Tom Coburn’s Cuts: Military’s Tricare Prime Health Care Program Targeted
Sen. Tom Coburn (R-Okla.) wants to cut taxpayer funding for non-military elements of the Defense Department, starting with making retired, uninjured service members pay more for what he described as “extremely low-cost health care for life” for themselves, their wives and dependents under the Tricare Prime system.
For military retirees eligible for Medicare, he also wants to raise the co-payments that they are charged to be in Tricare for life, the second payer for health care after Medicare. In addition, he wants to increase low fees that Tricare beneficiaries pay for pharmaceuticals purchased at their local drugstores.
Former defense secretary Robert M. Gates proposed raising Tricare Prime enrollment fees for single retirees from $230 a year to $260 a year and fees for retiree families from $460 a year to $520 a year. Coburn wants the fees to be much higher and more in line with private-sector health plans.
Part of his concern is fairness, first for uninjured veterans who, for example, served in Iraq and/or Afghanistan but “leave the military without serving 20 years [and] are not entitled to any of these health-care benefits.” They represent some 70 percent of those serving, according to Pentagon officials.
Another comparison he makes is to other federal government workers whose plans are not as cheap. A medical doctor, Coburn told reporters last Monday: “Nobody in the country, as a single person working 20 years for the government, should be able to get health care for $250 a year. Nobody was ever promised that, and nobody should be able to do that.”
Instead, he wants to increase the enrollment fee for single retirees to “approximately $2,000 per year and $3,500 for a family.” At the same time he would limit out-of-pocket expenses at $7,500 for those retirees with families. He thinks these changes could save $11.5 billion a year.
His Tricare for life would require retirees to pay up to $550 for half the initial cost not covered by Medicare and then up to $3,025, after which all costs would be paid by Tricare. This change could save $4.3 billion a year.
Coburn wants to reduce the $8 billion annual government share of the cost of drugs that Tricare beneficiaries purchase from their local private retail pharmacies rather than buying them at lower cost by mail order or at military base facilities. Where the price is now $3 for a 30-day supply of a generic drug and $9 for a brand-name from private pharmacies, Coburn would raise that to$15 for generic and $25 for brand names and save some $2.6 billion a year.
Coburn told reporters he has no doubt about the reaction to his Tricare ideas.
“There’s no question,” he said, “. . . retired military, they won’t like what I’ve done. But the fact is is nobody’s going to like what we’ve done, because everybody gets a pinch — everybody. ”
Beyond health care, Coburn has several other proposals that will rattle the Pentagon. He wants to eliminate most of the $1.3 billion-a-year subsidy that supports the Defense Commissary system of 252 grocery stores on military bases worldwide. Prices at commissaries are much lower than at civilian supermarkets; they are listed at cost plus a 5 percent surcharge. That money goes to offset costs of new commissaries or to repair and maintain old ones. It does not pay for salaries and benefits of the roughly 18,000 people who work at the commissaries.
Coburn supports a Congressional Budget Office proposal that would reduce the taxpayer subsidy over five years and see a gradual raise in prices so commissaries could become self-sufficient. The increase in cost, according to the CBO, would amount to $400 per service family per year and save the government about $900 million annually.
He also wants to close down the Congressionally Directed Medical Research Program, which for more than 20 years has added around $200 million a year primarily for breast, lung and prostate cancer projects that have to be managed primarily by contractors. Coburn’s option is to “transfer funding for cancer research that affects the general population back to [the National Institutes of Health] and reduce the administrative costs of administering this research for savings.”
By: Walter Pincus, The Washington Post, July 24, 2011
The Neocons Are Trying To Talk Us Into War — Again!
“They have learned nothing and forgotten nothing,” Voltaire said of the members of the Hapsburg dynasty of his day. The same might be said of the American hawks who are calling for U.S. military intervention in Libya’s civil war.
Sens. John McCain and Joe Lieberman, along with others, have raised the possibility of establishing “no-fly zones” in Libya, along the lines of those in Iraq between the end of the Gulf War in 1991 and the beginning of the Iraq War in 2003, in order to prevent Libyan dictator Moammar Gadhafi from using his air force to bomb the rebels seeking to overthrow his regime. Another suggestion is to help Libyan rebels establish secure enclaves, from which they can capture the rest of the country from forces loyal to Gadhafi.
The implication is that the enforcement of “no-fly zones,” by the U.S. alone or with NATO allies, would be a moderate, reasonable measure short of war, like a trade embargo. In reality, declaring and enforcing a no-fly zone in Libya would be a radical act of war. It would require the U.S. not only to shoot down Libyan military aircraft but also to bomb Libya in order to destroy anti-aircraft defenses. Under any legal theory, bombing a foreign government’s territory and blasting its air force out of the sky is war.
