Disabled GIs say higher co-pays, deductibles are bleeding them dry

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Subject: Disabled GIs say higher co-pays, deductibles are bleeding them dry

North Jersey Media Group Inc.
By HEATHER HADDON
HERALD NEWS
Sunday, March 4, 2007

Disabled GIs say higher co-pays, deductibles are bleeding them dry

The rifle butt hit his mouth so hard that he assumed he'd lost all his teeth.Dickson Perez's elite military platoon was on daytime patrol in Iraq when he walked into a house and an ambush. His assailant had run out of bullets for his AK-47, so he used it to smash Perez in
the mouth.

Far worse was when Perez walked past a roadside bomb. He's still uncertain about the immediate aftermath, but clearly recalls the agony of waking in a hospital bed with internal bleeding. Several surgeries had saved his teeth and Perez counted the days until his three-year tour concluded. He came back to Passaic in October, and since has suffered from chronic headaches and nausea that result in emergency trips to the hospital.

"Everyone knows me there. Even the janitor," joked Perez, 35, after he spent hours at the Veterans Affairs Medical Center in East Orange on Thursday. His casual attitude fades when talk turns to TRICARE -- the federal health benefit plan for veterans and soldiers on active duty. After risking his life, Perez is irked that his insurance is riddled with co-pays and high deductibles.

And if the federal government has its way, the fees will get dramatically worse."It's better to have something than nothing," said Perez, whose body is covered with scars. "But it's partial insurance. And they are trying to push a co-pay increase." Indignation is running high among military families, advocates and lawmakers over huge fee increases to TRICARE proposed by the Department of Defense for October.

A bill recently proposed by Sen. Frank Lautenberg, D-N.J., would prevent the dramatic cost changes and would require that future increases not outpace average military pay raises The legislation nearly passed last year, and is again gaining steam. "There are many people who are quite concerned about this," said Alex Formuzis, a Lautenberg spokesman.

The Defense Department hopes to reduce $1.9 billion in TRICARE costs primarily by quadrupling fees for vets. Annual premiums for retired soldiers with family coverage would rise from $460 a year up to $1,400. Pharmacy co-pays for active duty and retired soldiers would increase from a low of $3 to a maximum of $15. The move unleashed a firestorm of criticism when it was first proposed last year, leading the Defense Department to drop it.

But the proposal surfaced again in the president's preliminary budget. Under this incarnation, the cost increase would happen immediately, not phased in as originally proposed. Cynthia Smith, a Defense Department spokeswoman, said in a statement Friday that the changes were necessary to put TRICARE "on a financially sustainable path for the long-term." The increase would be the first since TRICARE fees were set in 1995, according to the military.

It would offset the growing cost of health care and the extension of TRICARE to National Guard members, the Defense Department says.But critics say the increase is unfair because many recruits join the military for health benefits, said John Class of the Military Officers Association of America, a group based in Washington, D.C. "It's just felt that health care is a big part of the package," said Class, a retired Navy officer.

"It's definitely not the pay." Currently, new recruits gross roughly $31,000 a year, less than New Jersey's medium income of $36,500. Passaic County's 21,000 veterans had a medium income of $34,100 in 2005, the Census found. Private employees shell out more of their salaries for health insurance, on average, but the burden is growing for soldiers.

A new recruit with comprehensive family benefits would pay roughly $1 of every $22 dollars earned under the fee increase -- before taxes. Perez, of Passaic, is now unemployed and searching for work. TRICARE is already expensive, he says. Perez must reach a $3,000 deductible before the full insurance coverage kicks in, and shells out co-pays for his many prescriptions.
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Dental surgery has taken a back seat to the headaches that doctors can't yet diagnose. "Things can't get worse," he said despondently. Paula Rogovin is similarly upset about the fee increase. Her 24-year-old son shipped out for active duty on Thursday, and she's terrified that he will come back hurt -- or not at all. "My kid could get killed.

My kid could get injured," said Rogovin, of Teaneck, who struggles to keep from crying about her son at work. The anger over the TRICARE increase comes as scrutiny intensifies over the military's care of soldiers.

Francis Harvey, secretary of the Army, resigned last week, and Army Maj. Gen. George W. Weightman, in charge of running Walter Reed Army Medical Center in Washington, D.C., was fired after the Washington Post exposed squalid conditions and a maze of bureaucracy in what is the nation's top hospital for the critically wounded.

"Everything has been poorly managed," said Rep. Bill Pascrell Jr., D-Paterson. "It's the epitome of insult." Rogovin was one of 15 military families who met with Lautenberg last week about the war.

Lautenberg promised to provide better gear and health services for troops,  Rogovin says, but she is more concerned about when the soldiers can return home."We're not interested in proper equipment," she said. "We're interested in them being out of there immediately."

Perez refrains from commenting on the war. He still speaks in "sirs" and "ma'am's", and keeps his hair closely cropped. But the benefits issue stokes his anger. "People are just paralyzed for life," he said. "There should at least be justice."
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Contributed,
YNCS Don Harribine, USN(ret)