Reforming the Military Health Care System
Abstract
High costs, wide beneficiary dissatisfaction, and inadequate readiness for war have stirred widespread interest in changing the military's system of health care. Large sums are at stake because of the military health care system's scope. The Army, Navy, and Air Force run 129 hospitals (medical centers and regional and community hospitals), and several hundred outpatient clinics in the United States. About 9 million people are entitled to use these facilities, including not only the 2.2 million men and women serving on active duty but their roughly 3 million dependents along with about 4 million retired military personnel and their dependents and survivors. Caring for dependents and retirees nonactive beneficiaries in military facilities costs the Defense Department more than $3 billion a year. When nonactive beneficiaries cannot obtain care directly from the armed forces, because a particular medical service is unavailable or because military facilities in general are hard to reach, they may use the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). CHAMPUS pays a large part of the costs of care obtained from civilian hospitals and doctors. Dependents and retirees can use CHAMPUS whenever they want for outpatient care, but for hospital care those living in a "catchment area"-the area roughly 40 miles around a military hospital must get specific permission from their local military medical commander. In recent years funding for CHAMPUS has tripled, from about $710 million in 1980 to more than $2 billion in 1987. In response, the Administration has put forward the CHAMPUS Reform Initiative (CRI), which has at its core several fixed-price contracts with private health care companies to provide care for beneficiaries who are not on active duty. Though it may save money, CRI also carries a risk of triggering much higher costs.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 1988
- Accession Number
- ADA474725
Entities
Organizations
- Congressional Budget Office