Braxton Taylor
The Pentagon’s top doctor pledged Monday to defend the military health system’s $61 billion budget but said more could be done to balance resources and improve medical care.
Dr. Steve Ferrara, the Defense Department’s acting assistant secretary of defense for health affairs, told an audience at the AMSUS Society of Federal Health Professionals that the system, which serves 9.6 million beneficiaries, is a “force multiplier” that meets Defense Secretary Pete Hegseth’s priority to strengthen U.S. operational forces.
In his role as acting assistant secretary, Ferrara said he would show Hegseth how the military health system, or MHS, budget, which accounts for 7% of the Pentagon’s top-line, is “100% worthy.” The press was barred from the conference, despite reporters having access for years, but Military.com reviewed a recording of Ferrara’s speech.
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“I show him how we take that 7% — which has been obviously jealously fought over, whether it’s going to be for bullets or bombs or submarines or tanks or airplanes — and use that 7% to make the force more lethal, more fit to fight and win,” Ferrara said during the speech.
The military health system has undergone a vast transformation in the past decade, with military treatment facilities, medical logistics, information technology, acquisitions, the Tricare health program for nonuniformed beneficiaries, and other services consolidated under the Defense Health Agency, while active-duty health care, uniformed medical professional training and development became the responsibility of the services’ medical commands.
The reforms were designed to save money by eliminating triplicate functions within the Army, Navy and Air Force medical commands and streamlining the Pentagon’s health organization. But they have left many military hospitals and clinics understaffed and patients leaving for — or being forced on — the private sector, jeopardizing the system’s balance.
This year, turmoil has demonstrated itself with delays in patient care as the result of a change in Tricare management contractors and billing processors, and on Friday, the head of the Defense Health Agency, Army Lt. Gen. Telita Crosland, resigned unexpectedly without explanation.
Ferrara, a retired Navy interventional radiologist and former CIA chief medical officer who is married to a Navy pediatric nephrologist, said a functioning, quality health care system is vital to the readiness of the U.S. armed forces, an “ethical imperative” the nation must honor.
Ferrara said his priorities are to “support, sustain and strengthen” — supporting the warfighters, sustaining professional medical skills, and strengthening the chain made up of the generations of providers who have served and will join in future.
To ensure satisfaction, he said, the system must work for everybody, including the soldier wounded on the battlefield, the sailor training at home, the service members who need embedded mental health providers, and the family members who get ill or injured.
“The last thing that a family or that service member needs is to be worried about whether their family is getting adequate or high-quality care,” Ferrara said.
In a separate speech at the AMSUS conference in National Harbor, Maryland, Navy Surgeon General Rear Adm. Darin Via said that Navy medicine is roughly 10% below its total manning capacity, a shortfall felt most at the military treatment facilities.
“That is felt most with access to care. When it comes to the sailor, the Marine and their families, where that is impacted most is when someone has an [anterior cruciate ligament] injury. If you’re a professional athlete, you’d [get surgery] as soon as the swelling goes down in a couple of weeks,” Via said in a copy of the speech reviewed by Military.com.
“From the MTFs, it is whenever the orthopod can get OR time within the schedule, which is already limited because there’s not enough anesthesiologists, there’s not enough nurses or there’s not enough [surgery] techs.”
Ferrara said that to make improvements, the system must ensure that its priorities and resources are intertwined, seeking out any “mismatches” and treading new ground, looking at improved partnerships with the Department of Veterans Affairs, academic health centers and foreign allies.
According to Ferrara, the Pentagon needs to fix its military hospital system; maximize the value of the Tricare health program and “simplify the Tricare experience;” and leverage technology, including doubling down on telehealth to expand capacity and using artificial intelligence.
Ferrara added that this review is an “all-hands-on-deck” initiative, calling for those who work daily within the military health system to voice their ideas.
“I’m hoping you can help me solve my problems, and so I thank you in advance,” Ferrara said.
President Donald Trump has nominated former CIA medical director Keith Bass, a retired Navy officer, rehabilitation counselor and health administrator, for the assistant secretary of defense for health affairs position.
Bass has not issued any public comments on the future of Defense Department health care. He served as the head of the White House medical unit from 2017 to 2019 and, at the time of his nomination, was the medical center director of the West Texas VA Health Care System.
Bass’ confirmation hearing before the Senate Armed Services Committee has not been set.
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