And you want the military controlling your medical career?

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USAFdoc

exUSAFdoc
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this article is another example of why you might not want the military controlling your medical career and practice.

FORT SAM HOUSTON, Texas - A diversion of dollars to help fight the war in Iraq has helped create a $530 million shortfall for Army posts at home and abroad, leaving some unable to pay utility bills or even cut the grass.

In San Antonio, Fort Sam Houston hasn't been able to pay its $1.4 million monthly utility bill since March, prompting workers in many of the post's administrative buildings to get automated disconnection notices.

Fort Bragg in North Carolina can't afford to buy pens, paper or other office supplies until the new fiscal year starts in October.

And in Kentucky, Fort Knox had to close one of its eight dining halls for a month and lay off 133 contract workers.

"Every time something goes away it impacts a person ... a soldier or their family or one of our civilians," said Col. Wendy Martinson, garrison commander at Fort Sam Houston, which has 27,300 military and civilian workers. "I'm charged with taking care of them, not taking things away from them."

Garrisons function as the city halls of Army installations, providing services such as garbage removal, mail delivery and firefighting. The Army's Installation Management Agency is $530 million short of what it needs through Oct. 1 to fund garrisons at the 117 installations it oversees in the United States, Europe and Asia, agency spokesman Stephen Oertwig said.

The skyrocketing cost of fuel is partly to blame, and it also is costing more to pay civilians in Asia and Europe, Oertwig said. Another major factor is the practice of funding the war through spending bills outside the annual budget.

As Congress spent months debating the supplemental spending bill, the Army had to divert money from the Installation Management Agency's budget to cover the cost of the war, Oertwig said.

The Army often diverts operations money for other programs, in times of war and peace, said Jeremiah Gertler, a senior fellow at the Center for Strategic and International Studies. The supplemental spending bill usually replenishes those funds.

This year, though, most of the defense money in the $94.5 billion bill was earmarked for the war, leaving little to pay back operations accounts, Gertler said.

Military officials could have asked for more money to ease the garrison budget crunch, but they knew a bigger request would have created a bigger fight in Congress, he said.

"The Pentagon is reluctant to ask for any more than they need for the war because it all looks like it's going to the war and becomes a very controversial bill," Gertler said.

But military analyst Michael O'Hanlon of the Brookings Institution said money management seems to be the larger problem. The Defense Department spends about as much on maintenance and operations as it does on weapons and personnel combined, he said, so there should be more than enough for the bills.

"It makes me worry if the Pentagon can't do its accounting well enough to find money for its electric bills," he said. "It just boggles my mind a little bit."

The legislation Congress approved June 15 included $722 million for the Installation Management Agency, to be split among its installations.

Martinson still doesn't know how much Fort Sam Houston will get, but she expects it will be enough to pay the electric tab. A spokesman for CPS Energy says the company understands the problem and won't turn off the lights any time soon.

However, it won't save the jobs of about 100 contract workers Martinson had to let go.

And it won't make it easier for her to scrounge up the dollars to buy chlorine for the pool where soldiers' kids take swimming lessons or feed for the horses that carry soldiers' caskets to their graves at Fort Sam Houston National Cemetery.

The new funds also won't change the orders the Installation Management Agency issued in early June to freeze civilian hiring and fire temporary employees, reduce cell phone, pager and government vehicle use and reduce, cancel or defer contracts.

Staff Sgt. Mark Barclay, 35, a small group leader with the Army Medical Department Noncommissioned Officer Academy at Fort Sam Houston, said he hasn't really noticed the cuts but is ready to adapt to them.

"All that happens is you just make do with what you have and try to get the best training for the soldiers," Barclay said.

Oertwig expects the austerity to last for at least another year and a half.

"Every day we're looking at what are those services that are required to keep the Army going and where can we get efficiencies," Oertwig said. "We're looking to get a dollar's worth of service out of 90 cents or less in some cases."

That alarms U.S. Rep. Lamar Smith (news, bio, voting record), a Republican whose district includes Fort Sam Houston.

