Healthcare oversight to be merged
By Tom Philpott
Air Force opposition has scuttled Army and Navy plans to merge the three services' large medical bureaucracies, led now by three surgeons general, into a single Unified Medical Command.
Deputy Defense Secretary Gordon England decided this month not to endorse such a major streamlining of the military healthcare system with Air Force leaders so strongly against it.
Instead, England approved a more modest "new governance plan" for the healthcare system that directs joint oversight over four "key functional areas." Dr. William Winkenwerder, assistant secretary of defense for health affairs, explained England's "conceptual framework" in a phone interview Tuesday.
Areas targeted for joint oversight are:
Whatever entity is created to oversee shared support services, it will report directly to his office, Winkenwerder said. But just as the Army will control medical research, a single service will be responsible for medical education and training, and for healthcare delivery in major markets.
Winkenwerder predicts it will require a minimum of two years to implement the changes.
TRICARE Management Activity will remain, but will focus on health insurance, support contractor management and benefit delivery. TMA will lose other joint support responsibilities, such as information technology. Those duties will shift to the new shared support services organization.
Economists with the CNA, a think tank that does a lot of Navy work, had projected savings of at least $500 million a year, and the Defense Business Board, a group of business leaders who advise the secretary and deputy secretary of defense. said that was conservative.
Lt. Gen. James G. Roudebush, Air Force surgeon general, had argued against a unified command on the grounds that service missions and cultures were just too different and those differences justify keeping separate medical staffs and resources.
