Grateful but Vigilant
TROA won't rest on its TRICARE For Life laurels.
By Lt. Gen. Michael A. Nelson, USAF-Ret.

We continue to follow the course of tricare For Life (TFL) very closely. We are active participants in the working level group hosted by the Department of Defense, we have good communication with the many parts of the system, and, most important, we pay attention to what we hear from you.

Judged by any measure of merit, TFL is coming closer each day to a routine operation. Yes, there are still some problems, but the early birthing pains of the program have been largely overcome.

We all should be happy about this reality, whether we're currently eligible or not. Almost 1.5 million beneficiaries are now immensely better off than they were before this legislation became law. And millions more yet to come will be able to look forward to relief from large health care expenses in their senior years.

It would be easy to declare victory and stop watching, but that is a mistake we won't make. There are several dangers we must look out for. First, because this is a great benefit, many outside its boundaries, including people in positions of power, may come to see it as too generous and call for cutting it back. Remember that one of the factors that made TFL possible was the existence of a federal budget surplus in the crucial year of 2000. With that surplus depleted, I think it realistic to be on the lookout for attacks on the law that created TFL.

Second, and a corollary to the first, I believe it will be tempting to budget-crunchers to nibble at the edges of TFL over time, especially if its costs turn out to be greater than anticipated. This might be seen, for example, in changes to covered procedures, less freedom of choice, and more costly out-of-pocket expenses.

Third, and potentially most important, is the future of Medicare itself. After all, TFL payment rates are tied to Medicare's (as are tricare rates for younger retirees and active duty families). To the extent that Medicare is weakened by payment reductions that diminish its attractiveness to providers, so, too, is TFL weakened. For that reason, troa and other beneficiary organizations are increasingly interested in and vocal about the state of Medicare itself. (You can help in this effort. See how on p. 24.)

We'll keep watching on your behalf, updating you, and letting you know when help is needed. In the meantime, though, we all have three responsibilities to consider.

First, because there is so much personal choice involved in TFL, we need to make sure we don't abuse the system through frivolous use. Second, I think we ought to be proud of this benefit and point it out to those who might consider a career in uniform. Sure, there is still work to be done in health care for retirees. But TFL is such a major step toward a promise kept that those who had reservations about urging young people to consider signing up should have a much different view now. And third, I think we all ought to give a shout of joy that this great event came in our lifetimes.

I hope you have a great Fourth of July. Wear something colorful, gather with friends, say thanks for the patriots who made the day a reality, and forget your diet. Happy 226th birthday!