1

(c) EFFECTIVE DATE.-The amendments made by sub

2 sections (a) and (b) shall take effect on October 1, 1988.

3

SEC. 405. AUTHORIZATION OF TRAINING STUDENT 4 LOADS.

5 (a) IN GENERAL.-For fiscal year 1989, the compo6 nents of the Armed Forces are authorized average military 7 training student loads as follows:

(3) The Marine Corps, 18,064.

(4) The Air Force, 36,857.

(5) The Army National Guard of the United

States, 19,561.

10

11

12

13

14

15

16

17

18

19

20

(6) The Army Reserve, 17,190.

(7) The Naval Reserve, 3,136.

(8) The Marine Corps Reserve, 3,459.

(9) The Air National Guard of the United States,

2,868.

(10) The Air Force Reserve, 1,827.

(b) ADJUSTMENTS.-The average military student

21 loans authorized in subsection (a) shall be adjusted consistent

10

1 with the end strengths authorized in parts A and B. The 2 Secretary of Defense shall prescribe the manner in which 3 such adjustment shall be apportioned among the Army, the 4 Navy, the Marine Corps, and the Air Force and the reserve 5 components in such manner as the Secretary of Defense shall 6 prescribe.

WARTIME MEDICAL READINESS

HOUSE OF REPRESENTATIVES,

COMMITTEE ON ARMED SERVICES,

MILITARY PERSONNEL AND COMPENSATION SUBCOMMITTEE,
Washington, DC, Thursday, February 25, 1988.

The subcommittee met, pursuant to notice, at 10:13 a.m. in room 2337, Rayburn House Office Building, Hon. Beverly B. Byron (chairman of the subcommittee) presiding.

OPENING STATEMENT OF HON. BEVERLY B. BYRON, A REPRESENTATIVE FROM MARYLAND, CHAIRMAN, MILITARY PERSONNEL AND COMPENSATION SUBCOMMITTEE

Mrs. BYRON. Good morning. As the subcommittee begins its ninth medical hearing in the 100th Congress, we turn our attention to the primary reason that the military has a medical system at all-namely, to save the precious American lives in time of conflict and to treat and return as many soldiers, sailors, and airmen as possible to the battlefield. I am, of course, referring to our wartime medical readiness.

The House Armed Services Committee has a long-standing concern about the state of medical readiness.

During the fiscal year 1987 authorization cycle, the subcommittee conducted an extensive review of the military medical care system and concluded that it could not adequately perform its peacetime or its wartime mission.

Since that time, I am sure we have gotten the military's attention in an area of peacetime care and although the problems are far from fixed, there are a number of initiatives underway that do hold promise.

I am not sure about the level of progress in the wartime area, however, and that is why we have called this hearing today.

Briefly reviewing the Department's medical readiness record, there is little doubt that the 15 years following the Vietnam War saw a disturbing erosion in the medical readiness capability.

In the early 1980s, the Assistant Secretary of Defense for Health Affairs implied that 9 out of 10 battlefield casualties could die as a result of inadequate medical readiness.

By the mid 1980s, Dr. Mayer, the current Assistant Secretary and our lead witness this morning, testified that three-quarters of the wounded during the first days of a major conflict would not receive "life saving, stabilizing, hemorrhage-stopping surgical care.' These statements represent no less than, in my estimation, a national scandal, and although more attention was being afforded

readiness concerns by 1986 than was the case in 1980, it was clear that far more remains to be done.

One of the most important challenges was and continues to be fixing all the pieces of medical readiness so that the equipment, medical personnel, the logistics, the aeromedical evacuation and so on are in sync.

What I mean to say by that is that it does not make sense to spend the billions of dollars that we have appropriated on procuring deployable hospitals if you do not have a plan to staff them with the proper number and the mix of physicians, if you don't have the supplies to treat the patients and if you cannot transport them from the scene of the battle to the hospitals.

Yet when this subcommittee delved deeply into these issues some 2 years ago, people, logistics, planning, and equipment seemed to be terribly out-of-sync, and there appeared to be no document that pulled all of these elements together.

In order to speed-up the system and to ensure that medical readiness was addressed as a top priority, this subcommittee directed the Department of Defense to develop a comprehensive, integrated master plan for curing the ills of the wartime medical readiness system by the 1992 timeframe.

This plan-as well as the medical readiness portions of this year's budget-is the primary focus of today's hearing.

As I mentioned earlier, we welcome Dr. William Mayer, the Assistant Secretary of Defense for Health Affairs as well as General Becker, General Chesney, Admiral Zimble, as the Surgeons General of the Army, Air Force, and the Navy.

Gentlemen, I would ask you to summarize your major points of your statement, and I will include your full written statement in the hearing record.

Mr. Bateman, did you have an opening remark?

Mr. BATEMAN. Madam Chairman, I ask unanimous consent that my prepared statement be included in the record, and in deference to our distinguished witnesses and many spectators that we go forward to hear from them.

[The prepared statement of Representative Bateman follows:]

OPENING STATEMENT OF HONORABLE HERBERT H. BATEMAN MILITARY PERSONNEL AND COMPENSATION SUBCOMMITTEE HEARING ON WARTIME MEDICAL READINESS

FEBRUARY 25, 1988

I want to join Chairman Byron in welcoming our witnesses here today. Over the past few years, both the Pentagon and the services have been paying increased -- and long overdue -attention to the critical shortfalls in our wartime medical

capability. In testimony in previous years, Dr. Mayer, you and your predecessors have cited the number of battlefield

casualties that would die without basic medical attention in the early days of a conventional conflict in Europe because of shortages of manpower and equipment. You and the Surgeons General are to be congratulated for the progress that has been made; much more remains to be done, however, if the current manpower and equipment shortfalls and other "war stoppers" are to be resolved by 1992.