The military health care community has transformed battlefield medicine by working together, and the services must now bring that same spirit of 'jointness' to the management levels, David S. C. Chu, undersecretary of defense for personnel and readiness, said at the 2007 Military Health System Conference.

"You have already demonstrated extraordinary results in the care of our wounded by acting together," Chu said to the conference attendees. "We need to bring that same spirit of joint leadership to the management of our resources."

In December, Deputy Defense Secretary Gordon England approved a new governance framework for the military health care system, Chu said. The new framework will establish joint leadership in areas with significant populations of more than one service, such as the Military District of Washington, he said. It will also integrate training, education, research and development efforts, using the best aspects of each service to deliver the best care possible, he noted.

A spirit of unity is also important in resource management among military treatment facilities, Chu said. Facilities that are struggling financially should look to the facilities that have increased their earnings as an example, he said. "Resources, of course, are always limited," he said. "We must make the best use of the resources we receive; we know that we can do better."

Another challenge the military health care system faces is in sustaining the benefit for military members and retirees, Chu said. Health care currently accounts for 8 percent of the DoD budget, up from 4.5 percent in the mid-1990s, and department officials have projected that healthcare will consume 12 percent of the budget by the middle of the next decade. Chu explained that this increase is partly because retired servicemembers who work in the private sector choose Tricare over their employers' medical plans.

"They find Tricare financially attractive, and you have made it substantively attractive as well," Chu said. "They find it financially attractive because we have not changed premium levels since the program's initiation a decade ago. For this reason, the department began advocating that we rebalance Tricare so that these beneficiaries' cost responsibility moves back toward what was originally established."

In 2006, Congress directed DoD to develop a task force to evaluate the medical budget issue, Chu said. This task force will report its findings this spring, and DoD will then know better how to proceed, he said.

"Sustaining a first-class benefit may require us to ask the retired beneficiary population that is working in a second career to pay a larger -- and a fairer -- share," he said. "I am confident that a solution can be found that will sustain the benefit in a manner that continues to advantage financially our retired community."

Chu thanked the members of the military health care community for their service and commitment. As the governance system is transformed, he called on the military medical professionals to continue their work, which he called extraordinary and awe-inspiring.

"I ask you to continue your success of working with your sister services in the ongoing responsibilities of making this the finest military health system in the world," he said. "On your competent shoulders rest the health and well-being of the men and women defending America, her friends and her interests around the world."

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