Research for Research Memoranda

This research memorandum is part of a study sponsored by the Commander, Seventh Fleet, to assess the security environment of the Asia-Pacific Region (APR) between now and 2010. It focuses on the most probable evolutionary trends for China during this period. China's emergence as a major regional power will be one of the principal factors affecting the security, politics, and economies of Asia and the Pacific between now and 2010. The forces shaping China's emergence are primarily internal, but include such important external factors as Beijing s perceptions of the intentions of its neighbors and of the United States. Much of the uncertainty about China's future course and impact on the region center on whether, and how, China accepts the norms of the international systems that have grown since World War II - norms that have not yet been tested by the rapid rise in national power of a large non-Western country. Alternative scenarios emerging from the rapid changes underway in China could have widely varying implications for this and other issues.

The Commander, U.S. Seventh Fleet, asked CNA to assess the security environment of the Asia-Pacific Region between now and 2010. This memorandum identifies the most probable evolutionary trends for the Indian Ocean Region, with particular emphasis on the largest factor, India. Research team members conducted interviews with officials, officers, and scholars in Washington, New Delhi, and Islamabad, and in Hawaii with CINCPAC staff members, and East-West Center and other University of Hawaii scholars. The project team also drew heavily on expert opinion available in Washington, at the Departments of State and Defense, at the National Defense University and from the intelligence and scholarly communities.

In October of 1992, the Tidewater area of Virginia was designated as a demonstration site for Tricare. The demonstration project makes fundamental changes in the financing and delivery of health care to military beneficiaries currently served by Naval Hospital, Portsmouth; McDonald Army Hospital, Ft. Eustis; and 1st Medical Group (TAC), Langley Air Force Base. Tricare Tidewater is a triservice managed-care initiative, designed to enhance military beneficiaries' access to care, improve mechanisms for quality assurance, control rising costs, and increase coordination between military and civilian components of the Military Health Services Systems (MHSS). Although increasing physician satisfaction was not a direct goal of the program, many of the changes implemented may affect the way that military physicians practice medicine in the Tidewater region and their attitudes regarding their role in the MHSS. Certainly, any positive effects would be welcomed, but a decline in physician satisfaction could lead to lower retention rates for military physicians, as well as lower levels of physician performance, patient satisfaction, and quality of care. In this research memorandum, we measure the impact of the first two years of the Tricare program on physician satisfaction.

For many years, the Center for Naval Analyses (CNA) has been charged with reconstructing and analyzing the Navy's major fleet exercises. Before deploying, a carrier battle group completes its work-up cycle by participating in a major exercise war. CNA provides reconstruction and analysis support at the request of the fleet commanders, who need an objective evaluation of their battle group's tactics and readiness. On 26 and 27 September 1995, Commander, Naval Base San Diego and Fleet Industrial Supply Center, Sand Diego hosted the 1995 San Diego Preparedness for Response Exercise Program (PREP) Area Exercise. This report documents our evaluation methodology, and offers a suggested evaluation plan for use in future PREP area exercises.