DOD’s civilian health care tour of Japan ends with high-profile meeting in Okinawa

CAMP FOSTER, Okinawa — Dr. Maisha Smith, one of two child clinical psychologists at the U.S. Naval Hospital Okinawa, took to the microphone during a town hall here Thursday night to talk about the wrist she injured in July.

It required surgery and could hurt her for the rest of her life because she didn’t get timely treatment, Smith said. She has to leave Okinawa soon for six months for this procedure and follow-up care.

“This will leave one pediatric clinical psychologist on active duty to meet the island-wide psychological assessment needs,” she said. “Right now, my dog ​​has better access to health care on base than I do.”

Smith was among more than 500 civilian employees and concerned service members who crowded into the base’s movie theater to discuss a recent change in base medical care with Gilbert Cisneros Jr., undersecretary of defense for personnel and readiness, and Celine Mullen, acting the position of Assistant Secretary of Defense for Health Affairs.

The town hall followed a standing-room-only event Wednesday at the Kadena Air Force Base clubhouse, which also drew more than 500 people. Meanwhile, on Thursday, Army Maj. Gen. Joseph Heck, the Defense Department’s director of health for the Indo-Pacific region, held a similar meeting at Sasebo Naval Base on Kyushu, the southernmost of Japan’s four main islands.

During both events in Okinawa, leaders contacted dozens of civilians who could not find affordable medical care in Japanese hospitals. Service members stood up to say that military readiness has been affected by DHA’s decision to limit care at base medical facilities to civilian employees who are not covered by Tricare Prime, the military’s top health plan.

As of Jan. 1, many DoD civilian employees, their families and some veterans are limited to same-day appointments available for immediate medical needs, under 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 understaffing, long waits, Japanese providers refusing to treat Americans and exorbitant upfront costs when such treatment is available.

Their complaints echoed statements Monday at Yokota Air Force Base and Tuesday at Camp Zama and the Yokosuka Naval Base. The Yokosuka meeting, like Foster’s, was marked by outbursts from the audience during the deputy secretary’s and assistant secretary’s responses.

Foster’s exchange became testy at times as the audience laughed or shouted abuse at Cisneros.

The leaders, who have made similar statements during previous town halls, did not offer specific solutions but said they would feed information gathered at the town halls back to a Pentagon task force trying to find medium- and long-term solutions to the crisis.

“We’re looking for ways we can make it better,” Cisneros said.

He said everything is on the table within the law to try to resolve the issue. Last year, Heck said DHA was authorized by Congress to prioritize the health care of active duty service members and their families over the care of DOD civilian employees.

In Kadena, dozens lined up to challenge the DHA’s decision.

Army Lt. Col. Aaron Brown, commander of Naha Naval Station in southern Okinawa, pleaded with Cisneros and Mullen to resolve the issue. Brown said 30 percent of his staff are civilians who have told him they would quit their jobs without guaranteed access to health care at military medical facilities. He called for the policy to be reversed immediately.

“This is bigger than politics; we’re talking about projecting joint forces in the South Pacific in response to [Chinese army]Brown said. “We don’t have time for bureaucracy to solve certain problems like this.”

Marissa Strickland, a Defense Education Activity elementary teacher and president of the American Association of Educators in Okinawa, said one of their members was denied hospitalization in a Japanese hospital after suffering a stroke.

A pregnant teacher miscarried at 17 weeks after being denied prenatal care at the U.S. Naval Hospital in Okinawa and at Japanese hospitals, Strickland said.

“These are just a few of many, many examples,” she said. “During COVID, we were considered mission critical. You can’t have it both ways; if we are mission critical, so is our health care.”