Medical Infrastructure Affects Readiness, Pentagon's Top Doctor Says

By Army Staff Sgt. Michael J. Carden
American Forces Press Service

March 19, 2009 - The more than 1,000 major facilities that make up the Defense Department's medical infrastructure are key strategic national assets, the department's top medical official told Congress here yesterday. Dr. S. Ward Casscells, assistant defense secretary for health affairs, told the House Armed Services Committee's subcommittees on military personnel and readiness that he not only is an advocate for military medicine and practitioners, but also is committed to dramatically improving the medical infrastructure – a responsibility he said he takes very seriously.

"Our buildings support vital, diverse and worldwide missions of the military health system," Casscells said. "We need outstanding facilities to deliver patient care, train medical professionals, conduct cutting-edge research and provide the support functions necessary to succeed on the battlefield and protect our nation."

The department's current medical infrastructure includes 59 hospitals, 663 medical and dental clinics, 258 veterinary clinics, 26 medical research and development offices, 19 training facilities and 10 medical installations.

The facilities are well-maintained, but improving such a large, diverse and complex set of buildings pose substantial challenges, Casscells said. About 41 percent of inpatient facilities are more than 40 years old, and 72 percent were built more than 20 years ago.

"Most of our hospitals were constructed prior to the introduction of modern and ever-changing clinical processes and technology that today are considered the standard of care," he added.

Military health care is one of the few functions that can be fairly, and directly, compared to the civilian sector, said Casscells, who called for a need to compete with the private sector to preserve the loyalty of the military community.

"The perceived quality of our facilities can often influence the perception of the quality of care we deliver," Casscells said, noting that instances of unfavorable perception by patients have prompted their willingness to seek care outside of the military health system. "In order for the military health system to succeed, we need a diverse and robust mix of patients coming through our doors to train and maintain the readiness of our medical staff and our deployable medical capability."

Military medical facilities also are among the few functions subject to outside civilian review. To maintain their accreditation, military facilities pass civilian inspections to civilian standards to continue operations, he said.

But because medical buildings normally cost more to build and operate than other Defense Department facilities, restoration and new construction projects within the military must be budgeted responsibly, he said.

"Just as we have a responsibility to care for our people, we also must serve as stewards of the resources provided by the American taxpayer," he said. "We must provide and operate truly excellent facilities but do so in a fiscally responsible manner."

Casscells said the military health system provides life-saving services to both "the toughest warfighter and the most vulnerable newborn," work that affects the readiness of the armed forces. Military health services affect the willingness of servicemembers and their families to continue serving, he added.

"Our facilities represent the tangible commitment we make to our active duty servicemembers and their families," he said. "Investing in our buildings tells people that we care about them. Where our facilities fall short, we send a signal that taking care of our people is not a high priority."