Evolution of the Military Health Care Benefit (MHCB): The Scope of the Changesand the Principal Drivers Behind Them

摘要

This thesis examines the evolution of the Military Health Care Benefit (MHCB) andthe principal factors that influenced its change. The Military Health Care Benefit is a critical part of the compensation package received by the military member. A detailed examination of United States Code, Title 10, along with congressional hearings, committee reports, legislative bills and external organizational literature was conducted. The congressional process for modifying the MHCB is explained, followed by identification and description of the major legislative changes to the MHCB between 1956 and 1996. Research revealed that the scope of the MHCB has dramatically increased since 1956. Three distinct periods of congressional action were identified. The first, 1956 to 1966, was characterized by establishment of the benefit structure and its initial expansion. The second, 1967 to 1982, was a status quo era in which Congress focused its attention on controlling the rising costs of CHAMPUS. The final period, 1983 to 1996, was dominated by congressional oversight, leading to further expansion of the MHCB and the development of Managed Care programs. Equity with private sector or other government sponsored health care programs was the primary factor in the growth of the MHCB. Understanding the process used to change the Military Health Care Benefit and the principal factors that influence this change allows planners an insight into possible future changes in military medical benefits and their associated costs.