DOD Health Care

Before reading further, please be aware that the person mentioned in this post asked that his presentation be off the record. While I do not mention the specifics of his presentation, I would prefer that any of my references to the presenter not be used for purposes beyond this blog post discussion or class.

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Last week, I missed class because I was meeting with Maryland's Center for International and Security Studies invited speaker, David Mosher, who is the Assistant Director for National Security for the Congressional Budget Office. Initially, I was interested in his analysis of the recently proposed defense cuts. His analysis was thorough and the solutions he suggested were thought provoking. However, this was not the part of his presentation that I ended up finding most compelling.

David spent a great deal of his time talking about the drivers of projected massive increases in defense spending. To my surprise, the projected increases in costs were not just caused by the development of expensive weapon systems or inefficient procurement programs. Defense Department health care programs are a significant cost driver for defense spending. This struck me as an economic issue deeply rooted in the topics that have been discussed in our moral dimensions class.

For DOD employees and their families, health care is significantly less expensive than for other Americans. In many ways, can be considered socialized medicine. One argument is that, because of health care is so inexpensive, people who participate in these health plans seek medical advice and attention at a higher rate than those who participate in civilian health care plans. Having only looked at this issue in a cursory way, there is still a lot I do not know. My first question is whether health care costs are increasing because of inexpensive health care or are the increases caused by the wars that have been waged over the past decade. Another is how these costs increases compare to other points in history.  Finally, what types of medical visits and procedures are people under these plans getting?

Even with these unanswered questions, this leads me to wonder what the United States’ obligation should be to those who are part of the defense establishment.  Should health care be free, or next to free, for those within the defense establishment? On one hand, defense spending is increasing at an astronomical rate, eating up money that could either be spent on social programs or be in the pockets of Americans. A utilitarian argument might be that population is best served by paying less for its military and devoting those resources for other purposes. At the same time, another contradictory utilitarian argument could be that a decrease in benefits to the military would weaken the United States’ ability to attract employees and, ultimately, protect itself.

On a moral level, there is the additional question of what does America owe its troops. In exchange for being put in harms way and, perhaps, having to deal with lifetime psychological and physical ailments, maybe soldiers should have unlimited access to inexpensive health care. Under this line of logic, maybe health care SHOULD be the biggest cost driver in Defense Spending.

There are economic solutions out there that would minimize costs, but these do not answer the more fundamental questions about how we should treat those in the military. What do others think?