Reorganizing the Military Health System: Should There Be a Joint Command?

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Format: Paperback
Pub. Date: 2001-06-01
Publisher(s): Natl Book Network
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Summary

Since the end of WWII, the question of whether to create a unified military health system has arisen repeatedly. Despite a variety of answers to this question, the system has largely retained its traditional structure, with separate Army, Navy and Air Force medical departments. This book documents research on the organization of the military health system. It considers 5 alternative organizational structures for their likely impact on peacetime health care and wartime readiness.

Table of Contents

Preface iii
Figures
vii
Tables
ix
Summary xi
Acknowledgments xv
Acronyms xvii
Introduction and Background
1(4)
Overview of the Military Health System
2(1)
The System's Dual Missions
2(3)
Options for Organizing the Military Health System
5(20)
Option 1: Current Organizational Structure
5(8)
MHS Organization for TRICARE
7(1)
MHS Organization for Readiness
7(5)
MHS Resource Management
12(1)
Option 2--5: Alternative Organizational Structures
13(12)
Option 2: Modification of the Current Structure
14(3)
Options 3--5: Joint Command Structures
17(6)
Level of Consolidation of Operational Medicine
23(1)
Joint Command Versus Defense Health Agency
23(2)
Organization in the Private Sector and Tricare
25(18)
Organization of Managed Health Care
26(10)
How Managed-Care Organizations Are Structured
28(4)
Accountability, Performance Evaluation, and Incentives
32(3)
Information Systems
35(1)
Summary of Lessons from Civilian Health-Care Organizations
36(2)
How the TRICARE Organization Compares with Civilian Organizations
38(5)
Accountability, Incentives, and Information
40(2)
Lessons for TRICARE from the Private Sector
42(1)
Medical Readiness and Operational Medicine
43(14)
Medical Readiness Skills
44(4)
Operational Medicine and Joint Doctrine
48(3)
Coordinating Readiness
51(3)
Readiness Objectives of the MHS Organization
54(3)
Other Assessments of the MHS Organization
57(12)
Previous Studies of Military Health System Organization
57(4)
Past Reorganization Objectives
61(1)
Interviews with Current Officials
62(6)
Reasons for Considering Reorganization
63(2)
Opinions on MHS Organization
65(2)
Other Organizational Issues
67(1)
Assessment of MHS Organization Over Time
68(1)
Assessing the Organizational Alternatives
69(20)
Examining the Alternatives
69(5)
Recommendations
74(1)
Measuring Performance and Providing Incentives
75(2)
Appendix
A. Unifying the Training Curriculum
77(4)
B. Principles of Organizational Structure
81(6)
C. Interviewee List
87(2)
Bibliography 89

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