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Department of Defense Appropriations for 2013 Hearings Committee on Appropriations DEPARTMENT OF DEFENSE APPROPRIATIONS FOR 2013 HEARINGS BEFORE A SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS HOUSE OF REPRESENTATIVES ONE HUNDRED TWELFTH CONGRESS SECOND SESSION SUBCOMMITTEE ON DEFENSE C. W. BILL YOUNG, Florida, Chairman JERRY LEWIS, California NORMAN D. DICKS, Washington RODNEY P. FRELINGHUYSEN, New Jersey PETER J. VISCLOSKY, Indiana JACK KINGSTON, Georgia JAMES P. MORAN, Virginia KAY GRANGER, Texas MARCY KAPTUR, Ohio ANDER CRENSHAW, Florida STEVEN R. ROTHMAN, New Jersey KEN CALVERT, California MAURICE D. HINCHEY, New York JO BONNER, Alabama TOM COLE, Oklahoma NOTE: Under Committee Rules, Mr. Rogers, as Chairman of the Full Committee, and Mr. Dicks, as Ranking Minority Member of the Full Committee, are authorized to sit as Members of all Subcommittees. TOM MCLEMORE, JENNIFER MILLER, PAUL TERRY, WALTER HEARNE, ANN REESE, TIM PRINCE, BROOKE BOYER, B G WRIGHT, ADRIENNE RAMSAY, and MEGAN MILAM ROSENBUSCH, Staff Assistants SHERRY L. YOUNG, Administrative Aide PART 1 Page Military Health Systems Governance Review .................. 1 Fiscal Year 2013 Department of Defense Budget Overview ................................................................................ 81 Fiscal Year 2013 Navy / Marine Corps Budget Overview 169 Fiscal Year 2013 Air Force Budget Overview ................... 335 U.S. GOVERNMENT PRINTING OFFICE 79–873 WASHINGTON : 2013 VerDate Mar 15 2010 01:34 Apr 06, 2013 Jkt 079873 PO 00000 Frm 00003 Fmt 7513 Sfmt 7513 E:\HR\OC\79873P1.XXX 79873P1 jbell on DSK7SPTVN1PROD with HEARING COMMITTEE ON APPROPRIATIONS HAROLD ROGERS, Kentucky, Chairman C. W. BILL YOUNG, Florida 1 NORMAN D. DICKS, Washington JERRY LEWIS, California 1 MARCY KAPTUR, Ohio FRANK R. WOLF, Virginia PETER J. VISCLOSKY, Indiana JACK KINGSTON, Georgia NITA M. LOWEY, New York RODNEY P. FRELINGHUYSEN, New Jersey JOSE´ E. SERRANO, New York TOM LATHAM, Iowa ROSA L. DELAURO, Connecticut ROBERT B. ADERHOLT, Alabama JAMES P. MORAN, Virginia JO ANN EMERSON, Missouri JOHN W. OLVER, Massachusetts KAY GRANGER, Texas ED PASTOR, Arizona MICHAEL K. SIMPSON, Idaho DAVID E. PRICE, North Carolina JOHN ABNEY CULBERSON, Texas MAURICE D. HINCHEY, New York ANDER CRENSHAW, Florida LUCILLE ROYBAL-ALLARD, California DENNY REHBERG, Montana SAM FARR, California JOHN R. CARTER, Texas JESSE L. JACKSON, JR., Illinois RODNEY ALEXANDER, Louisiana CHAKA FATTAH, Pennsylvania KEN CALVERT, California STEVEN R. ROTHMAN, New Jersey JO BONNER, Alabama SANFORD D. BISHOP, JR., Georgia STEVEN C. LATOURETTE, Ohio BARBARA LEE, California TOM COLE, Oklahoma ADAM B. SCHIFF, California JEFF FLAKE, Arizona MICHAEL M. HONDA, California MARIO DIAZ-BALART, Florida BETTY MCCOLLUM, Minnesota CHARLES W. DENT, Pennsylvania STEVE AUSTRIA, Ohio CYNTHIA M. LUMMIS, Wyoming TOM GRAVES, Georgia KEVIN YODER, Kansas STEVE WOMACK, Arkansas ALAN NUNNELEE, Mississippi ————— 1 Chairman Emeritus WILLIAM B. INGLEE, Clerk and Staff Director (II) VerDate Mar 15 2010 01:34 Apr 06, 2013 Jkt 079873 PO 00000 Frm 00004 Fmt 7513 Sfmt 7513 E:\HR\OC\79873P1.XXX 79873P1 jbell on DSK7SPTVN1PROD with HEARING DEPARTMENT OF DEFENSE APPROPRIATIONS FOR 2013 WEDNESDAY, FEBRUARY 8, 2012. MILITARY HEALTH SYSTEMS GOVERNANCE REVIEW WITNESSES LIEUTENANT GENERAL (DR.) CHARLES B. GREEN, SURGEON GENERAL OF THE AIR FORCE LIEUTENANT GENERAL PATRICIA D. HOROHO, SURGEON GENERAL OF THE ARMY VICE ADMIRAL MATTHEW L. NATHAN, SURGEON GENERAL OF THE NAVY VICE ADMIRAL JOHN M. MATECZUN, COMMANDER, JOINT TASK FORCE, NATIONAL CAPITAL REGION MEDICAL OPENING STATEMENT OF CHAIRMAN YOUNG Mr. YOUNG. The committee will come to order. This morning the committee will hold an open hearing on the Governance Review of the Military Health System. I would like to welcome the new Surgeon General of the United States Army, Lieutenant General Patricia Horoho, who has not been here in that official capacity before, so we are very happy to have you. Although we have known you and all of the others for quite some time, we welcome to your first visit, official visit to this committee. And the new Surgeon General of the United States Navy, Vice Admiral Matthew Nathan, same story. We have known him for years. We met him first during a big hurricane down in Pensacola when his hospital was nearly blown away, and his time at com- mand at Bethesda. But again, Admiral, in your first official visit before this subcommittee, so welcome to you, sir. And, General Green, you are the old timer, you have been here before and we always look forward to your testimony, and we look forward to it again today. Admiral Mateczun has been before the committee on a number of occasions, and we have had some interesting discussions during those periods, and we welcome him back for this general overview of the governance of our military health