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Recently, Senators McConnell (R-KY) and Coons (D-DE) cosponsored a bill to invest more than $850 billion to strengthen our nation's defense industrial base, upgrade its shipbuilding capabilities, replenish munitions, and support key allies. Although these are worthy goals, Congress and the White House must not overlook the system that safeguards the health of American warfighters - our military's most important asset.
Last March, the Chair of the Senate Armed Services Committee, Senator Roger Wicker (R-MS), made pointed remarks at the outset of a hearing on stabilizing the military health system:
"In 2019, the military departments implemented drastic cuts to military medical personnel on the faulty assumption that it would be easy for DHA (the Defense Health Agency) to hire civilians to take their places...In 2020, Congress ordered a halt to any additional military medical reductions, but it was too late. A significant number of reductions had already occurred, severely reducing the capability of military hospitals...This has proven more expensive and has sapped the military doctors' experiences that are vital to maintaining proficiency. Even worse, the Department of Defense (DOD) has refused to request adequate funding for DHA."
Unlike the Veterans Health Administration (VHA) or private healthcare systems, military health must always be ready to deploy uniformed healthcare professionals anywhere in the world in support 0f U.S. combat operations and other missions, including peacekeeping and humanitarian assistance.
To enable this work, the MHS maintains a network of stateside military hospitals and clinics, supplemented by healthcare purchased from private doctors and healthcare systems to treat active-duty service members, their family members, and military retirees. This second mission reinforces the first. The clinical duties that military doctors, nurses, and other health professionals perform in stateside military hospitals helps keep their skills sharp between deployments. It also allows them to teach and inspire the next generation of military healthcare professionals. In times of conflict, military hospitals receive and treat complex casualties. Finally, the high-quality care to wounded, ill and injured servicemembers as well as their families and military retirees helps the DoD recruit and retain its "all-volunteer" force.
Military health has played a key role in American history since the founding of our republic. In the Winter of 1777, General George Washington ordered the inoculation of the Continental Army against smallpox. It was the first time in history that an Army was immunized by command order. Washington also instituted policies on camp cleanliness and took other actions to preserve his army's fighting strength. The principles he established still guide military medicine to this day.
Health protection is so important to preserving fighting strength that the U.S. military monitors every unit's "disease and non-battle injury (DNBI)" rates to evaluate the quality of its leadership and medical support.
This discipline paid off in Afghanistan and Iraq. Despite logistical challenges and austere conditions, military medicine drove rates of DNBIs and deaths from severe battlefield wounds to the lowest levels in the history of warfare. It's one of the most remarkable achievements in the history of American medicine. Many of the innovations they pioneered have been adopted by civilian healthcare.
Instead of recognizing the value of military health, budget officials in the Pentagon viewed the MHS as little more than an HMO for beneficiaries. As the wars wound down, they began siphoning military health funding and positions for other DoD priorities. As a result, spending on military healthcare flattened, and is now far behind healthcare spending in the VA and our nation overall.
During Trump's first term, the Pentagon compounded this error by directing military families and retirees to go elsewhere for treatment. Then, as visits and hospital admissions fell, they downsized or closed many military clinics and hospitals. Even top hospitals, such as Walter Reed and Naval Medical Center San Diego, were left underfunded, understaffed, and underutilized. This weakened the link between stateside care and battlefield care.
By the time the Joint Chiefs of Staff realized that privatization had gone too far, the damage was done. In 2023, then Deputy Secretary of Defense Kathleen Hicks issued a directive to reverse course and begin restoring the MHS.
Today, different leaders are in charge. In the past, Defense Secretary Pete Hegseth has advocated diverting military and veteran healthcare benefits to enhance the Pentagon's "war-fighting capability." Military and veterans' healthcare IS a warfighting capability. It's a major reason why American servicemembers fight so hard, accept such risks and reenlist to do it again. Until recently, they knew that every time they were deployed, their families would be cared for by doctors and nurses who understood the stresses of military life. They were also confident that if anyone in their unit became ill or was wounded in battle, they'd receive the best healthcare in the world, expert rehabilitation, and if needed, long-term care.
If the Pentagon resumes its push to privatize the military health system, it will harm the health of our armed forces and diminish their battlefield performance. Two former Hegseth aides said as much in a recent New York Times op-ed:
"Even on the modern high-tech battlefield, war is still a people business. For the Department of Defense, this means it must care for its people along with developing its weapons in order to maintain lethality while also creating an environment that incentivizes Americans to continue to serve. When service members and their families cannot rely on the programs that are intended to ensure their quality of life, it distracts them from their duties, which inevitably limits their effectiveness in combat."
Although most Americans give little thought to military health, servicemembers, veterans and military retirees know better. If any member of your family, a friend, or a neighbor currently serves in uniform, you should care. If one or more of your children or grandchildren are considering military service, you should care. If you value any of the numerous advances military health has contributed to American medicine throughout our nation's history, you should care. As Commander-in-Chief of our nation's armed forces, President Trump should care and direct Defense Secretary Hegseth and his senior staff to rebuild our nation's military health system.