Every year of my 13 and a half years of active duty service in the US Navy it sat in the corner. Dark. A symbolic reminder of our mission. To protect and defend the Constitution of the United States. And the President.
'It' was the coronary care unit bed reserved just for the President. In my 13.5 years of service, I saw it used one morning: when preparations were made to perform cardioversion on then George Bush, Sr. after he developed atrial fibrillation while at Camp David. Remarkably, the room never was used since the President reportedly converted to sinus rhythm after an overnight loading dose of Procainamide. I remember the country breathed a collective sigh of relief that Dan Quayle wouldn't have to assume command of the country for those brief seconds of unconsciousness. (Politics is funny like that.) So the room was darkened again, just in case.
Recall that Washington had three military hospitals at the time: Walter Reed, Bethesda Naval hospital, and Andrews Air Force base. Why? Egos. Never mind that any serviceman would receive excellent care at any one of the facilities. Commanders fought to preserve their branches health care facilities tooth and nail. Commanders knew that relinquishing control of this benefit was a sign of weakness.
Things are a bit better now. In 2005, the Base Realignment and Closure committee recommended Walter Reed be closed. Presently, construction is underway to expand Bethesda Naval Medical Center so it can consolidate Walter Reed's Army care in the new facility. Tons of tax-payers money, but hey, it's needed for our military medicine mission.
Or is it?
This is not a small question in this time of great concern over where we get the money to pay for our nation's health care reform. Do we really need the duplicity of health care services offered by our military medical centers? Washington DC already has tons of civilian medical centers. Because of challenges the military has is recruiting subspecialists (neuroradiology was short-staffed when I was there), they often contract out services from civilian counterparts to fill staffing requirements - often at greater cost to them than their military equivalents. Other shortcomings exist as well: Bethesda is not even a Level 1 trauma center - mostly because of the security detail that limits access to the facility. (Imagine: a military center that doesn't see much trauma!) So they send their surgical residents to do rotations at the city's trauma centers. I, too, had to attend a civilian facility to learn my craft on the government's nickle. And at least six civilian medical centers are within a stone's throw of Bethesda.
Military medicine permits some interesting military-specific training, like biologic and chemical warfare training with all it's MOP gear. (Looks like fun, right?) But is there really a need for these facilities and all the personnel infrastructure they require as we struggle to find a way to fund our nation's health care? The government already has the glacially slow, underpaying Tricare and Tricare Prime insurance for our military members so they can receive care at civilian facilities when military medicine cannot fulfill the servicemen and servicewomens' needs.
The bottom line is, we should carefully reevaluate all our options for spending our precious health care resources wisely, and this includes greatly reducing or shuttering our military health care facilities.