring our government's promise of lifetime health care for our aging warriors. 

Objective one seeks congressional authority for Medicare subvention. 

Medicare subvention would require the Health Care Financing Administration (HCFA), which administers Medicare payments, to reimburse DOD for health care provided by military treatment facilities to military retirees enrolled in Medicare.  This would enable the armed forces to restore promised lifetime health care to approximately one-third of those military retirees age 65 and over who reside within a 40 mile radius of a military treatment facility.

The 1997 Balanced Budget Act authorized a three-year Medicare subvention test that began in September 1998.  This authorization marked the culmination of a ten-year effort.  Initial test data affirms that Medicare subvention enables the armed forces to provide health care to military retirees age 65 and over at a 25% cost savings to the HCFA.  Since approximately 3,000 military retirees age 65 and over are dying monthly, the test data warrants full implementation during the next fiscal year.

Objective two advocates congressional authority to afford military retirees age 65 and over the option of enrolling in the Federal Employee Health Benefits Program (FEHBP).

This option is necessitated by the military drawdown that closed scores of military treatment facilities, leaving 26 states without any.  Consequently, Medicare subvention would not be available to two-thirds of the military retirees age 65 and over.  The FY 99 Defense Authorization Act, which permits up to 66,000 Medicare-eligible military retirees to enroll in a three-year test to determine costs to the government, is a step in the right direction.  However, DOD's reluctance to support this option on the grounds of affordability is disheartening.

What makes DOD's reluctance particularly disheartening is that it provides quality, comprehensive lifetime health care to its civilian retirees through the FEHBP.  For its civilian retirees age 65 and over, DOD pays a 72% share of the FEHBP costs to the tune of $3 billion annually.  Conversely, the Administration's "bean counters" argue that DOD cannot afford the estimated $1 billion to make this option available to those aging warriors who endured the dangers and hardships of a military career.  This is unconscionable!

Objective three is the expansion of the DOD National Mail Order Pharmacy Program for Medicare-eligible military retirees.

The drastic downsizing of the military health care system and budget driven reductions of military treatment facility formularies have resulted in the loss of access to prescription medications for those military retirees age 65 and over.  This has created a debilitating financial hardship for a significant number of our aging warriors who trusted in and relied upon our government's promise of lifetime health care in exchange for their  lifetime of military service.

Progress toward securing eligibility in the DOD National Mail Order Pharmacy Program for all military retirees age 65 and over has been made thanks to support of Congresswoman Karen Thurman.  As a result of her dogged determination and herculean efforts, the FY 99 Defense Authorization Act directed DOD to develop and test the implementation of an expansion plan to include all military retirees age 65 and over. 

Preliminary cost projections for full implementation is $267 million annually.  Within the framework of a $1.7 trillion federal budget and projected budget surpluses for the next 15 years, this is a small price to pay for honoring our government's promise of lifetime health care..

In summary, treating our aging warriors as forgotten warriors is wrong!  Our government's abrogation of its long standing promise of lifetime health care has, therefore, directly contributed to the recruiting and retention challenges presently facing our armed forces. 
 
Congresswoman Thurman understands this wrong and its serious ramifications for the well-being of our aging warriors, as well as our armed forces.  When introducing her mail order pharmacy legislation, she forthrightly reminded our national leaders that "Our nation made a commitment when we asked them to sacrifice for America's future.  They held up their end of the bargain.  Now its our turn.  The passage of time does not erase our government's obligation to their well-being."