Ted Budd Presses Expert About Utilizing ‘Medical Innovation’ In The Military Health System

2 days ago

During a Senate Armed Services Committee hearing held before the congressional recess, Sen. Ted Budd (R-NC) questioned experts about military health innovations.

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Transcript

00:00Thank you very much, Senator King. Senator Budd, catch your breath.

00:23Major General, in your opening statement, whether here or able to watch it on the

00:28closed circuit, you identify the importance of the relationship between the military health

00:35system and the defense logistics enterprise. So should deterrence fail and the war break

00:42out in the Indo-Pacific, there are undeniable logistics constraints, particularly given

00:48the geography of Indo-Pacom. The logistics of replenishing medical supplies and evacuating

00:54wounded service members could make all the difference in reducing service member casualties.

00:59You provide a number of recommendations in your opening statement to address these concerns,

01:03including a number of reports and studies. So thank you for that. So what can our military

01:07health system do in the short term, like immediately, to address logistical constraints? And how

01:14can DOD leverage medical innovation to address some of those constraints?

01:19Thank you very much, Senator. I think that the most immediate recommendation that I included

01:23in my written statement was that whenever we contemplate an operation or we're updating

01:30plans, we do a medical feasibility assessment, very similar to the logistics feasibility

01:38assessment that the Joint Staff J4 does. We need to ensure that we are informing our combatant

01:44commanders about what is and is not possible. That is something that can be done very easily.

01:50The longer answer to your question gets back to the discussion that we were just having

01:55about partnering with industry, both on the equipment and pharmaceutical side and on the

02:00health care delivery side. We have the civilian reserve air fleet that allows us to commit

02:05money to ensure that we have industry partners willing to provide aircraft and support when

02:11we need it. We have no such analog in the health care space, even though we know, as

02:15multiple senators pointed out this morning, that there's insufficient capacity in the

02:20DOD and in the VA to care for our casualties. The NDMS currently is a voluntary system in

02:26which hospitals can say, yeah, OK. And then when we call them, they say, I'm busy today.

02:30I'm not going to participate. We actually need to codify a system, as we've done with

02:35other industrial partners, in which there's a commitment and an understanding of how the

02:40reimbursement would work.

02:42The last point that I would make on that, going forward, is in supplemental planning

02:46for future operations, we have to build in that cost. There is no question, if we're

02:51bringing back thousands of casualties, as Colonel Cannon described, that that is going

02:56to displace care and it's going to increase cost at hospitals. We have to plan for that.

03:01That's why this whole planning effort, the integrated CONUS medical operations plan,

03:05for which NORTHCOM is the lead, in partnership with industry, state, local, and HHS officials

03:11is so important, so we can bring back the requirements for funding and the challenges

03:16that we'll need congressional help to address.

03:19Thank you. Following up on that, you said we need to codify that. Do you have the language

03:24ready or has that been written in a way that we could review, either individually or as

03:28a committee?

03:30Senator, I took the liberty of including an attachment with suggested language, just in

03:34case anyone wanted to do that.

03:37We'll read it in a few moments. Thank you. Mr. Robb, as you know, the Department relies

03:43on a mix of military personnel, federal civilians, and contractors to carry out its mission.

03:49Talk to me about the roles of physician extenders, such as registered nurses, and what role do

03:54physician extenders play in ensuring the readiness of the broader force, and what challenges

03:58do you see to retention of physician extenders?

04:05Thank you for that question, Senator. I think it's key that the same issues of what I call

04:13proficiency in currency that exists for physicians exists for our physician extenders. The Army

04:22does a great job, especially in the way they've manned and equipped their fighting forces

04:27of using those physician extenders, all the way down to the corpsman, to the fullest extent

04:33of their capabilities. And so, I would argue, as we have these discussions about medical

04:40readiness and about our ability to care for what we call critical wartime specialties,

04:46we must remember trauma is a small percentage of that, but the majority of the care that

04:53is applied to our fighting forces comes from our primary care providers, which would be

05:00PAs, nurse practitioners, general practitioners, family physicians. So, we must ensure that

05:07they also have the critical thinking skills and the opportunity to practice at the top

05:12of their gate.

05:14Thank you all for the whole panel. Chairman?

05:18Senator Budd, yes, indeed, in looking at the statements which have all been admitted to

05:29the record by unanimous consent, I see on page 14 of Dr. Friedrich's prepared testimony

05:37attachment 1, suggested National Defense Authorization Act language. So, we do appreciate him acting

05:45as an uncompensated legislative staffer for this committee. We appreciate that. And thanks

05:52for the question.

Ted Budd Presses Expert About Utilizing ‘Medical Innovation’ In The Military Health System

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