Readers of Tom Philpott's Military Update column sound off.

Base Pharmacies Losing 'Discontented' Beneficiaries

Reference the column an TRICARE drug costs, I would like you to pass on to Rear Adm. [Thomas] McGinnis, TRICARE pharmacy chief, something he may be unaware of.

He continues to urge beneficiaries to use base pharmacies to save themselves and the government money. However, base pharmacies, at least the one I'm familiar with, continue to make it much less convenient to use their service than to go to WalMart, CVS or other commercial pharmacies.

I've been retired for more than 12 years and have given up using base facilities except the pharmacy. As I have a TRICARE supplement that covers prescription costs, it would be much easier for me to get them filled downtown than on base. I continue to use the base pharmacy, however, because after more than 28 years of active duty, I feel I earned it and don't wish to give it up.

I work on base with many other retirees but I am the only one among them who regularly uses the base pharmacy. When I ask the others why, they tell me it's too much of a pain in the a** to fill prescriptions on base and much easier to go downtown. I have to agree.  I also use downtown pharmacies when they tell me on base that they don't carry the medication or they recommend I go to an adjacent base and try there.

I don't have a couple of spare work hours, however, so I normally stop by a commercial pharmacy on the way home or I get it on the weekend. I don't need to go into more detail about how they make it inconvenient to use the base pharmacy because I don't think this is an isolated instance.

ALLEN MAKSYMUK
USAF-Ret.
Navarre, Fla.

We invited Rear Adm. McGinnis to respond:

Thank you for the comment on how it has become inconvenient to use your base pharmacy.  You are correct that you are not an isolated case of discontent.

Currently, Military Treatment Facility (MTF) pharmacies are facing a number of challenges in providing timely, beneficiary-orientated pharmaceutical care. Many factors influence waiting time and drug availability such as available staffing, the size of the MTF and physician mix all play a role.

Also, missions of the retail and the MTF pharmacies have differed greatly.  The MTF pharmacy mission was to support the patients and physicians associated with a particular MTF. As a result, its drug formulary was limited compared to that of a retail pharmacy whose goal is to meet the needs of all the patients and physicians in the local community.

The makeup of the MTF formulary is heavily influenced by the types of drugs needed to support primary and specialty care provided by each MTF. Larger MTFs provide a broader range of specialties and, as a result, the formulary is more extensive than at a smaller facility.

Also, each MTF pharmacy has been impacted to some degree by war-time deployments of personnel while the job market demand for pharmacists has increased and the pressure on salaries of MTF pharmacist positions, in some locales, has made vacant positions difficult to fill.

The bottom line is that we are losing customer focus on the front lines. As you have pointed out, it is beginning to cost us our most dedicated pharmacy supporters.  We have begun to address many of these issues that have materialized rapidly over the last few years. One effort, for example, is to replace lost manpower with increased use of technology.  But we still have more work to do before we will win you and other retirees back to the MTF pharmacy.

THOMAS McGINNIS
Rear Admiral, USPHS
Chief, TRICARE Pharmaceutical Operations
Falls Church, Va.

SBP for New Brides

How do you enroll your spouse in the Survivor Benefit Plan if you marry after you retire?  I just recently got married.  I would appreciate any help you can give me.

L. MILLER
Via email

You can elect SBP spouse coverage after you marry in retirement but such election must occur before your one-year marriage anniversary.  You can send a letter to the Defense Finance and Accounting Service or complete and mail DD Form 2656-6 requesting SBP spouse coverage.  You must provide your spouse's name, social security number, date of birth and a copy of the marriage certificate.  You also should certify that you have not been married from the date you retired through the day before marriage to your current spouse.

A valid election for SBP coverage will become effective on the first anniversary of the marriage

The mailing address is: Defense Finance and Accounting Service, U. S. Military Retirement Pay, PO Box 7130, London, KY  40742-7130.  You also can fax the letter or form to: 1-800-469-6559   -- Tom Philpott

More Survivor Benefit Plan FAQs.

PTSD and Home Stress

I am a combat medic for the Army National Guard.  I also am a respiratory care practitioner with more than 20 years of acute, critical and trauma care experience.  I am no expert on Post-Traumatic Stress Syndrome but I wanted to raise the issue in the context of what I observed during basic training and advanced individual training.

I went to basic training with no prior service at age 38.  I have four children, all of whom are away at universities completing their education. During training I sort of became the mother of the group. Many kids, mostly 18 to 22 year old, came to me for advice or when they were having trouble dealing with the stresses placed upon them by a drill sergeant.

About 90 percent of those I came in contact with, male or female joined the army for troubling reasons. I was shocked at the number who joined to get away from horrid situations at home, which varied from sexual abuse and alcoholic parents to parental neglect and an absence of structure or discipline in their lives. Some of these kids had prior drug problems or criminal backgrounds and were forced to join the military or go to jail.

Out of 92 females in our sleeping bay, only about 8-10 were well behaved and well disciplined. The rest were pretty much a bunch of trouble of varying degrees.  And here is my point regarding PTSD.

If you recruit someone having a tremendous amount of pent up, un-treated emotional baggage, and dump them into a highly volatile, stressful situation of a war zone where they can barely cope emotionally, you can bet it's going to take a serious toll on them.

Many soldiers have been exposed to horrific atrocities in Iraq or Afghanistan. You could have 10 soldiers go through the same trauma and, when they come home, some have PTSD and some do not. The ones who were more emotionally sound usually are better able to work through the stresses and traumas. So perhaps one way to deal with rising PTSD rates is not to send those who have had abusive home lives off to war.  

REBECCA L. WILSON
Private First Class, ANG
Roseburg, Oregon

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