One thing about the Canadian military which always seemed strange to me regards medical coverage. My understanding is those serving receive great coverage, but this does not necessarily apply to their spouses or children. Since one presumably wants a high level of morale, I have never understood this. I do know they recruit separately for military doctors, but I don’t think they see families perhaps due to scarcity.
Is this accurate? Is this true in the US military too? How do other militaries approach health care for military families?
If the families have access to UHC, does it make sense for the military to hire a disproportionate number of pediatricians and gynecologists for an institution that employees no children and (I’m guessing) 20% women?
No. But it makes sense for families to have access to a family physician for general care. This is all I am saying. (In Canada they would also provide general care for non-gravid women and healthy children.)
I’m not clearly understanding the OP’s contention in either post.
The dependents of Canadian servicemembers have the same UHC as any other Canadian. Just like those civilian Canadians who live next door to a Canadian military facility. So the service family would go to those same civilian doctors the nearby civilians do.
In US practice we have overseas posts which don’t allow servicemembers to bring families. So pediatricians aren’t needed at those locations.
Although those locations do need appropriate medical services for female servicemembers now, that wasn’t the case not so long ago. A lot of the architecture of current US DoD arrangements date from the era of the all-male force. At least the all male forward-deployed force. Accommodations have been made to the current reality of a female-inclusive forward-deployed force, but they’re still sorta bolt-ons.
You do raise the valid question about how Canadian servicemembers with families are cared for when the family is accompanying them to a station outside Canada. If the servicemember is stationed in Germany or in the US along with their family, how do the dependents get care? I sure don’t know.
ISTM there might be a terminology issue here. Not knowing what country the OP lives in. At least in US civilian practice it’s not common for an entire family with kids to have the same primary care physician. I didn’t have kids, but for 20+ years my wife and I went to separate primary care physicians. There’s no reason to want to combine them. Nor would I want a PCP for me who was focused on pediatrics. My parents certainly didn’t use the doctors they took me to as a child.
Perhaps “family physician” means something else in your world than in mine. To me it’s an informal term for a pediatrician. Not for somebody who tends to entire families as a unit. Nor would anyone I know particularly want their entire family tended by a single physician.
In Canada, a family physician is a generalist who cares for patients of all ages. More difficult cases are referred to specialists. Unlike the US, in Canada internists and paediatricians are generally specialists managing more complex cases or a specific area. Canada has a relative paucity of doctors compared to some countries. Not surprisingly, cities tend to have more doctors than rural areas.
Most Canadian service members are located in rural areas of Canada. Universal health care covers basic needs, but in Canada would not include a dental plan, cost of medications or some other services.
For the service member, if they are overseas or in.Canada, they will receive good care. The military has a shortage of doctors but the ones they have are skilled and well remunerated.
But their families also often live in isolated areas. There are not necessarily a lot of general practice doctors there. I agree the military does not need obstetricians, etc. But I don’t know if families have good access to dentists. Psychiatric stressors are significant for both service members and their families and access can be a problem in most rural areas. Stressors would be increased in the family if the service member was overseas without them.
So my question is, how do other militaries deal with military families? With psychiatric care?
There are a swarm of answers for the US military. Large bases in the US have MTFs (Medical Treatment Facilities) that may be capable of providing most medical care for the family. Even there they may need to contract out certain services to local providers.
Not everybody has access to an MTF or finds it convenient to their life circumstances They are managed via government supported health insurance. Depending on the specific circumstances there can be enrollment fees and deductibles for family members. Compared to civilian employer coverage, it is generally still a good deal.
As a general rule healthcare for service members is free…whether you want it or not. For family members it is a great deal compared to civilian plans.
Pretty regularly there are rumbling about changes to increase out of pocket costs for dependent coverage. About a quarter of DOD’s budget is for personnel costs. That includes costs like benefits for dependents. When you are talking about a part of the budget that is 180+ billion a year, people understandably look for areas to rein in costs.
One reduction that passed a few years back was a downsizing of the MTFs That reduces services available especially for dependents and retirees. In many cases that forces dependents onto coverage for civilian provided medical care. We are already transitioning to something closer to the Canadian armed forces model of what is provided on base.
Did you mean for this to be an exclusive statement? As in “we have overseas posts which don’t, in any and all cases, allow servicemembers to bring families”? Because of course some overseas posts don’t allow families, but then others do.
I meant it as “there are some (not all) overseas posts that …”. And then the next sentence went on to describe the reduced medical care at those overseas facilities which have zero dependents and therefore don’t need to provision care for them.
As you say, there are also overseas US posts that do have dependents. And therefore have an especial need to provision dependent care since the surrounding local non-US economy may be unable to provide it.