Could America’s war in Libya remain limited? The hawks glibly promise that the U.S. could limit its participation in the Libyan civil war to airstrikes, leaving the fighting to Libyan rebels.
These assurances by the hawks are ominously familiar. Remember the phrase “lift-and-strike”? During the wars of the Yugoslav succession in the 1990s, Washington’s armchair generals claimed that Serbia could easily be defeated if the U.S. lifted the arms embargo on Serbia’s enemies and engaged in a few antiseptic airstrikes. Instead, the ultimate result was a full-scale war by NATO. Serbia capitulated only when it was faced with the possibility of a ground invasion by NATO troops.
Undeterred by the failure of lift-and-strike in the Balkans, neoconservatives proposed the same discredited strategy as a way to remove Saddam Hussein from power in Iraq. Paul Wolfowitz and others proposed the creation of enclaves in Iraq, from which anti-Saddam forces under the protection of U.S. airpower could topple the tyrant. Critics who knew something about the military dismissed this as the “Bay of Goats” strategy, comparing it to the Kennedy administration’s failed “Bay of Pigs” operation that was intended to overthrow Fidel Castro without direct U.S. military involvement by landing American-armed Cuban exiles in Cuba. In Iraq, as in the Balkans, the ultimate result was an all-out U.S. invasion followed by an occupation.
In Afghanistan, Afghan rebels played a key role in deposing the Taliban regime. But contrary to the promises of the Bush administration that the Afghan War would be short and decisive, the objective was redefined from removing the Taliban to “nation-building” and the conflict was then thoroughly Americanized. The result is today’s seemingly endless, expensive Afghan quagmire.
The lesson of these three wars is that the rhetoric of lift-and-strike is a gateway drug that leads to all-out American military invasion and occupation. Once the U.S. has committed itself to using limited military force to depose a foreign regime, the pressure to “stay the course” becomes irresistible. If lift-and-strike were to fail in Libya, the same neocon hawks who promised that it would succeed would not apologize for their mistake. Instead, they would up the ante. They would call for escalating American involvement further, because America’s prestige would now be on the line. They would denounce any alternative as a cowardly policy of “cut and run.” And as soon as any American soldiers died in Libya, the hawks would claim that we would be betraying their memory, unless we conquered Libya and occupied it for years or decades until it became a functioning, pro-American democracy.
Those who are promoting an American war against Gadhafi must answer the question: “You and whose army?” The term “jingoism” comes from a Victorian British music-hall ditty: “We don’t want to fight but by Jingo if we do,/ We’ve got the ships, we’ve got the men, we’ve got the money too.” Unfortunately for 21st-century America’s jingoes, we haven’t got the ships, the men or the money. The continuing wars in Iraq and Afghanistan have stretched U.S. military manpower to the limits. The U.S. has paid for these wars by borrowing rather than taxation. The long-term costs of these conflicts, including medical care for maimed American soldiers, will run into the trillions, according to the economists Joseph Stiglitz and Linda Bilmes.
If a lift-and-strike policy failed, and the result was a full-scale American war in Libya, how would Sen. McCain propose to pay for it? Republicans since Reagan have preferred to use deficit spending rather than taxes to pay for wars and military buildups. No doubt the Republican hawks would support paying for a Libyan war, like the Iraq and Afghan wars, by adding hundreds of billions or trillions to the deficit, even as they claim that non-military programs are bankrupting the country.
Napoleon and Hitler were brought down when they foolishly fought wars on two fronts. In hindsight they look like strategic geniuses compared to the American hawks who, not content that the U.S. is fighting two simultaneous wars in the Muslim world, are recklessly proposing a third.
Fortunately, the American people in 2008 chose not to entrust Sen. McCain with the office of commander in chief. While his domestic policy has been too timid and incremental, in his foreign policy Barack Obama has proven to be the cautious realist that America needed after the trigger-happy George W. Bush. His prudence is shared by his conservative secretary of defense, Robert Gates, who recently told an audience of West Point cadets:
“In my opinion, any future defense secretary who advises the president to again send a big American land army into Asia or into the Middle East or Africa should ‘have his head examined,’ as General MacArthur so delicately put it.”
Gates is right. Those who propose U.S. military intervention in Libya, even as the U.S. remains bogged down in Iraq and Afghanistan, should get their heads examined.
By: Michael Lind, Salon, March 8, 2011
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