Ashish S. Vazirani, performing the duties of the undersecretary of defense for personnel and readiness, launched the 2024 Military Health System Conference—back after a decade-long hiatus—with a powerful message of personal anecdotes, and his commitment to changing the system to stabilize, strengthen, and modernize the MHS.

“As a veteran who advocates for military families, and the father of a currently serving Marine—I know the importance and the value of the Military Health System,” he said during his opening remarks at the conference in Portland, Oregon, April 9.

Addressing more than 2,100 personnel from across the MHS, he said, “I know for all of you, this is more than just a job. It's a mission."

Vazirani asked those in attendance to commit to the National Defense Strategy and MHS Strategy to face change head-on and to embrace the opportunities those changes offer.

The conference focused on the ongoing efforts to stabilize, strengthen, and modernize the MHS, especially within the Defense Health Agency.

“It's imperative that we operate as an integrated system of health and readiness that empowers and enables you to continue to deliver safe, high-quality, innovative care and support of our nation's military mission, anytime, anywhere at a moment's notice,” said Vazirani. “We must be integrated, innovative, and ready. And while we must be ready today, we also need to look forward and ensure that our MHS is resilient and ready to address the opportunities and challenges of the future.

Vazirani said that his office is focused on four areas for the MHS that support the Department of Defense secretary’s three priorities:

• Changing the culture to prevent behaviors across a continuum of harm, while promoting an environment where everyone can serve with dignity and respect
• Promoting the health, well-being and safety of the force and families
• Cultivating talent management
• Advancing strategic readiness

“The department requires a joint force that is lethal, resilient, sustainable, survivable, agile, and responsive,” said Vazirani. “We must provide care for 7.1 million beneficiaries in a manner like many civilian health systems, while at the same time delivering care for 2.5 million service members and generating military medical readiness. We have a system that must do both, and we have an obligation to do both.”

He acknowledged that in this unique health care environment, change is not going to be easy but is required to enhance and modernize the MHS.

“This change requires courage to break from the status quo,” said Vazirani. “To take a hard look at what is necessary to achieve our objectives. I'd like to commend the leaders across the national health services, health affairs, Defense Health Agency, military services, and the joint staff who are working together and showing the courage to undertake this change.

”He noted two major key lines of effort for this change.

• Establishing requirements for both medical and manpower: “We will take a deliberative approach to understanding, codifying and communicating our requirements. We must know what we need in very specific terms so that we can make informed decisions, risk recommendations and action plans,” Vazirani said.
• Improving capacity, starting with understanding current capacity and identifying gaps: To address those gaps, Vazirani noted that the MHS must improve staffing, military and civilian, at military hospitals and clinics.

“That includes revamping our approach to civilian hiring to be more competitive and timelier to address the requirements and ensure adequate and predictable staffing levels. We are also implementing changes to the uniform personnel management process,” he said.

“These changes are necessary to achieve our major objective – that of reattracting patients whose care has shifted to the private care network over the past several years,” said Vazirani. “Bringing patients back to the direct care system is essential as it ensures they continue to receive high-quality care, and our medical force remains mission ready.

“Let's move out of our comfort zone to embrace the opportunities and potential that this moment of change offers us,” he emphasized. “Realizing the benefits of these changes will require commitment.”

He closed with his ongoing support and dedication to creating change within the MHS.

“The MHS is quite simply the lifeblood of the men and women who go into harm's way to defend the nation,” said Vazirani. “What we do here today—how we transform the system—will determine the health and well-being of countless Americans who serve our country with honor and courage.” 

Dr. Lester Martinez-Lopez, the assistant secretary of defense for health affairs, shared his vision for change and for the future of the Military Health System, where he encouraged everyone from across the MHS to work as one for the same goal. Martinez addressed more than 2,100 participants at the 2024 MHS Conference in Portland, Oregon, April 10, 2024.

He noted his gratitude for MHS personnel “and the energy, enthusiasm, intellect and leadership you bring to this integrated, innovative and ready MHS.

”Following Vazirani’s opening session, Dr. Lester Martinez- López, the assistant secretary of defense for health affairs, shared his vision for the future of the MHS.

He emphasized that the MHS is an integrated system. It is a system of health and readiness that depends on the strengths of each part, including the DHA, USUHS, and the services.

“We have to start thinking of ourselves as a system—the Military Health System. That’s our primary identity,” said Martinez. “We have to think of everything we do, every decision we make, in terms of its impact on the system, not just on the immediate component.”

Martinez encouraged this team mentality when he talked about what it’s going to take to improve the system, and spoke briefly about how the system got to its current state.

A shrinking provider force, both civilian and military, patients moving to the private sector, and the readiness of the medical force are all elements that need to be addressed, according to Martinez.

“Some of these situations have been years in the making, based on past assumptions that have not proven true,” Martinez said.

“For example, it was assumed that it would cost less to send patients to the private sector—not true. That the network had sufficient capacity to take on the additional patient load—not true. And that in a post-war era, we could afford to reduce military medical manpower—not true.”

He said with steady progress, needed changes can be made to solidify the MHS to meet the needs of its 9.5 million beneficiaries for decades to come.

“The time that I’ve spent on the road, visiting our facilities and talking with our people gives me confidence that although our challenges are great, we can meet them and deliver the readiness the American people deserve in their armed forces.”