Until the 21st Century Sailor initiative ends all booze/tobacco sales at NEXs. It's not that far fetched....
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Commissaries Closing?
- Thread starter exNavyOffRec
- Start date
Until the 21st Century Sailor initiative ends all booze/tobacco sales at NEXs. It's not that far fetched....
Spekkio
He bowls overhand.
If we're talking bottom-line money for the DoD...
Involuntary geobachelors cost the DoD more money. They get paid BAH for their last duty station or their current one, whichever is higher, AND per diem for the BEQ/BOQ while forward deployed. It is cheaper to move them over-seas, and that's not counting the 2nd order retention effects of sending the message to servicemembers that you don't give a damn if they see their families for 3-5 years.
As for 'Obamacare,' I'm not sure what you mean by that. State exchanges? They'll cost more than Tricare Prime in most states. Perhaps you mean that all dependents should be forced into Tricare Prime and see military physicians to save DoD money from paying private doctors? Do you mean that servicemembers should now incur the full bill of paying for 100% of their own insurance costs?
While we're there, how would adjusting the above and then raising servicembers' pay lower the cost to the DoD?
I'm with you with retirement. It is a fairly lucrative deal IF you can make it that far -- ~$25k/year for life for a retiring E7, $35k/year for life for a retiring E9/O-5 at 20 years. I would like to have that deal, but I would understand completely if they said that you had to wait until 62 or 65 or whatever to start cashing in, with exceptions for people who are disabled from being wounded.
With the present capability (manning) with military medicine, DOD would need to hire a lot of more doctors (especially specialists) and acquire or build more medical facilities if every dependent were forced to only go to an MTF.
I believe your question was rhetorical, but after hearing from the CO of the hospital here the numbers of service members and dependents in the Jax area, I was shocked. Those numbers did not include the retirees...
Spekkio
He bowls overhand.
I wasn't talking specialists really... no specialist at the MTF then you get sent out to town. It probably doesn't happen often enough to warrant hiring specialists except in the largest bases like Norfolk, San Diego, Pearl, etc.
My point was that it's cheaper to hire a bunch of general practitioners and OB-GYNs collecting O-3 pay than to send dependants to doctors out in town to physicians pulling a median NET salary north of $200k/year. Every one of them are crooks with the way they do billing (for example, the $900 an ENT tried to bill tricare for a 10 minute visit for my daughter was quite comical, but he still got between $150-200 for it), but they are doing the best they can in a broken system that is about to get worse. If that ENT were being paid as an O-3, the cost of the DoD to pay him for the same visit would be $7.70. Yea, I'm not including facility costs but economy of scale makes that not come close to costing $200 per patient for 10 minutes.
My point was that it's cheaper to hire a bunch of general practitioners and OB-GYNs collecting O-3 pay than to send dependants to doctors out in town to physicians pulling a median NET salary north of $200k/year. Every one of them are crooks with the way they do billing (for example, the $900 an ENT tried to bill tricare for a 10 minute visit for my daughter was quite comical, but he still got between $150-200 for it), but they are doing the best they can in a broken system that is about to get worse. If that ENT were being paid as an O-3, the cost of the DoD to pay him for the same visit would be $7.70. Yea, I'm not including facility costs but economy of scale makes that not come close to costing $200 per patient for 10 minutes.
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Anyone on Prime does have to see a military doctor, if there is capacity for them to be seen. And anyone on Standard pays for the privilege of doing otherwise, so I'm not sure what would really be changing under that plan. A few more doctors squeezed into current facilities, I guess, but I don't see that makign much of a difference. And recruiting doctors can't be cheap or easy, can it? (Honest question.) Certainly building additional medical facilites, which would be needed if they were really gong to attempt to have all but the most specialized care be done on base would be hugely expensive.
Perhaps increasing the costs associated with Standard might make sense, but it that forces people off Standard and back to Prime, then the increased capacity might cause more people to be seen by civilians anyway (and not pay for it, since they aren't Standard), so that might end up costing more.
