politico | Esper
rolled out the results of the first iteration of the defense-wide review
in February, revealing $5.7 billion in cost savings that he said would
be put toward preparing the Pentagon to better compete with Russia and
China, including research into hypersonic weapons, artificial
intelligence, missile defense and more.
But
the proposed health cuts, in the second iteration of the defense-wide
review, would degrade military hospitals to the point that they will no
longer be able to sustain the current training pipeline for the
military’s medical force, potentially necessitating something akin to a
draft of civilian medical workers into the military, the two defense
officials said.
The
second official noted the challenge in finding outside doctors given
longstanding complaints from some U.S. hospitals and researchers that
there aren’t enough physicians to serve civilians.
“How’s a 'draft' even going to work?” the official said “The U.S. is dealing with a doctor shortage.”
As
a result, the proposed reductions would hurt combat medical capability
without actually saving money, the officials argued. The Pentagon is
already significantly overspending on private sector care and TRICARE
because patients are being pushed out of undermanned military health
facilities to the private health care network, they said. The cuts also
would follow nearly a decade of the Pentagon holding military health
spending flat, even as spending on care for veterans and civilians has
ballooned.
The
officials blamed the Pentagon’s Cost Assessment and Program Evaluation
office, or CAPE, under the leadership of John Whitley, who has been
acting director since August 2019, for the cuts. CAPE conducts analysis
and provides advice to the secretary of defense on potential cuts to the
defense budget.
During Whitley's confirmation hearing to be the permanent CAPE director last week, Sen. Doug Jones (D-Ala.) pressed him on the health cuts.
“Folks
in my state have expressed some concern and opposition to some of the
policies, which allow only active-duty service members to visit military
treatment facilities,” Jones said. “What do I tell those folks?”
“The
department does have work to do on expanding choice and access to
beneficiaries,” Whitley responded. “Sometimes that’s in an MTF,
sometimes that’s in the civilian health care setting.”
Whitley has specifically tried to eliminate the Murtha Cancer Center as an unnecessary expense, said one senior official.
Last
fall, Whitley and CAPE also sought to close the Uniformed Services
University of the Health Sciences, which prepares graduates for the
medical corps, as part of the defense-wide review, the people said.
Although at the time Esper denied the proposal, CAPE is now seeking
major cuts to USU as part of the $2.2 billion. The reductions include
eliminating all basic research dollars for combat casualty care,
infectious disease and military medicine for USU, as well as slicing
operational funds.
