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Advocates: Tricare's 'Adequate' Care Isn't Enough

A long awaited report from the Defense Department on Tricare's care for children released July 15 says the agency is meeting the needs of children, yet still has areas that need more examination. But despite that caveat, it has still drawn criticism from advocates who say that the report's use of the word "adequate" shows a major disconnect between what DoD sees as acceptable and what children actually need.

“This report demonstrates sufficient access and adequacy of the Tricare network for pediatric beneficiaries,” the report concludes. "However, review is needed of several policies, benefits, or manual language as well as authorities, requirements, and costs before next steps can be defined.”

You can read more about what the report says over here at my Military.com news story.

Advocates like Jeremy Hilton, an Air Force spouse who has in the past contributed to SpouseBuzz, worry that the 108 page report says one thing while demonstrating another.  For example, he says, the portion of the report that examines Tricare's Extended Health Care Offering (ECHO), which helps pay for specific services for special needs users, completely missed the mark.

The report titles the section on ECHO "an assessment on the adequacy of the ECHO program in meeting the needs of dependent children with extraordinary health needs." But Hilton says the report doesn't even begin to do an assessment. Instead, he said, it simply restates facts about ECHO.

"I would submit they missed the boat entirely, failing to answer the underlying question: whether or not this almost decade-old program is meeting its purpose," he said.

Read the entire report, popularly known as "Tricare for Kids," here.

But more that just missing data throughout the report (which you can read more about on Military.com), every single advocate I spoke with for this story identified this as a key problem: the use of the word "adequate."

"'Adequate' to me is not a good word in regards to healthcare," said Susan Reynolds, an Air Force spouse and mother who fought for Congress to request the report as part of the 2013 defense authorization bill. "'Adequate' is average. Everyone knows in school 'adequate' is a 'C,'  -- that's it, you're just doing average work. Healthcare should not be average, especially with children."

Hilton agreed. "What is 'adequate' health care? Do you want your child to have 'adequate' health care or excellent health care? I can get adequate healthcare in India, but am I going to go there? Probably not."

Tricare officials said the use of "adequate" is meant to demonstrate that the agency is performing as needed.

"As the report concludes, Tricare and the military departments are meeting the medical and related service needs of children - including those with special needs - as specifically addressed in each of the nine elements the study focused on, with access to high-quality care," said Kevin Dwyer, a Tricare spokesman. "However, there are areas where future study and analysis are recommended."

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