I'd be down with charging at least a nominal fee for enrolling family members in Tricare at all. I know back in the days when I wasn't a lazy house-frau, my job offered full benefits, but I still had Tricare coverage. Why not? It was free. (Actually I don't even know if it is possible to disenroll from any and all Tricare coverage). If I would have had to pay any fee at all, I probably would have passed on Tricare, since having secondary coverage wasn't really much of a benefit. I can't imagine I was the only one in that boat, though in my case I kept my work coverage as well because it was free so I never used my Tricare, except one time when a prescription I needed wasn't covered. But there are people who turn down work coverage because they don't want to pay a premium when they can get Tricare for free.
This is a problem that is being looked at with retirees, but it doesn't seem like anyone has addressed it for active duty.
Perhaps increasing the costs associated with Standard might make sense, but it that forces people off Standard and back to Prime, then the increased capacity might cause more people to be seen by civilians anyway (and not pay for it, since they aren't Standard), so that might end up costing more.
I'd be down with charging at least a nominal fee for enrolling family members in Tricare at all. I know back in the days when I wasn't a lazy house-frau, my job offered full benefits, but I still had Tricare coverage. Why not? It was free. (Actually I don't even know if it is possible to disenroll from any and all Tricare coverage). If I would have had to pay any fee at all, I probably would have passed on Tricare, since having secondary coverage wasn't really much of a benefit. I can't imagine I was the only one in that boat, though in my case I kept my work coverage as well because it was free so I never used my Tricare, except one time when a prescription I needed wasn't covered. But there are people who turn down work coverage because they don't want to pay a premium when they can get Tricare for free.
This is a problem that is being looked at with retirees, but it doesn't seem like anyone has addressed it for active duty.
Not entirely, the commissary sells at cost of procurement (straight from their website: "Commissaries are required by law to sell items at prices set only high enough to recover item cost") meaning, what they pay for the item - you pay, plus 5% - which is used construction and maintenance of commissaries, which is why they operate at a huge loss each year. The simplest solution to this, in my mind, would be have them sell at total cost, but with no profit - this way - they can actually account for the cost of the labor, capital, utilities, etc. This would also incentivize them to minimize these costs and act as a "for profit" - but without actually making a profit and still giving the service-member a benefit over companies that make profits on their groceries (granted, it would be a smaller benefit, but still). It's a simple, market based solution.
On the same topic though, I do believe overseas locations should be subsidized; but then again, I don't see the need for many of the permanent overseas bases we currently have.
As I mentioned in another thread (or mayber earlier in this one...?) what I found online is a bit vague about how much the DoD actually funds the Exchanges. While it less than the Commissary I can't find anything saying how much it actually is, the only thing I saw that came close to answering that question was a claim that '98% of Exchange funding comes from the Exchanges themselves'. So while there is the claim out there that they are 'self-funding' and certainly are more so than the commissaries they aren't completely, someone has to run them and that includes civil servants and military personnel as well as some incidental facility/accomodation costs.
The reason I am a bit wary of the claim they are 'completely self-supporting' is that I have seen this about the commissaries as well, though the officials in charge don't make the claim explicitly, and that is a load of BS.
The problem you run into there is that adding those costs to the prices at the commissary diminishes even further the difference in prices between the commissaries and grocery stores out in town. At taht point, what is the point?
That is because retirees are costing DoD the most money when it comes to TRICARE. Something like 11 million or so people are covered by Tricare and at least 5 million or so are not on active or their dependents.
Right, but I think the issue of people using Tricare when they have other insurance available can be addressed for both retirees and AD dependents.
Spekkio
He bowls overhand.
It is being addressed. The DoD's leading medical cost for ADSMs are rehab and pain killers for patients wounded or injured in battle. It makes sense -- what else is going to be the leading healthcare cost of a population of that mostly consists of 18-30 year old men who were physically screened for the job?
A signifiant minority of ADSM undergoing chronic treatment frequently misses their appointments, and there is a strong correlation between patients missing appointments and time spent in rehab and on these drugs (and hence increased cost to DoD). So there's where you can make a significant improvement, although there is disagreement on how much of the onus for missed appointments falls on MTFs and their scheduling processes or the servicemember and thus disagreement on how to improve the issue.
