Secretary Hits the Ground Running
Dr. David Shulkin was sworn in as the ninth
secretary of Department of Veterans Affairs after receiving unanimous approval
from the Senate.
MOAA was pleased to see Shulkin installed and
ready to get on with the major business at hand, including continued implementation
of many of the initiatives he pursued as the former undersecretary of the
Veterans Health Administration (VHA).
“It's comforting to see
that even in a highly politicized environment like we're currently in, the
Senate can put aside partisan differences to focus on veterans and their
needs,” said Cmdr. René Campos, USN (Ret), director of veterans and wounded
warrior care for MOAA's Government Relations Department.
The new secretary has a
tough road ahead of him, though, balancing the often competing priorities of
Congress, the White House, his own agency, and the American public as well as
the veterans he is committed to serving.
His first major action
must be to work with lawmakers to extend the Choice Act, legislation allowing
qualified veterans to receive care in the private sector. Under current law,
the program is set to expire this August.
Extending the Veterans
Choice Program (VCP) would also allow the VA time to put in place a new program
to meet the rising demand for veterans' health care brought about since the VCP
was established in 2014.
The Choice Act was
Congress' answer to the reports of secret wait lists in the Phoenix VA Health
Care system in Arizona. With only 90 days to implement what was initially a
temporary program, the VHA had to establish a massive contracting effort to
expand delivery of health care to veterans through an integrated network of
civilian providers until the VA could address the demand within its own system.
Though initially plagued
with problems, over time the VA and Congress implemented laws and adjusted
policies to make it easier for veterans to access care through the VCP.
Today, more than 1
million veterans have been able to access care thanks to the Choice Act.
determines the next steps for the VCP, the VA also has taken lessons from
implementing the program to create a new community care program.
MOAA and other veterans
service organizations (VSOs) have worked closely with the VA over the years to
ensure the veteran's perspective is considered during the VA's transformation.
On Friday, VSOs received
another quarterly update from the VA's community care team, this time on how
the VA will deliver pharmacy benefits, manage appointments, and pay civilian
providers under a new community care contract.
MOAA will provide more
details on the new program once the contract has been announced.
Secretary Shulkin also
will appear before the House Veterans' Affairs Committee on March 8 to give an
update on the Choice Act and to share with Congress what he is doing to improve
access and quality of health care to veterans.
Savings Redefined to 20%
Year after year, the
Defense Commissary Agency (DeCA) told Congress and store patrons that
commissary shoppers saved an average of at least 30 percent on brand-name
groceries over prices in commercial stores and supermarkets.
The claim lost some
credibility over time with the rise of big box discounters and retail
supercenters. Also, DeCA's price-tracking methodology lost support in Congress
and at the Pentagon amid a push to transform commissaries into more
business-like operations, using commercial tools such as variable pricing and
private-label brands to try to reduce DeCA's $1.3 billion annual appropriation.
DeCA officials now
concede the 30-percent savings figure didn't include price comparisons at
Walmart Supercenters. Nor did it consider the popularity of private-label goods
that outside grocers find so profitable. Nor did DeCA adjust its own estimates
to give greater weight to products in highest demand with lower savings.
On Monday, in response
to a congressional mandate, DeCA released a new set of “baseline” estimates of
commissary savings that reflect these factors and more.
Without reducing the
value of the shopping benefit, DeCA says, it has redefined how it measures
savings. Global savings across all 238 commissaries are calculated now at 23.7
percent and savings stateside at 20.2 percent. At 61 overseas commissaries,
average savings are 44.2 percent against local food prices.
To be able to shift to
variable pricing, DeCA also is publishing average savings by seven U.S.
commissary regions. The 36 commissaries operating on New England bases, for
instance, provide average savings of 21.4 percent. Across 30 commissaries in
the South Atlantic states, savings average 19.9 percent.
The combined region of
Alaska/Hawaii, with nine commissaries, offers the highest savings for patrons
at 32.6 percent. Twenty commissaries in the Rocky Mountain region, which runs
south from the Canadian border through Arizona and New Mexico, had the lowest
savings - 17.6 percent compared to prices off base.
The Pacific coastline
states, with 31 commissaries, provide average savings of 20.9 percent, while 18
military grocery stores in North Central states save shoppers an average of
“This enhanced way of
calculating savings doesn't change the actual dollars that patrons save, but it
will give patrons a better understanding of price comparisons in their local
area,” said DeCA Director Joseph H. Jeu in a press release Monday unveiling
revised savings estimates.
