Eliminate the Defense Health Agency (DHA) and return control of the Military Health System (MHS) to the military services.
A constellation of underfunding, noncompetitive hiring practices, and mismanagement on the behalf of the Defense Health Agency (DHA) are threatening the capacity to care for the vulnerable patient population of the Military Health System (MHS).
Our commitments to Active Duty Servicemembers, retirees, and their families are evaporating as budget cuts ravage the MHS under the guise of standardization of care dictated by the DHA. Severe staffing shortages are forcing many Active Duty spouses, retirees, and retiree families out to civilian networks. Many applicants lose interest because they are able to be hired more quickly at civilian practices. Hiring and credentialing are protracted and compensation in the MHS is pale in comparison even to the Department of Veterans Affairs (VA).
Once patients enter the civilian networks, they face substantial delays in care and the cost of their care dramatically increases, compared with the costs of care when it is provided by the MHS. Most civilian networks have started treating Tricare akin to Medicaid due to poor reimbursement, so these individuals are facing a dire situation. Meanwhile, the DHA is hiring more administrators and inflating its operating costs as the focus transitions from providing excellent care to emulating the operations of civilian health systems.
Given your position of influence, we humbly request your assistance in helping revive our dying military treatment facilities. It is my opinion that dismantling the DHA and shifting authority back to Commanders of these facilities would lead to both better and cheaper care for our patient population. In a time of a recruiting crisis, we should affirm our commitments to Servicemembers, retirees, and their families, rather than degrading them.
Below I outline examples of how the DHA is continually failing to uphold its stated missions and values:
Severe staffing shortages at military treatment facilities are now sending increasing numbers of beneficiaries to the civilian networks. This is also starting to compromise the care of Active Duty Servicemembers.
Japan overseas civilian workforce, where once they had regular access to U.S. military doctors through the various on-base hospitals and clinics, they now have much more restricted “space available” clinic visits as their only option.
Tricare acceptance is restricted at civilian networks, limiting access to care, especially for those lacking concurrent Medicare benefits.
MHS Genesis universally considered a failure by military physicians. Deemed unacceptable to Department of Veterans Affairs.
“The Department of Veterans Affairs has abandoned plans to introduce its new electronic health records system at more facilities, announcing Friday that it has halted all future deployments as it moves to fix the system at the five places where it currently is used.”
Defense Health Agency used “phantom award restrictions” to limit the number of companies that could qualify for global IT services contract.
Tricare beneficiaries in the West Region will get a new managed care contractor in 2024 under a major contract award to TriWest Healthcare Alliance. This will soon further limit access to care.
Representative Jackie Speier (D-CA) February 5, 2020: “I have not seen evidence that real improvement has occurred,” Speier said Wednesday during a House Armed Services Committee subpanel hearing. “In fact, I hear too often about medical errors that cause grievous harm to patients and quality assurance investigations that drag on for years while suspect providers continue to practice.”
Senator Jerry Morgan (R-KS) 3/17/2023 RE: Slow, inaccurate reporting on pharmacy contracting changes. Lack of transparency masked by insolent demeanor.
In a memo sent to Defense Secretary Mark Esper on Aug. 5, 2020, the secretaries of all military services called for the return of all military hospitals and clinics already transferred to the DHA and suspension of any planned moves of personnel or resources.
COVID-19 outbreak has demonstrated that the reform, which was proposed by Congress in the fiscal 2017 National Defense Authorization Act, “introduces barriers, creates unnecessary complexity and increases inefficiency and cost.”
"The proposed DHA end-state represents unsustainable growth with a disparate intermediate structure that hinders coordination of service medical response to contingencies such as a pandemic.”