As Congress continues to “crawl forward” in its healthcare reform bill, a new report suggests that there are many lessons that can be learned from the Military Healthcare System (MHS).

The MHS is one the largest healthcare systems in the U.S., covering 9.5 million active duty, retiree and dependent beneficiaries. Operated by the Department of Defense (DoD), it provides medical services through a network of military clinics and hospitals, in addition to 1,700 civilian hospitals, 300,000 civilian doctors, and 60,000 pharmacies all over the world.

Just like civilian systems, the MHS aims to provide equitable, cost-effective care to a diverse population. Under TRICARE, the military insurance program, premiums and deductibles are eliminated or reduced, while co-pays are non-existent. Given that this is the closest system to some form of universal coverage that we have in this country, many lessons can be learned about what might work and what might not work for the general healthcare system.

First of all, despite the universal aspect of the MHS, significant racial and ethnic gaps in child health do exist. For example, compared to white children, African-American children in the MHS are more likely to have asthma, more likely to have an asthma-related hospital or ER visit, and less likely to visit an asthma specialist. The same applies to Hispanic children when compared to white children, even though the differences are smaller. Therefore, it seems that universal coverage alone does not eliminate racial and ethnic disparities.

Moreover, TRICARE beneficiary satisfaction is significantly reduced due to limited choice in deciding on a primary care doctor. The authors suggest that “despite the richness of its benefits, the military system faces considerable challenges with access, patient satisfaction, care coordination and other primary care functions.”

The findings from the report suggest that even with universal coverage, insurance reform and cost control measures, the most serious problems in the healthcare system are not likely to disappear.