In a letter to Army Secretary Francis Harvey, Smith said he worries the budget crisis will affect Fort Sam Houston's ability to accommodate the 11,000 additional personnel being sent there starting next year by the Base Closure and Realignment Commission.

"That Fort Sam cannot even pay for basic post operations is, frankly, Mr. Secretary, a disgrace," he said.

http://news.yahoo.com/s/ap/20060706/ap_on_re_us/army_budget_crunch

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I remember being on the pharmaceutical and therapeutics committe at my hospital and being charged to cut 3 million dollars from a 30 million dollar budget to avoid a shortfall. We screwed a bunch of retirees out of their medications and made many use the mail order pharmacy... the mail order pharmacy is 2-3 times more expensive for we the taxpayers but it allowed our commander to be in the black on his little budget management... luckily, he was recently promoted to general.
 
former military said:
I remember being on the pharmaceutical and therapeutics committe at my hospital and being charged to cut 3 million dollars from a 30 million dollar budget to avoid a shortfall. We screwed a bunch of retirees out of their medications and made many use the mail order pharmacy... the mail order pharmacy is 2-3 times more expensive for we the taxpayers but it allowed our commander to be in the black on his little budget management... luckily, he was recently promoted to general.

and I waited 3 years for some medical equipment that was on back order, and still had not arrived by the time I separated.

I am sure many other military medical personnel have similar stories.

The big picture is that with the financial strain that ALL of medicine is feeling, those in the military will be squeezed the most because the military is inherently one of the most inefficient, slowest to respond correctly to change, biggest beurocratic messes there is. Things that could be easily fixed in a more typical business are forever cemented in red tape in the military. :(
 
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USAFdoc said:
and I waited 3 years for some medical equipment that was on back order, and still had not arrived by the time I separated.

I am sure many other military medical personnel have similar stories.

The big picture is that with the financial strain that ALL of medicine is feeling, those in the military will be squeezed the most because the military is inherently one of the most inefficient, slowest to respond correctly to change, biggest beurocratic messes there is. Things that could be easily fixed in a more typical business are forever cemented in red tape in the military. :(


Before we deployed last year on a ship, we had ordered a new exam table, the same kind most of us have in any office, your average ordinary $900 gyn exam table with drawers.

We ordered it at the lowest priority that we could because it really wasn't essential that we actually get it soon since the one it was to replace was only partially broken.

THe damn thing shows up on our deck during an unrep in the Arabian Gulf.

I talked to our suppo about how to avoid ordering stuff in such a manner that it gets shipped around the world. He essentially said, that if I had ordered at any lower priority, it would have never been bought, and there isn't any way to put the caveat in the supply system, that it can wait at home until we return.

So it turns into a Catch 22, unless your deployed, your not high enough priority to get anything. As long as your tied to the pier where the supply chain is easy, your not a priority, but as soon as you deploy, your the priority, so they will spend huge amounts of money shipping stuff to you that you should have recieved while sitting at the pier.

i want out
 
USAFdoc said:
and I waited 3 years for some medical equipment that was on back order, and still had not arrived by the time I separated.

I am sure many other military medical personnel have similar stories.

:(

Unfortunately weapons systems, fuel, propulsion system repair, and ammo take top priority. Almost everything else is secondary.
 
We wanted a laser to break up kidney stones.... we couldn't buy the 30, 000$ dollar laser that would do the trick because the under 100, 000$ dollar fund was used up... we could, however, buy a more expensive (110K)$ overkill laser because that came out of a different (kettle of money) which was available....
 
former military said:
We wanted a laser to break up kidney stones.... we couldn't buy the 30, 000$ dollar laser that would do the trick because the under 100, 000$ dollar fund was used up... we could, however, buy a more expensive (110K)$ overkill laser because that came out of a different (kettle of money) which was available....


That reminds me of a Radar that was almost completely replaced out of repair funds because the budget wouldn't support buying a new one.

So rather than buy a new one, they bought each individual component except for one cable. Kept a single old cable, and you have a new radar all from repair budget.

The CO kept asking Suppo if he was going to go to jail for this.

i want out
 
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