Subtle Threats to US Combat Readiness Include Healthcare Access on Overseas Bases

A marching army might feel heavy on its stomach but deployed soldiers are more likely to stay focused when they know that their families will be taken care of at home.

Concerns over financial and family health concerns can pose a subtle but serious threat to force readiness for front-line warfighters stationed aboard forward-deployed United States ships and bases.

These strains can lead to suicides such as the seven self-inflicted deaths of enlisted men on board USS George Washington in April 2021–April 2022. Poor dependent access and insufficient healthcare on military bases can also cause distractions and problems in the field.

During a March 7 hearing at the Senate Appropriations Committee’s Defense Subcommittee regarding the Defense Health Agency (DHA) FY24 Spending Needs, senators heard directly from the Pentagon director and the chief medical officers for the three branches of military service about how these strains could impact operational readiness.

The Pentagon completed a seven year transition in 2018 that made the DHA a joint, integrated combat-support agency. Each military branch had its own. Its FY23 budget stood at $773 million, and the FY24 request is close to $800 million. These figures are within the $885 billion budget for military spending that was set by the Biden administration.

March and April are usually when multiple military commandos and Veterans Administration (VA), officials testify before Congressional panels regarding their spending requests in the annual budget cycle that leads up to October 1, the official beginning of the federal fiscal year.

Thus far, unit/regional commanders, Defense Department chiefs, and veterans’ affairs officials have discussed in hearings an array of topics and undefined—until Biden’s budget reveal—spending needs. From March 6-10, there were 16 hearings held on Capitol Hill about military and veterans affairs issues.

‘Lighten the Load’ 

During the March 7 hearing before the Senate defense appropriations panel, Assistant Secretary of Defense for Health Affairs Dr. Lester Martínez-López said the military is paying more attention to mental health and dependents’ access to medical services to enhance overall force readiness, especially in addressing the “ongoing cases of suicide by serving members and family members.”

The Pentagon must “reverse the heartbreaking trends we have witnessed,” He said that suicide is a national problem, but it is also a common symptom in the armed forces. It is an indication of active duty personnel who are under operational stress and who are not able or afraid to seek mental health counseling.

Sen. Dick Durbin (D-Ill.) said mental health counseling “is so important for all of us—all of us—but especially in the military” However, in the past there were a “stigma attached” to doing so.

“There’s movement in the bullpen on that” but it will take time,  Martínez-López said. “Mental health is health. Now we can put it on the table.”

Once “on the table,” He stated that the majority of people who have a mental health problem are dealing with stress issues related to other things.

“We need to lighten the load on military members,” He said that financial crises can be alleviated and concerns about dependents’ quality-of-life in military housing, or it can lead to a decrease in force readiness.

Sen. Susan Collins (R. Maine) stated that one of the problems in expanding mental health services for active duty military personnel and their families was that DHA takes nearly a year to hire psychiatrists and over a year to hire psychologists. It’s not uncommon for DHA to decline job offers because applicants have found other jobs.

‘Arctic Warrior’ Stresses

Senator Lisa Murkowski (R. Alaska) stated that suicide is a problem among active duty personnel at Fort Wainwright U.S Army and Eielson A.F. Bases.

It’s no wonder she stated, noting that some Wainwright soldiers had to walk three miles from their barracks to get there. “WWII Era dining facility,” It can be a difficult and frustrating way to live, especially in winter.

The military reported on Wainwright and called for the replacement of old buildings.

“We know we’ve got to do something. Doing the studies doesn’t necessarily change lives,” Murkowski said, noting a proposed ‘Arctic Warrior’ bill will provide those stationed in Alaska an additional stipend and allow them to be reimbursed for the cost of a flight home.

These are “financial stressors” She stated that it would increase force readiness. “They need a $2,000-$3,000 for a flight home” It is not affordable for many.

Murkowski stated that many commands are plagued by outdated technology, especially those forward-deployed and manned with active-duty soldiers. “not being paid on time.”

Some complaints were received by her “waiting up to seven months to get paycheck situations straightened out. That kind of financial stress on service members … isn’t right.”

A Force Diminisher is a Japanese term for a Force Diminisher.

Biden’s FY24 budget request states “military families are key to the readiness and well-being of the All-Volunteer Force, and therefore are critical to national security.”

However, the absence of medical facilities at bases in Japan forces military families to wait longer for appointments. Defense Department civilians are forced to search for treatment. “host nation providers” To tend to routine and long-term care issues.

Sen. John Tester (Republican-Mont.), Committee ChairWhen addressing the Japan situation, Tester began his remarks with: “I want to talk about China.”

He stated that the United States had “troops in Japan and in other places” Face-off against Chinese forces requires vigilance. This can be threatened by instability at their bases. “a lack of healthcare for dependents and DOD civilians.”

Tester was referring specifically to the 8,000 Defense Departments. U.S. Forces Japan Civil employees are restricted to “space available” Beginning Jan. 1, appointments are made at U.S. military bases medical facilities for routine health issues 2023.

In October, the DHA announced DOD civilian employees in the Indo-Pacific region—which spans the globe from the U.S. West Coast to the Arabian Sea—must receive routine medical care from a “local host nation provider” Military hospitals are unable to provide service for them from Jan. 1.

After an evaluation of forward-deployed bases, it was determined that more space in existing medical facilities should be allowed and upgraded to treat active duty casualties, such as those in a conflict with China.

The USFJ would be a pivotal component—and target—in the event of a war. It currently has around 54,000 active-duty soldiers and 45,000 dependents. They are scattered among 84 facilities primarily on Honshu and Kyushu islands.

USJF also includes the Headquarters of the 7th Fleet and 5th Air Force on Honshu, Tokyo, and the 3rd Marine Expeditionary Force Okinawa.

The restricted access is most acutely an issue for the 8,000 USFJ civilian employees working on bases on mainland Japan, especially on Yokota Air Force Base, Naval Hospital Yokosuka, and Camp Zama,  headquarters of U.S. Army Japan.

Many DOD civilian employees are key weapons system technicians and technology consultants. However, they do not have access for on-base care, Tester said. “This is going to end up being an incredible recruitment challenge.”

He said that base commanders have been pushing for more medical facilities for some time. But now, “These reports are …. repeatedly delivered with a sense of urgency from military leaders in Japan.

“The consequences for our military readiness are alarming.”