The unified command would have merged the medical assets of the United States Navy, Air Force, and Army and reduced the duplication of effort that currently exists.
The Department of Defense instead created a governance plan that creates joint oversight in four key areas: medical research, medical education and training, health care delivery in major military markets, and shared support services.[1]
Enlisted military members from all services will receive medical training at a joint center at Fort Sam Houston, Texas.
Major military markets, particularly those in metropolitan areas such as San Antonio, Texas, and Washington, D.C., will consolidate their operations and be the responsibility of a single service.
Support services such as information management and technology, facilities management, contracting and procurement, and logistical and financial functions will all be consolidated
To implement these changes, the Department of Defense will be creating a transition team to review options and recommend steps for implementation. The implementation process is expected to take at least two years.
Additionally, the TRICARE Management Activity will be maintained, but with more focus on health insurance, contractor management and benefit delivery. Other responsibilities such as information technology will be transferred to the support services command.
The Defense Information Systems Agency (DISA), known as the Defense Communications Agency (DCA) until 1991, is a United States Department of Defense (DoD) combat support agency composed of military, federal civilians, and contractors. DISA provides information technology (IT) and communications support to the President, Vice President, Secretary of Defense, the military services, the combatant commands, and any individual or system contributing to the defense of the United States.
Fort Sam Houston is a U.S. Army post in San Antonio, Texas. Known colloquially as "Fort Sam," it is named for the U.S. Senator from Texas, U.S. Representative from Tennessee, Tennessee and Texas governor, and first president of the Republic of Texas, Sam Houston.
The Goldwater–Nichols Department of Defense Reorganization Act of October 4, 1986 made the most sweeping changes to the United States Department of Defense since the department was established in the National Security Act of 1947 by reworking the command structure of the U.S. military. It increased the powers of the chairman of the Joint Chiefs of Staff and implemented some of the suggestions from the Packard Commission, commissioned by President Reagan in 1985. Among other changes, Goldwater–Nichols streamlined the military chain of command, which now runs from the president through the secretary of defense directly to combatant commanders, bypassing the service chiefs. The service chiefs were assigned to an advisory role to the president and the secretary of defense, and given the responsibility for training and equipping personnel for the unified combatant commands.
The U.S. Army Medical Command (MEDCOM) is a direct reporting unit of the U.S. Army that formerly provided command and control of the Army's fixed-facility medical, dental, and veterinary treatment facilities, providing preventive care, medical research and development and training institutions. On 1 October 2019, operational and administrative control of all military medical facilities transitioned to the Defense Health Agency.
The United States Strategic Command (USSTRATCOM) is one of the eleven unified combatant commands in the United States Department of Defense. Headquartered at Offutt Air Force Base, Nebraska, USSTRATCOM is responsible for strategic nuclear deterrence, global strike, and operating the Defense Department's Global Information Grid. It also provides a host of capabilities to support the other combatant commands, including integrated missile defense; and global command, control, communications, computers, intelligence, surveillance, and reconnaissance (C4ISR). This command exists to give "national leadership a unified resource for greater understanding of specific threats around the world and the means to respond to those threats rapidly".
The United States Transportation Command (USTRANSCOM) is one of the eleven unified commands of the United States Department of Defense. In both times of peace and war, USTRANSCOM's role is to provide the Department of Defense with air, land, and sea transportation. USTRANSCOM was founded in 1987 and is based at Scott Air Force Base in Illinois.
The Defense Logistics Agency (DLA) is a combat support agency in the United States Department of Defense (DoD). The agency is staffed by over 26,000 civilian and military personnel throughout the world. Located in 48 states and 28 countries, DLA provides supplies to the military services and supports their acquisition of weapons, fuel, repair parts, and other materials. The agency also disposes of excess or unusable equipment through various programs.
A unified combatant command, also referred to as a combatant command (CCMD), is a joint military command of the United States Department of Defense that is composed of units from two or more service branches of the United States Armed Forces, and conducts broad and continuing missions. There are currently 11 unified combatant commands, and each is established as the highest echelon of military commands, in order to provide effective command and control of all U.S. military forces, regardless of branch of service, during peace or during war time. Unified combatant commands are organized either on a geographical basis or on a functional basis, e.g., special operations, force projection, transport, and cybersecurity. Currently, seven combatant commands are designated as geographical, and four are designated as functional. Unified combatant commands are "joint" commands and have specific badges denoting their affiliation.
