The surgeons general were testifying before the subcommittee on the defense health program. At $18.9 billion, the program's fiscal 2006 budget is an 8.9 percent increase over the previous year's.

"Every dollar invested in the defense health program does much more than just provide health insurance to the department's beneficiaries," Army Surgeon General Lt. Gen. Kevin Kiley said. "Each dollar is an investment in military readiness. In ( Operation Iraqi Freedom ) and ( Operation Enduring Freedom ), that investment has paid enormous dividends. And in my visits to Iraq, I can document that personally."

The dividends he spoke of also were heralded by Navy Surgeon General Vice Adm. Donald Arthur and Air Force Surgeon General Lt. General George Peach Taylor Jr. They each reported seeing improvements to battlefield medicine that have reduced the number of servicemembers who did not survive their injuries to less than 10 percent. This figure is a significant improvement over Operations Desert Storm, during which approximately 22 percent of injured servicemembers did not survive.

"This improved survivability is due to superior training of our combat medics, leveraging technology to provide resuscitative surgical care far forward on the battlefield, the superb efforts of the Air Force's critical care and medical evacuation teams, and the advanced research and state-of-the art care available at our medical centers," Kiley said.

It's also because of teamwork and the members of Congress who have supported numerous advances in combat casualty care, he said.

Arthur said that the care received in theater also was key to increased survivability.

"The thing that was most critical to the care of wounded soldiers and Marines over there was the training that the corpsmen and medics got," he said. "The corpsmen and medics were there and delivered the care at the time of the wounding, the training of the surgical teams and the rapid ( medical evacuation ) and the incredibly great service at Landstuhl ( Regional Medical Center in Germany ) on their way back to the United States ( all contribute to survivability )."

Taylor focused on the rapid evacuation, saying that the Air Force's aeromedical-evacuation personnel have completed approximately 55,000 patient movements since the beginning of Operation Iraqi Freedom.

"In addition, partnering with our critical-care air-transport teams, our air and medical-evacuation system has made it possible to move seriously injured patients with astonishing speed -- as short as 36 hours from the battleground to stateside medical care," Taylor said. He added that this was "unheard of even a decade ago."

The Air Force's expeditionary medical support teams, or EMEDS, are also the lynchpin of the ground mission, he said The EMEDS' modularity has supported field commanders by ensuring the right level of medical care is provided to servicemembers wherever they are, Taylor added.

"As importantly, the speed with which we can deploy EMEDS is unprecedented, making EMEDS the choice for Special Forces and quick-reaction forces in the United States as well as abroad," Taylor said.

Despite improvements, Taylor said, there are still challenges in the military healthcare system. One challenge is sustaining a world-class environment in which military medical personnel can practice their specialties. The number of casualties returning to stateside medical facilities presents another challenge. "We've had to prioritize workload to support casualty care and deployment medical screening," Taylor said. "Family member and retiree care have, in some cases, shifted to the private sector."

While private-sector medical facilities are tangibly equipped to handle combat casualties, which would reduce stress on the military system, they would not understand the unique needs of wounded servicemembers, Arthur said.

"At ( the National Naval Medical Center in Bethesda, Md. ) or Walter Reed ( Army Medical Center here ), these Marines and soldiers are still in combat," he said. "They still remember the stresses that they incurred in combat, and we care for them in a way that civilian hospitals could not do, just because we have the background and we have shared that combat experience with them."

Finally, the success of the military medical system for its patients and their families comes down to teamwork, he said.

"I would say that one of the great benefits of our medical department is that we're not just a medical corps or a nurse corps, ... we're a combination," he said. "We're a team, and it's that teamwork, that synergistic effort of all of our corps together, that really makes us strong. You don't find that in civilian institutions, and that's what I think makes our military medical departments great."

Published on: 2005-05-11