As the COVID-19 pandemic sweeps across the world and our nation, one steadying and encouraging resource has been the nation’s military. The Department of Defense (DoD) activated thousands of National Guardsmen and Reservists, tapping into our nation’s largest source for medical surge capability.
Military medicine has long been a critically valuable source of research, insight, training and skill for the nation and now is no different. Yet even as leaders turn to the military for manpower, medics, and expertise, the Defense Department is engineering a reduction of that system. Following through on this plan would be a terrible mistake.
DoD’s so-called Military Health System (MHS) Reform would eliminate up to 18,000 military medical personnel — 4,000 from the Air Force, 7,000 from the Army, and 5,000 from the Navy. Dozens of Military Treatment Facilities (MTFs) would be downsized, with access limited to active duty personnel.
That would push 84,000 family members and 110,000 military retirees out of the MTFs and into already over-burdened civilian medical facilities unprepared for the increase. In some communities, DoD acknowledges, medical providers won’t even accept all of the military’s Tricare insurance programs.
The military surgeons general and the Defense Health Agency are committed to ensuring everyone is taken care of, however, the best route forward is to not make cuts.
Congress wisely put the brakes on DoD’s plans for cutting these positions a year ago. Saying the department had failed to conduct the necessary analyses and determine the unintended consequences of the cuts, Congress sent DoD back to do its homework. The original directive to “right-size” the military healthcare system dates to Sec. 703 of the fiscal 2017 National Defense Authorization Act (NDAA). That legislation directed DoD to eliminate care that doesn’t contribute directly to military readiness and to move it instead into the Tricare civilian healthcare network.
Reportedly, some beneficiaries are already getting shoved from the MTFs.
Defining the readiness mission is difficult, however. When military parents can’t secure healthcare for a sick child, that affects readiness. When local providers reject military health insurance, forcing family members to travel out of the area for care, that affects readiness too. And when the military gives up health care capacity, the nation loses some of its ability to surge in response to health care emergencies. As we can see today with the COVID-19 pandemic, that is most certainly a national readiness concern.
Today’s crisis should be a wake-up call to rethink any effort to downsize military healthcare. Our nation has been caught ill-prepared for this pandemic. We lack both ready stockpiles of critical equipment and trained personnel to help respond. Our frontline healthcare workers in hotspots around the country are heroically responding to the call. But our national capacity to help is falling far short of what it could have been. The military is, of course, part of the answer. But a smaller military healthcare system will be even less prepared to help in future crises.
Yet even now, DoD has plans for further cuts, including potentially cutting its investment in the Uniformed Services University of the Health Sciences (USUHS) by at least 30 percent. The mission of USUHS is “to support the readiness of America’s Warfighter and the health and well-being of the military community by educating and developing uniformed health professionals, scientists and leaders; by conducting cutting-edge, military-relevant research, and by providing operational support to units around the world.” That’s a mission we cannot afford to cut today.
Last spring, the federal government changed the fees it reimburses to civilian hospitals that provide health care to military members. The cuts drove some hospitals to decline to take such patients, effectively denying health care services to some.
Congress must step in now to prevent a looming disaster. Our nation has too much to lose in military and medical power. There should be a minimum five-year delay on any moves to reduce military health care capacity, allowing for a full evaluation of the value and requirements for military health expertise in times of national crisis. USUHS, the only combined medical and nursing school in the country, provides essential seed corn for our nation’s health care system. It should be bolstered, not cut.
Congress should also act immediately to permit licensed medical practitioners to cross state lines. Today’s mishmash of state regulations and licensure requirements limits the ability of doctors and nurses to move in response to national needs or even the needs of their families. The lack of license reciprocity imposes a particular burden on the mobility of military spouses, as has been noted for years by The Military Coalition, a powerful group of leading military and veterans advocacy organizations representing 5.5 million members.
The Military Health System is arguably among the most effective medicine systems in the world and is our nation’s strategic medical reserve. This recent pandemic highlights the imperative to maintain such capacity rather than risk reducing it in size and scope. Imprudent cuts to military health care pose risks that reach far beyond the military and include the nation’s greater health system. We must heed today’s lessons and apply them appropriately for our future.
As the Air Force Association’s top executive, retired Air Force Lt. Gen. Orville Wright directs the association’s professional staff. He is responsible for the management and operations of AFA and its 97,000 members, and he serves as the publisher of Air Force Magazine, the official journal of the Air Force Association.
Keith Zuegel, a retired Air Force colonel, serves as the Senior Director, Government Relations for the Air Force Association (AFA) where he develops and executes the Association’s aerospace advocacy and promotes a dominant U.S. Air Force and U.S. Space Force.
Editor’s note: This is an Op-Ed and as such, the opinions expressed are those of the author. If you would like to respond, or have an editorial of your own you would like to submit, please contact Military Times managing editor Howard Altman, haltman@militarytimes.com.