A day later Jeu
announced that, effective June 3, he will retire after six-and-a-half years at
DeCA's helm and more than 38 years' total federal service.
“The transformation is
well on its way and the right people are in place to see it through,” Jeu's
statement on Tuesday said.
executives, said industry sources, were surprised and upset by DeCA's
announcement on the new baseline savings. Exchange directors have argued for
years that their own store traffic and sales performance are linked to the
popularity of commissaries, and commissary sales are falling.
Since last October,
start of fiscal 2017, DeCA sales are down 7.6 percent and by more than 10.5
percent in January compared to January 2016.
“It's just really
bleak,” said one representative for manufacturers serving the military resale
system. “If your sales are down, the last thing you want to do is send out a
press release saying that people are saving 10-percent less than they thought
they were. That's just going to drive sales way down.”
Some might challenge
Jeu's timing, but he was on the clock. Congress first ordered DeCA to produce
more realistic baseline savings, including across regions, in 2015. The due
date to report was March 2016, so DeCA was 11 months late.
director of family policy and spouse programs for Military Officers Association
of America, said senior defense officials have given assurances if the revised
savings rate “drops even 1 percent, DeCA will begin evaluating a corrective
measure.” The hope is that a more granular approach to tracking savings will
“be good for patrons, as it provides a more definitive benchmark on a regional
basis rather than national scale,” Goldberg said.
Some advocates for
military families fear that the mere perception of lower savings could put
commissaries at greater risk, despite DeCA's vow that it only has clarified
current savings in order to preserve them through the changes ahead.
“I do think it means
less certainty for families moving forward,” said Eileen Huck, government
relations deputy director for National Military Family Association. “Families
have always been told they could expect a certain level of savings when
shopping at the commissary, regardless of where they happened to be stationed.
“Now the rules of the
game have changed somewhat. Although DeCA has stated its commitment to
preserving this new level of savings, there are many more factors in play,”
including variable pricing of products and introduction of DeCA-branded
products later this year. So, said Huck, “it is fair for families to question
what this will mean for the value of the commissary benefit in the long run.”
For years, DeCA measured
shopper savings by comparing a 26-week average of brand-name prices, always set
at cost, against average market prices across the country. It used Nielsen
price data and filled in any gaps -- for Alaska, Hawaii, and overseas -- with
limited manual price comparisons in those locales.
That method of
calculating savings for 38,000 branded items at the national level has been
replaced by a new method more suited to the transformation.
“We are adding more
geographic specificity, since cost of living varies by region,” said a DeCA
official. “Adding a regional savings level will provide a better sense for how
much our patrons save by shopping at their local commissary, compared to
retailers in their particular region.”
DeCA has also updated
the products it uses for our price comparisons, emphasizing “the most common
patron purchases” within sales categories like produce or meat. The new savings
benchmark also take into consideration patron purchases at local commercial
grocers, as manually gathered in every region.
Critics have raised
concerns about how DeCA is relying more heavily now on “clipboard” pricing
methods rather than Nielsen data to benchmark local savings across regions. But
the greater worry is how patrons will react to the results.
“It certainly has the
potential to adversely affect patronage,” said Tom Gordy, president of the
Armed Forces Marketing Council. “But what I think people have to fully
understand is the prices have not changed. It's just the way the savings are
calculated has changed.”
Another industry analyst
was more skeptical, suggesting new baseline savings leave headroom for Defense
officials or Congress to slash DeCA's $1.3 billion budget while still claiming
to preserve customer savings. He also pointed to a new Government
Accountability Office report on DoD construction projects that showed DeCA
surcharge dollars were used to fund only one construction project in fiscal
“Construction is the
best manifestation of the health of the resale system,” he said. “This report
indicates that the system might already be faltering.”
12 Apps to
Improve Heart Health
Every 40 seconds someone dies from
heart disease in the U.S, according to the American Heart Association. And
cardiovascular disease is the leading cause of preventable deaths in the U.S.
To gain a better understanding of
your heart health, reduce the risk factors of developing cardiovascular disease
(like obesity, high cholesterol, and high blood pressure), and make daily
changes that will go a long way toward living a heart healthier lifestyle,
check out these 12 apps. (Search for them in the iTunes App Store of Google
Play on your smart device.)
