Military Health Care Reorganization
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Richard Gardner | Wednesday, May 24, 2006 |
In the next chapter of the military health care system is broken, or the military health care is the model for a national health care system, we have yet another proposal to reorganize military health care, following on the really stupid proposal to increase fees to drive folks away from TRICARE (all it would do is shift accounting, total expenditures would be roughly the same).
Army, Navy Press for Potent Unified Medical Command
The Defense Department is shaping a final decision document to reorganize the military health care system around a new unified medical command, say senior officials. The command would be led by a four-star medical officer given unprecedented authority. He would take charge of what now are service-unique responsibilities for medical staffing, training, purchasing, operations and medical readiness across the Army, Navy, Air Force and Marine Corps.
Noted, the Services will outsource medical to throw it off their budget. Fake savings? But the Service Chiefs will no longer have to testify about entitlements.
Service and Defense leaders in early May received, for review and comment within 30 days, three options for a new command structure.
UM, sounds like the decision has was made
Under the first, which enjoys strong support from the Army and Navy surgeons general, the new medical command would be a major combatant command similar to the U.S. Special Operations Forces Command (SOCOM), and reporting directly to Defense Secretary Donald Rumsfeld.
A four-star general or admiral would command all medical personnel, equipment and facilities, just as SOCOM controls combined special forces. Medical personnel still would be trained for service-unique missions and in the culture of their parent service. But overall medical training, assignments, procurement and operational support would be centrally controlled. Medical staff would be assigned according to command needs.
The money side of SOCOM hasn’t been the best. ASDS is the poster child for bad acquisition projects. I doubt a unified medical command will be better.
I do think the support functions should be separated from the services.
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Medical personnel still would be trained for service-unique missions and in the culture of their parent service. But overall medical training, assignments, procurement and operational support would be centrally controlled. Medical staff would be assigned according to command needs.
Holy crap, but that's a bad idea. Not only that, but I'd go so far as to say it's simply not possible - you can't say you're going to take the basic military support mission to Organize, Train, and Equip forces in a completely 'purple' fashion, and then say they'll also be trained and assigned as their services see fit. It can't be done. And I'd also like to remind the military medical community of a lesson the USAF communications folks learned the hard way in the late 90s - functions that are completely outsourced to civilian contractors can no longer be deployed to the field... the uniformed people you do keep won't know how to do the jobs you have outsourced. This is a recipe for tragedy.
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Another command? Give me a friggin break! All this is going to do is to create another monster bureaucracy. The new commander is going to demand a seat at the table with all the other COCOMs.