TRICARE Genetic Test Policy: Pennywise, Pound Foolish

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Philpott’s Forum presents opinions, insights and questions from readers of Tom Philpott’s Military Update news column. 

I want to comment on last’s week article about TRICARE not covering genetic laboratory fees.

My husband is active duty military and our whole family uses TRICARE Prime. My son is suspected of having a rare genetic disorder called neurofibromatosis and has seen many doctors including pediatricians, dermatologists, neurologists, ophthalmologists and a geneticist.

TRICARE does not want to approve genetic testing because this test is not approved by the FDA and so is considered experimental and unproven. The test has an accuracy rate of 97 percent.

Doctors say that if they cannot prove my son does not have this genetic disorder, via the blood test, then we have to treat him medically as though he does indeed have it. This includes routine and sedated MRI's to assess for potential tumor development because the disorder causes tumors and, in some cases, leukemia. Also he would need an annual eye exam as the disorder can also cause optic nerve tumors that lead to blindness. Moreover, TRICARE is willing to pay for all these expensive routine exams every year including travel pay to out-of-state genetics doctors.

If he takes the genetic test and it is negative, then we will no longer have to do these expensive annual exams. Doctors believe our son has a 50/50 chance of having the disorder.

My husband and I have decided to pay for this blood test our selves. The cost is about $2000. We really cannot afford this, but we need a diagnosis. If my son tests negative, TRICARE and the Defense Health Agency will have save thousands of dollars on the results that we paid for.

I plan to write members of Congress about this. TRICARE’s handbook says it will consider genetic testing if results will affect medical treatment. This contradicts the truth because there, as far as I know, there is only one genetic test not on DHA's “no pay list” which is a breast cancer test.
JENNIFER MASHBURN
Navarre, Fla.

PROTECT COMMISSARIES
No cuts in benefits, including to commissary privileges, should be on the table.

Our service members earned benefits by giving ultimate sacrifice, time away from families, holiday time, being in harm’s way and the worst, being disfigured or killed.

Do not take anymore away from our military personnel!
KERMIT F. STENGEL JR
Disabled Army Veteran
Vietnam ‘69
Via email

I, too, am outraged.

I served 24 years in the Navy, 14 of them at sea or in-country Vietnam. Commissaries are the last benefit we have.

We live in an extremely high cost-of-living area and can ill afford to have this benefit trashed. The man who sits in the commander-in-chief’s chair spent billions on worthless programs and green manufacturing.

Now his administration says we can't support you warriors. Additionally it seems to be a conceived plan as Time magazine is questioning the supposed cost of these benefits.

We older veterans need these benefits.
THOMAS R. TURPIN
Chief Warrant Officer, USN-Ret.
Via email

It makes sense to close commissaries on stateside military posts close to urban and suburban areas where there is a healthy, competitive supermarket environment.

But more isolated military communities should be able to keep their commissaries.
BRIAN TILBURY
Via email

If the commissaries are closed, Defense Department leaders need to negotiate with the local stores such as Wal-Mart and Kroger's to offer discounts close to what we receive at the commissary.

It would be a win-win situation with more money pumped into local markets by military patrons.
BENNY JOHNSON
Via email

Why does the military have commissaries?

One reason is that when they were established the services did not have to give military personnel more pay.

When the economy improves, recruitment will suffer. Why join the military when they have cut benefits for those serving and those that have served.
It is very hard to survive on retirement dollars. Commissaries help in providing a better quality of life.
ROBERT R. ESCAMILLA
USA-Ret.
Via email

Estimated savings in commissaries of 30 percent has been my experience in over 40 years as a patron. Although prices are lower than outside, typically the discount is nowhere close to that. With large box stores adding grocery items to their offerings, and large buyer’s clubs doing the same, that gap has closed to a point where prices are nearly the same.

About the only benefit to commissaries now is the tax saving. Product quality for meats has fallen. Fruits and vegetables are typically of very low quality and staple items are regularly out of stock.

That said, for junior enlisted living paycheck to paycheck, this is one benefit they cannot afford to lose. And some retired members on limited incomes are forced to choose between utilities, medicine and food. Loss of the commissaries would be devastating for these heroes of past conflicts.
GARY CRUMRINE
Via email

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