Investigating the Military Medical System


The Basics

In covering this topic, it’s important to ALWAYS keep in mind that two different institutions provide medical help to wounded soldiers and veterans.

1. The Department of Defense

Department of Defense sealThe DoD has its own system of medical care, ranging from basic treatment in the field, to combat support hospitals (think M*A*S*H) to modern, full-service hospitals such as Walter Reed Army Medical Center in Washington, D.C. or Landstuhl Regional Medical Center in Germany.

The primary goal of the DOD medical system is to get active duty soldiers better so they can return to the battlefield, or care for them until they are discharged from the military.

Each branch of the military (Army, Air Force, Navy, Marines) has its own Surgeon General, who is the top medical commander for that branch.

Medical information, including basic statistics, can be found at www.health.mil.

2. The Department of Veterans Affairs

Veterans Affairs LogoThe VA is a completely different animal, and much of the controversy and effort at improving medical care for soldiers and veterans over the past few years has been devoted to better connecting the VA and the DoD medical systems together.

The primary goal of the VA is to provide care for members of the armed forces who have been discharged from their respective military branches. The VA takes all comers, from all branches, from all different times of military services – vets from World War II to Iraq and Afghanistan.

The VA has a terrific statistical breakdown via the National Center for Veterans Analysis and Statistics. It provides all kinds of information about veterans – including such topics as how many homeless vets, how much money is being spent – by geographic area. Available here.

Another key difference from the DoD is that the VA also administers veterans’ disability benefits under a branch called the Veterans Benefits Administration.

So the VA provides both medical care and benefits for those veterans temporarily or permanently disabled. The disability benefits area is often the single most controversial topic. Veterans constantly complain about delays in receiving their benefits,  of errors in disability ratings and about the amount of money they are receiving.

Tricare

Tricare is another story. Technically speaking, Tricare is the Department of Defense’s health system. It pays for all care for active duty soldiers and funds military hospitals and clinics. However, although Tricare falls under the Department of Defense, it is best known for providing a kind of health insurance network used by veterans, soldiers and reservists to receive care from local civilian doctors.

In its function as an insurance plan, Tricare is quite literally the tail that wagged the dog—the insurance part is much larger than the direct care to soldiers part.

While Tricare is managed by the DoD, it is actually executed by contracted health care providers (As of August 2011, United, Aetna, TriWest). Each of these contracts is the single largest contract executed by the military (each worth around $18 billion over a five-year period as of 2011). Tricare is perhaps the most opaque, impenetrable bureaucracy because so little of it is done by the private sector instead of government.

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