September 1, 2020, 3:36 pm News Staff -- The Academy recently called on Congress to maintain the military medical workforce -- which includes thousands of AAFP members -- and delay changes that would be especially disruptive as the COVID-19 pandemic continues.
The National Defense Authorization Act for fiscal year 2021, wrote the AAFP and 14 other medical organizations, should include key provisions of draft House and Senate bills "that would consider the needs of members and families of the armed forces by addressing issues related to preserving the military medical workforce and transformation of the Military Health System."
"Specifically, we strongly urge you to include language in the final conference report from House Sections 704 and 705 and Senate Sections 721 and 745," said the Aug. 14 letter to the chairs and ranking members of the Senate and House Armed Services committees and their personnel subcommittees.
Those provisions would ensure that reductions in or realignment of military medical end strength would not occur for at least one year after enactment of the NDAA and, after that occurs, not until required analyses and reviews are completed.
AAFP membership includes approximately 2,600 physicians in the uniformed services.
Among the letter's other 14 co-signatories were the American College of Physicians, the American Academy of Pediatrics and the AMA.
The advocacy echoes a call made last year by the Academy and other organizations to safeguard some 15,000 medical billets jeopardized by the 2020 Department of Defense budget. The 2020 NDAA ultimately set limits on those cuts, pending further review.
Ongoing protections remain imperative while "America is still grappling with the COVID-19 pandemic," the Aug. 14 letter told lawmakers.
"Members of the armed forces and their families are already experiencing disruptions to health care services, child care, education, permanent change of station orders, finances and employment, among others. Even once spread of COVID-19 is contained in communities, there will likely be long-term effects that remain, including physical and mental health outcomes."
The organizations wrote that going through with reductions that have been proposed, "while health care services are already being disrupted for beneficiaries, and uniformed and civilian providers are already overburdened, would simply exacerbate the devastating impacts on service members and their families."
The letter also expressed concern about proposed budget reductions to the Uniformed Services University of the Health Sciences.
"Were these cuts to move forward, it would have severe consequences for our military service member and family care," the AAFP and its co-signatories cautioned.
The groups cited a report issued in May by the Government Accountability Office that concluded the DOD's methodology to determine the planned restructuring of medical treatment facilities has relied on incomplete and inaccurate information.
"Specifically, the report demonstrated that the DOD's civilian health care assessments did not consistently account for provider quality or account for access to an accurate and adequate number of providers near MTFs," the letter said.
The GAO report also found that the department had conducted only limited assessments of these facilities' support to the readiness of military primary care and nonphysician medical care providers. "Until DOD resolves methodology gaps by using more complete and accurate information about civilian health care quality, access and cost-effectiveness, DOD leaders may not fully understand risks to their objectives in restructuring future MTFs," the report noted.
"With this report in mind," the letter said, "we fully support House Section 705 delaying implementation of MTF realignment for at least a year."
The other provisions named in the letter would delay the congressionally mandated transfer to the Defense Health Agency of the Army Medical Research and Development Command (and potentially other military medical research organizations), as well as military public health commands or programs, until Sept. 30, 2024. These provisions also would require a study on force-mix options and service models to optimize readiness of the medical force to deliver combat casualty care.
"As with other aspects of DHA's transformation of the MHS, it is important to delay moving the research enterprise and public health commands, particularly since many of these organizations are heavily invested in research and development of a COVID-19 vaccine and therapeutics," the Academy and its co-signatories wrote.
In January, U.S. Army Secretary Ryan McCarthy also called for the DHA takeover to be slowed.