Dr. S. Ward Casscells is a cardiologist. But he has more
than medical skills now to ease the stress on military
retirees from recent proposals to raise sharply their
TRICARE fees, co-pays and deductibles.
Five weeks ago Casscells became the new assistant secretary
of defense for health affairs, arriving from the University
of Texas’ Health Science Center in Houston where he was a
distinguished professor and its vice president of
biotechnology.
His appointment could be good news for under-age-65 retirees
and their families because Casscells isn’t a fan himself of
the steep increases in TRICARE fees that Defense officials
proposed early last year.
“Just from the standpoint of doing the right thing for the
patient, I think abrupt changes in fees and deductibles
could be unsettling,” he said.
As the Pentagon’s top policymaker on health issues,
Casscells will be working with lawmakers next year on a more
palatable set of fee increases.
“I would look for some small, gradual increases in fees and
deductibles over the years. Not this year, because we’ve
got plenty on our plate right now -- more than we can say
Grace over,” said Casscells in a 45-minute phone interview,
his first since becoming assistant secretary.
Casscells, 56, exudes the good will of a country doctor
rather than the caution of new political appointee who fears
moving off message. “I’m trying to be a policy guy,” he
said. “I haven’t graduated to politics yet.”
He peppers his remarks with homespun humor and
self-deprecation. He compared his first weeks on the job to
riding the mechanical bull at the Houston Livestock Show and
Rodeo. He acknowledged that the military surgeons general
are upset about “efficiency wedges” imposed on their
budgets. They probably liken that term, he said, to the
bedside manner of Procrustes from Greek mythology who
invited travelers to stay for the night and then either
stretched their bodies or amputated their feet to fit the
bed.
Casscells wants beneficiaries to feel they are partners in
actions ahead to make military healthcare more efficient and
effective. He praised the work of his predecessor, William
Winkenwerder, saying that “in a lot of areas he had the ball
on the 10-yard line” which makes a new quarterback’s job
easy.
But Casscells doesn’t sound the same alarms over the
doubling of military health costs since 2001. He noted that
17 percent of the nation’s gross domestic product last year
went for health care, yet health spending by the military is
only eight percent of the defense budget.
“By that metric we’re doing okay. There are other metrics
which make us look less efficient in the civilian health
world. And there is no doubt we can be more efficient
because we’re not at full capacity” in base hospitals.