Joint Task Force-Global Network Operations (JTF-GNO) was a subordinate command of United States Strategic Command whose mission was to: direct the operation and defense of the Global Information Grid (GIG) across strategic, operational, and tactical boundaries in support of the US Department of Defense's full spectrum of war fighting, intelligence, and business operations.
Brooke Army Medical Center (BAMC) is the United States Army's premier medical institution. Located on Fort Sam Houston, BAMC, a 425-bed Academic Medical Center, is the Department of Defense's largest facility and only Level 1 Trauma Center. BAMC is also home to the Center for the Intrepid, an outpatient rehabilitation facility. The center is composed of ten separate organizations, including community medical clinics, centered around the Army's largest in-patient hospital. BAMC is staffed by more than 8,000 Soldiers, Airmen, Sailors, Civilians, and Contractors providing care to wounded Service Members and the San Antonio Community at-large.
The under secretary of defense for personnel and readiness, or USD (P&R) is a high-ranking civilian position in the Office of the Secretary of Defense (OSD) within the United States Department of Defense responsible for advising the secretary and deputy secretary of defense on recruitment, career development, pay and benefits, and oversight of the state of military readiness. The under secretary is appointed from civilian life by the president and confirmed by the Senate to serve at the pleasure of the President.
The United States Army Intelligence and Security Command (INSCOM) is a direct reporting unit that conducts intelligence, security, and information operations for United States Army commanders, partners in the Intelligence Community, and national decision-makers. INSCOM is headquartered at Fort Belvoir, Virginia.
The 59th Medical Wing (MDW) is the U.S. Air Force's largest medical wing and is the Air Force functional medical command for Joint Base San Antonio (JBSA). It comprises seven medical groups across San Antonio. Three are located at the Wilford Hall Ambulatory Surgical Center (WHASC); the 959th Medical Group is located at San Antonio Military Medical Center (SAMMC), JBSA-Fort Sam Houston; the 59th Training Group - the wing's newest group, activated on 4 January 2016, is also located at JBSA-Fort Sam Houston. The 359th and 559th Medical Groups are located at and support the missions of JBSA-Randolph and JBSA-Lackland, respectively.
The Bureau of Medicine and Surgery (BUMED) is an agency of the United States Department of the Navy that manages health care activities for the United States Navy and the United States Marine Corps. BUMED operates hospitals and other healthcare facilities as well as laboratories for biomedical research, and trains and manages the Navy's many staff corps related to medicine. Its headquarters is located at the Defense Health Headquarters in Fairfax County, Virginia. BUMED has 41,930 medical personnel and more than a million eligible beneficiaries.
The structure of the United States Army is complex, and can be interpreted in several different ways: active/reserve, operational/administrative, and branches/functional areas.
The U.S. Army Medical Center of Excellence (MEDCoE) is located at Fort Sam Houston, Joint Base San Antonio, Texas. MEDCoE comprises the 32d Medical Brigade, the U.S. Army Medical Professional Training Brigade (MPTB), and the AMEDD Noncommissioned Officers Academy (NCOA). It serves the U.S. Army in educating and training all of its medical personnel. The Center formulates the Army Medical Department's (AMEDD's) organization, tactics, doctrine, equipment, and academic training support. In 2015, the mission for the Academy of Health Sciences (AHS) moved from the School to the Center, and was renamed the Department of Training and Academic Affairs (DoTAA) as result of a reorganization.
Joint Base San Antonio (JBSA) is a United States military facility located in San Antonio, Texas, US. The facility is under the jurisdiction of the United States Air Force 502d Air Base Wing, Air Education and Training Command (AETC). The wing's three Mission Support Groups perform the installation support mission at the three bases that form JBSA.
A joint base (JB) is a base of the armed forces of the United States utilized by multiple military services; one service hosts one or more other services as tenants on the base. In most cases, joint bases have interservice support agreements (ISSAs) to govern how the host provides services to the tenants.
The Chief of Joint Capabilities (CJC) is the head of the Joint Capabilities Group (JCG) in the Australian Department of Defence. The Joint Capabilities Group was raised on 1 July 2017 with the position created as a result, with the inaugural CJC being Air Marshal Warren McDonald. The current chief is Lieutenant General John Frewen, who was appointed to the position in September 2021.
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