From a reader: The problems with Tricare could have been prevented by meeting with the Retirees here and getting their input on the local medical system. Instead, we were shut out and the Project was conceived and implemented with no regard to the differences between the U.S. medical system and the one in the Philippines. At one of the closed meetings with attendance restricted to 30 Retirees to announce the project, their ignorance was glaring. For example, the Tricare reps were shocked to learn that Philippine doctors do not make appointments, nor do they have office staffs to do the billing. Deferred billing is not customary here and payment for services is due when care is received. Setting up a system here based on a U.S. model will fail due to the differences between the two. Here, if you do not have cash, you get no treatment, period. You won't be seen even at an Emergency Room. Also, if you cannot pay your bill in full for treatment in any other setting other than a ward, you may be physically restrained from leaving the hospital until you do. Hospitals routinely do not stock drugs and surgical supplies so you must send someone to a Pharmacy to buy them and bring them to you in the hospital. As Tricare has steadfastly refused to put anyone in the country as a Representative who could learn the system here and advise them, this Project is doomed to failure. With the Retirees being denied access to needed medical care, it will only be a matter of time before we start dying of accidents and diseases that could be easily treated if a system were in place to ensure that doctors and hospitals were paid promptly and Retirees were reimbursed promptly for their treatment. Instead, we get pronouncements from on high in the U.S. where they smugly sit back and congratulate themselves on adding yet another stumbling block to a failed system. Sending out self-serving surveys that pat themselves on the back with no space for comments does not get the job done.