Defense Health Care

The Defense Department's (DOD) military health care system provides medical services and support both in peacetime and in war to members of the armed forces and their families, as well as to retirees and survivors. Post-Cold War planning scenarios, efforts to reduce the overall size of the military, federal budget cuts, and base closures and realignments have focused attention on how large DOD's health care system is and what its makeup is, how it operates, whom it serves, and whether its missions can be carried out in a more cost-effective way. This report describes the Military Health Services System, past problems faced by DOD as it ran the system and efforts to solve those problems, and the management challenges now confronting DOD. GAO summarized this report in testimony before Congress; see: Defense Health Care: DOD's Managed Care Program Continues to Face Challenges, by David P. Baine, Director of Federal Health Care Delivery Issues, before the Subcommittee on Military Personnel, House Committee on National Security. GAO/T-HEHS-95-117, Mar. 28, 1995 (12 pages).

GAO found that: (1) MHSS offers health care to about 8.3 million people at a cost of over $15 billion annually; (2) MHSS provides services through a system of medical centers, smaller hospitals, and clinics, and through the Civilian Health and Medical Program of the Uniformed Services; (3) DOD has had problems providing adequate medical support to deployed forces, including inadequate training, missing equipment, and large numbers of nondeployable forces; (4) DOD is examining the impact of a smaller force to determine the optimal size and structure of its medical force; (5) DOD initiated a series of demonstration programs to explore different means of more cost-effectively managing the care it provides and funds; (6) DOD began TRICARE, a nationwide managed care program, in 1993, to improve beneficiary access to care while containing system costs; (7) TRICARE must address emerging operational challenges if it is to achieve its goals; and (8) including military beneficiaries under the Federal Employees Health Benefits Program may be an alternative if TRICARE does not meet its objectives.