When I read the article “Accepting TRICARE Shows Support for Military” (AAOS Now, October 2013), I was bothered by the insinuation that an orthopaedic surgeon who does not participate in the TRICARE program is not supportive of the U.S. military. What the article failed to cover is the egregious job that the U.S. Congress has done in providing for those who defend our country.

For generations, Congress has promised those who serve their country that their health care would be covered for the rest of their lives in exchange for having put their lives on the line. This promise has deteriorated to the point that we now have the TRICARE system. Congress promised coverage through the military hospitals, through the Veterans Administration or through TRICARE, but did not bother to point out that the reimbursement to physicians for some TRICARE services would be even worse than that from Medicare.

The difficulty of keeping a practice open and solvent with an increasing percentage of patients for whom reimbursement is based on the Medicare or Medicaid physician fee schedules is well known. No degree of patient volume can make up what is lost on these patients. To tell us that we have a duty to accept TRICARE if we want to show our support for the military is pulling at heartstrings while driving our practices to the brink of insolvency.

The real culprits in this TRICARE travesty are members of Congress who proclaim support for the military while only allocating enough money for a second-rate insurance program. They take their junkets on the dime of the defense contractors, and the contractors thrive on the inefficiency and waste in the military procurement system.

As a long-time member of the U.S. Navy Reserve, I can testify that it is the warriors and their families who are left to grab at the scraps thrown by Congress under the guise of our country caring for its own. I practice in a Navy town, and my multispecialty group cannot afford to participate in TRICARE due to reimbursements that are far below the market level.

I do see the occasional TRICARE patient, and I encourage the patient and his or her family that they really need to call and email their Congressional representatives and express their righteous indignation. Why should those families who give so much for our country be saddled with insurance that is worse than Medicare?

Instead of asking orthopaedic surgeons (and our medical colleagues) to balance the federal budget on our backs in the name of patriotism, Congress needs to rein in profligate defense spending and make sure that sufficient funds are allocated to the health care of our military members and their families. It is time that we all understand where the true patriotism must be demonstrated.

Brian P. Wicks, MD, is an orthopaedic surgeon at The Doctors Clinic, a multispecialty medical group in Silverdale, Wash. He can be reached at bwicks@thedoctorsclinic.com