This is the birthday of the United States Marine Corps. On that special day 236 years ago the first of this nation's military services was formed. In the city of Philadelphia and a place called Tun Tavern, that first man finished the last drop of ale in his tankard, marched to recruiter Captain Samuel Nicholas' table and placed his mark on the enlistment role. From that day, November 10, 1775, men and women have faithfully and honorably served this nation as members of its military forces. Sadly, the country has not always been as honorable or as faithful in its treatment of all these Marines, or their fellow soldiers, sailors and airmen.

During World War II, through the 40s, 50s and into the 1960s armed forces recruiters, military commands and even nationally printed government documents repeatedly promised all service personnel that in exchange for at least 20 years of active duty service to their country, they and their dependents would have earned medical care for life. That promise, like so many others made by our federal government, vanished when Congress decided that retired military personnel were easy targets when it came to budget cuts.

The first thing that happened was health care for retirees became a service only offered on a "space available" basis. Next there was no space available.

The Supreme Court did find that earned medical care promises had been made by the government to career military personnel, but that no legislation had been passed by Congress to authorize such expenditures. Various programs were initiated to free up military care facilities for active duty personnel, with the government finally settling on the Tricare system for all retirees.

There are actually four different Tricare plans. Tricare for Life serves as a supplement to Medicare for military retirees over age 65. The retiree must pay the full Medicare rate for his "earned free medical care", but he does receive the Tricare for Life supplement without additional charge. For those retirees under age 65 there is Tricare Standard, Tricare Extra, or Tricare Prime. Retirees are not required to pay a premium for either Tricare Standard or Extra. However, Standard has a high cost share imposed on the member. The Extra program does give the retiree a 5% discount on his or her cost share. Most retirees select Tricare Prime for their coverage and must pay an ongoing premium for this "earned" benefit.

Now into this medical insurance mess we toss the bane of all military retirees, Arizona Senator John McCain. He has been very active in urging the Super Committee on debt reduction to take Tricare Prime coverage away from any military retiree of working age. Of course, that would mean all military retirees would lose Tricare Prime coverage because they are all of "working age". For many military retirees that loss would be almost unnoticed. Because so many doctors have refused to accept Tricare, numerous working retirees have obtained insurance coverage from their civilian employers.

Checking with Marine and a Navy contact during this birthday week, an interesting thing was discovered. Some retirees are very happy with the medical coverage they have been provided. Others have extreme difficulty.

1stSgt John W. Collick has retired to Suffolk, Virginia. His son was treated on a space available basis at the Naval Medical Center Portsmouth for Acute Myeloid Leukemia. After six months of inpatient care he came out of a coma and has been in remission since that time. The Navy hospital did accept Collick's Tricare Prime coverage and he claims his son had the best of medical care.

Patricia A. Fitzgerald is a retired Marine Gunnery Sergeant living in Quantico, Virginia. She has had so many problems with Tricare that she has signed up for Blue Cross/Blue Shield with her employer. She has serious medical conditions that require visiting specialists. To see a specialist, she must first go to her primary doctor, provide him with a co-pay, have him write a letter to Tricare requesting a specialist, wait for the answer, then see the specialist and be charged a second co-pay. They send her miles away to Alexandria, Virginia for an MRI, when there is another facility that is Tricare approved just blocks from her home. Fitzgerald says the Tricare communications system is so antiquated that it is almost impossible to reach them. Their website is too complicated to navigate and too many elderly retirees are not computer savvy. She says her assumption is that Tricare really does not want to communicate with its beneficiaries.

Master Gunnery Sergeant Art Cohan, USMC (Ret) makes his home here in Harlingen, Texas. His wife Debbie has had three surgeries and follow-up treatment over the past year. He too has had health concerns requiring treatment by a cardiologist. Through all of this he has had no problems with medical facilities or doctors accepting Tricare.

Colonel Phil Torres is another retired Marine who writes from San Antonio, Texas. He has used Tricare Prime for treatment at military facilities and has been outsourced to specialists. He claims everyone was more than happy to accept his coverage.

Randy Givens is a retired Marine in the Austin, Texas area. He charges Wal-Mart will not accept Tricare for Life to pay for his medical prescriptions. His wife is covered by Tricare Standard and has had several doctors refuse to accept her coverage.

LtCol Jim Casford, USMC (Ret) writes from Anaheim Hills, California. His doctors have been accepting his Tricare for Life coverage and feel fortunate he has found any doctor to see him and his wife. However, the government has cut doctor payments so much that Casford is now required to pay an additional $300 a year above government payments just to have his medical services continued.

A single Navy retiree answered my Tricare inquiry. John Wocher now makes his home in Japan. He has a real quandary. Though Tricare was accepted in the military medical facilities, he is now 65 and must enroll in Medicare. Once a retiree is Medicare eligible Tricare is lost. Also. Medicare is not accepted overseas, so it really becomes a Catch 22 for the military retiree. One day Tricare covered him...the next day he was uninsured. The only solutions available to Wocher were to return to the United States for treatment, which was far too costly...or enroll in the Japanese National Health Insurance Program. The Japanese government now takes care of this American's military retiree's medical needs.

Semper Fidelis

Thomas D. Segel

Harlingen, Texas