Starting with the U.S. Navy in July 2005, the military services will begin a multiyear effort to replace thousands of uniformed medical personnel in base hospitals and clinics with civilians, and in some cases private contractors.
This is part of the Bush administration’s plan to transform the military, in this case by converting 10 percent to 12 percent of military medical positions into civilian jobs, which would reduce personnel turnover in the health care system and, over time, lower costs.
As many as 15,000 jobs could be affected through 2011 if the Army and Air Force match the Navy, which has identified 5,400 medical positions out of 41,000 that could be filled by civilian personnel. The Navy said more than 35,000 medical jobs must remain in the military, however, to deploy with the fleet, serve alongside Marines or be sent to bases overseas when needed.
In recent years, the Navy has identified “nonreadiness” positions with “potential to be converted to civilian or contractor,” said Lt. Cmdr. Tim Weber, head of manpower operations for the Navy’s Bureau of Medicine. It therefore was ready in January when the Defense Department directed it to convert 1,772 medical positions to civilian jobs between July and September 2005.
The remaining 3,643 nonreadiness positions could be converted later in the current budget planning cycle, which runs through 2011.
Army and Air Force medical position conversions are expected to begin in fiscal 2006, but the number of jobs involved awaits final approval.
The Army initiative is aimed at freeing up more military personnel to serve in war-fighting units, but without degrading quality of care or access to care for beneficiaries still at home, said Virginia Stephanakis, spokeswoman for the Army Medical Command,
“Generally, we will recommend for conversion only those military positions that allow us to meet these goals, and for which the civilian market has available, affordable replacements,” Stephanakis said.
Weber emphasized the same points in describing the Navy job shift.
For 2005, the Navy requested $35.8 million to add 1,772 civilian medical workers to its payroll for the last three months of fiscal 2005. That’s an average cost of $20,000 per new employee for the July-September quarter, or $80,000 per position annually.
No military personnel will be involuntarily separated, Weber said. Because Navy medicine is already understaffed, those leaving converted positions will fill existing vacancies.
The conversion process, Weber said, is an opportunity for medical commands to reorganize to be more efficient. For example, he said, a hospital converting 10 corpsmen filling administrative jobs might decide to hire only five civilian replacements, but also three transcription specialists to lighten the paperwork load of the physicians.
Every Navy surgeon serves in a readiness position, so none of these jobs will be converted. But 150 primary care physician jobs will be filled by civilians in the first three months of the plan. Of the 1,772 jobs to be converted in late 2005, more than 500 are officers and 1,200 enlisted.
The decision to convert a position will depend on the availability of a qualified and affordable replacement, Weber said.
“We are absolutely not changing the quality of care,” he said. “We are solely changing the color of the uniform. This is a conversion; this is not a cut.”
The conversion of medical jobs, first reported by The Washington Post, is part of a larger Defense Department effort to privatize as many military jobs as possible to make more effective use of uniformed personnel. More than 20,000 jobs are to be converted this year and next.
Weber said the first choice of Navy medicine is to replace military positions with federal civilian employees. Using contractors is a second, but not preferred, alternative.
Even if all 5,415 nonreadiness medical jobs are converted by 2011, it will not hinder the Navy’s ability to prepare and move assets for a national emergency or global war, Weber said.
He noted that Navy hospitals and clinics already have more than 10,000 civilians on staff. Because they fill the same kinds of jobs now marked for conversion, the shift should be uneventful for patients.
Defense officials are said to predict some long-term savings from converting medical staff to civilians, especially through lowered retirement obligations. For now, Navy Medicine sees the shift largely as cost neutral.
Premiums rising: Medicare Part B premiums will make their biggest jump ever in January, rising by 17 percent, or $11.60, to a new monthly rate of $78.20.
To comment, write Military Update, P.O. Box 231111, Centreville, VA, 20120-1111, e-mail milupdate@aol.com or go to www.militaryupdate.com.
Talk to us
> Give us your news tips.
> Send us a letter to the editor.
> More Herald contact information.
