Fayetteville (N.C.) Observer
February 29, 2000
Tricare Woes Scrutinized
A diverse group discusses problems in the military's
managed-care
health system with lawmakers.
By J.S. Newton, Staff writer
The military health care system is broken and needs fixing,
witnesses
told a congressional subcommittee Monday.
The Fort Bragg ''field hearing'' brought together doctors,
patients,
service members and their families to discuss problems in the
military's
managed-care health program.
Witnesses mostly complained about appointment backlogs, billing
mistakes and unwanted delays in their Tricare medical treatment.
The House Armed Services Committee's Subcommittee on Military
Personnel conducted the rare field hearing. About 150 to 200
doctors,
patients and administrators from North Carolina's military bases
attended.
''Tricare is not a bad system,'' said Command Sgt. Maj. Aubrey
Butts,
who is with the 1st Battalion, 505th Parachute Infantry
Regiment, at
Fort Bragg. ''It is just a system that is very short of what is
needed by the soldier and his family.''
Those who attended included representatives from Fort Bragg,
Pope Air
Force Base, Camp Lejeune Marine base, Cherry Point Marine Corps
Air
Station and Seymour Johnson Air Force Base.
Most witnesses said when they were finally able to get
treatment,
their medical care was usually adequate.
But they said before -- getting an appointment to see a doctor
-- and
after -- getting Tricare to pay doctors on time -- creates
stress and
frustration for service members.
The hearing -- which was attended by North Carolina Reps. Robin
Hayes, a Republican from the 8th District, and Mike McIntyre, a
Democrat from the 7th District, and Rep. Neil Albercrombie, a
Democrat from Hawaii -- heard a litany of stories.
There was the Tricare patient whose breast cancer surgery was
postponed 30 minutes before the procedure, because her Tricare
paperwork was not in order.
Dr. Michael Bryant, of Sand Hills Physician Associates, said one
Tricare patient had to wait eight to 10 weeks after her
diagnosis to
get breast cancer surgery.
''I dare say any of us in this room would want our wives and
daughters to wait 8-10 weeks for adequate treatment for breast
cancer,'' he said.
Unpaid bills
There were stories from service members whose names had been
sent to
collection agencies, because Tricare had not paid the doctor
bill in a
timely fashion. In fact, Brig. Gen. Larry Gottardi, commander of
the
18th Airborne Corps Artillery, said he had a problem with an
unpaid
$75 medical bill.
''I have had a provider come after me relating to an unpaid
bill,''
he said. ''If it happens to me, it happens to anybody.''
Rep. Steve Buyer, a Republican from Indiana, and chairman of the
subcommittee, dropped his jaw when he found out the cost of
processing
a Tricare claim -- between $8 and $15.
He said it costs the government just $1 to process a Medicare
claim.
He did some rough computing and determined the government was
wasting
some $400 million a year in claim processing alone.
''Wow,'' he said, looking at James Ford, vice president of
Anthem
Alliance, whose company administers Tricare billing for two
regions of
the United States. ''This is a lot of money.''
''We're going to take this one on,'' Buyer added.
Family members of service members from North Carolina said they
tried
for days to get local doctor's appointments from ''800'' service
numbers a state away.
Tracy Fazekas, whose husband is Marine Maj. Scott Fazekas,
complained
that she could not get simple medical appointments through
Tricare
until she got her husband involved.
''I think it is an utter disgrace and humiliating that I need my
husband's help to get an appointment for my children,'' she
testified. ''The health care is not at all timely.''
''The perception at the unit level is that the focus of Tricare
is to
keep costs down and not provide quality health care,'' Scott
Fazekas
said. ''The perception is out there, and it is affecting
morale.''
Getting appointments
Service members and their families complained about having to
call 1
(800) numbers in adjoining states to make appointments with
local
hospitals.
Lt. Cmdr. Jamie Otto, who is an officer on the USS Theodore
Roosevelt, said getting treatment for a common cold can take
weeks.
''As a result, a patient who has a cold of flu now had
pneumonia,''
he said.
He said he knew of military families that have resorted to lying
so
they could get an appointment. A family might say their child
has a
104-degree temperature when they don't, just to get in to see
the
doctor, he said.
He said health care for the military is hurting efforts to keep
quality
people.
''Right now, they are falling short,'' he said. ''You get what
you
pay for, and you reap what you sow.''
Senior Airman Glenn McClelland, a Pope Air Force Base airmen,
said he
got the Tricare runaround, too.
He said one year and three months after he received medical
treatment, he started getting bills from Tricare.
''I just kind of put it aside,'' he said.
The result? A lawsuit for $44 he said he never owed.
''I've put my credit in jeopardy,'' he said. ''I'm still trying
to
work the issue.''
Marci McClain -- whose husband is a Pope Air Force base fighter
pilot, Capt. Terry McClain -- has been fighting a Tricare claim
for
16 months.
She said she had to submit her paperwork seven times before
Tricare
officials would ''actually admit they had received the claims.''
''If my claim had received as much attention as getting me here
today, we wouldn't be here talking about this,'' she said.
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