Progress Report - Chapter 4


Can Defense Afford its Health University?

Fiscally, at least, the proposal to eliminate the Defense Department's Uniform Services University of the Health Sciences seemed easy to justify.

Yes, the 22-year-old university in Bethesda, Maryland, once served to offset a shortage in Defense Department medical personnel. Butas the Congressional Budget Office noted, university physicians cost the government $562,000 each, compared to $110,000 per physician in subsidies under the Health Professions Scholarship Program. Closing the facility and relying on the scholarship program and volunteers would save the department $300 million over five years. [11]

NPR wasn't the first entity to recommend the closing. Others have included the Grace Commission of more than a decade ago and various groups of lawmakers in packages of spending cuts that have circulated on Capitol Hill. The Office of Management and Budget, Congressional Budget Office, and others have documented its high costs.

The question was not whether the university was a worthwhile venture. Sure it was, in an earlier era of seemingly limitless resources. Rather, the question was, could the Defense Department afford to keep running a university that supplied only 10 percent of its physicians, at a much higher cost than other sources, and at a time when Americans have demanded cuts in defense appropriations.

As Senator Russell Feingold, D-Wisconsin, put it:

With the overall downsizing of our force structure, and the continued pressure put on the entire federal budget by our deficit, it doesn't make good economic sense to keep funding USUHS. It is only a matter of time before the school is closed down.[12]

Not so fast! Few eliminations of programs or facilities are easy to push through Congress, and this was no exception. The tale of this facility points up the obstacles that all proposals of this type will face.

It was not long after President Clinton proposed the elimination that the university's supporters went to work. University Professor Matthew Pollack wrote an impassioned defense of the facility for the Washington Post. The area's federal representatives as well as candidates for federal offices vowed not to let it die. So, too, did lawmakers on important defense-related committees.

Actually, the university's elimination was included in NPR-related legislation that passed the House. In the Senate, however, supporters and opponents squared off.

In the end, the Senate adopted a compromise: Under an amendment, the General Accounting Office would study the facility and report back to Congress by next July. Whether even a recommendation by GAO to kill the university (if it comes to that) would tip the scales against USUHS or just take a place alongside its predecessors remains to be seen.


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