All Branch Topic (ABT) Concerns Well Summarized

[militaryPHYS]

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Well articulated summary of what seems to be most of our concerns.

Medical cuts could cause irreversible damage

The proposed elimination of 18,000 medical billets, or about 20% of the force, could have profound and long-lasting consequences on the military health system, a former Navy surgeon general writes.

www.militarytimes.com

 

[CSCH]

3 branches want to cut 17,000 jobs
I stumbled across a similar article ^^^

Didn't really understand what I read, and haven't found any discussion on this forum that explains it in terms a non-military person can understand. I've seen some pros (agreements between military and civilian facilities so that milmed docs won't need to moonlight in order to get their acuity/numbers up--not sure how this will work) and some cons (fewer specialty options, fewer residency choices).

The line that I didn't get was this: "medical personnel from the Army, Navy and Air Force would be 'repurposed as war fighters or combat-support skills to increase lethality and size of operational units'."
What do they mean by "repurposed as war fighters"?

What is the DHA, what does it do now, and what is the significance of it taking over the delivery of military medicine? (From what I gathered from google, it's the part of milmed that currently provides/organizes healthcare in zones of conflict. Am I anywhere near accurate?)

 

[Perrotfish]

The line that I didn't get was this: "medical personnel from the Army, Navy and Air Force would be 'repurposed as war fighters or combat-support skills to increase lethality and size of operational units'."
What do they mean by "repurposed as war fighters"?

They mean that when they get rid of 17,000 medical personnel they are going to hire 17,000 warfighters. So the military is staying the same size, but fewer doctors/nurses and more infantry/artillary.

 

[sonofva]

They mean that when they get rid of 17,000 medical personnel they are going to hire 17,000 warfighters. So the military is staying the same size, but fewer doctors/nurses and more infantry/artillary.

and/or less pediatric left eye retinal sub-specialists .... more GMOs

 

[Perrotfish]

and/or less pediatric left eye retinal sub-specialists .... more GMOs

Two different things

The personnel cuts are just cuts. 17,000 less medical staff, 17,000 more warfighters. None of those 17,000 turn into GMOs, they just stop being medical people entirely.

There is also restructuring within the medical corps: fewer subspecialists and more deployable docs. So of the docs who are left after they shrink the MC by 17,000 people a much larger percentage will be generalists in operational billets and a much smaller percentage will be subspecialists.

We will see to what extent those things actually happen, of course. Very few plans this large are implemented without changes along the way.

 

[HighPriest]

We will see to what extent those things actually happen, of course. Very few plans this large are implemented without changes along the way.

That’s the thing, init? All it takes is one new conflict, one new leader high enough up the chain, or just a spotlight of negative attention to completely or partially change this. That’s partially why it’s so difficult to make a good recommendation regarding HPSP in many cases. Until this shakes out, who knows.

 

[pgg]

Until this shakes out, who knows.

I'm not sure it'll ever shake out and be clear ... except in retrospect. I think this uncertainty is just the new normal.

 

[HighPriest]

I'm not sure it'll ever shake out and be clear ... except in retrospect. I think this uncertainty is just the new normal.

Nah, we’ll start a new war at some point, and someone will decide that the waterfall of cash will be infinite “this time.”

 

[Perrotfish]

Nah, we’ll start a new war at some point, and someone will decide that the waterfall of cash will be infinite “this time.”

What's weird is that the waterfall is pretty near infinite now. These aren't Clinton era cuts where they were trying to deal with a shrinking budget. There is now particularly good reason why these changes are happening at this particular time, they're just happening.

 

[usma05]

What's weird is that the waterfall is pretty near infinite now. These aren't Clinton era cuts where they were trying to deal with a shrinking budget. There is now particularly good reason why these changes are happening at this particular time, they're just happening.

Seems like the best way to increase your combat arms numbers/budget in preparation for a near-peer war without getting congressional approval and without bringing much attention to most of the US public or near-peer adversaries is their aim. Particularly when you stand up a new government entity to that will eventual have it's own budget and manage stateside care when that war breaks out. Your not trying to save money for the US with DHA, just the DoD. This is how the DoD leaves the US government with the check and takes those slots and their slice of the DoD budget to finance their wishlist.

 

[orbitsurgMD]

and/or less pediatric left eye retinal sub-specialists .... more GMOs

They played that card quite a while ago.

 

[HighPriest]

What's weird is that the waterfall is pretty near infinite now. These aren't Clinton era cuts where they were trying to deal with a shrinking budget. There is now particularly good reason why these changes are happening at this particular time, they're just happening.

I would argue that there are good reasons why it’s happening. Very good reasons, whether they execute the changes in a way that actually improves things aside. And, unless things have changed I’m the last few years (which they may have), there was certainly not an impression that our command was bathing in cash a-la Scrooge McDuck. Just the opposite. But, I don’t know the budget of MEDCOM in detail. What I do know is that a large portion of the impetus here is cost savings, and so the waterfall I’m referring to is a change in strategy rather than a dollar amount. At some point, something will change and someone will decide again that the military ought to do more medicine, cost be damned. That’s how they got there in the first place.
It may never go back to where it is now, or was 20 years ago. With DHA, for example, it will probably never revert back to completely separate branch controlled hospitals. Which, to me, is a good thing. But the doom and gloom and cuts will stop at some point for some reason. That kind of thing always happens in cycles. I suppose primarily I just disagree with the idea that things will always be uncertain from here on out, as suggested above.
Of course, if or when we switch to a universal system in the US, that will change things dramatically as well.