The Military Health System(s): Separate But Equal

Joint operations are the baseline of all future military activities. Yet the Services continue to operate their own health care systems that, at best, cooperate with each other in providing benefit and readiness missions to eligible patients during peace and war. Despite numerous recommendations for organizational change to improve resource efficiency and operational responsiveness, the Military Health System MHS structure has evolved little since World War II. The Services operate relatively separate but equal deployable medical systems to support deployed combat forces. As called for in Joint Vision 2020, current resource shortages and threats in the security environment demand revolutionary innovations. By leveraging existing transformation efforts and creating a unified U.S. Medical Command--headed by a four-star medical force commander with subordinate Service and TRICARE components--the MHS can achieve the resource efficiency and operational flexibility needed to change both how it provides force health protection to combat forces and brings all players together to carry out its benefit and readiness missions. The MHS is one of the largest and most complex health care organizations in the United States. Its mission is to enhance DoD and our nations security by providing health support for the full range of military operations and sustaining the health of all those entrusted to our care. In operating its network of 76 hospitals and more than 500 medical and dental clinics, the MHS is a 28 billion annual enterprise that cares for almost 9 million patients, including nearly 1.5 million uniformed personnel. There are two parts to the MHS health support mission the readiness and benefit components. The readiness component, or force health protection, includes fit and healthy force maintenance, casualty prevention, and casualty care management.