The US Department of Defense's health care program is perhaps one of the most complex in the country. With 91 hospitals and 374 clinics facilities spread over the entire country and overseas for the uniformed service individuals in the Army, Navy, Air Force, Coast Guards, Marine Corps, Public Health Service and National Oceanic and Atmospheric Administration, the program no doubt is one of the most comprehensive and lucrative in the provision of health care services. The system that takes care of the complex health care program is known as TRICARE. TRICARE offers managed-care and fee-for-service options through its three primary services known as TRICARE Prime, TRICARE Standard and TRICARE Extra. Together they provide care to eight million active duty service members, survivors, retirees, their families and dependents. The system works on a dual mission namely to maintain medical readiness and support to the armed forces operations wherever they are; and to provide benefits to the armed forces personnel, their dependents and others who are entitled to military health care (Cecchine and Hosek 2001).
[...] officers of the Army and contract surgeons shall whenever possible attend the families of the officers and soldiers free of charge." (Tyquiengco 2001). Almost a century later the government had been able to establish the Civilian Health and Medical Program of the Uniformed Service (CHAMPUS) in 1967 whereby the Department of Defense offered health care benefit programs for military personnel, their families and retired members. CHAMPUS offered transplant services, hospital care, and family health care programs at no cost of military members (Tyquiengco 2001). [...]
[...] Beneficiaries who did not enroll were covered by a preferred provider organization (PPO) which basically offers MTF care subject to availability and two alternatives of TRICARE Extra (network civilian provider) and TRICARE Standard (non-network providers) options. Health care plans under TRICARE resembled the civilian managed care plans where the organization was aimed at cost effectiveness and provision of a network of health care provider. The management revolved around the government's ability to select, contract, operate and market the providers to the beneficiaries (Cecchine and Hosek 2001). [...]
[...] The higher the participation of the families and relations of military personnel in the TRICARE program, readiness is higher. In situations like war, the usage of readiness medical provision increases with time and then out-of-pocket costs from members of TRICARE cannot withstand the rising cost. This result in once again high cost of military health care, a factor that the government has been trying to avoid in the first place (Hosek et al 2002). Seeing these potential effects on the program, the government has attempted to change its tactics so as to include more effective programs that would eliminate high payments by the members. [...]
[...] To resolve the new TRICARE networked with civilian providers and gave the impression of networked service providers accessible at any time those users wanted to access. Limitations however materialized due to the organizational structure of TRICARE. Cecchine and Hosek (2001) noted TRICARE's cost effectiveness depended on the provider network and utilization management program to attract beneficiaries to highly managed options. This means that most beneficiaries would have to opt for Prime network in order to contract more payable facilities which would result in higher revenue for TRICARE. [...]
[...] With the introduction of TRICARE however, the government took on its shoulder a new baggage with many problems and issues that continue to wage even today. With TRICARE, mismanagement had been eminent as it has been based on the managed care organization structure. This structure even in the civilian sector has had problems in administration, costs, facilities and care. When implemented in the military setting it did not improve. Instead it deteriorated because of the magnitude and complexity of the demands of the population. [...]
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