Bye MHS, Hello Unified Med Command?

The fiscal 2011 Defense Authorization Bill approved by the House Armed Services Committee yesterday calls for replacement of today's Military Health System with a new Unified Medical Command modeled on the Special Operations Command.

MHS has responsibility for everything from battlefield medical care to operation of the TRICARE health insurance system with an organizational structure unlike any other organization in the Defense Department, the committee said in a summary of the bill.

This includes a disconnect between requirements -- everything from field dressings to MRI machines -- determined by the services, and resource allocation (funding) currently controlled by the assistant secretary of Defense for Health Affairs.

This structure has "demonstrated shortcomings" that the committee did not elaborate on and should be replaced by a "proven command structure" modeled on the Special Operations Command.

Until 1987, Special Forces -- Navy SEALS and Army Green Berets -- operated under their respective services, with budgets determined by those services. In 1987, Congress mandated establishment of the Special Operations Command, with its own budget and control of assets and personnel drawn from all the services and headed by a four-star general or admiral.

If the committee intends to model the new Unified Medical Command after the Special Operations Command, this implies it will be headed by a four-star doc, the first in history, because the Army, Navy and Air Force surgeons general currently only sport three stars.

Establishment of the Unified Medical Command has to go through numerous legislative hoops before it becomes reality -- and the Defense bill as it stands faces a possible veto, because it includes funding for a second engine contractor for the F-35 fighter, a provision Defense Secretary Robert Gates adamantly opposes.