DOD civilian health care tour in Japan ends with raucous meeting on Okinawa
Stars and Stripes February 2, 2023
CAMP FOSTER, Okinawa — Dr. Maisha Smith, one of two child clinical psychologists at U.S. Naval Hospital Okinawa, stepped up to a microphone during a town hall here Thursday evening to speak about the wrist she injured in July.
It requires surgery and may pain her for the rest of her life because she did not receive timely treatment, Smith said. She must soon depart Okinawa for six months for that procedure and follow-up care.
“This will leave one pediatric clinical psychologist, who is active duty, to meet the psychological evaluation needs for the entire island,” she said. “Currently, my dog has better access to on-base health care than me.”
Smith was among more than 500 civilian employees and concerned service members who crowded into the base movie theater to discuss recent change to on-base medical care with Gilbert Cisneros Jr., undersecretary of defense for personnel and readiness, and Seileen Mullen, acting assistant secretary of defense for health affairs.
The town hall followed a standing-room-only event Wednesday at Kadena Air Base’s enlisted club that also drew more than 500 people. Meanwhile on Thursday, Army Maj. Gen. Joseph Heck, director of the Defense Health Agency Indo-Pacific Region, held a similar meeting at Sasebo Naval Base on Kyushu, the southernmost of Japan’s four main islands.
During both Okinawa events, the executives heard from dozens of civilians who found no available medical care at Japanese hospitals. Service members stood up to say military readiness is affected by DHA’s decision to restrict care at base treatment facilities for civilian employees not covered by Tricare Prime, the top-tier military health plan.
Since Jan. 1, many DOD civilian employees, their families and some veterans have been limited to same-day, space available appointments for immediate medical needs, according to a decision announced by Heck last year. In October, he said those affected by the change should find health care in their Japanese communities.
Nearly a dozen civilians described a lack of staff, long waits, Japanese providers refusing to treat Americans and prohibitively high upfront costs when that treatment is available.
Their complaints echoed statements Monday at Yokota Air Base and on Tuesday at Camp Zama and Yokosuka Naval Base. The meeting at Yokosuka, like Foster’s, was marked by audience outbursts at the undersecretary and assistant secretary’s answers.
The Foster exchange grew testy at times as the audience laughed or shouted rebukes at Cisneros.
The executives, who made similar statements during previous town halls, offered no concrete solutions but said they would take the information gathered at the town halls back to a Pentagon working group trying to find medium and long-term solutions to the crisis.
“We’re looking at ways we can make it better,” Cisneros said.
He said everything was on the table within the limits of the law to try and address the issue. Last year, Heck said DHA was mandated by Congress to prioritize health care for active-duty service members and their families over care for DOD civilian employees.
At Kadena, dozens lined up to question the DHA decision.
Army Lt. Col. Aaron Brown, commander of the Naha Military Port in southern Okinawa, implored Cisneros and Mullen to solve the problem. Brown said 30% of his staff are civilians who told him they would have declined their jobs without guaranteed access to health care at military treatment facilities. He called for the policy to be immediately reversed.
“This is bigger than policy; we’re talking about projecting the joint force in the South Pacific in response to the [Chinese army],” Brown said. “We don’t have time for bureaucracy to fix certain issues like this.”
Marisa Strickland, a Department of Defense Education Activity elementary school teacher and president of the American Educators Association of Okinawa, said one of their members was denied in-patient care at a Japanese hospital after suffering a stroke.
A pregnant teacher miscarried at 17 weeks after being denied prenatal care at U.S. Naval Hospital Okinawa and at Japanese hospitals, Strickland said.
“These are just a few of many, many examples,” she said. “During COVID, we were considered mission essential. You can’t have it both ways; if we’re mission essential, then so is our health care.”