King Suggests The Senate Make An Inquiry About Workforce Downsizing In The Military Health System

22 hours ago

During a Senate Armed Services Committee hearing held before the congressional recess, Sen. Angus King (I-VT) questioned experts about workforce strength in the military health system.

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Transcript

00:00Thank you, Mr. Chairman. First, I want to thank you for having this hearing very timely

00:05and important. Secondly, I want to associate myself with Senator Cotton's comments about

00:11a sort of Barry Amendment for drugs, the idea that we have to buy Made in America shirts

00:17for our troops, but we're worried about the availability of crucial drugs. It seems to

00:22me that's something that should be pursued. We could even call it the King Cotton Amendment,

00:27but I'll pass on that. Also, Mr. Chairman, before getting into the questions, and these

00:36witnesses wouldn't have the answers, but I think in light of this hearing, the committee

00:41should make an inquiry about whether there have been firings or early retirements encouraged

00:45within the medical facilities at the Defense Department, because we know there's a lot

00:53of that going around, and I'd like to know whether that's happening in the Defense Health

00:58Agency. Secondly, there's the impact of the continuing resolution. That's certainly not

01:04going to help this situation in terms of maintaining demand signals, continuity, pilot programs,

01:10all of that is gone in a continuing resolution. For the first time in my knowledge, I think

01:15the first time in American history, we're faced with a year-long continuing resolution

01:19which basically vitiates the entire budget process. Okay. What we're really talking about,

01:25it seems to me, is surge capacity, and it's impractical to maintain a capacity within

01:33the Defense Department or even Defense plus VA for the kind of casualties that would be

01:39generated in a significant conflict. Therefore, I see no other alternative than a cooperative

01:48surge agreement with the private sector. That's where capacity is, even though that's

01:56fairly limited, but Dr. Friedrichs, isn't that really what we're talking about here

01:59is how do we deal with a conflict way beyond what we're seeing now within the current capacity?

02:10Defense Health Agency couldn't do it. VA couldn't do it. It's got to be relationships, and shouldn't

02:15we have those relationships in advance so this isn't something that we scramble to do

02:20as we did during COVID, for example? Senator King, I could not agree more strongly,

02:26and I'll point out that- That's a record show of what he does.

02:30Thank you, sir. In the Cold War, we had what was called the Integrated CONUS Medical Operation

02:36Plan, which it was essentially what you just described. It was our shared commitment as

02:41a nation to care for our nation's casualties if and when our nation went to war. That depended

02:48on the National Disaster Medical System as part of the integrating function between the

02:52federal and the civilian healthcare system. The NDMS has been allowed to tread. I echo

02:58the recommendations to reauthorize the Pandemic and All Hazards Preparedness Act because that

03:04in part enables the NDMS, but I implore you to go further.

03:10The Integrated CONUS Medical Operation Plan needs to be updated, and we started that work

03:14when I was the Joint Staff Surgeon, and it's continuing today. Having the NDMS in name

03:19is not sufficient. We actually have to build out the numbers by community of what beds

03:25would be available, who would take them. With pre-existing conditions and analysis

03:30of deaths. Yes.

03:32I just wonder if the Pentagon has war-gamed this issue. They war-gamed everything else.

03:38Absolutely, sir. We actually did a war-game on this that we hosted first when I was the

03:42Transportation Command Surgeon and again when I was the Joint Staff Surgeon. What we found

03:47was just as you said, it can't be done unless it's a whole of a nation effort. The only

03:52way to get to that point is if we do much more detailed planning. Taking down funding

03:58for state and local readiness officials, for example, is not going to help them do more

04:03planning or preparing. We need to work together to build and flesh out that plan, and we

04:09must bring industry into that. The Defense Industrial Base provides the equipment. The

04:14Health Industrial Base addresses the points that you make.

04:16And we have an analog in Transcom, which has agreements with the private sector both in

04:21terms of airplanes and ships in the case of an emergency. That's where our surge capacity

04:27is. So it seems to me, I mean, here we are talking about it, but I think there needs

04:32to be some very specific good new looks at this relationship in order to be ready so

04:40again we're not scrambling. Dr. Robb, you're nodding. I take it you agree.

04:44Yes, I would absolutely concur. And again, I keep going back to the same theme is we've

04:48got to build up those six to eight to ten strategic military treatment facilities. We

04:53have to resource them. And then you create the already established military VA partnerships,

05:01and then you just keep expanding that ring. But you have to have those relationships codified

05:08and in place, and that's what Dr. Friedrichs is talking about. You can't just all of a

05:12sudden, when it kicks off, pick up the phone and say, how's it going?

05:15You've got to have them in place before the crisis hits.

05:18Absolutely.

05:19Thank you, gentlemen. Appreciate it. Thank you, Mr. Chairman.

King Suggests The Senate Make An Inquiry About Workforce Downsizing In The Military Health System

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