Military Health Care Rivals Private Industry, Pentagon Official Says

By John J. Kruzel
American Forces Press Service

Jan. 28, 2008 - Providing troops quality health care through a military system that rivals and even outperforms the private sector is a top Defense Department priotity, a senior Pentagon official said today. In opening remarks to a packed auditorium at the Military Health System conference here today, Dr. S. Ward Casscells, assistant secretary of defense for health affairs, delivered a presentation featuring data comparing military care to treatment by private industry providers.

The data showed that last year, the Air Force provided complete childhood immunizations in higher numbers than the private sector, according to the Advisory Committee on Immunization Practices. Air Force health personnel immunized 86 percent of eligible recipients, compared to 84 percent immunized by the highest-rated state and 77 percent nationally. Complete immunizations comprised vaccinations of diphtheria, tetanus, and pertussis; polio; measles, mumps and rubella; haemophilus influenza type B; hepatitis B; and varicella.

Furthermore, the Air Force provided the same regimen of vaccines more promptly than the commercial sector and Medicaid, according to findings by a Health Plan Employer Data and Information Set evaluation. The Air Force met 75 percent of vaccination deadlines, the commercial sector 70 percent, and Medicaid 59 percent.

"The reason we collect this data is because I was told (on) Day One that we faced a crisis," said Casscells, who has served since April as the Pentagon's top health affairs official. "I believe we have got the brakes on this, and we're going to get it going in the other direction."

According to DoD Health Affairs data, the military health system is leading the nation in overall influenza vaccinations in the 18-to-65-year-old demographic. The numbers of flu vaccines performed by the military in fiscal 2007 dwarfed the latest national averages tracked by the Centers for Disease Control. The military also is ahead of national averages in administering vaccination for pneumonia, according to Health Affairs findings.

Despite the military's higher incidence of burn victims -- victims who often suffer more extensive injuries -- servicemember burn victims' mortality rate is comparable to those in the civilian sector. In his presentation, Casscells cited information from the June 2006 publication of Annals of Surgery that found "similar mortality ... (of) civilian compared to the military (burn) patient, despite longer time to definitive care, greater amount of full thickness burns, higher incidence of inhalation injury and more associated non-burn injuries."

Improvements in military health care between June and December were reflected in news media coverage during that time, Casscells said. In military health care news last June, 27 percent of the coverage was "positive," 55 percent was "balanced," and 18-percent was negative, according to information provided by Health Affairs. The data noted a dramatic shift in the tone of December's coverage, with 49 percent positive, 50 percent balanced and only 1 percent negative.

In a survey of Defense Department beneficiaries conducted by Health Affairs this month, patients' confidence in military health care appears to be rebounding. Of those surveyed, 17 percent said military health care is much better than in the civilian sector. Eighteen percent said military health is "slightly better," while 47 percent said the two systems offer roughly the same quality treatment.

Fifteen percent of those surveyed said the military's care is "slightly worse," and 4 percent called it "much worse." The main complaints cited about the military health system were a lack of adequate parking and hitech medical equipment, and difficult-to-navigate facilities.

In another survey, inpatient and outpatient care was significantly favored over the treatment administered at the average non-military hospital. Inpatient Tricare service rated an 89 percent satisfaction rate, and outpatient care fetched an 84 percent rating.

"I have learned from this perspective at Health Affairs ... that our military health clinicians are better than the outside world realizes," Casscells told the audience of military health professionals. "And you're better than you realize."