Dr. S. Ward Casscells is a cardiologist. But he has more than medical skills now to ease the stress on military retirees from recent proposals to raise sharply their Tricare fees, co-pays and deductibles.

Five weeks ago, Casscells became the new assistant secretary of defense for health affairs, arriving from the University of Texas Health Science Center in Houston, where he was a distinguished professor and its vice president of biotechnology.

His appointment could be good news for under-65 retirees and their families, because Casscells isn't a fan himself of the steep increases in Tricare fees that defense officials proposed early last year.

"Just from the standpoint of doing the right thing for the patient, I think abrupt changes in fees and deductibles could be unsettling," he said.

As the Pentagon's top policymaker on health issues, Casscells will be working with lawmakers next year on a more palatable set of fee increases.

"I would look for some small, gradual increases in fees and deductibles over the years. Not this year, because we've got plenty on our plate right now," said Casscells in a 45-minute phone interview, his first since becoming assistant secretary.

Casscells, 56, exudes the good will of a country doctor rather than the caution of a new political appointee who fears moving off message. "I'm trying to be a policy guy," he said. "I haven't graduated to politics yet."

He peppers his remarks with homespun humor. He compared his first weeks on the job to riding the mechanical bull at the Houston Livestock Show and Rodeo. He acknowledged that military surgeons general are upset about "efficiency wedges" imposed on their budgets. They probably liken that term, he said, to the bedside manner of Procrustes, in Greek myth, who invited travelers to stay for the night and then either stretched their bodies or amputated their feet to fit the bed.

Casscells wants beneficiaries to feel they are partners in actions ahead to make military healthcare more efficient and effective. He praised his predecessor, William Winkenwerder, saying that "in a lot of areas, he had the ball on the 10-yard line," which makes a new quarterback's job easy.

But Casscells doesn't sound the same alarms over the doubling of military health costs since 2001. While 17 percent of the nation's gross domestic product last year went for healthcare, military health spending is only 8 percent of the defense budget, he said.

"By that metric, we're doing OK. There are other metrics which make us look less efficient in the civilian health world. And there is no doubt we can be more efficient, because we're not at full capacity in base hospitals."

Casscells wants to see more patients in base hospitals, more medical advice online and co-payments that discourage misuse of care.