We've posted on the mil-civ conversion plans before. This is the general notion that uniformed physicians should be replaced with civilian contractors to save the MHS money in the long run. Is that really the case?
On paper it sounds good but implementation has had a different result. Contractor physicians are paid more than uniformed providers but don't take call or go on deployments. This creates an akward working environment were highly skilled professionals work side-by-side with markedly different compensation packages. These positions also increase the "churn rate" by enticing uniformed providers to hang up their packs and become contractors. Rapid change in staffing and loss of uniformed physicians destabilizes graduate medical education which forms the core of the MHS.
What are the government analysts saying about mil-civ conversion? Here are some select quotes from a GAO report dated May 2006:
The Air Force, Army, and Navy have converted or have plans to convert several thousand military health care positions to civilian positions and have made progress in hiring civilian replacement personnel. From fiscal years 2005 through 2007, the Air Force, Army, and Navy collectively have converted or plan to convert a total of 5,507 military health care positions to civilian positions. Of the 5,507 military health care positions, the departments plan to convert 152 physician positions, 349 nurse positions, and 208 dental positions to civilian positions.
It is unknown whether the conversion of military health care positions to civilian positions will ultimately increase or decrease costs for DOD because:
it is uncertain what actual compensation levels will be required to successfully hire most civilian replacement personnel and
the programming rates the departments are considering using in their certifications to Congress about the cost of the conversions to DOD do not include the full compensation costs for military personnel.
While officials in the offices of the surgeons general for the Air Force, Army, and Navy believe that the military-to-civilian conversions will not increase costs, we believe it is uncertain how much it will cost to hire civilian replacement personnel for recent and planned conversions of military health care positions and whether this cost will exceed the cost for the military positions. While the military departments have made progress in hiring civilian personnel within a short time, many civilian personnel remain to be hired. As of January 31, 2006, the Navy had recruited 67 percent of the personnel it plans to hire for the conversions made in fiscal year 2005, and the Air Force and Army had recruited 37 percent and 30 percent, respectively, of the positions they converted in fiscal year 2006. However, according to DOD officials, as of March 6, 2006, the Air Force, Army, and Navy had not compared the actual costs to hire these federal civilian employees with what it had cost them to employ military personnel in these positions.
Comment: The MHS is like a massive skyscraper built on the backs of its uniformed physicians. More detailed analysis needs to be conducted before any further mil-civ conversion takes place.
Comments
1 comment postedIt is critical that the leadership does not understand the clearly seen early failure of this policy, and would be crazy to persue it. Certainly clear is the fact that this would cost alot more money, as this civiilan work force is going to demand compensation at least on par with any other civilian practice. Once again, there is a total disconnect between the people in command, and the people who are in the trenches doing the work.