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TOP MILITARY DOCTORS BLAST PHONY HEALTH BUDGET
"EFFICIENCIES" -- Will not produce real
efficiencies
but will only mean cuts in on-base medical
services for military members.
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http://www.heraldnet.com/
stories/07/03/31/100bus_philpott001.cfm
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Efficiency cutbacks in budgets criticized
Tom Philpott
Military Update
The surgeons general of the Army, Navy and Air Force have accused
defense officials of imposing $650 million in phony efficiency cutbacks
on their medical budgets that will not produce real efficiencies but
will mean cuts in medical services.
The feud between the services' top medical officers and the office of
the under secretary of defense for force readiness and personnel got its
first public airing at a February meeting of the Task Force on the
Future of Military Healthcare. They continued and perhaps intensified
their criticism Tuesday before the House armed services subcommittee on
personnel.
To illustrate the impact of a $343 million cut to Navy medicine, Vice
Adm. Donald Arthur said it's comparable to closing a large family
practice hospital at Camp Lejeune, N.C., or the naval base in Pensacola,
Fla.
To capture the cynicism of the maneuver, Arthur quoted Portia in
Shakespeare's "Merchant of Venice": "You may have your pound of flesh
but draw nary a drop of blood." The same sort of impossible circumstance
exists here, Arthur said, with defense officials telling military
medicine to handle the budget cuts simply by being smarter managers.
"There is no more flesh to be gained without drawing the blood of
services from our family members and our active duty," Arthur said.
Unless Congress intervenes, he continued, "we will have to have a
serious conversation about what services we can provide at 16 percent
less funding than the year before."
Major Gen. Gale Pollock, acting Army surgeon general, said the cuts are
the budget equivalent of losing a large medical department, which means
a community hospital plus support elements.
"So it's not efficiency. It's a flat-out cut in service at a time when
our nation's at war?" asked Rep. Vic Snyder, D-Ark., chairman of the
personnel subcommittee.
"Sir, it will be a cut in service," Pollock said.
The Air Force faces its own $190 million efficiency cutback for the
fiscal year that begins in October. Lt. Gen. James Roudebush said there
are ways to handle it besides cutting patient services, but none will
produce real savings. Patients who can't be treated on base simply move
to the private sector, which means even higher Tricare costs, said the
Air Force surgeon general. But before that happens, the service will
slow spending on facility maintenance, on new medical equipment, on
research and training.
"Your seed corn?" Snyder asked.
"Yes sir," said Roudebush. "You push things downstream" creating "a bow
wave of obsolescence, a bow wave of risk."
The efficiency mandates imposed by Defense officials are in addition to
$1.86 billion withheld from the 2008 defense health care budget on the
assumption that Congress will approve the Bush administration's plan to
raise Tricare fees on military retirees under age 65 and their families.
Arthur told the military health care task force Feb. 20 that, in his
opinion, the efficiency cutbacks directed by Dr. David Chu, under
secretary of defense for personnel and readiness, are just one more way
to show lawmakers the consequences of not raising Tricare fees.
"I don't like it," Arthur said, "but I think we're being squeezed in the
middle of the politics of that."
Defense officials want money shifted from military direct care to help
pay for burgeoning Tricare support contracts for networks of physicians
and other providers who treat beneficiaries off base, Arthur said.
The Navy, Arthur said, has been able to fill only 83 percent of health
care billets converted to civilian positions. If that pattern holds, the
2008 conversions will leave the Navy short 136 more medical staff, he
said. "I was at Bethesda (Naval Medical Center) this week and was told
of a problem with overtime pay to the civilians we had, because it's
already an issue. They (work) no nights, no weekends, 40-hour weeks, no
deployments. And they sit right beside a lesser-paid active duty member
who is doing the same job," Arthur said.
Army medicine has asked for a hold on more military-to-civilian
conversions, Pollock said, "so we're making better decisions and not
breaking health care as a result of a personnel change."
The Navy will have to reverse course on cutting 900 more corpsmen,
Arthur said, because the Marine Corps will need more as it grows by
28,000.
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Larry Scott --