But retirees are much more likely to visit the doctor often because the human body starts to break down in the 50s and 60s, so they cost the DoD more money for visits and prescription costs than a bunch of healthy strapping 18-30 year olds. I've only seen a physician three times in 5 years since joining the Navy: once at OCS, once because my 5-year physical was due, and once because I had a cough that wouldn't go away.
As for Tricare Standard, it's better than most insurance plans that private companies offer out there and certainly better than Obamacare. For the low monthly fee of $0, you get 85% of your medical bills paid and your out-of-pocket cap for the family is $1000 per fiscal year, after which 100% of medical costs are covered. To my family, that cost was worth not having to deal with the potential of running into a MTF physician who thinks it's his job to be stingy with referrals to specialists, as I have heard about far too often, and worth not dealing with their broken sick call process that would have my wife sitting in the waiting room for 4-6 hours with two children to see a doc for an acute illness. But compared to Obamacare exchanges, which are on average $250-300/mo for an individual plan with a $6k deductible and 60% coverage or $400-500 for a family plan, it's a steal. I wouldn't call a $0 fee for 85% coverage 'paying for it.'
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I agree with you, but it at least rids the $1.4B loss the commissary costs the taxpayer each year. It still gives some benefit, albeit, smaller. With that said, based on volume sales, there's certainly a question if smaller commissaries could compete (I assume commissaries are broken into regions for what they buy; I say this because brands carried and even some of the more "ethnic" foods change commissary to commissary). If that's the case, I would have no problem shutting down the commissaries (the spouse employment argument is weak) and increase BAS (why do we get BAS if we also have a commissary?). In that case, take the supposed "benefit" the servicemember is supposed to receive from a year of shopping at the commissarry and give it to him in cash instead. Keep overseas and remote commissaries open as a benefit to those on those tours.
Isn't this really a cost versus revenue problem, and who in the end must pay? By eliminating the commissaries and thus eliminating the $1.4B gap between cost and revenue, who picks up the weight of that cost? The answer is the service member (or anyone who is going to the commissary to shop). The reason the commissary is cheaper is because it is subsidized. A private contractor will never be able to match those prices because they would be operating in the red (probably about $1.4B).
Ao, the question is can the service member comfortably increase his or her monthly expenses (as anyone who shops at the commissary will incur increased cost) and is the government willing to ask them to do so. For an O-4 over 12, I can absorb that cost. Don't want to, but I can. For the E-3 with 2 children, the change will be much more significant. There is a reason the commissary is madness on the 1st and 15th. Those families are shopping with their paycheck before spending it on anything else. So with no increase in servicemember pay, and a reduction in benefits, you are asking the service member, instead of the taxpayer, to take the strain. With the current deployment cycles and the demands asked of these members over the past 10 years by the country, is that really the right thing to do? My opinion is no. There are other places to cut some of this money I'm sure. The pockets of sailors I think is the last place we should be looking.
Ao, the question is can the service member comfortably increase his or her monthly expenses (as anyone who shops at the commissary will incur increased cost) and is the government willing to ask them to do so. For an O-4 over 12, I can absorb that cost. Don't want to, but I can. For the E-3 with 2 children, the change will be much more significant. There is a reason the commissary is madness on the 1st and 15th. Those families are shopping with their paycheck before spending it on anything else. So with no increase in servicemember pay, and a reduction in benefits, you are asking the service member, instead of the taxpayer, to take the strain. With the current deployment cycles and the demands asked of these members over the past 10 years by the country, is that really the right thing to do? My opinion is no. There are other places to cut some of this money I'm sure. The pockets of sailors I think is the last place we should be looking.
What is the point of all of this restructuring? Are you suggesting you take the $1.4B from DECA and give it to the sailors instead? That is just shifting the cost from one line to another. The idea is to save money, not shut down the commissary. I fail to see how this would fix anything in terms of money.
Some of the increase could be offset by taking half of that 1.4B and giving it to service members directly.
The government still saves money, and the service member has much of the increase offset. All the money spent on salaries and other nonsense is cut out. So of the money being spent, more of it would go to the actual service member.
I'd say the only people that would see a significant change in the finances would be retirees. Assuming they wouldn't be given a raise, they'd be paying the full increase in grocery costs.
You should run for Congress…or a seat in the Japanese Diet.
