Reforms Always Have an Impact: Measuring the Efficiency of Medical Personnel Policy in the U.S. Military Health System

Abstract

The U.S. Military Health System is among the largest programs in the federal government and one of the most complex health care delivery systems in the world. The Military Health System costs more than $60 billion dollars annually and employs over 200,000 Active Duty and Reserve medics, civilian employees, and contract support personnel operating on hundreds of military installations worldwide. The system is critical to national security and combat readiness. For over a decade, on-going reforms and perturbations affected the system. One of the most significant was a change in Department of Defense policy that transferred day-to-day control over most Active Duty medical personnel from health care administrators at military medical treatment facilities to operational units. Qualitative, quantitative, and normative tests show that this transfer of personnel reduced the overall efficiency of military health care.