system, a health system that is just extremely important. I just want to make a, just a couple of quick comments before I yield to Mr. Dicks and then we will go to the witnesses. In today’s world, our soldiers, sailors, airmen, marines, Coast Guardsmen are getting hurt really bad. But because of the ad- vances in new medicines, because of the better training for our (1) VerDate Mar 15 2010 02:06 Apr 06, 2013 Jkt 079873 PO 00000 Frm 00001 Fmt 6633 Sfmt 6633 E:\HR\OC\A873P2.XXX A873P2 tjames on DSK6SPTVN1PROD with HEARING 2 medics and corpsmen, because of the ability to move from the bat- tle zone quickly to a field hospital or to a hard hospital, and then quickly on to a hospital like Landstuhl and then back to the U.S., we are saving soldiers who would have died in previous conflicts. Because of that, we have a tremendous obligation to them, and that obligation is going to last for a long time because these inju- ries, as we see them, and we encourage as many of our colleagues as we can to visit the hospital at Walter Reed Bethesda so that they can see firsthand what it is that this war is actually costing us, not the cost in dollars, but it is a big cost, and it is a big obliga- tion. But, anyway, we—I read this Department of Defense task force or Military Health System governance several times, and I will tell you it is really interesting reading. And you have to read it several times to fully understand it. And I am not sure that I fully under- stood it yet, but it is really good reading and creates a lot of ques- tions, and we will be discussing some of those things. But before we go to your testimony, let me yield to my friend and my former chairman, Mr. Dicks. REMARKS OF MR. DICKS Mr. DICKS. Thank you, Mr. Chairman. We want to welcome all of our witnesses today, and the subcommittee has had a history of championing for the soldiers, sailors, airmen and, marines that willingly serve and are truly at the heart of what services do. We know that taking care of our servicemembers and ensuring that they, as well as their dependents, receive world class medical care, is at the heart of what you do. We also know that governance and military health is a topic that has been widely studied and discussed, but is difficult to change. Today we want to discuss governance of the Military Health Sys- tem, and we are interested in hearing each of your thoughts on how the task force on governance proposed structure will enable you to provide the best care possible as well as what proposals may create obstacles to overcome. We are also interested in hearing how implementing rec- ommendations for better governance can create efficiencies within the system and highlight opportunities for new partnerships, not only between the services, but with local communities and the De- partment of Veterans Affairs. As for the National Capital Region we are interested in hearing how the new Walter Reed National Military Medical Center at Be- thesda is operating and with an integrated staff, resulting from the merging of the Navy and Army cultures. Each brings their own unique capabilities to the mission to provide care and help to servicemembers and their family heal. We now eager to hear from the new Fort Belvoir Community Hospital that is operating. We have also seen a dramatic rise in the need for behavioral health services for our wounded warriors returning from war and assimilating back into their services, their home life, and in the case of the Guard and Reserve, their towns and cities. These invis- ible wounds have been called the signature wound of this genera- tion. I believe the health care issue will be one of the greatest chal- VerDate Mar 15 2010 02:06 Apr 06, 2013 Jkt 079873 PO 00000 Frm 00002 Fmt 6633 Sfmt 6602 E:\HR\OC\A873P2.XXX A873P2 tjames on DSK6SPTVN1PROD with HEARING 3 lenges for personnel who are correctly serving and for veterans as well. We thank all of you for your service, and we look forward to hearing your views on governance. Thank you, Mr. Chairman. Mr. YOUNG. Yes. Mr. Dicks, thank you very much. We understand that you don’t have prepared statements, which is certainly not necessary, because I know that you all know your issues extremely well, and so we will just, we will hear from you, whatever you want to tell us, tell us and we are going to listen pa- tiently. We will do our best not to interrupt you as you proceed, but then you are fair game after you have finished your opening state- ments. Let me start with General Horoho. General—and we will go to all four of you before we do open up for questions. SUMMARY STATEMENT OF GENERAL HOROHO General HOROHO. Okay, thank you, sir. Chairman Young, Ranking Member Dicks and distinguished members of the committee, thank you for providing me the oppor- tunity to talk with you today about the future of the Military Health System.
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