Tuesday, August 18, 2020

No Lives Matter: SecDEF Esper Wants To Cut $2.2 Billion From Military Healthcare Budget


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.