ASCVD Risk Estimator (American
College of Cardiology): The ASCVD's free app helps you understand the risks of
developing cardiovascular disease, as well as which risk factors are most
relevant to you. As part of this highly individualized app, users can enter
basic information - like their age and whether or not they smoke - and then
further customize the app's tips by including their history of conditions like
high blood pressure and diabetes. After entering this health data, the app
provides a lifetime risk assessment for developing heart disease along with
detailed information about individual risk factors and how to avoid them.
Blood Pressure Companion (Maxwell Software):
Blood Pressure Companion (free) illustrates the correlation between blood
pressure and weight. As you track your blood pressure and weight through this
app, you get data that shows how fluctuations in pounds can affect your blood
pressure readings. In addition, the app reminds you to test your blood
pressure, which helps to keep the data as accurate as possible.
Blood Pressure Log - MyDiary
(Zlamaniec): While this free app does not include a blood pressure monitor, it
does keep detailed records to analyze trends. By entering data such as blood
pressure readings, body posture, and cuff location, users create detailed
graphs that can be sent to a doctor via email or used to generate reports in
Excel spreadsheets or MS Word documents. Users can also track their glucose
levels, weight, and oxygen saturation with this app.
Blood Pressure Monitor (Taconic
System LLC): This app allows users to monitor their blood sugar and blood
pressure levels, as well as their weight. You can enter the medications you use
and your daily diet in order to get statistical reports on vital functions. In
addition, the free app allows you to easily email health data to your
Cardiio (Cardiio Inc.): Cardiio
(free) helps users determine their ideal heart rate and, as they monitor their
progress, lets them know when they're experiencing abnormalities. In addition,
Cardiio shows how your heart rate measures up against others, like an Olympic
athlete or someone living on an island. The app also has a seven-minute workout
Cardiograph (MacroPinch Ltd.):
Cardiograph ($1.99) makes heart health a family affair. By using the same type
of technology found in a doctor's office, this app allows multiple users to
track their heart rhythm by taking a picture of their fingertip. In addition,
the app includes fun facts and trivia to help you learn about heart health in
an entertaining way.
Health Mate (Withings): Users can
find out their blood pressure trends and real-time data through Health Mate,
which includes a health pressure monitor. The app is free, but the blood
pressure monitor can be purchased for $129.95.
Healthy Heart 2 (Ringful LLC): If
you are at high risk for developing heart disease, you can track your blood
pressure, glucose, potassium, and cholesterol levels with this free app. In
addition, you can enter information about your medications and behavioral
factors that might contribute to the possibility of developing heart disease.
Instant Heart Rate (Azumio Inc.):
Through Instant Heart Rate ($2.99), you can monitor your heart rate as you
exercise, while avoiding putting too much stress on your heart. In addition,
this app allows you to make comparisons about your heart rate during different
activities. From running to resting and everything in between, Instant Heart
Rate provides data that gives you an idea of when you're making your target
heart rate - and when you're not.
Kardia Mobile (AliveCor Inc.):
Kardia Mobile is a $99 product, which can be used with Android and Apple
devices, designed for those who already have a history of cardiovascular
problems. This compact tool allows users to record a medical-grade EKG in less
than a minute and send data to a doctor to diagnose possible atrial
fibrillation. In addition, Kardia Mobile tracks sleep, exercise, and dietary
habits, as well as shortness of breath.
MotionX 24/7 (MotionX): Those who
want to monitor their heart health while they're awake and asleep use MotionX
24/7 ($0.99). For daily monitoring, you can compile data on weekly and monthly
heart-rate highs and lows, as well as get information on heart rates during
exercise and rest. In addition, MotionX 24/7 has a motion sensor that tracks
sleep habits, a microphone to detect snoring, and a smart alarm. This app also
has a pedometer function to help users track heart health data on multiple
Smart Blood Pressure (SmartBP) BP
Tracker (Evolve Medical Systems LLC): This free app is particularly helpful for
those who either have heart disease or are at high risk of developing it.
Through SmartBP, patients can record their systolic and diastolic blood
pressure, as well as their pulse, and easily share that data with their doctor.
It also has a feature that tracks body mass index, helping those who want to
lose weight meet their goals.