Tom Jurkowsky| The Fayetteville Observer

For the past several years, the Department of Defense (DoD) has been relentless in its attempt to cut 18,000 medical positions. The cuts represent a 20 percent reduction and would affect all the military services.

At Fort Bragg, both the Joel and Robinson outpatient facilities would be closed or downsized. Beneficiaries would be forced to obtain care from civilian providers, potentially creating health care shortages for both military beneficiaries and civilians seeking care in surrounding communities.

Congress fortunately has not yet authorized DoD to make the cuts. Last year, Congress directed a pause to ensure DoD conducted an assessment on the impacts such cuts may have on beneficiaries. This included not just the cost effectiveness of the cuts but whether civilian providers were even able to accommodate the military beneficiaries.

This year the House Armed Services Committee has once again made the right decision, telling DoD to conduct a more accurate and complete evaluation of its proposal by including provisions in its version of the National Defense Authorization Act (NDAA) that increase transparency, DoD reporting requirements and congressional oversight of the medical facility restructuring and personnel reductions.

The Armed Services Committee, like the General Accountability Office (GAO), told DoD that it needed to do a more accurate and complete evaluation of civilian care availability for its beneficiaries active duty members, their families and retired military personnel who qualify for medical care.

In its study of the issue, the GAO said DoDs civilian health care assessments did not consistently account for provider quality. For example, GAO found that DoD considered the quality of nearby civilian providers for only one of 11 selected military treatment facilities. Similarly, DoD did not properly consider the distance beneficiaries would have to travel to get their medical care.

Another finding was the cost effectiveness of the cuts. GAO said DoD applied assumptions that likely under-estimated the cost effectiveness of military treatment facilities.

An additional concern is the impact a 20 percent cut in military personnel would have on the battlefield. Can the services absorb these reductions and still support combat operations, humanitarian aid and relief missions?

The militarys response to COVID alone has demonstrated the key role the military can play in such a crisis. Since the pandemic began its global scourge, nearly 4400 military medical personnel have surged to augment courageous civilian medical personnel at U.S. medical facilities. This number does not include the approximately 58,000 active duty, Reserve and National Guard personnel who have also supported the response.

The Army also deployed four active-duty field hospitals.

Secretary of the Army Ryan McCarthy himself has expressed concern over the manpower cuts. He has questioned how the cuts might impact medical research facilities with resultant battlefield consequences.

DoDs attempt to affect these cuts is not well thought-out. Unlike its colleagues on the House Armed Services Committee, the Senate Armed Services Committee has not included any provisions in its version of the NDAA to halt the cuts. Accordingly, a conference committee composed of both House and Senate members will now meet to resolve this issue and several others in order to finalize the fiscal year 2021 Defense authorization bill.

North Carolinas two senators, Senators Richard Burr and Thom Tillis, even though they may not be on the conference committee, should urge their Senate colleagues to join the House in disapproving DoDs efforts to ravage military medicine.

Any reforms aimed at increasing military medical provider readiness, achieving efficiencies and improving the patient experience should be supported. But these reforms must be achieved in a thoughtful manner.

Just recently, the civilian secretaries of all the military branches, along with the uniformed heads of the services, called on Defense Secretary Mark Esper to suspend any planned moves of medical personnel or resources. They said the proposed end-state that DoD wants represents a disparate structure that hinders coordination of response to contingencies such as a pandemic.

For all the politically appointed civilian service secretaries and the uniformed service leaders to tell DoD they disagree with an action is unprecedented and speaks volumes. Hopefully, the Senate conferees, including Senators Burr and Tillis, will see the significance of this memo and act accordingly.

Tom Jurkowsky is retired Navy rear admiral who served on active duty for 31 years. He is a board member of the Military Officers Association of America (MOAA), a non-profit advocacy organization that supports a strong defense and its people. His book The Secret Sauce for Organizational Success: Communications and Leadership on the Same Page, was recently released. He lives in Annapolis, Maryland.

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U.S. Senate, including Tillis and Burr, must act to save military medicine - The Fayetteville Observer