Page:United States Statutes at Large Volume 105 Part 2.djvu/457

 PUBLIC LAW 102-190—DEC. 5, 1991 105 STAT. 1409 the level of satisfaction of the persons who have received health or dental care under such alternative methods. (c) SURVEY. —The study required by subsection (a) shall also include a survey of members of the Armed Forces gmd covered beneficiaries in order to— (1) determine their access to and use of inpatient and outpatient health care services in the military medical care system— (A) by source of care and source of payment, including private sector health insurance; and (B) in relation to civilian sector standards established for particular clinical services; and (2) determine their attitudes and the extent of their knowledge regarding— (A) the quality and availability of health and dental care under the military medical care system; (B) their freedom of choice with respect to health care providers and level of health care benefits; (C) the premiums, fees, copayments, and other charges imposed under the military medical care system; and (D) any changes in the rules, regulations or charges that characterize the military medical care system. (d) CONTENT OF REPORT.— The report required by subsection (a) shall include with respect to the systematic review of the military medical care system required under subsection O^XD the following: (1) For each of the fiscal years 1993 through 1997 and over a longer range periods of 10 years and 15 years, the numbers, types, and geographic distribution of active duty and civilian personnel and fixed military treatment facilities needed to support the Armed Forces during a war or other conflict if such a war or conflict occurred during such fiscal years and each such period, respectively. (2) An analysis of adjustments to the military medical care system that may be needed to provide cost-effective care in peacetime to covered beneficiaries, including in the analysis of cost-effectiveness the following: (A) The various methods available for providing health and dental care to covered beneficiaries (including providing such care through Medicare risk contractors) that exist as alternatives to the existing methods of providing such care to covered beneficiaries under the military medical care system. (B) The full range of marginal costs associated with providing different clinical services directly in military treatment facilities and a comparison of the costs of providing such care in facilities of the uniformed services with the costs of providing such care pursuant to regional indemnity contract plans and health maintenance organization contract plans. (C) Any plans of the Secretary of Defense to increase or reduce premiums, fees, copayments, or other charges, and the likely responsiveness of beneficiaries to such changes, including the "trade-off factors displayed when covered beneficiaries choose between direct military care and care provided in the civilian sector. (D) Any differences in providing care between covered beneficiaries who live within 40 miles of military treatment

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