During Thursday's Senate Armed Services Committee hearing, Sen. Tammy Duckworth (D-IL) demanded that the ability of service members to access foreign medical facilities be improved.
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00:00Chairman, although I do endorse my colleague from Virginia's editorial statement, Admiral Paparo, General Brunson, thank you for being here today and for sharing your assessment for posture, capabilities, and readiness in the Indo-Pacific.
00:13One of my major priorities, everyone knows I am Transcom's biggest advocate, so I can't go through a posture hearing like this without asking questions about the logistical environment that we will face if our nation's darkest days comes, and we must fight a war in the Pacific.
00:29Preparing for the logistical realities of large-scale conflict is not only critical for the fight tonight scenario, but it is also key to deterrence.
00:39We must demonstrate to our adversaries that we have the capability to sustain a fight, if necessary, even as they seek to contest that, to make it clear that such a war would be costly for all of us.
00:52And I applaud both your efforts to improve the logistical readiness of the force, and with our allies and partners, but I do think there's more to do.
00:59And I'll just start off with medical readiness.
01:02We must improve our ability to provide life-saving care to wounded service members, including the regional hospital access and effective aeromedical evacuation.
01:10We have partners in the ROK, in Thailand, in the Philippines, that have medical facilities that meet U.S. hospital certification standards.
01:18Those are opportunities for us to develop those relationships.
01:22The Indo-Pacific's vast distances, logistical challenges, and maritime environment present a much less permissive environment for the medical mission than the global war on terror did.
01:31And as I've said before, long gone is the golden hour, and we must do comprehensive planning to ensure that our warfighters have foreign medical facility access in the Indo-Pacific.
01:41This is why I secured a provision in the fiscal year 25 NDAA to establish an Indo-Pacific medical readiness program.
01:48Admiral Paparo, General Brunson, as you implement this program, what are the primary barriers that hinder the necessary medical cooperation,
01:55and how can this committee help as you begin that effort?
01:58Good morning, Senator Duckworth.
02:00I strongly endorse your viewpoint, and also, too, I strongly endorse what's essentially a concept of operation within what you're saying,
02:10which is put the medical expertise of our allies and partners to ensure that that can augment what our own medical providers can execute.
02:19And so, one is a medevac capability in order to get to the location, the agreements to do so, the ability to practice and exercise so it's not the first time that we do it if the unforgiving hour comes.
02:34And so, I think some of the barriers are physical, and that is lift, medical lift, medevac lift, and then some of the barriers are, I should say, authorities.
02:47And we'd hope for more authorities to be able to broaden our ability to plan for bringing to bear the medical capabilities of our allies to care for the wounded in conflict.
03:01So, thank you.
03:03General Brunson?
03:05Ma'am, one of the things that you know, and I know you're full well aware of this, is our healthcare comes from the community.
03:14We have the ONI agreement in ROK.
03:16Yes, ma'am.
03:17Yes, ma'am.
03:18So, we get tremendous amounts of care there.
03:20What we're trying to do at All Good Hospital at the present time is have greater access to PROFIS doctors routinely.
03:28I need them to be on the peninsula in times other than crisis or conflict.
03:34In competition, we want to bring them to the peninsula so that they better understand the medical landscape and what might be required of them.
03:41We're also looking to UN command.
03:43There are several nations that provided hospitals during the Korean conflict.
03:48We want the Italians to come back with their hospitals again.
03:51We want the Dutch to come back with their hospitals again as well.
03:54And those things we think we then provide to the greater INDOPACOM family that we might be another resource used in time of conflict.
04:03I want to pivot to the critical platforms we need to project and sustain forces in a contested logistical environment, especially our sea lift fleet.
04:12Admiral Papaya, do you agree that INDOPACOM would benefit from the ability to surge replacements of naval auxiliary vessels or to conduct battle damage maintenance of these vessels within the region closer to the point of need?
04:25Strongly, I urge for that, Senator.
04:28Because I am concerned that in a war, naval auxiliary vessels would be easy targets.
04:32And we might have to fight our way in and fight our way out.
04:34And what can we do to help you with that effort?
04:37Well, as we enhance our protection capability, we enhance our ability to see, understand the operational environment,
04:44to build windows of opportunity to execute, sustainment capability, you know, nine classes of supply, medical and so forth,
04:53in those areas.
04:55And so, first it's just the quantities.
04:57The quantities of TAKEs, AOs, the quantity of gray tails, C-17s, tankers.
05:05That's critical.
05:06And then the ability to exercise it.
05:09What about co-sustainment with our allies like Japan or the ROK of those vessels?
05:14Because they certainly have the capabilities, especially the auxiliary vessels.
05:18And when we gain this, we frequently rely on one another to do this.
05:23And then while operating at sea, sometimes actually the necessity of having one leads us to use a Japanese oiler or for an American oiler to refuel a coalition ship.
05:34And so we have to be able to sum all of the sustainment capability among us, have the authorities to do so, so we can turn to it with alacrity.
05:44But I would be more comfortable with our own ability to contribute to that effort with U.S. capability.
05:53Thank you, Mr. Chairman.
05:54The momentary substitute.
05:55The momentary substitute.