Tall Paul

Rumor has it that Annette Funicello
Was singing about Warren (Paul) Murrell
When she recorded this song back in 1959

(okay, okay maybe not)
He would have been hanging around in
In his hometown...Lafayette Louisiana about then
Maybe 16 years old
Probably already "Tall"

He may have already met his wife, Nell 

Of more than 50 years by then to

Some years later he was an Air Force Lieutenant Colonel

Running the assignments and career development section
For the Air Force Medical Service Corps
At Randolph Air Force Base Texas
The job was a 'tall order
And he was successful in getting help
By adding a new position...
A deputy of sorts

I was a brand new major
About to come off a humanitarian assignment
And Paul interviewed me at an MSC symposium
He was suffering from some sort of judgement deprivation that day
So he chose me
We would go on to spend something over three years together
Supporting around 1,200 Air Force health care administrators
As they moved on average every three years
(Some much more often)
From base to base around the world

Of the 1,200, a thousand or more were on their way up
In rank, responsibility or both and we tried to help
Around 100 were on their way down and we tried to help soften the blow
In my 50 plus years of work, from apple picker to hospital administrator 

To health plan COO to consultant
I have never had a finer job nor a finer boss

The women and men of the Medical Service Corps
In the mid-eighties were by and large ethical, hard working
Collegial and devoted to quality health care delivery
For all Air Force families
Tall Paul Murrell was their perfect shepherd

His favorite saying was (and probably still is)
"On the other side of it..." as a preface to looking
At an issue from another perspective
And then, when he didn't want to give in on an issue
His other favorite expression would surface; "I continue to believe..."
All in that Southern gentleman voice, wrapped in persuasion
I never got tired of witnessing that
As every day he and I tried to successfully work our way through
The politics of job assignments

There were a lot of times when there was no clear answer 

Or the powers that be dictated an action
And we ended up making a move that did not appear correct
When that happened, he would shake his head, flash that huge grin
And we would move on

His primary weapon was the truth
His primary goal was doing the best job for everyone
If you were face-to-face he would add that huge grin
And a twinkle in his eye
That signaled...between the two of you,
You could work things out

Paul and I have worked a lot together in our second lives:

• The start up of CRI - the original Tricare contract
• Firms like Aetna and Prudential in pursuit of subsequent Tricare contracts
• Small non-profit health care quality assurance firms on Medicare and Medicaid initiatives

Beyond the Medical Service Corps
Through it all, the magic and the truth 

(however hard that can be sometimes)
Has always served us

I am thinking, whenever he hits those heavenly gates,
Saint Peter will call him aside and say;
"Hey Paul, I need someone to help me make sure all these people
Get where they need to be. You seem to be the perfect man for the job."

That move would have my vote.

Remember the "I" in TRICARE

Consider this "TRICARE Health Matters" newsletter I received in the mail today. At least I think it was intended for me as it is addressed to; "TRICARE BENEFICIARY AT..."

Sure I looked at it. After all I am interested even if it was intended for someone else at this address...like maybe another "BENEFICIARY" here...my wife.

But then I thought, 'I have to be a little more critical as the spin seems a little off.'

First the easy stuff; Why do I have to be referred to as "TRICARE BENEFICIARY?" After all, if they can include my address, can't they include my name? How about Mr. and Mrs. Tom Campbell or something similar? And why do I have to be called "beneficiary?" Does that word make it seem like I am on the dole somehow? But that's okay, I don't want to nit pick here...or do I?

The next thing that caught my attention was the heading; "An Excellent Value." Now I do not recall exactly when the implied promise of a lifetime of health care was taken off the book of expectations for military retirees but it is clear...that promise is gone. In the meantime, I will likely never consider TRICARE an "excellent value" because... Airman Basic Tom Campbell figured if he stuck around for 20 or more years, health care would be one thing he wouldn't have to worry about. This wasn't just implied, it was stated many times by superiors and in print.

Next; "Generous Coverage"  Now I am starting to get a little rankled. "Generous?" Someone is being generous with me after I served for 24 years? I don't think so. To me, "generous" describes the $188,000 a year a retired fire chief here in Sacramento gets (just read this in the Bee today).

"Superior health care?" Well, everyone claims to deliver that, but I won't debate it.  I hold TRICARE (then CRI) enrollment card #2. Doctor Jim Shubert, RIP, holds #1).  I served with Jim at Foundation Health when TRICARE first rolled out and I think our combined military/civilian health system was and is terrific. I have been enrolled for more than 25 years now and have always believed I and my family had access to the best of whatever care we needed.

"Decisions are health driven, not insurance driven" Agree, and that is the way it should be for our entire nation. In the end, we all end up paying for those who neglect health care for lack of insurance and end up clogging the emergency rooms and chronic care functions of our system. In fact, if we got at them with decent health care early, it wouldn't cost as much. Oh yea, and we are all paying around 20 cents of each health care dollar to insurance executives so they will "contain costs."

"High satisfaction with care." Hear, hear!  There is nothing puffed up about that at all. We have known this ever since the first independent assessment was conducted by the Rand Corporation in 1990.

"Low out-of-pocket costs." True but...I am supposed to be thankful for that?! Nope.  Never happen. (See previous argument about "An Excellent Value")

"Easy access" Hear, hear again! Two thumbs up to companies such as Foundation Health now HealthNet, Humana, TriWest and recently, United Health for doing a fine job here but let's not forget; they are all getting paid and paid well.  Example; one CEO who came on right after CRI start up, claimed credit for "turning the company around," then left with over $30 million in his pocket after maybe 4 years.  So tell me, how much health care would $30 million buy?

So why is it necessary to put all that hyperbole on the front page of the TRICARE newsletter? Why 'sell' something when the newsletter is aimed at existing enrollees? Maybe there is a group of communications specialists at all these companies who are paid to make sure all documents include this stuff. In fact, maybe it is the same folks who were doing it over 25 years ago. Enrollees are mighty happy with the program and will continue to sign up in droves for lack of even a close second in terms of options. Just give us the facts and please, don't insult us by spinning a story about how lucky we are. We in the military kept comm specialists, their bosses and elected officials free so they could keep legislating, writing and getting paid the big bucks...you know, them and the fire chiefs and CEOs. We earned our humble place in the scheme of things.