December 22, 1997 in Nation/World

Military Medical System Under Attack Some Suggest Scaling Back Network Of Defense Hospitals

Cox News Service
 

America’s military medical system, under fire for the quality of care it provides to active-duty troops, their families and retirees, is fighting for its own life.

Military health officials vowed last month to correct “real problems” which they acknowledged exist in the quality of military medicine. The problems were detailed in a seven-part series of Dayton (Ohio) Daily News articles on medical malpractice in military hospitals.

But some analysts believe the problems could best be solved by drastically scaling down the network of Army, Navy and Air Force hospitals - a move that some believe would save hundreds of millions of tax dollars.

Such ideas are opposed vigorously by the Defense Department’s Office of Health Affairs and by the top medical officers in each service.

But with the Cold War over and the cost of the military medical care system still rising, proposals continue to surface both in Congress and within the Defense Department.

Most recently, Pentagon budget writers recommended downsizing 36 community hospitals and six major medical centers - and suggested that in addition to saving money, the move would result in improved medical care.

The idea was dropped last month after opposition from the Pentagon’s Office of Health Affairs.

A study by the Congressional Budget Office two years ago concluded that the Defense Department would save $1.7 billion a year if it were to downsize its network of clinics, community hospitals and medical centers by nearly three-fourths and enroll its non-active-duty patients in the same health care plan used by federal civil servants and retirees.

The study, “Restructuring Military Health Care,” noted that the military health care system grew during World War II and the Cold War to more than 30,000 hospital beds, requiring more than 13,000 active-duty physicians along with 55,000 civilian employees and 135,000 active-duty support personnel.

At the same time, a growing population of military dependents, retirees and their dependents means that most of the patients treated in military hospitals are civilians.

The system faces an “increasing gap” between the needs of its beneficiaries and its ability to meet them, the Congressional Budget Office study said.

The system also faces growing dissatisfaction among retirees and other civilian beneficiaries over the quality and availability of the care they receive. Some military family groups and veterans organizations are lobbying to be shifted from the Defense Department’s system of financing civilian health care to the federal employee system.

That leaves training as the principal justification for maintaining a large peace-time medical system. But the congressional study suggests that the armed services might get better training somewhere other than in military hospitals.

The study noted that only 25 percent of the most frequent disease and non-battlefield injuries incurred by Marines in Vietnam match the peacetime workload of military hospitals - where the most common medical procedure is delivering babies. And only 5 percent of actual battlefield injuries match the hospitals’ peacetime workload, the study added.

On the other hand, 98 percent of the cases treated at a civilian trauma center in Baltimore matched the military’s list of battlefield injuries and other casualties, the study noted. If American military doctors spent peacetime assignments in trauma centers and emergency rooms of urban hospitals, their training would have a closer relationship to wartime needs, the study said.

xxxx SAVINGS PLAN A Congressional Budget Office study concluded that the Defense Department could save $1.7 billion a year by downsizing its network of clinics, community hospitals and medical centers and enrolling non-active-duty patients in another federal health care plan.


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