US war vets thankful scam uncovered

James Dale, a retired master sergeant in the United States Air Force, feels safe now that the scam committed by a Philippine company on the US military’s health insurance program had been uncovered and those behind it convicted.

But while Dale, 70, has a greater sense of security now, some 2,000 American veterans in this city that hosted the Clark Air Base for almost a century until 1991 consider the case a lesson to guard against any efforts to mess up the Tricare system.

“They took advantage of it,” said Dale, referring to Health Vision Corp. (HVC) and its subsidiary, the Philippine International Hospital (PIH) in the village of Malabanias here.

“We in the Philippines are very sensitive that we do not want to lose our Tricare privilege. We resent that any doctor or medical [service] provider can upset the system,” he told the Philippine Daily Inquirer on Monday.

The issue has been the subject of conversations among retirees in the last few days.

Dale said if the Tricare system bogs down and its support cut to US veterans like him, they would be forced to go to the US every time they need to avail of medical services under the Medicare system. The latter is not applicable in the Philippines.

Dale, who retired in 1984, settled in Angeles City when he married a Filipina in January 1985. They have two children who are in their teens.

“This has been my home,” he said, proud of the house-cum-hotel he and his wife started out on Fields Avenue here.

Dale suspected he got almost victimized when a PIH doctor in February 2005 diagnosed him to be having a tumor in the brain. Two tests, the doctor told him, confirmed that.

Dale, however, declined to undergo surgery, saying he preferred to undergo more tests in the US in October that year.

In the US, his doctor said he saw no traces of tumor.

“I wanted to raise hell,” he recalled, citing the torment he and his wife suffered from the earlier diagnosis of the Filipino doctor. “I find that strange.”

He did not know if PIH or the mother company, HVC, actually made claims on his behalf.

“I did not get anything though from Wisconsin, where Tricare Overseas administers the health insurance. Most of us didn’t know how they were doing it,” he said.

As far as he knew, the veterans in Angeles City were “not in complicity” with whoever was involved in the swindle.

Dale said he went to see Jack McDonald, then PIH administrator, about the complaints he learned from fellow retirees.

“Jack said he did not know what was happening even as he was the hospital’s administrator. He said those in Olongapo (HVC) controlled the billing. He said he knew nothing about the billing,” Dale said.

Now that the swindle had been confirmed, Dale said, “it’s like a lesson learned for us, too.”

“Maybe we could ask more specific questions. Before, we were not knowledgeable about the procedures in Tricare. We took it at face value,” he said.

“The concern now is to how to protect ourselves. We’re more knowledgeable. We will try to be less trustful [of how the Tricare system is utilized locally],” he said.

Three hospitals -- Cybercare, Lifeline and Mercedes -- handle Tricare patients here, but are not known to be involved in the swindle.

“I think they’re double-checking the system. We shouldn’t be signing blank documents,” Dale said.

Jim Boyd, chair of the Retirees Affairs Office here, said the Tricare system covers also the dependents of the veterans if the family or single person “[spends] $3,000 out of pocket expenses per fiscal year.”

“After that Tricare pays 100 percent [of the bills],” Boyd said.

According to Boyd, there are around 2,000 military retirees in Angeles City. Their average age is 55 and about 15 percent are past 70 years old.

“Tricare provides medical support [for] all eligible members. However, they are cautious due to past abuse,” he said.

Dale said that if any hospital messes up again, “we lose a benefit that we absolutely need here.” By Tonette Orejas - Inquirer Central Luzon Desk