Congress must stop the closure of the Uniformed Services University

The Department of Defense (DOD) appears to be continuing its pursuit to decimate military medicine. For the past several years, it has attempted to eliminate 18,000 medical positions across all the services. Congress fortunately has intervened each year to halt those reductions. 

Now DOD is targeting the Uniformed Services University of the Health Sciences (USU) in Bethesda, Md. This federal health professions academy serves as the medical school for the armed services. It supports the readiness of the warfighter and the health of the military community by educating health professionals and scientists. USU also conducts cutting-edge military relevant research.

If allowed to proceed, DOD’s plan to reduce or eliminate funding for the school and many of its programs will seriously jeopardize the ability of the military health system to fulfill its mission — that is, to support the warfighter and provide health care to the defense family as promised. Congress must step in and put the brakes on this plan.

Last fall, DOD’s Cost Assessment and Program Evaluation (CAPE) office led a department-wide review to impose further reductions to the military health system on top of the more than $114 billion in cuts levied since 2010. In that review, CAPE targeted USU for “right-sizing” or elimination. Fortunately, Secretary of Defense Mark Esper rejected the option to close USU.

Nonetheless, despite the decision by Esper and a report by the Institute for Defense Analysis (IDA) that detailed the strategic value of USU, CAPE continues to pursue closure by seeking major cuts to USU:

• $90 million from operations and maintenance from fiscal years (FY) 2021-2025;
• $73.3 million from research for FY 2021-2025, eliminating all basic research, including research for combat casualty care, infectious disease and military medicine; 
• Elimination of several programs, including the DOD Medical Ethics Center, the National Center for Disaster Medicine and Public Health, the Tri-Service Nursing Research Program and the Center for Deployment Psychology; and
• 70 percent reduction to the Center for the Study of Traumatic Stress.

These drastic cuts were included in DOD’s FY2021 budget submission. They were then approved by the House Armed Services Committee in its markup of the FY 2021 National Defense Authorization Act (NDAA). Meanwhile, the Senate Armed Services Committee’s language supports restoring the cuts. A conference committee must now resolve the differences between the two committees.

The Military Coalition — a consortium of 35 organizations representing 5.5 million service members, veterans, their families and survivors — has written a letter to the chairmen and ranking members of the House and Senate Armed Services Committees, urging them to restore funding for USU. 

The letter pointed out that USU is the largest accession source to military medicine. In 2018, USU graduated 3,157 students — more than the next 20 Health Profession Scholarship Program (HPSP) schools combined. The letter also noted that DOD has been unable to fill all available scholarship program slots in recent years, emphasizing the importance of USU to the medical provider pipeline. 

The coalition clearly stated that USU graduates are critical to DOD’s ability to provide medical support for its servicemembers during wartime. They are not only essential for readiness, but they also serve as a valuable source of competent beneficiary care for retirees, family members and survivors.

The Military Coalition also highlighted the fact that USU graduates are career-oriented and committed to military medicine. Graduates serve on active duty significantly longer than HPSP graduates —15 years compared with nine years. USU graduates also deploy more than 250 percent longer than other accession sources —731 days versus 266.

Another letter of concern about the status of USU was written by Dr. Thomas J. Nasca, president and CEO for the Accreditation Council for Graduate Medical Education. Nasca is a professor of medicine and molecular physiology at Thomas Jefferson University and a senior scholar at the University of Illinois at Chicago College of Medicine.

In a letter to the dean at USU and a senior medical official at the Defense Health Agency, Nasca said he is aware of the discussions regarding the future of the military physician training system and has “grave concerns.”

Nasca states that military physicians must be trained in the systems of care that are operative in military medicine, which is significantly unlike civilian medicine in many ways. Military medicine is practiced in circumstances not seen in civilian medicine or encountered in American medical practice, he notes. 

Using the example of medical support provided to our warfighters in Afghanistan, Nasca says a civilian trained physician — no matter how well-trained — would not function effectively if placed in that environment. “The outstanding care that our military physicians, nurses and technicians provide to our wounded military personnel would suffer without this preparation,” Nasca writes.

Perhaps most concerning to Nasca is what the dismantling of USU equates to — closing a school with an outstanding academic infrastructure designed explicitly to serve those who put their lives on the line and their families who support them. Says Nasca: “These heroes deserve our best efforts to provide state-of-the-art care in often the most challenging of circumstances.”

As Nasca clearly points out, military medicine has advanced research into the care of individuals suffering traumatic injury, critical care, rehabilitation medicine, prosthetics, psychiatric care of those traumatized, and closed-head neurologic injury, to name just a few.

The sacrifices of our active military demand these advances. Congress needs to stop this death to military medicine by a thousand cuts and fully restore funding for USU.

Tom Jurkowsky is a retired Navy rear admiral who sits on the board of the nonprofit Military Officers Association of America (MOAA), which advocates for a strong national defense and for military service members. His book, “The Secret Sauce for Organizational Success: Communications and Leadership on the Same Page,” was recently released.