Military health discussion at National Defense Forum

As a combat surgeon during the Iraq War and a member of Congress, Brad Wenstrup has a unique perspective of handling healthcare for servicemembers and their families, and preparing medical professionals for military deployments.

“We take on the responsibility to provide the deserved benefit to not only take care of our troops downrange, but to take care of them at home,” said Wenstrup, an officer in the Army reserve and a member of American Legion Post 318 Anderson Township, Ohio. “Making sure they are ready to go downrange when the call comes up but also to take care of their families, and take care of the retirees.”

Wenstrup, R-Ohio, serves on the House Permanent Select Committee on Intelligence, the Armed Services Committee, and the Committee on Veterans’ Affairs as the chairman of the Subcommittee on Health. During his time in Congress, Wenstrup is fulfilling his reserve duties by treating patients at Walter Reed National Military Medical Center in Bethesda, Md.

He was among the security experts who addressed various panels Dec. 1-2 at the Reagan National Defense Forum: Reinvesting Peace Through Strength, which was held in the Presidential Library at the Ronald Reagan Presidential Foundation and Institute, in Simi Valley, Calif.

The mission of the Reagan National Defense Forum (RDNF) is to address the health of U.S. national defense and stimulate discussions that promote policies to strengthen the U.S. military. RDNF brings together leaders from across the political spectrum and key stakeholders in the defense community including members of Congress, civilian officials, military leaders and defense industry executives.

Wenstrup was joined by fellow panelists Vice Adm. Raquel Bono, director of Defense Health Agency; Dov Zakheim, former Under Secretary of Defense (Comptroller/CFO); and Orie Mullen, president of Humana Military Healthcare Services.

During the session — “Military Health: Are we providing a benefit worthy of the sacrifice?” — panelists discussed the importance of quality health care and how it factors into military readiness. The discussion was intended to evaluate efforts to reform TRICARE and the military health system. The panel also examined proactive approaches to sharing resources and information between the Departments of Defense and Veterans Affairs.

“Through the Defense Health Agency, we’ve been able to take a very strategic approach in how we deliver that health care,” said Bono, who is also a diplomat of the American Board of Surgery. Her personal decorations include three Defense Superior Service medals, four Legion of Merit, two Meritorious Service Medals, and two Navy and Marine Corps Commendation Medals.

“Part of what we do in defense health system is we deal with military health, and making sure we take care of our active duty and retirees,” said Bono. “We make sure they are always at the peak of their performance, and the defense health agency allows us to do that in a way that’s very contemporary, its leading edge, and it allows us to participate with industry and others to create that type of product.”

Zakheim is a senior Adviser at the Center for Strategic and International Studies and Senior Fellow at the CNA Corporation. “The fact of the matter is our surgeons at military facilities are simply not getting enough experience,” Zakheim said.

Another issue Zakheim addressed is the importance of getting surgeons on site immediately. “There’s this thing called the magic hour,” he explained. “If you can get to somebody who can be saved in the first 59 minutes you have a 50 percent chance of saving that person. But if you get to them in the first 23 minutes, you have a 95 percent chance of saving them. That has to happen.”

Zakheim has a lot of reservations about the way medical personnel are trained.

“We still do not train in teams, we need to,” Zakheim said. “We need our corpsman, and we need our enlisted to be absolutely up to speed with the surgeons because they operate as teams. There are only two places in this country where the surgeons are trained in a hospital. That’s just not good enough.”

Zakheim also expressed concern about the types of surgeries being performed by military doctors. “If you were involved in some, God forbid, major tragedy in this country would you want to go to somebody who helps women give birth to babies?” Zakheim asked. “You would want to go to the admiral who could take care of you. Because she’s had a lot of practice and she’s practicing the right things. So this is a very serious matter.”

Bono agrees that there is a place for working together. “With the Defense Health Agency, we have an opportunity here now to work more closely with industry to find out what some of those best practices are, that we can bring into our military health system to make them more modern, more contemporary and more relevant,” she said.

Mullen has been president of Humana Military Healthcare Services, Inc. since February 2012, and has also served as its chief executive officer. He wants to help find ways to maximize the assets and capabilities of each organization. “It’s just a great opportunity for us to talk about sharing inter-operability, and really think about how is this stuff funded and how could it be done differently,” he said.

As with any discussion involving the government, the military and the industry, the big question is money. What is the budgetary process for military health care? “My answer is very simple,” said Zakheim. “What is the budgetary cost of saving somebody’s life? Of increasing the percentage from 50 to 95? Over and over and over again?”

Bono said it’s imperative that the military receives funding to update and modernize the health system, especially given how rapidly the technology is changing and the importance of providing servicemembers the highest level of health care.

“If I look at what Secretary of Defense (Jim) Mattis is asking us to do in terms of reforming and rebuilding, then what the Defense Health Agency allows us to do is create those efficiencies and find those savings that we can not only capitalize and reinvest in our own military modernization,” Bono said.