Written By: Christopher Plein, Ph.D. West Virginia University & MFLN Military Caregiving Concentration Area
Over the past few years, when June rolls around I have offered a blog on the theme of, “A Little Summer Reading.” Past blogs have focused on such topics as recent developments in healthcare and Medicaid. The idea of the “Little Summer Reading” series is to provide some reading suggestions on topics that are of interest to those who work with military families. A common thread that runs through all of these, and indeed much of our MFLN programming, is the close connection that exists between military and civilian life.
The building blocks of our society and community, be they public institutions or public policy, or the stores, parks, and service organization that make up our communities are all shared ground. While aware of distinctions between the civilian and military world, I look for similarities and commonalities.
In this regard, I am probably influenced by the work of the anthropologist, Claude Levi-Strauss. He sought to understand underlying similarities and structures across cultures. But the more I think about it, I might have also deeply influenced by my own childhood. I was raised as a child in a civilian family in the greater Washington, D.C. area. Many of my friends, mentors, and authority figures (that is my friends’ parents) were from military families. In our neighborhood, civilian and military distinctions were blurred at block parties, dinners, school functions, and backyard play. Living in this context, no doubt all the parents shared common concerns about work, home, and health.
I have come across various publications that highlight the common ground between military and civilian families. One has to do with that must fundamental issues – the nature of work. The July issue of the Atlantic Magazine, has a feature article by Jerry Useem entitled, “At Work, Expertise is Falling out of Favor.” Ostensibly, it is about new staffing arrangements in U.S. Navy littoral combat ships. The new focus is on cross-training and multiple responsibilities. The article’s broader intent is to illustrate how the nature of 21st century work is placing great emphasis on “fluid intelligence” that enables employees to handle many tasks and responsibilities. This is a reflection of both the growing complexity of organizational systems and the downsizing of labor in favor of new technologies. The new military catchphrase is “minimal manning.” Civilian readers of this article will no doubt consider their own prospects in a time of rapid economic and technological change.
If work is a constant concern for families, so too are the places they make home. Not too long ago, the magazine, Governing, which is devoted to state and local affairs and aimed primarily at public officials, offered an article entitled, “Where Housing is Least and Most Affordable for Military Families.” The challenges facing military families, especially those with lower pay grades and dependents, mirror those of the general public in attaining affordable housing. The problem is especially acute in rental housing. For various reasons, as discussed in a Forbes website article, rental housing has become more expensive in much of the United States. Given Permanent Change of Station (PCS) or transfer practices, this is a special concern to military families who rely greatly on off-base rental housing.
For those with family members who may have special health care needs and require access to needed services and accommodations in educational systems, these pressures are intensified. This story emphasizes that military families are not immune to broader market trends in civilian housing. Indeed, they may be even more at risk.
Along with employment and housing, military families are no different than civilian families when it comes to concerns about healthcare access and coverage. Big changes have been underway with TRICARE. Our MFLN Caregiving Team has provided information on these changes through overview and topic specific webinars. The big takeaway is that military healthcare is increasingly reflecting healthcare systems found in the civilian setting. While still an affordable and enviable health coverage benefit, TRICARE is being reformed in ways that mirror larger developments in healthcare service and delivery in the United States. Greater reliance on case management and managed care arrangements are an example of this, as the Defense Health Agency seeks to control utilization and costs. A lengthy and comprehensive review of these changes and their objectives can be found in the DOD’s own Evaluation of the TRICARE Program: Fiscal 2019 Report to Congress.
Summer reading can be both light and heavy. The suggestions offered here are a mixture of both. But most importantly, they reveal how the common ground we find between military and civilian life when it comes to work, home, and health. New innovations and practices in military staffing will no doubt inform changes in the civilian workforce. The issue of affordable housing cuts across both worlds. Those in the military are seeing a healthcare system that reflects trends and practices in coverage and access provided “outside the gate.” Difference is important, but so too is recognizing all that we share.