LEGACY BENEFIT
I read with interest the article “Tricare Choice: What’s in it for you?” [March 23]. The unintended result of this new program will probably be the further loss of patients from military treatment facilities.
When Tricare was implemented in 1998, its stated purpose was to ensure that MTF appointments would be filled first with the overflow going to the Tricare network. Beginning with obstetrics, the concept changed so that patients could opt out of treatment at MTFs for care with civilian Tricare providers. The system has now evolved to the point that Tricare Prime beneficiaries in the Washington, D.C., area can choose Johns Hopkins for care just as they would for an MTF. Tricare Choice completes this evolution. Essentially, military hospitals will now compete with civilian health plans for Tricare Prime patients. This is another nail in the coffin of the MTF system. With this development, it is time to question the future of the MTFs and take a look at military health care overall.
Like the officers’ club, theater and commissary, the post hospital has become a legacy system. Fort Drum in New York and Fort Huachuca in New Mexico are prime examples. Their partnership with civilian hospitals has worked well and should be models for other installations in the continental U.S.
Critics will say that the MTF system is the backbone of military health care, necessary for readiness, cost containment and for providing a higher quality of care than the civilian sector. I disagree.
When a combat unit deploys, it deploys with soldiers who have worked and trained together over time. When a medical unit deploys, it is staffed by individual fillers who train together for three weeks before departure. When I went to Iraq in 2004, I knew almost no one in my combat support hospital before leaving. The only real readiness that I had at my home station before departure was working in my medical specialty. I could have had the same experience in a civilian hospital.
Military health care is expensive. In addition to the costs of maintenance, purchasing and administration, the military trains almost all of its enlisted medical personnel and the majority of its physicians. These are skills that can be taught in civilian institutions; military-specific training can be done at Fort Sam Houston. Military providers could work in civilian hospitals that care for Defense Department beneficiaries and then join the military hospital when they deploy.
Overall, the quality of care in our MTFs is excellent; but, it is a struggle to maintain. MTFs are in constant transition. Lack of continuity at all levels results in an inertial system that can never truly compete with its more stable civilian counterparts.
I am not a disgruntled vet but a concerned retiree who hopes the MTF system does not go through the slow attrition that befell other legacy programs.
Army Col. (Dr.) John H. Chiles (ret.)
Bethesda, Md.
JUDGING CHAPLAINS
I read the March 23 Air Force Times article on Navy Chaplain Lt. Cmdr. Wes Modder with trepidation [“Chaplain faces discharge after sailors say he is ‘intolerant,’ ”].
A lot has changed in the Navy since Modder came on board as a chaplain in 1999. The Navy has evolved into a kinder, gentler, more politically correct military. This was brought on by profound changes in our society at large that have trickled down to impact the Navy and other services.
I trust that the Navy knew just about what they were getting when Modder signed on. Over the ensuing years, judging from his glowing fitness reports, they got just what they were paying for.
Defense Department and Navy policies changed over the years, but apparently Modder did not. The Navy became more tolerant, diverse and pluralistic. For his employer to expect as much from him, an Assembly of God chaplain, was really asking a lot. Like all men of the cloth, whether in or out of uniform, they answer first and foremost to a higher authority.
Maybe Modder needs to leave the Navy. Most assuredly, the Navy has already left him. His employer is just as guilty of breach of contract as Modder is accused of being.
A compromise is in order: Modder should be allowed to retire. Then it can be left up to the highest authority to write Modder’s final fitness report.
Col. Bill Malec (ret.)
O’Fallon, Ill.
One of the problems with Chaplain Modder’s viewpoints is they are not unique to him, nor are they unique to his Pentecostal denomination. They are typical of the larger Evangelical community, 285 million strong worldwide in more than 100 denominations, according to Wikipedia.
While controversial and even objectionable to people outside this movement, most Evangelicals would agree with his positions on sexual morality. Mormons, as well as conservative Catholics and conservative Jews would as well.
If Chaplain Modder is forced from the service we can’t stop with him. We should remove all chaplains who agree with his viewpoints, and, if the military hasn’t guts enough to do this, the sponsoring churches should remove their clergy from the chaplaincy as a matter of integrity. Their statements of belief will no longer be compatible with military policy or core values.
Master Sgt. Robert Price (ret.)
Abilene, Texas
